Temperature and particulate matter as environmental factors associated with seasonality of influenza incidence – an approach using Earth observation-based modeling in a health insurance cohort study from Baden-Württemberg (Germany)

• DOI: 10.1186/s12940-022-00927-y
• Publication Date: 2022-12-16T06:02:53Z
• Authors: Jörn Rittweger; Lorenza Gilardi; Maxana Baltruweit; Simon Dally; Thilo Erbertseder; Uwe Mittag; Muhammad Naeem; Matthias Schmid; Marie-Therese Sch...; Sabine Wüst; Stefan Dech; Jens Jordan; Tobias Antoni; Michael Bittner
• Keywords: Seasonality

Abstract Background Influenza seasonality has been frequently studied, but its mechanisms are not clear. Urban in-situ studies have linked influenza to meteorological or pollutant stressors. Few investigated rural and less polluted areas in temperate climate zones. Objectives We examined influences of medium-term residential exposure fine particulate matter (PM 2.5 ), NO 2 , SO air temperature precipitation on incidence. Methods To obtain complete spatial coverage Baden-Württemberg, we modeled environmental from data the Copernicus Atmosphere Monitoring Service Climate Change Service. computed spatiotemporal aggregates reflect quarterly mean values at post-code level. Moreover, prepared health insurance yield incidence between January 2010 December 2018. used generalized additive models, with Gaussian Markov random field smoothers for input, whilst using quarter as temporal input. Results In 3.85 million cohort, 513,404 cases occurred over 9-year period, 53.6% occurring 1 (January March), 10.2%, 9.4% 26.8% quarters 2, 3 4, respectively. Statistical modeling yielded highly significant effects temperature, precipitation, PM . Computation stressor-specific gains revealed up 3499 infections per 100,000 AOK clients year that attributable lowering ambient 18.71 °C 2.01 °C. Stressor specific were also substantial matter, yielding 502 an increase 7.49 μg/m 15.98 Conclusions Whilst strong statistical association other stressors makes it difficult distinguish direct mediated effects, results confirm genuine by both urban a climate. Future should attempt further establish mediating inform public policies.