Relationship between meteorological factors, air pollutants and hand, foot and mouth disease from 2014 to 2020

Abstract

Background

Meteorological factors and air pollutants have been reported to be associated with hand, foot, and mouth disease (HFMD) epidemics before the introduction of vaccine. However, there is limited evidence for studies with long-term dimensions.

Methods

We collected the daily HFMD counts, weather and air pollution data from 2014 to 2020 in Chengdu. Distributed lag non-linear models (DLNM) were used to assess the associations of meteorological factors and air pollutants on HFMD cases.

Results

From 2014–2020, high relative humidity and precipitation and extremely high and low levels of PM₁₀, O₃, SO₂ and CO increased the risk of HFMD. In pre-vaccination period, extreme high and low temperatures, PM₁₀ and NO₂, low precipitation and high concentrations of PM_2.5 and O₃ significantly increase the risk of HFMD; In post-vaccination period, high relative humidity and low level of CO can significantly increase the incidence of HFMD; During the period of COVID-19, only low temperature will significantly increase the risk of HFMD; Low concentration of air pollutants has the greatest impact on the 6–14 age group, while the high concentration of air pollutants has the greatest impact on the 0–1 age group.

Conclusions

Our study suggest that high relative humidity and precipitation and extremely high and low levels of PM₁₀, O₃, SO₂ and CO increased the risk of HFMD from 2014 to 2020. The results of this study provide a reference for local authorities to formulate intervention measures and establish an environment-based disease early warning system.