{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T09:07:28Z","timestamp":1777280848287,"version":"3.51.4"},"posted":{"date-parts":[[2025,12,11]]},"group-title":"Epidemiology","reference-count":96,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,4,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:p>\n                  <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                  (pneumococcus) remains a major global cause of invasive human disease with seasonal variation suggesting that environmental factors may drive transmission. The pneumococcus includes &gt;100 serotypes and lineages with different disease patterns. Potential interactions between microbial diversity, environmental factors, and invasive pneumococcal disease (IPD) have not been explored. We examined effects of air pollution and meteorological factors on 59,017 IPD cases over 15 years, including 4,350 genome-sequenced isolates, using Bayesian spatio-temporal hierarchical models linking environmental exposures to bacterial diversity. Humidity and air pollution were important environmental drivers. Humidity (33-49%) conferred a 5% disease risk, while high humidity was protective. Weekly PM\n                  <jats:sub>2.5<\/jats:sub>\n                  exposure (50 \u03bcg\/m\u00b3) was associated with a 4% increase in disease risk, was greatest in adults\n                  <jats:underline>&gt;<\/jats:underline>\n                  65, and varied by disease type. Quantifying these relationships may refine vaccine-impact models and inform air pollution policy targets.\n                <\/jats:p>","DOI":"10.64898\/2025.12.10.25341877","type":"posted-content","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:35:17Z","timestamp":1765499717000},"source":"Crossref","is-referenced-by-count":0,"title":["Microbial diversity modifies the impact of air pollution on pneumococcal disease risk"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9778-7174","authenticated-orcid":false,"given":"Sophie","family":"Belman","sequence":"first","affiliation":[{"name":"Barcelona Supercomputing Center (BSC), Barcelona, Spain"},{"name":"Parasites and Microbes, Wellcome Sanger Institute, Hinxton, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1264-2284","authenticated-orcid":false,"given":"Cebile","family":"Lekhuleni","sequence":"additional","affiliation":[{"name":"Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases of the National Health Laboratory Service; 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