Hu Quanman, Zhao Fei, Yang Yanyan, Lu Saiwei, Xie Yaqi, Geng Juan, Yang Haiyan, Long Jinzhao, Jin Yuefei, Chen Shuaiyin, Duan Guangcai
College of Public Health, Zhengzhou University, Zhengzhou, 450001, China.
Disease control and prevention center, Xinyang, 463600, China.
BMC Public Health. 2025 Aug 6;25(1):2663. doi: 10.1186/s12889-025-23517-2.
Previous studies examining the relationship between air pollution and the incidence of hand, foot and mouth disease (HFMD) have been inconsistent. We conducted a comprehensive systematic review and meta-analysis to clarify this issue and offer insights into identifying high-risk factors.
A comprehensive search was conducted through PubMed, Web of Science,, Embase and Scopus for published literature up to 12 May 2025. The cumulative relative risk and 95% confidence interval (CI) were calculated to assess the association between different pollutants, including particulate matter(PM)10, PM2.5, Nitrogen dioxide(NO), Sulfur dioxide(SO), Ozone(O), and Carbon monoxide(CO), and the incidence of HFMD.
After conducting a comprehensive literature search strategy and rigorous screening process, a total of 17 relevant records were included in this study. The findings revealed significant associations between high concentrations of air pollutants, including PM10 (RR: 1.16; 95% CI: 1.04-1.29; I = 97.3%), NO (RR: 1.19; 95% CI: 1.03-1.38, I² = 83.1%), and SO (RR: 1.51; 95% CI:1.14-1.99, I² = 84.6%), and the risk of HFMD. Consistent research characteristics of included studies, such as larger population and long term lag period can significantly reduce the heterogeneity.
Our findings demonstrate that various high-concentration air pollutants are associated with an increased risk of HFMD. It is recommended that government departments implement comprehensive strategies to mitigate air pollution, thereby reducing the prevalence of HFMD. Furthermore, during periods of high air pollution, targeted preventive measures should be adopted, such as minimizing children's outdoor activities.
以往关于空气污染与手足口病（HFMD）发病率之间关系的研究结果并不一致。我们进行了一项全面的系统综述和荟萃分析，以阐明这一问题，并为识别高危因素提供见解。
通过PubMed、Web of Science、Embase和Scopus对截至2025年5月12日发表的文献进行全面检索。计算累积相对风险和95%置信区间（CI），以评估不同污染物之间的关联，这些污染物包括颗粒物（PM）10、PM2.5、二氧化氮（NO）、二氧化硫（SO）、臭氧（O）和一氧化碳（CO），以及手足口病的发病率。
在实施全面的文献检索策略和严格的筛选过程后，本研究共纳入17条相关记录。研究结果显示，高浓度空气污染物与手足口病风险之间存在显著关联，这些污染物包括PM10（RR：1.16；95%CI：1.04 - 1.29；I² = 97.3%）、NO（RR：1.19；95%CI：1.03 - 1.38，I² = 83.1%）和SO（RR：1.51；95%CI：1.14 - 1.99，I² = 84.6%）。纳入研究的一致研究特征，如较大的样本量和较长的时间滞后，可以显著降低异质性。
我们的研究结果表明，各种高浓度空气污染物与手足口病风险增加有关。建议政府部门实施综合策略以减轻空气污染，从而降低手足口病的发病率。此外，在空气污染严重期间，应采取针对性的预防措施，如尽量减少儿童户外活动。
