Short-term effects of meteorological factors and air pollution on childhood hand-foot-mouth disease in Guilin, China

Guoqi Yu; Yonghong Li; Jiansheng Cai; Dongmei Yu; Jiexia Tang; Wenwen Zhai; Yi Wei; Shiyi Chen; Quanhui Chen; Jian Qin

doi:10.1016/j.scitotenv.2018.07.329

Short-term effects of meteorological factors and air pollution on childhood hand-foot-mouth disease in Guilin, China

Sci Total Environ. 2019 Jan 1:646:460-470. doi: 10.1016/j.scitotenv.2018.07.329. Epub 2018 Jul 24.

Authors

Guoqi Yu¹, Yonghong Li², Jiansheng Cai¹, Dongmei Yu¹, Jiexia Tang¹, Wenwen Zhai³, Yi Wei¹, Shiyi Chen¹, Quanhui Chen¹, Jian Qin⁴

Affiliations

¹ Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China.
² Guangxi Center for Disease Control and Prevention, Acute Infectious Disease Prevention and Control Institute, Nanning, Guangxi Zhuang Autonomous Region, China.
³ Department of Health Related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China.
⁴ Department of Environmental and Occupational Health, Guangxi Medical University, Shuangyong Road, 22, Nanning, Guangxi Zhuang Autonomous Region, China; Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China. Electronic address: qinjian@gxmu.edu.cn.

PMID: 30056233
DOI: 10.1016/j.scitotenv.2018.07.329

Abstract

Background: Previous studies have always focused on the impact of various meteorological factors on Hand-foot-mouth disease (HFMD). However, only few studies have investigated the simultaneous effects of climate and air pollution on HFMD incidence.

Methods: Daily HFMD counts among children aged 0-14 years in Guilin city were collected from 2014 to 2016. Distributed lag nonlinear models (DLNM) were used to assess the effects of extreme meteorological factors and air pollution indicators, as well as the effects of different lag days on HFMD incidence. Furthermore, this study explored the variability across gender and age groups.

Results: Extreme temperatures, high precipitation and low-O₃ concentration increased the risk of HFMD. Hot effect was stronger and longer lasting than cold effect. Risks of rainy effect and low-O₃ effect continued to increase as lag days extended, with the maximum RR values: 1.60 (1.38, 1.86) (90th vs median) and 1.48 (1.16, 1.89) (1th vs median) at 0-14 lag days, respectively. By contrast, extremely high wind speed, low precipitation, low PM_2.5 and high O₃ exerted a certain protective effect on HFMD incidence. The corresponding minimum RR values were: 0.85 (0.74, 0.98) (90th vs median) at 0-14 lag days, 0.98 (0.97, 0.99) (10th vs median) at 0-14 lag days, 0.73 (0.61, 0.88) (1th vs median) at 0-14 lag days and 0.81 (0.73, 0.90) (99th vs median) at 0-7 lag days, respectively. Male children and children aged 0-1 years (followed by 1-3 years) were the most susceptible subgroups to extreme climatic effects and air pollution.

Conclusions: Our results indicated that daily meteorological factors and air pollution exert non-linear and delayed effects on pediatric HFMD, and such effects vary depending on gender and age. These findings may serve as a reference for the development of an early warning system and for the adoption of specific interventions for vulnerable groups.

Keywords: Air pollution; Children; Hand–foot–mouth disease; Meteorological factor; Susceptible population.

MeSH terms

Adolescent
Air Pollution / statistics & numerical data*
Child
Child, Preschool
China / epidemiology
Environmental Exposure / statistics & numerical data*
Hand, Foot and Mouth Disease / epidemiology*
Humans
Incidence
Infant
Infant, Newborn
Male
Meteorological Concepts*
Temperature