Climate and air pollution alter incidence of tuberculosis in Beijing, China

This study evaluated the possible association between climate and environment and the incidence of tuberculosis and determined the characteristics of tuberculosis in different climatic and air pollution conditions.Data on tuberculosis incidence, climate (i.e., precipitation, atmospheric pressure, relative humidity, temperature, and wind speed), and air quality (inhalable particulate matter, sulfur dioxide, and nitrogen dioxide concentrations) in Beijing from 2004 to 2016 were collected and systematically analyzed based on a structural equation model.The tuberculosis incidence was negatively correlated with the concentration of inhalable particulate matter, sulfur dioxide, or nitrogen dioxide. Precipitation, atmospheric pressure, and relative humidity had negative effects on tuberculosis incidence by indirectly lowering the concentrations of inhalable particulate matter and sulfur dioxide. By contrast, wind speed had a significant positive correlation with the incidence of tuberculosis. Temperature and wind speed had positive effects on tuberculosis incidence by improving the concentrations of inhalable particulate matter and sulfur dioxide.Climate and air quality are potential regulators of the incidence of tuberculosis. The improved air quality contributes to the decline of incidence of tuberculosis in Beijing. The impact of climatic indicators on the incidence of tuberculosis was mainly regulated by the environment. Further studies are needed to formulate preventive and regulatory strategies for tuberculosis based on different climatic and air quality conditions.