Association of PM2.5 and its components with lengths of hospital stay for hand foot and mouth disease in children

Abstract

BackgroundHand foot and mouth disease (HFMD) is a public health concern. Studies on air pollution and the lengths of hospital stay (LOS) of HFMD are scarce. MethodsWe characterized the clinic demographic features of 5135 hospitalized HFMD in Nanjing, China from 2012 to 2017, and analyzed the association between short-term exposure to PM 2.5 as well as its components (OM, BC, SO4 2− , NH4 + , NIT, SOIL and SS) and the LOS of HFMD. ResultsAmong them 98.62% were aged 0-6 years old, and 3772 (73.46%) were hospitalized for seven days or less. The LOS of HFMD children was different in different ages, illness onset years and illness onset seasons (P<0.01). For per IQR increase in PM 2.5 concentrations, LOS of HFMD increased by 0.52(0.33, 0.71), 0.50 (95% CI, 0.31-0.69) and 0.46 (95% CI, 0.28-0.65) day in adjusted models at lag 3 days, lag 7days and lag 14 days, respectively. In addition, per IQR increase of BC, SO 4 2− , NH 4 + , NIT and SOIL were also signi cantly associated with the LOS of HFMD. ConclusionsOur ndings corroborated the hypothesis that short-term PM 2.5 exposure was associated with increased the LOS of HFMD, and its components (BC, SO 4 2− , NH 4 + , NIT and SOIL) of PM 2.5 might play a key role in the prolonged LOS of HFMD.

Long-term exposure to ambient PM2.5, particulate constituents and hospital admissions from non-respiratory infection

“…However, evidence on the association between sulfate and infections is still lacking. A recent study observed that exposure to sulfate particles was associated with increased length of stay from hand-foot-mouth disease 29 . One potential mechanism for the observed effect could be that acidic sulfates turn the metal oxides from PM2.5 into metal ions which are soluble in the lung lining fluid, producing oxidative compounds and ultimately perturb the immune system [30][31][32] .…”