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Supplement figures Supplementary Figure 1: The secular trend (2015-2019) of PM2.5 (monthly average) in Tainan City (left) decreased but was statistically insignificant (p = 0.3387). In contrast, the trend of monthly cases of influenza A (H1N1) in the Chi Mei medical systems (right) significantly increased (slope, 0.0357; p = 0.001). Supplementary Figure 2: A: Gradient of annually local ambient mean PM2.5 levels in 2018, increasing from northern to southern Taiwan. Epidemiology of aspergillosis in Tainan City 3 was correlated with local ambient mean PM2.5 levels higher than 20 μg/m in areas south to central Taiwan. B: Tainan IPA in 2018 is significantly correlated with the local PM2.5 pollution (Tainan and Zuoying) in southern Taiwan, but not correlated with PM2.5 pollution in distant areas, like northern and eastern Taiwan, with an interface at central Taiwan between Xitun and Fengyuan districts. Supplementary Figure 3: In 2018, Tainan IPA (cases/month) in Tainan City is significantly 3 correlated with PM10 (μg/m ) at cities in southern Taiwan using Spearman’s correlation calculation, including Tainan west-central area (p = 0.005), Xinying (p = 0.0008), and Zuoying (p < 0.0001), but not related to distant areas in central Taiwan, such as Xituin (p = 0.064) and Fenyuan (p = 0.102) and in northern Taiwan, such as Taipei Chongshan district (p = 0.190). The vertical axis represents monthly case number for Tainan IPA and also for monthly average concentrations of PM10 of various areas. Supplementary Figure 4: From 2015 to 2019, Tainan IPA monthly cases (blue bar) are 3 positive correlated to local PM2.5 (μg/m ) curve in Tainan (red), but there is no statistically significant correlation of Tainan IPA with PM2.5 in distant areas, including Zuoying district of Kaohsiung City (black), Xitun district of Taichung City (yellow) and Chungshan District of Taipei City (green). The p values represent Spearman’s correlation calculation between Tainan IPA and PM2.5 of each area in various city. .

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