Key result
High relative humidity significantly increased the risk of hand, foot, and mouth disease with a cumulative relative risk of 1.63, alongside extreme levels of PM10, O3, SO2, and CO.
Why the study?
Meteorological factors and air pollutants have been linked to HFMD epidemics before vaccine introduction, but evidence from long-term studies remains limited.
Observational (n=315,441)
No
Relative Risk: 1.63 (95% CI 1.39–1.91)
High relative humidity, precipitation, and extreme levels of air pollutants (PM10, O3, SO2, CO) are associated with an increased risk of hand, foot, and mouth disease in children.
May guide HFMD surveillance during humidity or pollution extremes; hypothesis-generating observational data leave causality open and require prospective validation.
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 from 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 PM2.5 and O3 significantly increase the risk of HFMD; In post-vaccination period, low temperature and high relative humidity, O3, NO2 and 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.
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Hongxia et al. (2022) conducted an observational in Hand, foot, and mouth disease (HFMD) (n=315,441). Meteorological factors and air pollutants (high relative humidity) vs. Median relative humidity was evaluated on Incidence of HFMD (cumulative effect of high relative humidity) (RR 1.63, 95% CI 1.39-1.91). High relative humidity significantly increased the risk of hand, foot, and mouth disease with a cumulative relative risk of 1.63, alongside extreme levels of PM10, O3, SO2, and CO.
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