ArticleThe Science of the total environment2019
Interactions between climate factors and air pollution on daily HFMD cases: A time series study in Guangdong, China.
Article in The Science of the total environment, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Temporal relationships between climate variables and hand-foot-mouth disease: a multi-province study in the Mekong Delta Region, Vietnam.International journal of biometeorology · 2020Pooled it
- Epidemiological characteristics and spatiotemporal analysis of hand-foot-mouth disease in Shandong Province, China.International health · 2026Article
- Impact of precipitation patterns on the risk of hand, foot, and mouth disease in Southwest China: insight from a disease burden perspective.BMC public health · 2025Article
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- A retrospective study on the association of ambient air pollutants and temperature co-exposure with female infertility risk in Chengdu, China.Scientific reports · 2025Article
- Quantifying the temporal trends of the combined effect of temperature and relative humidity on hand, foot, and mouth disease in Yunnan, China.Frontiers in public health · 2025Article
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- Air pollution's numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from China.BMC public health · 2024Article
- Time series analysis of the interaction between ambient temperature and air pollution on hospitalizations for AECOPD in Ganzhou, China.Scientific reports · 2024Article
- Article
- Impact of meteorological factors on the incidence of hand-foot-mouth disease in Yangzhou from 2017 to 2022: a time series study.Frontiers in public health · 2023Article
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- Assessing the impact of ambient temperature on the risk of hand, foot, and mouth disease in Guangdong, China: New insight from the disease severity and burden.PLoS neglected tropical diseases · 2022Article
- Relationship between meteorological factors, air pollutants and hand, foot and mouth disease from 2014 to 2020.BMC public health · 2022Article
- Effects of temperature and PMEnvironmental science and pollution research international · 2022Article
- Synergistic effects of gaseous pollutants on hospital admissions for cardiovascular disease in Liuzhou, China.Environmental science and pollution research international · 2022Article
- Effect of temperature and its interactions with relative humidity and rainfall on malaria in a temperate city Suzhou, China.Environmental science and pollution research international · 2021Article
- Leading Enterovirus Genotypes Causing Hand, Foot, and Mouth Disease in Guangzhou, China: Relationship with Climate and Vaccination against EV71.International journal of environmental research and public health · 2021Article
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6 authors.
Funding
Abstract
backgroundPrior studies have shown that climate factors and air pollution are associated with hand, foot, and mouth disease (HFMD) epidemics. However, the interaction between air pollution and climate factors remains unknown.
methodsDaily HFMD counts from 2009 through 2012 in Guangdong were collected. We used distributed lag non-linear models to assess the associations of climate factors and air pollution on HFMD cases. The effects of climate factors were stratified by air pollution stratum to examine the interaction effect of air quality index (AQI) and temperature, as well as relative humidity. In addition, we explored the variability across gender groups.
resultsWe observed associations between HFMD cases and environmental factors, including temperature, relative humidity, and AQI. The highest relative risks (RR) were observed at the middle level of temperature and AQI, and high level of relative humidity. The effects for the interaction between AQI and climate factors on HFMD cases were also statistically observed. Compared with low level temperatures (≤23.5 °C), high level temperatures (>23.5 °C) had a RR of 1.486 (95%CI: 1.469,1.503) on days with "good" air quality (AQI ≤ 46), and RR of 1.013 (95%CI: 1.003,1.023) on days with "moderate" air quality (AQI > 46). For relative humidity, the high level (>77%) had a RR of 1.082 (95%CI: 1.076,1.089) on days with "good" air quality, and RR of 1.039 (95%CI: 1.033,1.046) on days with "moderate" air quality. The associations and the interactions remained robust for males and females.
conclusionsOur findings indicate that climate factors and air pollution imposed lagged and non-linear effects on HFMD epidemics. The effects of climate factors on health potentially vary by AQI. Our study is practical and useful for targeted prevention and control, and provides environmental-based evidence.
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