Weather effects on hand, foot, and mouth disease at individual level: a case-crossover study
Weather effects on hand, foot, and mouth disease at individual level: a case-crossover study
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天气对个体手足口病的影响：病例交叉研究
DOI：
10.1186/s12879-019-4645-4
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发表时间：
2019-12-03
影响因子：
3.7
通讯作者：
Hao, Yuantao
中科院分区：
文献类型：
--
作者：
Du, Zhicheng;Lin, Shao;Hao, Yuantao
背景手足口病在亚太地区，尤其是中国，是一个紧迫的公共卫生问题。天气因素与手足口病之间的联系已被广泛研究，但结果不一致。此外，以往利用生态设计的研究不能排除暴露错误分类和未观察到的混杂因素的偏差。方法采用病例-交叉分析评估天气因素与手足口病的相关性。收集广东省2009年至2012年手足口病个案，纳入距气象监测点10 公里以内的病例。通过前7天的 检查滞后效应。此外，我们还通过在20 公里和30 公里范围内改变距离来探索这种变异性。结果我们观察到手足口病与包括温度和相对湿度在内的天气因素的相关性。手足口病同一天和之前7个 天的温度关系呈近似U型关系，而相对湿度呈近似指数形关系。在距监测点10 公里范围内进行评估时，手足口病发病率的显著增加与滞后天数0-6天的温度[超标率(ER)：7.7%；95%可信区间(CI)：3.9，11.7%]和相对湿度(ER：1.9%；95%CI：0.7，3.0%)每增加10个单位有关。检测到的温度(30 °C)和相对湿度(70.3%)的潜在阈值与手足口病有关。在20 公里和30 公里范围内，这种相关性仍然很强。结论我们的研究发现，温度和相对湿度与手足口病发病率的增加显著相关。气象因素与手足口病之间存在阈值和滞后效应。我们的发现有助于规划手足口病的有针对性的预防和控制。
BackgroundHand, foot, and mouth disease (HFMD) raises an urgent public health issue in the Asia-Pacific region, especially in China. The associations between weather factors and HFMD have been widely studied but with inconsistent results. Moreover, previous studies utilizing ecological design could not rule out the bias of exposure misclassification and unobserved confounders.MethodsWe used case-crossover analysis to assess the associations of weather factors on HFMD. Individual HFMD cases from 2009 to 2012 in Guangdong were collected and cases located within 10 km of the meteorological monitoring sites were included. Lag effects were examined through the previous 7 days. In addition, we explored the variability by changing the distance within 20 km and 30 km.ResultsWe observed associations between HFMD and weather factors, including temperature and relative humidity. An approximately U-shaped relationship was observed for the associations of temperature on HFMD across the same day and the previous 7 days, while an approximately exponential-shaped was seen for relative humidity. Statistically significant increases in rates of HFMD were associated with each 10-unit increases in temperature [Excess rate (ER): 7.7%; 95% Confidence Interval (CI): 3.9, 11.7%] and relative humidity (ER: 1.9%; 95% CI: 0.7, 3.0%) on lag days 0–6, when assessing within 10 km of the monitoring sites. Potential thresholds for temperature (30.0 °C) and relative humidity (70.3%) detected showed associations with HFMD. The associations remained robust for 20 km and 30 km.ConclusionsOur study found that temperature and relative humidity are significantly associated with the increased rates of HFMD. Thresholds and lag effects were observed between weather factors and HFMD. Our findings are useful for planning on targeted prevention and control of HFMD.