Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)

BackgroundNon-pharmaceutical interventions (NPIs) during the COVID-19 pandemic altered influenza transmission patterns, yet the age-specific effects of air pollutants on influenza dynamics remain unclear.MethodsUtilizing influenza surveillance data of Jiangsu Province from 2020 to 2024, we integrate...

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Main Authors: Chengxi Zheng, Xin Jiang, Yi Yin, Qigang Dai, Shuhan Tang, Jianli Hu, Changjun Bao, Haitao Yang, Zhihang Peng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1555430/full
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author Chengxi Zheng
Xin Jiang
Yi Yin
Qigang Dai
Shuhan Tang
Jianli Hu
Changjun Bao
Haitao Yang
Zhihang Peng
Zhihang Peng
Zhihang Peng
author_facet Chengxi Zheng
Xin Jiang
Yi Yin
Qigang Dai
Shuhan Tang
Jianli Hu
Changjun Bao
Haitao Yang
Zhihang Peng
Zhihang Peng
Zhihang Peng
author_sort Chengxi Zheng
collection DOAJ
description BackgroundNon-pharmaceutical interventions (NPIs) during the COVID-19 pandemic altered influenza transmission patterns, yet the age-specific effects of air pollutants on influenza dynamics remain unclear.MethodsUtilizing influenza surveillance data of Jiangsu Province from 2020 to 2024, we integrated generalized additive quasi-Poisson regression model and distributed lag non-linear models (DLNM) to quantify lagged effects and exposure-response relationships between air pollutants (NO2, SO2, PM2.5) and influenza risk across young, middle-aged, and older adult groups. Meteorological factors, including temperature and humidity, as well as the implementation stages of NPIs, were controlled in the model to isolate the impact of pollutants on influenza transmission.ResultsThe NO2 and SO2 both showed significant positive effects in all age groups. The effect of NO2 is most significant in the young group (RR = 5.02, 95% CI: 4.69–5.37), while SO2 exhibited the most pronounced effects in middle-aged and older adult groups (RR = 4.22, 95% CI: 3.36–5.30; RR = 8.31, 95% CI: 5.77–11.96, respectively). PM2.5 elevated risks in young (RR = 1.99, 95% CI: 1.87–2.12) and older adult (RR = 1.45, 95% CI: 1.07–1.94) groups. Interactions between meteorological factors (temperature, humidity) and pollutants were statistically insignificant.ConclusionsAir pollutant impacts on influenza transmission are age-dependent: NO2 dominates in younger populations, whereas SO2 disproportionately affects older adults. These findings highlight age-related vulnerability to air pollution and the need for targeted public health strategies for different population subgroups.
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spelling doaj-art-680efdbf7dcd422cb53fe2ebeb9ba88e2025-08-20T03:06:35ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-04-011310.3389/fpubh.2025.15554301555430Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)Chengxi Zheng0Xin Jiang1Yi Yin2Qigang Dai3Shuhan Tang4Jianli Hu5Changjun Bao6Haitao Yang7Zhihang Peng8Zhihang Peng9Zhihang Peng10School of Public Health, Nanjing Medical University, Nanjing, ChinaSchool of Public Health, Nanjing Medical University, Nanjing, ChinaSchool of Public Health, Nanjing Medical University, Nanjing, ChinaDepartment of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, ChinaSchool of Public Health, Nanjing Medical University, Nanjing, ChinaDepartment of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, ChinaDepartment of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, ChinaDepartment of Acute Infectious Diseases Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, ChinaSchool of Public Health, Nanjing Medical University, Nanjing, ChinaNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, ChinaChinese Center for Disease Control and Prevention, Beijing, ChinaBackgroundNon-pharmaceutical interventions (NPIs) during the COVID-19 pandemic altered influenza transmission patterns, yet the age-specific effects of air pollutants on influenza dynamics remain unclear.MethodsUtilizing influenza surveillance data of Jiangsu Province from 2020 to 2024, we integrated generalized additive quasi-Poisson regression model and distributed lag non-linear models (DLNM) to quantify lagged effects and exposure-response relationships between air pollutants (NO2, SO2, PM2.5) and influenza risk across young, middle-aged, and older adult groups. Meteorological factors, including temperature and humidity, as well as the implementation stages of NPIs, were controlled in the model to isolate the impact of pollutants on influenza transmission.ResultsThe NO2 and SO2 both showed significant positive effects in all age groups. The effect of NO2 is most significant in the young group (RR = 5.02, 95% CI: 4.69–5.37), while SO2 exhibited the most pronounced effects in middle-aged and older adult groups (RR = 4.22, 95% CI: 3.36–5.30; RR = 8.31, 95% CI: 5.77–11.96, respectively). PM2.5 elevated risks in young (RR = 1.99, 95% CI: 1.87–2.12) and older adult (RR = 1.45, 95% CI: 1.07–1.94) groups. Interactions between meteorological factors (temperature, humidity) and pollutants were statistically insignificant.ConclusionsAir pollutant impacts on influenza transmission are age-dependent: NO2 dominates in younger populations, whereas SO2 disproportionately affects older adults. These findings highlight age-related vulnerability to air pollution and the need for targeted public health strategies for different population subgroups.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1555430/fullinfluenzaair pollutantsage-specific transmissibilityDLNMCOVID-19
spellingShingle Chengxi Zheng
Xin Jiang
Yi Yin
Qigang Dai
Shuhan Tang
Jianli Hu
Changjun Bao
Haitao Yang
Zhihang Peng
Zhihang Peng
Zhihang Peng
Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)
Frontiers in Public Health
influenza
air pollutants
age-specific transmissibility
DLNM
COVID-19
title Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)
title_full Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)
title_fullStr Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)
title_full_unstemmed Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)
title_short Exploration of the impact of air pollutants on the influenza epidemic after the emergence of COVID-19: based on Jiangsu Province, China (2020–2024)
title_sort exploration of the impact of air pollutants on the influenza epidemic after the emergence of covid 19 based on jiangsu province china 2020 2024
topic influenza
air pollutants
age-specific transmissibility
DLNM
COVID-19
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1555430/full
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