ArticleEpidemiology and infection2020
Associations between ambient air pollution and daily incidence of pediatric hand, foot and mouth disease in Ningbo, 2014-2016: a distributed lag nonlinear model.
Article in Epidemiology and infection, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Association between ambient air pollution and risk of hand, foot, and mouth disease: a systematic review and meta-analysis.BMC public health · 2025Pooled it
- Interactive and joint effects of multiple meteorological and air pollution exposures on hand, foot and mouth disease risk in western China: a time-series analysis.BMJ public health · 2026Article
- Article
- Bayesian joint spatiotemporal modelling of primary infection and reinfection of HFMD at county level in Jiangsu, China, 2009-2023.BMC public health · 2025Article
- 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
- How multiple air pollutants affect hand, foot, and mouth disease incidence in children: assessing effect modification by geographical context in multicity of Sichuan, southwest China.BMC public health · 2024Article
- Article
- Associations between ambient air pollutants and childhood hand, foot, and mouth disease in Sichuan, China: a spatiotemporal study.Scientific reports · 2023Article
- 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.Frontiers in public health · 2023Article
- Article
- Modification effects of socioeconomic factors on associations between air pollutants and hand, foot, and mouth disease: A multicity time-series study based on heavily polluted areas in the basin area of Sichuan Province, China.PLoS neglected tropical diseases · 2022Article
- Article
- Effects of temperature and PMEnvironmental science and pollution research international · 2022Article
- Effects of Meteorological Factors and Atmospheric Pollution on Hand, Foot, and Mouth Disease in Urumqi Region.Frontiers in public health · 2022Article
- Time Series Analysis and Forecasting of the Hand-Foot-Mouth Disease Morbidity in China Using An Advanced Exponential Smoothing State Space TBATS Model.Infection and drug resistance · 2021Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hand, foot and mouth disease (HFMD) has high prevalence around the world, with serious consequences for children. Due to the long survival period of HFMD virus in ambient air, air pollutants may play a critical role in HFMD epidemics. We collected data on daily cases of HFMD among children aged 0-14 years in Ningbo City between 2014 and 2016. Distributed lag nonlinear models were used to assess the effects of particulate matter (PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3) on the daily incidence of HFMD among children, with analyses stratified by gender and age. Compared with moderate levels of air pollution, high SO2 levels had a relative risk (RR) of 2.32 (95% CI 1.42-3.79) and high NO2 levels had a RR of 2.01 (95% CI 1.22-3.31). The RR of O3 was 2.12 (95% CI 1.47-3.05) and that of PM2.5 was 0.77 (95% CI 0.64-0.92) at moderate levels of air pollution. Specifically, high levels of SO2 and NO2 had RRs of 2.39 (95% CI 1.44-3.96) and 2.02 (95% CI 1.21-3.39), respectively, among 0-4-year-old children, while high O3 had an RR of 2.31 (95% CI 1.09-4.89) among 5-14-year-old children. Our findings suggest significant associations of high SO2 and NO2 levels and moderate O3 levels in HFMD epidemics, and also indicate that air pollution causes lagged effects on HFMD epidemics. Our study provides practical and useful data for targeted prevention and control of HMFD based on environmental evidence.
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