Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study
Objectives Hand, 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...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2022-11-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e067127.full |
| _version_ | 1797905342783291392 |
|---|---|
| author | Tao Zhang Yue Ma Fei Yin Qiang Lv Yaqiong Liu Jiaqi Huang Tiejun Shui |
| author_facet | Tao Zhang Yue Ma Fei Yin Qiang Lv Yaqiong Liu Jiaqi Huang Tiejun Shui |
| author_sort | Tao Zhang |
| collection | DOAJ |
| description | Objectives Hand, 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.Design A time-series study.Setting and participants Daily 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 measures Distributed 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.Results The cumulative exposure–response curves of SO2 and NO2 were inverted ‘V’-shaped and ‘M’-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10 concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10 on HFMD, with individual RERIs 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 SO2 and PM10 on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions.Conclusions There 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. |
| first_indexed | 2024-04-10T10:03:17Z |
| format | Article |
| id | doaj.art-9b9ed89dfe1f4cd8b69d59179eb6c932 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-10T10:03:17Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-9b9ed89dfe1f4cd8b69d59179eb6c9322023-02-16T05:00:06ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-067127Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series studyTao Zhang0Yue Ma1Fei Yin2Qiang Lv3Yaqiong Liu4Jiaqi Huang5Tiejun Shui6Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, ChinaDepartment of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, ChinaDepartment of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, ChinaDepartment of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, ChinaDepartment of Acute Infectious Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, ChinaDepartment of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu, ChinaDepartment of Leprosy Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, ChinaObjectives Hand, 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.Design A time-series study.Setting and participants Daily 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 measures Distributed 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.Results The cumulative exposure–response curves of SO2 and NO2 were inverted ‘V’-shaped and ‘M’-shaped, respectively, and the risk of HFMD gradually decreased with increasing PM10 concentrations. We found that there were synergistic interactions between mean temperature and SO2, relative humidity and SO2, as well as relative humidity and PM10 on HFMD, with individual RERIs 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 SO2 and PM10 on HFMD were stronger under high temperature (>17.3°C) or high humidity (>80.0%) conditions.Conclusions There 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.https://bmjopen.bmj.com/content/12/11/e067127.full |
| spellingShingle | Tao Zhang Yue Ma Fei Yin Qiang Lv Yaqiong Liu Jiaqi Huang Tiejun Shui Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study BMJ Open |
| title | Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study |
| title_full | Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study |
| title_fullStr | Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study |
| title_full_unstemmed | Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study |
| title_short | Interactive effects of meteorological factors and air pollutants on hand, foot, and mouth disease in Chengdu, China: a time-series study |
| title_sort | interactive effects of meteorological factors and air pollutants on hand foot and mouth disease in chengdu china a time series study |
| url | https://bmjopen.bmj.com/content/12/11/e067127.full |
| work_keys_str_mv | AT taozhang interactiveeffectsofmeteorologicalfactorsandairpollutantsonhandfootandmouthdiseaseinchengduchinaatimeseriesstudy AT yuema interactiveeffectsofmeteorologicalfactorsandairpollutantsonhandfootandmouthdiseaseinchengduchinaatimeseriesstudy AT feiyin interactiveeffectsofmeteorologicalfactorsandairpollutantsonhandfootandmouthdiseaseinchengduchinaatimeseriesstudy AT qianglv interactiveeffectsofmeteorologicalfactorsandairpollutantsonhandfootandmouthdiseaseinchengduchinaatimeseriesstudy AT yaqiongliu interactiveeffectsofmeteorologicalfactorsandairpollutantsonhandfootandmouthdiseaseinchengduchinaatimeseriesstudy AT jiaqihuang interactiveeffectsofmeteorologicalfactorsandairpollutantsonhandfootandmouthdiseaseinchengduchinaatimeseriesstudy AT tiejunshui interactiveeffectsofmeteorologicalfactorsandairpollutantsonhandfootandmouthdiseaseinchengduchinaatimeseriesstudy |