Indoor environmental factors associated with influenza transmission in mainland China between February and April 2023

Nan Zhang; Shuyi Ji; Beidi Niu; Hua Qian; Yuguo Li; Hao Lei

Indoor Environments (Oct 2024)

Indoor environmental factors associated with influenza transmission in mainland China between February and April 2023

Nan Zhang,
Shuyi Ji,
Beidi Niu,
Hua Qian,
Yuguo Li,
Hao Lei

Affiliations

Nan Zhang: Beijing Key Laboratory of Green Built Environment and Energy Efficient Technology, Beijing University of Technology, Beijing, China
Shuyi Ji: School of Public Health, Zhejiang University, Hangzhou, China
Beidi Niu: School of Public Health, Zhejiang University, Hangzhou, China
Hua Qian: School of Energy and Environment, Southeast University, Nanjing, China
Yuguo Li: Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, SAR China; School of Public Health, The University of Hong Kong, Hong Kong, SAR China; Correspondence to: Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, SAR China.
Hao Lei: School of Public Health, Zhejiang University, Hangzhou, China; Corresponding author.

Journal volume & issue: Vol. 1, no. 3
p. 100027

Abstract

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Background: The relaxation of strict COVID-19 control measures has led to a considerable increase in the number of influenza cases in 2023. This worrisome situation has posed a greater burden on public health and healthcare systems. Understanding environmental drivers of influenza epidemics can provide valuable insights for developing effective interventions. Methods: We conducted an online survey from April 13th to 14th, 2023 to investigate the incidence of influenza-like illness (ILI) and influenza A within the past two months. A total of 4916 valid questionnaires were collected in mainland China. The questionnaire explored the relationship between the spread of ILI/Influenza A and factors including personal attributes, living environment, indoor ventilation, and personal behaviours. Results: Out of the 4916 respondents, 1583 reported having ILI in the past two months, and among them, 456 were infected with influenza A. The multivariate logistic regression analysis revealed significant associations with a lower likelihood of reporting ILI for the following variables: being female (Adjusted OR (aOR) = 0.834), having bedroom ventilation time exceeding 12 hours (aOR = 0.782), wearing masks in public places (aOR = 0.646), and using surgical masks (aOR = 1.417). Conversely, variables associated with an increased risk of ILI included larger household size (>4: aOR = 2.405), presence of odours in the bathroom (aOR = 1.163), commuting by bus (aOR = 1.265), longer indoor stay during weekdays (>18 h: aOR = 1.969), and a history of COVID-19 infection (aOR = 1.459). Furthermore, handwashing after toileting (aOR = 0.694) was associated with a lower reporting of influenza A. Conclusions: Our study innovatively examined the impact of personal and environmental factors on influenza transmission. These observational findings can provide a scientific guidance for preventive measures against influenza.

Published in Indoor Environments

ISSN: 2950-3620 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Public aspects of medicine; Technology: Building construction
Website: https://www.sciencedirect.com/journal/indoor-environments

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