Association between Sulfur-dioxide and Nitrogen-dioxide levels with Acute Respiratory Infections during Covid-19 Pandemic in Cilacap Regency

Abstrak

Introduction: Restrictions on human mobility and industrial activities during the COVID-19 pandemic temporarily improved air quality in many regions, including Indonesia. Cilacap Regency, an industrial area with high traffic density, provides a relevant setting to examine the relationship between air pollutants and respiratory health outcomes.Methods: This ecological time-series study used secondary data from 2019–2022 obtained from the Cilacap Environmental Bureau and Health Office. The study analyzed trends in sulfur dioxide (SO₂) and nitrogen dioxide (NO₂) concentrations and their association with Acute Respiratory Infection (ARI) incidence using Pearson correlation analysis.Results: SO₂ and NO₂ concentrations declined during the mobility restriction period in 2020 and increased again in 2021–2022. Similarly, ARI cases decreased in 2020 and rose to 147,198 cases in 2022. Pearson correlation analysis showed no statistically significant association between pollutant levels and ARI incidence (p = 0.458).Conclusion: The findings suggest that SO₂ and NO₂ concentrations were not significantly associated with ARI incidence during the study period. However, limited monitoring frequency and the absence of other key pollutants may have affected the results. Improved air quality monitoring and inclusion of additional environmental variables are recommended to better understand the relationship between air pollution and respiratory health.