摘要
[背景]在全球变暖的背景下,极端天气事件在全球频频发生,极端气象因素对手足口病发病影响值得关注。[目的]分析极端气象因素对杭州市萧山区0~6岁儿童手足口病发病风险的影响,为手足口病的防控工作提供科学依据。[方法]2009—2019年杭州市萧山区0~6岁儿童手足口病病例资料来源于中国疾病预防控制信息系统和病后个案随访资料,同期气象参数资料来源于中国气象科学数据共享服务网。采用分布滞后非线性模型,调整长期趋势、星期几和节假日等潜在混杂因素后,计算相对于参考值P50,在一定滞后时间内气象因素对手足口病发病的影响。所有发病风险均以相对危险度(RR)表示,由气象因素第90或第10百分位数与P50进行比较,并以性别、年龄(0~3岁和4~6岁)、抚养方式(散居儿童和幼托儿童)、居住地(村庄和小区)进行分层分析。[结果]2009—2019年杭州市萧山区共报告0~6岁儿童手足口病病例21965例,发病高峰在5—7月。男、女性别比为1.14∶1;0~3岁组和4~6岁年龄组分别占儿童病例总数的65.86%(14467例)和34.14%(7498例);散居儿童和幼托儿童分别占76.45%和23.55%;居住在村庄的儿童病例占68.12%,居住在小区的儿童占31.88%。气象因素对手足口病发病的影响均呈非线性,且具有滞后性。以18.9℃为参考,极端高温29.4℃(P90)当天发病风险最高(RR=1.54,95%CI:1.34~1.77),滞后3~8 d仍有发病风险。分别以相对湿度73.0%和无雨为参考,极端高湿91%(P90)滞后5 d、极高降雨量14.5mm(P90)滞后6 d发病风险均增加5%。以日照4.1 h为参考,无日照(P10)滞后4~11 d手足口病发病风险较高,而以滞后5 d的危害效应最高(RR=1.04,95%CI=1.02~1.07)。分层分析显示,极高温和极高相对湿度时各亚组人群均存在较高发病风险,强度接近。分别与女童、小于3岁儿童和居住在小区的儿童相比,男童、4~6岁儿童、居住在村庄的儿童手足口病发病可
[Background]In the context of global warming,extreme weather events occur frequently across the world,and their influences on the incidences of hand-foot-mouth disease(HFMD)raise concerns.[Objective]This study evaluates the effects of extreme meteorological factors on the risk of HFMD in children aged 0-6 years in Xiaoshan District of Hangzhou,and provides scientific evidence for the prevention and control of the disease.[Methods]The HFMD cases aged 0-6 years in Xiaoshan District of Hangzhou from 2009 to 2019 were retrieved from the information system of the Chinese Center for Disease Control and Prevention and the follow-up records,and meteorological variables of the same period were sourced from the China Meteorological Data Service Center.The influences of extreme meteorological factors(versus P50)over certain lag time on HFMD incidence were analyzed by a distributed lag nonlinear model(DLNM)adjusting for potential confounders such as secular trend,day of the week,and holidays.All effects were presented as relative risks(RR)for the 90th or 10th percentiles of the meteorological variables using their P50 values as reference.Stratified analysis was performed by gender,age(0-3 and 4-6 years),child-rearing method(sporadic children and institutional preschool children),and residence(village and community).[Results]From 2009 to 2019,a total of 21965 HFMD cases aged 0-6 years were reported in Xiaoshan District of Hangzhou,and the peak incidence was from May to July.The boy-to-girl ratio was 1.14:1.Children of 0-3 years old and of 4-6 years old accounted for 65.86%(14467 cases)and 34.14%(7498 cases)of the total cases respectively.There were 76.45%sporadic children and 23.55%institutional preschool children,and 68.12%village children and 31.88%community children.Selected meteorological factors had nonlinear and lagged impacts on the incidence of HFMD.The risk of HFMD of extreme heat(P90,29.4℃)was the highest(RR=1.54,95%CI:1.34-1.77)on the current day,and such risk still existed at lag 3-8 days when reference temperat
作者
徐兴福
毕建萍
李骏
XU Xing-fu;BI Jian-ping;LI Jun(Hangzhou Xiaoshan Center for Disease Control and Prevention,Hangzhou,Zhejiang 311203,China;Law Enforcement Unit of Hangzhou Xiaoshan Health and Family Planning,Hangzhou,Zhejiang 311203,China)
出处
《环境与职业医学》
CAS
CSCD
北大核心
2020年第10期957-962,共6页
Journal of Environmental and Occupational Medicine
关键词
手足口病
极端天气
儿童
分布滞后非线性模型
hand-foot-mouth disease
extreme weather
child
distributed lag nonlinear model
