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Volume 26, Number 5—May 2020
Research

Effects of Air Pollution and Other Environmental Exposures on Estimates of Severe Influenza Illness, Washington, USA

Ranjani Somayaji, Moni B. Neradilek, Adam A. Szpiro, Kathryn H. Lofy, Michael L. Jackson, Christopher H. Goss, Jeffrey S. Duchin, Kathleen M. Neuzil, and Justin R. OrtizComments to Author 
Author affiliations: University of Calgary, Calgary, Alberta, Canada (R. Somayaji); University of Washington, Seattle, Washington, USA (R. Somayaji, A.A. Szpiro, C.H. Goss, J.S. Duchin); The Mountain-Whisper-Light Statistics, Seattle (M.B. Neradilek); Washington State Department of Health, Shoreline, Washington, USA (K.H. Lofy); Kaiser Permanente Washington Health Research Institute, Seattle (M.L. Jackson); Seattle & King County Public Health, Seattle (J.S. Duchin); University of Maryland School of Medicine, Baltimore, Maryland, USA (K.M. Neuzil, J.R. Ortiz)

Main Article

Table 3

Secondary analysis of population attributable risk (PAR) of influenza or respiratory syncytial virus (RSV)-associated respiratory and circulatory hospitalizations by age group modeled with and without environmental covariates, September 2007–December 2012

Model type Age group
0–6 mo 7–23 mo 2–4 y 5–14 y 15–49 y 50–64 y ≥65 y
Without environmental covariates*
All influenza and 
RSV, % 14.0
(10.0–17.6) 6.5
(2.0–10.6) 6.9
(2.6–10.9) 8.3
(5.1–11.3) 1.2
(0.2–2.3) 1.4
(0.1–2.6) 0.6
(−0.4 to 1.5)
Influenza A,† % 1.9
(−0.1 to 3.9) 2.7
(0.4–5.0) 2.7
(0.5–4.6) 5.8
(4.0–7.5) 0.7
(0.2–1.2) 0.6
(−0.0 to 1.1) 0.0
(−0.5 to 0.5)
Influenza B, % −0.4
(−1.9 to 1.0) −0.9
(−2.5 to 0.6) 0.2
(−1.1 to 1.4) 1.7
(0.7–2.7) −0.0
(−0.3 to 0.3) 0.2
(−0.1 to 0.6) 0.4
(0.1–0.7)
RSV, %
 12.8
(9.4–15.8)
 4.8
(1.0–8.0)
 4.2
(0.9–7.6)
 1.1
(−1.8 to 3.8)
 0.5
(−0.3 to 1.3)
 0.6
(−0.4 to 1.6)
 0.2
(−0.6 to 1.0)
With environmental covariates*
All influenza and 
RSV, % 12.9
(8.6–16.7) 6.9
(2.3–10.9) 7.4
(3.0–11.6) 10.2
(6.9–13.4) 1.7
(0.6–2.7) 1.9
(0.6–3.1) 1.0
(0.0–2.0)
Influenza A,† % 2.0
(0.0–4.0) 2.8
(0.4–5.0) 3.1
(1.0–5.0) 6.1
(4.3–7.8) 0.6
(0.1–1.1) 0.5
(−0.1 to 1.0) −0.1
(−0.6 to 0.4)
Influenza B, % −0.4
(−1.8 to 1.0) −1.0
(−2.6 to 0.6) −0.0
(−1.3 to 1.2) 1.6
(0.6–2.6) −0.0
(−0.3 to 0.3) 0.2
(−0.1 to 0.5) 0.4
(0.1–0.7)
RSV, %
 11.5
(8.1–14.6)
 5.1
(1.3–8.6)
 4.4
(0.8–8.2)
 2.8
(−0.1 to 5.6)
 1.1
(0.2–2.0)
 1.2
(0.1–2.2)
 0.7
(−0.1–1.5)
Risk difference‡
All influenza −1.1 0.4 0.5 1.9 0.5 0.5 0.4
Influenza A† 0.1 0.1 0.4 0.3 −0.1 −0.1 −0.1
Influenza B 0 −0.1 −0.2 −0.1 0 0 0
RSV −1.3 0.3 0.2 1.7 0.6 0.6 0.5

*Environmental covariates included daily averages of temperature, relative humidity, dew point, and particulate matter with a diameter <2.5 μm.
†We could not discern between influenza A(H3N2) and influenza A(H1N1) because of testing limitations over the study period.
‡With covariates minus without covariates.

Main Article

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Page updated: April 16, 2020
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