Particulate matter deposition and its impact on tuberculosis severity: A cross-sectional study in Taipei

The objective of this study was to examine the association between the lung lobe -deposited dose of inhaled fine particulate matter (PM 2.5 ) and chest X-ray abnormalities in different lung lobes of pulmonary tuberculosis (TB), multidrug-resistant tuberculosis (MDR -TB), and non -tuberculosis mycobacteria infections (NTM). A crosssectional study was conducted between 2014 and 2022, comprising 1073 patients who were recruited from chest department clinic in a tertial refer hospital in Taipei City, Taiwan. Ambient 1-, 7-, and 30 -day PM 2.5 exposure and the deposition of PM 2.5 in different lung lobes were estimated in each subject. The beta coefficient for PM 2.5 and deposited PM 2.5 in lungs with the outcome variables (pulmonary TB, MDR -TB, and NTM infection) was derived through regression analysis and adjusted for age, gender, BMI, smoking status, and family income. We observed that a 1 mu g/m 3 increase in ambient PM 2.5 was associated with an increase of MDR -TB infections of 0.004 times (95%CI: 0.001-0.007). A 1 mu g/m 3 increase in 1 -day and 7 -day PM 2.5 deposition in left upper lobe and left lower lobe was associated with an increase in chest X-ray abnormalities of 9.19 % and 1.18 % (95%CI: 0.87-17.51 and 95%CI: 0.08-2.28), and 4.52 % and 5.20 % (95%CI: 0.66-8.38 and 95%CI: 0.51-9.89) in left lung of TB patients, respectively. A 1 mu g/m 3 increase in 30 -day PM 2.5 deposition in alveolar region was associated with an increase in percent abnormality of 2.50 % (95%CI: 0.65 -4.35) in left upper lobe and 3.33 % (95%CI: 0.65 -6.01) in right middle lobe, while in total lung was 0.63 % (95%CI: 0.01 -1.27) in right upper lobe and 0.37 % (95%CI, 0.06 -0.81) in right lung of MDR -TB patients. Inhaled PM 2.5 deposition in lungs was associated with an exacerbation of the radiographic severity of pulmonary TB, particularly in pulmonary MDR -TB patients in upper and middle lobes. Particulate air pollution may potentially exacerbate the radiographic severity and treatment resistance in individuals with pulmonary TB.