Short-term effects of meteorological factors, air pollution, and sunspot on childhood hand, foot, and mouth disease in T
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RESEARCH ARTICLE
Short-term effects of meteorological factors, air pollution, and sunspot on childhood hand, foot, and mouth disease in Tianjin, China: a new time series regression, 2014–2018 Xue-Yue Ji 1
&
Li-Yuan Huang 2 & Jia Song 1 & Chun-Nan Fei 1 & Jun Liu 1 & He Liu 1
Received: 16 October 2019 / Accepted: 17 June 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract This study is aimed at defining the relationship between a set of environmental factors and childhood HFMD and then at estimating the related effect. The 16 environmental factors included meteorological, air pollution, and sunspot. A traditional TSR modified by using susceptible-infectious-recovery models and distribution lag nonlinear model was applied to estimate the short-term effects of daily environmental factors on children HFMD occurrence in 2014–2018 with adjustment of potential confounding factors. A total of 70,027 children aged 0–15 years with HFMD were enrolled. No significant effect was observed for daily sunspot numbers and average visibility. We found positive effects of the ambient average temperature, with an approximately m-shaped curve of the overall cumulative relationship, peaking at 25.6 °C with a relative risk (RR) of 1.45 (95% confidence intervals 1.21–1.73). The largest RR value of hot effect was achieved on the current day and then decreased by 2 days (total group, male group, and scatter group) or 1 day (female group and nursery group), and the effect lasted about 6 to 8 days from the lag 4 or lag 6 day. A greater association of temperature with HFMD for the female group and the scattered group was observed. This study suggests that ambient average temperature might be a risk factor for children HFMD in Tianjin. Further studies are warranted to confirm these findings. Keywords Hand . Foot . Mouth disease . Meteorological factor . Air pollution . Sunspot . DLNM
Introduction Hand, foot, and mouth disease (HFMD), first reported in 1957 in New Zealand, is a worldwide common viral infectious disease caused mainly by coxsackievirus A16 (Cox A16) and enterovirus 71 (EV 71). HFMD is named after its general clinical characteristics, mild symptoms of febrile illness and rashes involving the skin of the hands, feet, mouth, and occasionally the buttocks and genitalia (Huang et al. 2016; Zhuang Li-Yuan Huang is a co-first author Responsible editor: Philippe Garrigues * Xue-Yue Ji [email protected] 1
Department of Infectious Disease, Tianjin Centers for Disease Control and Prevention, No. 6 Huayue Road, Hedong District, Tianjin, China
2
Editorial Department of China Journal Environment and Health, Tianjin Centers for Disease Control and Prevention, Tianjin, China
et al. 2015). Infants and children younger than 5 years were particularly susceptible to HFMD (Zhu et al. 2012; Zhu et al. 2016), the number of cases in children older than 5 years continually increased from 2001 (Zhuang et al. 2015). Some patients can quickly develop potentially fatal nervous system and systemic complications, especially in cas
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