City-level meteorological conditions modify the relationships between exposure to multiple air pollutants and the risk of pediatric hand, foot, and mouth disease in the Sichuan Basin, China

Exploring the spatiotemporal effects of meteorological factors on hand, foot and mouth disease: a multiscale geographically and temporally weighted regression study

The influence of meteorological factors on hand, foot, and mouth disease (HFMD) is not on the same scale, it's rare for previous studies to measure and recognize the independent regression relationship between each variable in space and time scale. This study used a multiscale geographically and temporally weighted regression (MGTWR) model to explore the relationship between the incidence of HFMD and related meteorological factors in Shandong Province, China, during 2015-2019 and attempted to quantify the influence of meteorological factors on HFMD under different spatiotemporal effects. Meanwhile, we used the Global Moran's I statistic and Local Moran's I statistic to test the spatial autocorrelation of the incidence of HFMD. HFMD had spatial autocorrelation at the county level in Shandong Province. The MGTWR model outperformed the OLS and GTWR models in determining the relationship between meteorological factors and HFMD. The study highlights significant spatiotemporal non-stationarity in the relationship between meteorological factors and HFMD. Temperature was predominantly positively correlated with HFMD, especially in the peninsula region during spring and summer. Humidity exhibited a predominantly positive correlation, especially in the Shandong Peninsula. Precipitation also showed a positive correlation with HFMD, particularly in western regions and during the winter months. Wind speed had a predominantly negative correlation with HFMD in the central and southwestern regions. The results might help public health authorities set priorities for targeted prevention and control measures in different regions and weather conditions, and provide guidance for the government to rationally allocate public health resources.

Modification effects of long-term air pollution levels on the relationship between short-term exposure to meteorological factors and hand, foot, and mouth disease: A distributed lag non-linear model-based study in Shandong Province, China

The occurrence of hand, foot, and mouth disease (HFMD) is closely related to meteorological factors. However, location-specific characteristics, such as persistent air pollution, may increase the complexity of the impact of meteorological factors on HFMD, and studies across different areas and populations are largely lacking. In this study, a two-stage multisite time-series analysis was conducted using data from 16 cities in Shandong Province from 2015 to 2019. In the first stage, we obtained the cumulative exposure-response curves of meteorological factors and the number of HFMD cases for each city. In the second stage, we merged the estimations from the first stage and included city-specific air pollution variables to identify significant effect modifiers and how they modified the short-term relationship between HFMD and meteorological factors. High concentrations of air pollutants may reduce the risk effects of high average temperature on HFMD and lead to a distinct peak in the cumulative exposure-response curve, while lower concentrations may increase the risk effects of high relative humidity. Furthermore, the effects of average wind speed on HFMD were different at different levels of air pollution. The differences in modification effects between subgroups were mainly manifested in the diversity and quantity of significant modifiers. The modification effects of long-term air pollution levels on the relationship between sunshine hours and HFMD may vary significantly depending on geographical location. The people in age＜3 and male groups were more susceptible to long-term air pollution. These findings contribute to a deepening understanding of the relationship between meteorological factors and HFMD and provide evidence for relevant public health decision-making.