Does air pollution exposure impact the incidence of childhood hand, foot and mouth disease?
Air pollution exerts nuanced, heterogeneous influences on childhood HFMD incidence across numerical, spatial, and temporal dimensions.
BACKGROUND: While stationary links between childhood hand, foot and mouth disease (HFMD) and air pollution are known, a comprehensive study on their heterogeneous relationships (nonstationarity), jointly considering numerical, temporal and spatial dimensions, has not been reported. METHODS: Monthly HFMD incidence and air pollution data were collected at the county level from Sichuan-Chongqing, China (2009-2011), alongside meteorological and social environmental covariates. Key influential factors were identified using random forest (RF) under the stationary assumption. Factors' numerically, temporally, and spatially heterogeneous relationships with HFMD were assessed using generalized additive model (GAM) and geographically and temporally weighted regression (GTWR). RESULTS: in spring, summer, and autumn, concentrated in specific regions of Sichuan-Chongqing. CONCLUSIONS: This study underscores the nuanced and three-perspective heterogeneous influences of air pollution on HFMD in small areas, emphasizing the need for differentiated, localized, and time-sensitive prevention and control strategies to enhance the precision of dynamic early warnings and predictive models for HFMD and other infectious diseases, particularly in the fields of environmental and spatial epidemiology.
Tang et al. (Tue,) studied this question.