Effects of temperature and PM2.5 on the incidence of hand, foot, and mouth in a heavily polluted area, Shijiazhuang, China

Liu, Ran; Cai, Jianning; Guo, Weiheng; Guo, Wei; Wang, Wenjuan; Yan, Lei; Ma, Ning; Zhang, Xiaolin; Zhang, Shiyong

doi:10.1007/s11356-021-16397-7

Cited by 10 publications

(10 citation statements)

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“…We observed that the association between SO 2 concentration and HFMD produced an inverted ‘V’-shaped curve with the RR peaking at 16.6 μg/m 3 , which was consistent with two studies conducted in Shijiazhuang and Tianjin 48 49. Originating from numerous industrial processes, SO 2 has been confirmed to affect human health by irritating the respiratory tract, promoting oxidative damage and decreasing immunity 50–53.…”

Section: Discussionsupporting

confidence: 89%

“…An ‘M’-shaped relationship between NO 2 concentration and HFMD was revealed in our study. Similarly, both Liu et al and Peng et al revealed that low concentrations of NO 2 showed protective effects against HFMD, while high concentrations of NO 2 induced harmful effects 48 54. NO 2 , which is mainly derived from vehicle emissions, is closely related to elevated biomarkers of systemic inflammation and tissue repair 55 56.…”

Section: Discussionmentioning

confidence: 95%

“…Similarly, both Liu et al and Peng et al revealed that low concentrations of NO 2 showed protective effects against HFMD, while high concentrations of NO 2 induced harmful effects. 48 54 NO 2 , which is mainly derived from vehicle emissions, is closely related to elevated biomarkers of systemic inflammation and tissue repair. 55 56 However, Yan et al noticed an increased risk of HFMD with increasing NO 2 concentrations in only children under 1 year of age in Shenzhen, 16 and Gu et al showed that the NO 2 concentration was approximately linearly and positively correlated with HFMD in Ningbo.…”

Section: Discussionmentioning

confidence: 99%

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Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study

Huang

et al. 2022

BMJ Open

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ObjectivesHand, foot, and mouth disease (HFMD) is a viral infectious disease that poses a substantial threat in the Asia-Pacific region. It is widely reported that meteorological factors are associated with HFMD. However, the relationships between air pollutants and HFMD are still controversial. In addition, the interactive effects between meteorological factors and air pollutants on HFMD remain unknown. To fill this research gap, we conducted a time-series study.DesignA time-series study.Setting and participantsDaily cases of HFMD as well as meteorological and air pollution data were collected in Chengdu from 2011 to 2017. A total of 184 610 HFMD cases under the age of 15 were included in our study.Outcome measuresDistributed lag nonlinear models were used to investigate the relationships between HFMD and environmental factors, including mean temperature, relative humidity, SO2, NO2, and PM10. Then, the relative excess risk due to interaction (RERI) and the proportion attributable to interaction were calculated to quantitatively evaluate the interactions between meteorological factors and air pollutants on HFMD. Bivariate response surface models were used to visually display the interactive effects.ResultsThe cumulative exposure–response curves of SO2and NO2were inverted ‘V’-shaped and ‘M’-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10on HFMD, with individualRERIs of 0.334 (95% CI 0.119 to 0.548), 0.428 (95% CI 0.214 to 0.642) and 0.501 (95% CI 0.262 to 0.741), respectively, indicating that the effects of SO2and PM10on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions.ConclusionsThere were interactive effects between meteorological factors and air pollutants on HFMD. Our findings could provide guidance for targeted and timely preventive and control measures for HFMD.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study

Huang

et al. 2022

BMJ Open

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“…Spearman's rank correlation analysis was used to analyze the correlation among environmental factors, and strong correlations (rs > 0.8) were not incorporated into the model to avoid strong multicollinearity between variables. In this study, outpatients with psoriasis could be regarded as lowprobability events, following a Poisson distribution; a Quasi-Poisson distribution was finally adopted as the function family because of the overdispersion of data (24). A generalized linear regression model (GLM) combined with the DLNM was used to study the non-linear, cumulative, and hysteretic effects of air pollutants on outpatients with psoriasis.…”

Section: Statistical Analysesmentioning

confidence: 99%

Short-term effects of air pollutants on outpatients with psoriasis in a Chinese city with a subtropical monsoon climate

Wang

Xia

Zhang

et al. 2022

Front. Public Health

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IntroductionPsoriasis is a common skin disease that seriously affects patients' quality of life. The association of air pollutants with psoriasis, and the extent of their effects remains unclear.MethodsBased on a distributed lag non-linear model, this study explored the short-term effects of air pollutants on outpatients with psoriasis in Hefei, China, between 2015 and 2019 by analyzing the exposure–lag–response relationship, after controlling for confounding influences such as meteorological factors, long-term trends, day of the week, and holidays. Stratified analyses were performed for patients of different ages and genders.ResultsThe maximum relative risks of psoriasis outpatients' exposure to SO2, NO2, and O3 were 1.023 (95% confidence intervals (CI): 1.004–1.043), 1.170 (95% CI: 1.046–1.307), and 1.059 (95% CI: 1.030–1.090), respectively. An increase of 10 μg/m3 of NO2 was associated with a 2.1% (95% CI: 0.7–3.5%) increase in outpatients with psoriasis, and a decrease of 10 μg/m3 of O3 was associated with an 0.8% (95% CI: 0.4–1.2%) increase in outpatients with psoriasis. Stratified analyses showed that male subjects were more sensitive to a change in meteorological factors, while female subjects and outpatients with psoriasis aged 0–17 years old were more sensitive to a change in air pollutants.DiscussionShort-term air pollutant exposures were associated with outpatients having psoriasis, suggesting that patients and high-risk people with psoriasis should reduce their time spent outside and improve their skin protection gear when air quality is poor.

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“…Considering the substantial threat to child health, identifying risk factors is urgent for the prevention of HFMD.The adverse health effects associated with ambient air pollution have prompted increasing concern in recent decades due to its substantial contribution to the global burden of disease 9 . Recently, some studies have implied that ambient air pollution may affect the incidence of HFMD [10][11][12][13][14][15][16][17] . Most previous studies employed time-series analyses, such as distributed lag nonlinear models (DLNMs), according to the nonlinear and lagged associations…”

mentioning

confidence: 99%

Associations between ambient air pollutants and childhood hand, foot, and mouth disease in Sichuan, China: a spatiotemporal study

Qian

Luo

et al. 2023

Sci Rep

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Hand, foot, and mouth disease (HFMD) is a major public health concern in the Asia–Pacific region. Previous studies have implied that ambient air pollution may affect the incidence of HFMD, but the results among different regions are inconsistent. We aimed to deepen the understanding of the associations between air pollutants and HFMD by conducting a multicity study. Daily data on childhood HFMD counts and meteorological and ambient air pollution (PM2.5, PM10, NO2, CO, O3, and SO2) concentrations in 21 cities in Sichuan Province from 2015 to 2017 were collected. A spatiotemporal Bayesian hierarchical model framework was established, and then a distributed lag nonlinear models (DLNMs) was constructed to reveal exposure-lag-response relationships between air pollutants and HFMD while controlling for spatiotemporal effects. Furthermore, given the differences in the levels and seasonal trends of air pollutants between the basin region and plateau region, we explored whether these associations varied between different areas (basin and plateau). The associations between air pollutants and HFMD were nonlinear, with different lag responses. Low NO2 concentrations and both low and high PM2.5 and PM10 concentrations were associated with a decreased risk of HFMD. No significant associations between CO, O3, and SO2 and HFMD were found. The associations between air pollutant concentrations and HFMD were different between the basin and plateau regions. Our study revealed associations between PM2.5, PM10, and NO2 concentrations and HFMD, deepening the understanding of the relationships between air pollutants and HFMD. These findings provide evidence to support the formulation of relevant prevention measures and the establishment of an early warning system.

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Effects of temperature and PM2.5 on the incidence of hand, foot, and mouth in a heavily polluted area, Shijiazhuang, China

Cited by 10 publications

References 67 publications

Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study

Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study

Short-term effects of air pollutants on outpatients with psoriasis in a Chinese city with a subtropical monsoon climate

Associations between ambient air pollutants and childhood hand, foot, and mouth disease in Sichuan, China: a spatiotemporal study

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