دانلود رایگان مقاله انگلیسی تاثیرات کوتاه مدت عوامل هواشناختی و آلودگی هوا بر روی کودکان مبتلا به بیماری دست-پا-دهان - الزویر 2019

abstract

Background: Previous studies have always focused on the impact of various meteorological factors on Hand–foot– mouth disease (HFMD). However, only few studies have investigated the simultaneous effects of climate and air pollution on HFMD incidence. Methods: Daily HFMD counts among children aged 0–14 years in Guilin city were collected from 2014 to 2016. Distributed lag nonlinear models (DLNM) were used to assess the effects of extreme meteorological factors and air pollution indicators, as well as the effects of different lag days on HFMD incidence. Furthermore, this study explored the variability across gender and age groups. Results: Extreme temperatures, high precipitation and low-O3 concentration increased the risk of HFMD. Hot effect was stronger and longer lasting than cold effect. Risks of rainy effect and low-O3 effect continued to increase as lag days extended, with the maximum RR values: 1.60 (1.38, 1.86) (90th vs median) and 1.48 (1.16, 1.89) (1th vs median) at 0–14 lag days, respectively. By contrast, extremely high wind speed, low precipitation, low PM2.5 and high O3 exerted a certain protective effect on HFMD incidence. The corresponding minimum RR values were: 0.85 (0.74, 0.98) (90th vs median) at 0–14 lag days, 0.98 (0.97, 0.99) (10th vs median) at 0–14 lag days, 0.73 (0.61, 0.88) (1th vs median) at 0–14 lag days and 0.81 (0.73, 0.90) (99th vs median) at 0–7 lag days, respectively Male children and children aged 0–1 years (followed by 1–3 years) were the most susceptible subgroups to extreme climatic effects and air pollution. Conclusions: Our results indicated that daily meteorological factors and air pollution exert non-linear and delayed effects on pediatric HFMD, and such effects vary depending on gender and age. These findings may serve as a reference for the development of an early warning system and for the adoption of specific interventions for vulnerable groups.

5. Conclusions

This study confirmed that meteorological and air pollution factors influence HFMD incidence. However, the specific effects can vary depending on gender and age. The extreme and delayed effects of mean temperature, precipitation, as well as PM2.5 and O3, are associated with HFMD incidence. Male children and those aged 0–3 years are more susceptible to extreme external conditions than the other subgroups. The present results are of substantial practical importance to local authorities for the formulation of targeted disease interventions and for the construction of environment-based early warning systems for diseases.