Impact of outdoor air pollution on the incidence of tuberculosis in the Seoul metropolitan area, South Korea

BACKGROUND/AIMS: Although indoor air pollution is a well-known risk factor for tuberculosis (TB), the possible link between outdoor air pollution and TB development has not been examined fully. We assessed the impact of outdoor air pollution on TB development in the Seoul metropolitan area, South Korea. METHODS: The mean concentrations of ambient particulate matter (PM) with an aerodynamic diameter ≤ 10 µm (PM(10)), O(3), CO, NO(2), and SO(2) levels in Seoul, between January 1, 1997 and December 31, 2006, were determined. Furthermore, their association with the risk of developing TB after adjusting for socioeconomic status, between January 1, 2002 and December 31, 2006, was investigated. RESULTS: Between January 1, 2002 and December 31, 2006, a total of 41,185 TB cases were reported in Seoul. Concentrations of PM(10), O(3), CO, and NO(2) were not associated with TB incidence in males or females. However, the interquartile increase in SO(2) concentration was associated with a 7% increment in TB incidence (relative risk [RR], 1.07; 95% credible interval [CrI], 1.03 to 1.12) in males but not in females (RR, 1.02; 95% CrI, 0.98 to 1.07). CONCLUSIONS: Long-term exposure to ambient SO(2) increased the risk of TB in males.