{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T03:06:08Z","timestamp":1788231968415,"version":"build-2803163510"},"reference-count":39,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T00:00:00Z","timestamp":1739750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Background and Objective: Air pollution poses significant risks to global public health and has well-established links to respiratory diseases. This study investigates the associations between air pollution markers\u2014Air Quality Index (AQI), ambient ozone, and nitrogen dioxide (NO2)\u2014and the incidence of chronic obstructive pulmonary disease (COPD), asthma, and tuberculosis. It also examines how socioeconomic factors such as gross domestic product (GDP) per capita, tobacco prevalence, and healthcare expenditure influence these relationships. This study includes data from 27 countries, thereby offering a global perspective to inform public health interventions and policy reforms. Methods: Data on average air pollution levels, respiratory disease incidence, and socioeconomic factors were collected from publicly available sources spanning four years. The 27 countries included in the study were selected to represent a broad range of pollution levels, income brackets, and geographical regions. Statistical analyses were performed using Python 3.12.0 to explore the relationships between these variables. Key Findings: AQI and NO2 levels were significantly associated with increased incidences of COPD and tuberculosis, with rates rising especially during periods of heightened pollution. Conversely, ambient ozone exhibited inconsistent relationships with respiratory diseases, heavily influenced by socioeconomic factors. Higher GDP per capita and healthcare expenditure were linked to improved management of infectious diseases like tuberculosis, though they also corresponded with higher reporting of chronic conditions such as COPD. Tobacco smoking emerged as a critical risk factor for COPD across all regions. Conclusions: This study underscores the strong associations between air pollutants and respiratory diseases, particularly tuberculosis and COPD, with socioeconomic factors significantly influencing these relationships. Reducing air pollution and improving healthcare systems, particularly in low-income regions, are essential to mitigating the global burden of respiratory diseases.<\/jats:p>","DOI":"10.3390\/tropicalmed10020056","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T10:26:12Z","timestamp":1739787972000},"page":"56","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Assessing the Impact of Air Quality and Socioeconomic Conditions on Respiratory Disease Incidence"],"prefix":"10.3390","volume":"10","author":[{"given":"Mustfa Faisal","family":"Alkhanani","sequence":"first","affiliation":[{"name":"Biology Department, College of Science, University of Hafr Al Batin, P.O. Box 1803, Hafr Al Batin 39524, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e535","DOI":"10.1016\/S2542-5196(22)00090-0","article-title":"Pollution and health: A progress update","volume":"6","author":"Fuller","year":"2022","journal-title":"Lancet Planet. Health"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Manisalidis, I., Stavropoulou, E., Stavropoulos, A., and Bezirtzoglou, E. (2020). Environmental and Health Impacts of Air Pollution: A Review. Front. Public Health, 8.","DOI":"10.3389\/fpubh.2020.00014"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wiegman, C.H., Li, F., Ryffel, B., Togbe, D., and Chung, K.F. (2020). Oxidative Stress in Ozone-Induced Chronic Lung Inflammation and Emphysema: A Facet of Chronic Obstructive Pulmonary Disease. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.01957"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Enweasor, C., Flayer, C.H., and Haczku, A. (2021). Ozone-Induced Oxidative Stress, Neutrophilic Airway Inflammation, and Glucocorticoid Resistance in Asthma. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.631092"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kim, M.-S., Lim, Y.-H., Oh, J., Myung, J., Han, C., Bae, H.-J., Kim, S., Hong, Y.-C., and Lee, D.-W. (2024). Long-Term Ozone Exposure, COPD, and Asthma Mortality: A Retrospective Cohort Study in the Republic of Korea. Atmosphere, 15.","DOI":"10.3390\/atmos15111340"},{"key":"ref_6","first-page":"260","article-title":"Air pollution and chronic obstructive pulmonary disease","volume":"6","author":"Duan","year":"2020","journal-title":"Chronic Dis. Transl. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1001\/jama.2019.10255","article-title":"Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function","volume":"322","author":"Wang","year":"2019","journal-title":"JAMA"},{"key":"ref_8","first-page":"PA3129","article-title":"Associations between long-term exposure to air pollution and lung function in the LEAD general population study","volume":"64","author":"Altug","year":"2024","journal-title":"Eur. Respir. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"313","DOI":"10.4046\/trd.2022.0116","article-title":"Adverse Effects of Air Pollution on Pulmonary Diseases","volume":"85","author":"Ko","year":"2022","journal-title":"Tuberc. Respir. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1001\/jamainternmed.2021.2441","article-title":"Socioeconomic Inequality in Respiratory Health in the US From 1959 to 2018","volume":"181","author":"Gaffney","year":"2021","journal-title":"JAMA Intern. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Schikowski, T., Sugiri, D., Reimann, V., Pesch, B., Ranft, U., and Kr\u00e4mer, U. (2008). Contribution of smoking and air pollution exposure in urban areas to social differences in respiratory health. BMC Public Health, 8.","DOI":"10.1186\/1471-2458-8-179"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4432","DOI":"10.1038\/s41467-023-39797-4","article-title":"Global air pollution exposure and poverty","volume":"14","author":"Rentschler","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"215","DOI":"10.2471\/BLT.15.155812","article-title":"Household air pollution and the sustainable development goals","volume":"94","author":"Amegah","year":"2016","journal-title":"Bull. World Health Organ."},{"key":"ref_14","first-page":"275","article-title":"Inequality in the global incidence and prevalence of tuberculosis (TB) and TB\/HIV according to the human development index","volume":"33","author":"Bitaraf","year":"2019","journal-title":"Med. J. Islam. Repub. Iran"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1136\/thoraxjnl-2018-211793","article-title":"Urbanisation and asthma in low-income and middle-income countries: A systematic review of the urban\u2013rural differences in asthma prevalence","volume":"74","author":"Rodriguez","year":"2019","journal-title":"Thorax"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.jfma.2011.07.003","article-title":"Do indoor environments influence asthma and asthma-related symptoms among adults in homes? A review of the literature","volume":"110","author":"Jie","year":"2011","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3390\/ijerph6010209","article-title":"Smoking and chronic obstructive pulmonary disease (COPD). Parallel Epidemics of the 21st Century","volume":"6","year":"2009","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Adatia, A., Wahab, M., Shahid, I., Moinuddin, A., Killian, K.J., and Satia, I. (2021). Effects of cigarette smoke exposure on pulmonary physiology, muscle strength and exercise capacity in a retrospective cohort with 30,000 subjects. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0250957"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6315","DOI":"10.21037\/jtd-19-crh-aq-002","article-title":"Prevalence of respiratory diseases in relation to smoking rate in adults living in four Chinese cities: A comparison between 2017\u2013 2018 and 1993\u20131996","volume":"12","author":"Yan","year":"2020","journal-title":"J. Thorac. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101936","DOI":"10.1016\/j.eclinm.2023.101936","article-title":"Global burden of chronic respiratory diseases and risk factors, 1990\u20132019: An update from the Global Burden of Disease Study 2019","volume":"59","author":"Momtazmanesh","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ivankova, V., Gavurova, B., and Khouri, S. (2022). Understanding the relationships between health spending, treatable mortality and economic productivity in OECD countries. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.1036058"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e121","DOI":"10.1016\/S2542-5196(20)30272-2","article-title":"Premature mortality due to air pollution in European cities: A health impact assessment","volume":"5","author":"Khomenko","year":"2021","journal-title":"Lancet Planet. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"110703","DOI":"10.1016\/j.envres.2020.110703","article-title":"Impact of long-term exposure to ambient air pollution on the incidence of chronic obstructive pulmonary disease: A systematic review and meta-analysis","volume":"194","author":"Park","year":"2021","journal-title":"Environ. Res."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Huang, S., Xiang, H., Yang, W., Zhu, Z., Tian, L., Deng, S., Zhang, T., Lu, Y., Liu, F., and Li, X. (2020). Short-Term Effect of Air Pollution on Tuberculosis Based on Kriged Data: A Time-Series Analysis. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17051522"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2023GH000972","DOI":"10.1029\/2023GH000972","article-title":"Spatio-Temporal Pattern of Tuberculosis Distribution in Romania and Particulate Matter Pollution Associated With Risk of Infection","volume":"8","author":"Peptenatu","year":"2024","journal-title":"GeoHealth"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"109002","DOI":"10.1016\/j.envres.2019.109002","article-title":"Long-term exposure to ozone and children\u2019s respiratory health: Results from the RESPOZE study","volume":"182","author":"Dimakopoulou","year":"2019","journal-title":"Environ. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.cegh.2019.10.006","article-title":"Study of relationship between nitrogen dioxide and chronic obstructive pulmonary disease in Bushehr, Iran","volume":"8","author":"Saki","year":"2020","journal-title":"Clin. Epidemiol. Glob. Health"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1093\/her\/cyt086","article-title":"Smoking cessation in groups--who benefits in the long term?","volume":"28","author":"Wenig","year":"2013","journal-title":"Health Educ. Res."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zhang, Q.-Y., Yang, D.-M., Cao, L.-Q., Liu, J.-Y., Tao, N.-N., Li, Y.-F., Liu, Y., Xu, T.-T., Li, S.-J., and An, Q.-Q. (2020). Association between economic development level and tuberculosis registered incidence in Shandong, China. BMC Public Health, 20.","DOI":"10.1186\/s12889-020-09627-z"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1016\/S0140-6736(02)11274-8","article-title":"Air pollution and health","volume":"360","author":"Brunekreef","year":"2002","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1164\/rccm.201709-1883OC","article-title":"Short-Term Elevation of Fine Particulate Matter Air Pollution and Acute Lower Respiratory Infection","volume":"198","author":"Horne","year":"2018","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"166340","DOI":"10.1016\/j.scitotenv.2023.166340","article-title":"The impact of air pollution on respiratory diseases in an era of climate change: A review of the current evidence","volume":"898","author":"Tran","year":"2023","journal-title":"Sci. Total. Environ."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Wang, L., Xie, J., Hu, Y., and Tian, Y. (2022). Air pollution and risk of chronic obstructed pulmonary disease: The modifying effect of genetic susceptibility and lifestyle. EBioMedicine, 79.","DOI":"10.1016\/j.ebiom.2022.103994"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"64","DOI":"10.5588\/ijtld.10.0535","article-title":"Modeling social, environmental and biological determinants of tuberculosis","volume":"15","author":"Murray","year":"2011","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Zhao, M., Zhang, Y., and Feng, Y. (2023). How does urbanization affect public health? New evidence from 175 countries worldwide. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.1096964"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Epelle, E.I., Macfarlane, A., Cusack, M., Burns, A., Thissera, B., Mackay, W., Rateb, M.E., and Yaseen, M. (2022). Bacterial and fungal disinfection via ozonation in air. J. Microbiol. Methods, 194.","DOI":"10.1016\/j.mimet.2022.106431"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1080\/10643389.2022.2043094","article-title":"A critical review on the inactivation of surface and airborne SARS-CoV-2 virus by ozone gas","volume":"53","author":"Farooq","year":"2023","journal-title":"Crit. Rev. Environ. Sci. Technol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1183\/09031936.00142414","article-title":"Global and regional trends in COPD mortality, 1990\u20132010","volume":"45","author":"Burney","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1136\/oemed-2015-102995","article-title":"Ambient air pollution and risk of tuberculosis: A cohort study","volume":"73","author":"Lai","year":"2015","journal-title":"Occup. Environ. Med."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/2\/56\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:35:50Z","timestamp":1760027750000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/2\/56"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,17]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["tropicalmed10020056"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10020056","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,17]]}}}