Abstract
Hand, foot, and mouth disease (HFMD) is a common childhood infection that causes a substantial disease burden in the Asia-Pacific region. Various climate variables, such as humidity and temperature, have been associated with HFMD. However, few studies have assessed the impact of PM10 on childhood HFMD. This study investigated the association between PM10 and HFMD. We fitted a standard distributed lag non-linear model to investigate the temporal lagged relationship between PM10 and HFMD, and then further assessed whether this relationship varied by gender and pathogen. Between 2011 and 2015, a total of 122,564 HFMD cases under 15 years of age were reported in Chengdu. The PM10-HFMD associations were shown to be non-linear in all subgroups, with the peak at 101–218 μg/m3. Male children were more sensitive to PM10 effects. For pathogen-specific relative risks, we found that the risk estimates were generally higher in cases of CVA16 infection. Our study provides evidence that PM10 increases the risk of HFMD. Authorities and parents should be fully aware of the impact of PM10 on childhood HFMD. Furthermore, appropriate protective measures should be taken to reduce risks.
Highlights
Hand, foot, and mouth disease (HFMD) is a common childhood infection that usually affects infants and young children[1]
The impact of air pollution on respiratory diseases has been demonstrated by many epidemiological studies[13,14], but very few studies have documented the link between particulate matter under 10 microns (PM10) and childhood HFMD
The daily mean PM10 concentration significantly exceeded the values recommended by the national air quality standards and the World Health Organization (WHO)
Summary
Foot, and mouth disease (HFMD) is a common childhood infection that usually affects infants and young children[1]. HFMD is typically characterized by fever, mouth ulcers, and ulcerations on the hands, legs, or buttocks and mouth[2]. The impact of air pollution on respiratory diseases has been demonstrated by many epidemiological studies[13,14], but very few studies have documented the link between PM10 and childhood HFMD. In 2013, for instance, there were only 139 days when the air quality in Chengdu met the national air quality standard of 70 μg/m3 (24-hour average) for PM1018. This number (139 days) was lower than those in most of the other big cities in China, such as Tianjin (145 days), Beijing (167 days), Guangzhou (259 days), and Shanghai (246 days)[18]. A better understanding might be attained for the association between PM10 and HFMD by adopting a more sophisticated model
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