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Short-Term Effects of Meteorological Factors and Air Pollutants on Hand, Foot and Mouth Disease among Children in Shenzhen, China, 2009–2017

Author

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  • Siyu Yan

    (Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
    Siyu Yan and Lan Wei contributed equally to this paper.)

  • Lan Wei

    (Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China
    Siyu Yan and Lan Wei contributed equally to this paper.)

  • Yanran Duan

    (Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China)

  • Hongyan Li

    (Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China)

  • Yi Liao

    (Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China)

  • Qiuying Lv

    (Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China)

  • Fang Zhu

    (Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China)

  • Zhihui Wang

    (Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China)

  • Wanrong Lu

    (Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China)

  • Ping Yin

    (Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
    Hongwei Jiang, Jinquan Cheng and Ping Yin contribute equally to this work and should be considered as co-corresponding authors.)

  • Jinquan Cheng

    (Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen 518055, China
    Hongwei Jiang, Jinquan Cheng and Ping Yin contribute equally to this work and should be considered as co-corresponding authors.)

  • Hongwei Jiang

    (Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
    Hongwei Jiang, Jinquan Cheng and Ping Yin contribute equally to this work and should be considered as co-corresponding authors.)

Abstract

Background: A few studies have explored the association between meteorological factors and hand, foot, and mouth disease (HFMD) with inconsistent results. Besides, studies about the effects of air pollutants on HFMD are very limited. Methods: Daily HFMD cases among children aged 0–14 years in Shenzhen were collected from 2009 to 2017. A distributed lag nonlinear model (DLNM) model was fitted to simultaneously assess the nonlinear and lagged effects of meteorological factors and air pollutants on HFMD incidence, and to further examine the differences of the effect across different subgroups stratified by gender, age and childcare patterns. Results: The cumulative relative risk (cRR) (median as reference) of HFMD rose with the increase of daily temperature and leveled off at about 30 °C (cRR: 1.40, 95%CI: 1.29, 1.51). There was a facilitating effect on HFMD when relative humidity was 46.0% to 88.8% (cRR at 95th percentile: 1.18, 95%CI: 1.11, 1.27). Short daily sunshine duration (5th vs. 50th) promoted HFMD (cRR: 1.07, 95%CI: 1.02, 1.11). The positive correlation between rainfall and HFMD reversed when it exceeded 78.3 mm (cRR: 1.41, 95% CI: 1.22, 1.63). Ozone suppressed HFMD when it exceeded 104 µg /m3 (cRR at 99th percentile: 0.85, 95%CI: 0.76, 0.94). NO 2 promoted HFMD among infants and the cRR peaked at lag 9 day (cRR: 1.47, 95%CI: 1.02, 2.13) (99th vs. 50th). Besides, children aged below one year, males and scattered children were more vulnerable to high temperature, high relative humidity, and short sunshine duration. Conclusions: Temperature, relative humidity, sunshine duration, rainfall, ozone and NO 2 were significantly associated with HFMD, and such effects varied with gender age and childcare patterns. These findings highlight the need for more prevention effort to the vulnerable populations and may be helpful for developing an early environment-based warning system for HFMD.

Suggested Citation

  • Siyu Yan & Lan Wei & Yanran Duan & Hongyan Li & Yi Liao & Qiuying Lv & Fang Zhu & Zhihui Wang & Wanrong Lu & Ping Yin & Jinquan Cheng & Hongwei Jiang, 2019. "Short-Term Effects of Meteorological Factors and Air Pollutants on Hand, Foot and Mouth Disease among Children in Shenzhen, China, 2009–2017," IJERPH, MDPI, vol. 16(19), pages 1-14, September.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:19:p:3639-:d:271565
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    References listed on IDEAS

    as
    1. Roger D. Peng & Francesca Dominici & Thomas A. Louis, 2006. "Model choice in time series studies of air pollution and mortality," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 169(2), pages 179-203, March.
    2. Ruixue Huang & Guolin Bian & Tianfeng He & Lv Chen & Guozhang Xu, 2016. "Effects of Meteorological Parameters and PM 10 on the Incidence of Hand, Foot, and Mouth Disease in Children in China," IJERPH, MDPI, vol. 13(5), pages 1-13, May.
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