Impact of PM10 and meteorological factors on the incidence of hand, foot, and mouth disease in female children in Ningbo, China: a spatiotemporal and time-series study

Abstract

Hand, foot, and mouth disease (HFMD) is a viral illness that is considered a critical public health challenge worldwide. Previous studies have demonstrated that meteorological parameters are significantly related to the incidence of HFMD in children; however, few studies have focused only on female children. This study quantified the associations of HFMD incidence with meteorological parameters and PM (particulate matter with an aerodynamic diameter of 10 μm) among female children. Data were collected on daily HFMD cases, meteorological variables, and PM levels in Ningbo, China, from January 2012 to December 2016. Data were assessed using a distributed lag nonlinear model (DLNM) with Poisson distribution. A total of 59,809 female children aged 0-15 years with HFMD were enrolled. The results showed that highest relative risk (RR) of HFMD for temperature was 3 °C and the lag effect was 3 days. The highest RR for PM was 80 mg/m and the lag effect was 5 days. Spatial analysis showed that female HFMD incidence was mainly concentrated in the suburban of Ningbo city indicating that female children in this area should be more paid attention on avoiding this disease outbreak. Our findings suggest that HFMD prevention strategies should focus more attention on local meteorological parameters.

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

“…Fortunately, the China Food and Drug Administration (CFDA) approved the first inactivated EV 71 whole virus vaccine for the prevention of severe HFMD in 2015 (Mao et al 2016). HFMD is highly contagious and spreads through direct contact or fecal-oral transmission through nasopharyngeal secretions such as saliva or nasal mucus (Huang et al 2018). In mainland China, since it has been made statutorily notifiable in May 2008, an average of about 2 million HFMD cases was reported every year, which has been one of the leading causes of child death and has raised substantial public health concerns in the Asia-Pacific region (Zhao et al 2016).…”

“…It is well known that weather plays a vital role in the transmission of many infectious diseases (Xiao et al 2017). The seasonality of the incidence of HFMD has led to extensive research by epidemiologists in an attempt to quantify the association with meteorological variables (Huang et al 2018;Sumi et al 2017;Yu et al 2019;Zhao et al 2017). The results obtained from different regions on the effects of various meteorological factors were not entirely consistent, and the temperature-HFMD relationship was the most controversial.…”

“…The inconsistency in results can be attributed in part to the diversity of methodologies and data sources. Still, it is also possible to suggest that temperature-HFMD relationships are modified by some other factors, such as air pollutants (Huang et al 2018;Yu et al 2019) or sunspot (Towers 2017) and location-specific variables, that contribute to the influence of temperature on the incidence of HFMD (Xiao et al 2017). Of particular concern is particulate matter, such as PM 2.5 or PM 10 ; that particulate matter having an aerodynamic diameter of 2.5 μm or 10 μm can enter the human respiratory system, even penetrate lung cells, and enter the circulatory system, resulting in serious health problem, especially in children.…”

Spatial-temporal mapping of hand, foot and mouth disease in relation to climate factors in Xinjiang, China from 2008 to 2016

“…In recent years, the HFMD has become increasingly recognized as a significant health problem [33,34]. Moreover, in areas with different regions, the HFMD risk has introduced a significant difference.…”

“…In temperate regions, HFMD outbreaks usually occurred in summer or early fall [5] since temperature rise and precipitation increase occurred later than in tropical regions. Therefore, HFMD incidence in temperate regions was different from that in tropical and subtropical regions [19,34]. For example, a study conducted in Vietnam located in Southeast Asia showed that the peak of HFMD comes in April.…”