Department of Infectious Disease Control and Prevention, Anhui Center for Disease Control and Prevention, 12560 Fanhua Avenue, Shushan District, Hefei, Anhui, 230601, China.
Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Shushan District, Hefei, Anhui, 230032, China.
Int J Biometeorol. 2024 Dec;68(12):2677-2692. doi: 10.1007/s00484-024-02777-4. Epub 2024 Oct 17.
Previous research has demonstrated the influence of environmental factor on the occurrence of infectious diseases. However, there is insufficient and conflicting evidence regarding the association between Hand, foot and mouth disease (HFMD) and environmental variables, particularly the interaction of environmental variables. This study aims to investigate the individual and interactive effects of particulate matter (PM) and meteorological factors on HFMD incidence in Fuyang. The generalized additive models were combined with distributed lag non-linear models to assess the individual effects between PM and meteorological factor on HFMD incidence in Fuyang. Subsequently, a product term was incorporated into the model to investigate the interaction between PM and meteorological factors. Temperature and PM were identified as the two primary risk factors for HFMD, with relative risks (RR) of 1.586(1.493,1.685) and 1.349(1.325,1.373), respectively. Furthermore, PM exhibited a synergistic effect with meteorological factors. For instance, the RR values for PM in relation to HFMD were 1.029 (95% CI: 1.024-1.035) and 1 0.117 (95% CI: 1 0.108 - 11 0.127) under different temperature group categories. Notably, HFMD predominantly affects children under the age of five years old and infants aged between zero to one year old demonstrate heightened susceptibility to environmental variables. The results showed that both PM and meteorological factors were risk factors for HFMD, with evidence of an interaction between these variables. These findings have important implications for local HFMD incidence prediction and the development of effective prevention strategies.
先前的研究已经证明了环境因素对传染病发生的影响。然而，关于手足口病（HFMD）与环境变量之间的关联，特别是环境变量之间的相互作用，仍存在证据不足且相互矛盾的情况。本研究旨在探讨颗粒物（PM）和气象因素对阜阳市 HFMD 发病率的单独和交互作用。采用广义加性模型结合分布滞后非线性模型，评估 PM 和气象因素对阜阳市 HFMD 发病率的单独影响。随后，在模型中纳入乘积项，以探讨 PM 和气象因素之间的相互作用。结果表明，温度和 PM 是 HFMD 的两个主要危险因素，相对风险（RR）分别为 1.586（1.493，1.685）和 1.349（1.325，1.373）。此外，PM 与气象因素表现出协同作用。例如，在不同温度组类别下，PM 与 HFMD 的 RR 值分别为 1.029（95%CI：1.024-1.035）和 1.011（95%CI：1.008-1.012）。值得注意的是，HFMD 主要影响五岁以下儿童，零至一岁的婴儿对环境变量更为敏感。这些发现表明，PM 和气象因素均为 HFMD 的危险因素，且这些变量之间存在相互作用。这些结果对于当地 HFMD 发病率预测和制定有效的预防策略具有重要意义。
