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Sharma A, Yajing K, Lin MC, Deng L, Lin YK, Chianghsieh LH, Sung FC, Wang YC. Emergency room visits (ERVs) among occupational groups associated with ambient conditions in Taiwan. Int Arch Occup Environ Health 2024; 97:779-789. [PMID: 38958673 DOI: 10.1007/s00420-024-02084-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/24/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE This population-based study explored emergency room visits (ERVs) from all-causes, circulatory and respiratory diseases among different occupational groups in Taiwan associated with ambient average temperature. METHOD Daily area-age-sex specific ERVs records were obtained from the Taiwan's Ministry of Health and Welfare from 2009 to 2018. Distributed lag-nonlinear model (DLNM) was used to estimate the exposure-response relationships between daily average temperature and ERVs for all-causes, circulatory and respiratory diseases by occupational groups. Random-effects meta-analysis was used to pool the overall cumulative relative risk (RR) and 95% confidence interval (CI). RESULTS The exposure-response curves showed ERVs of all-cause and respiratory diseases increased with rising temperature across all occupational groups. These effects were consistently stronger among younger (20-64 years old) and outdoor workers. In contrast, ERVs risk from circulatory diseases increased significantly during cold snaps, with a substantially higher risk for female workers. Interestingly, female workers, regardless of indoor or outdoor work, consistently showed a higher risk of respiratory ERVs during hot weather compared to males. Younger workers (20-64 years old) exhibited a higher risk of ERVs, likely due to job profiles with greater exposure to extreme temperatures. Notably, the highest risk of all-causes ERVs was observed in outdoor male laborers (union members), followed by farmers and private employees, with the lowest risk among indoor workers. Conversely, female indoor workers and female farmers faced the highest risk of respiratory ERVs. Again, female farmers with consistent outdoor exposure had the highest risk of circulatory ERVs during cold conditions. CONCLUSION Our findings highlighted the complexity of temperature-related health risks associated with different occupational contexts. The population-level insights into vulnerable occupational groups could provide valuable comprehension for policymakers and healthcare practitioners.
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Affiliation(s)
- Ayushi Sharma
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
- Department of Civil Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
| | - Kang Yajing
- Department of Labor and Human Resources, Faculty of Social Sciences, Chinese Culture University, No. 55, Huagang Road, Yangmingshan, Taipei City, 11114, Taiwan
| | - Min-Chun Lin
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
| | - Liwen Deng
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan
| | - Yu-Kai Lin
- Department of Health and Welfare, College of City Management, University of Taipei, 101, Sec. 2, Zhongcheng Road, Taipei, 111, Taiwan
| | - Lin-Han Chianghsieh
- Institute of Environmental Engineering & Management, National Taipei University of Technology, Taipei, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Zhongli, 320, Taiwan.
- Research center for Environmental Changes, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 11529, Taiwan.
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Merenda B, Drzeniecka-Osiadacz A, Sówka I, Sawiński T, Samek L. Influence of meteorological conditions on the variability of indoor and outdoor particulate matter concentrations in a selected Polish health resort. Sci Rep 2024; 14:19461. [PMID: 39169074 PMCID: PMC11339401 DOI: 10.1038/s41598-024-70081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 08/12/2024] [Indexed: 08/23/2024] Open
Abstract
The article evaluates air pollution by particulate matter (PM) in indoor and outdoor air in one of the Polish health resorts, where children and adults with respiratory diseases are treated. The highest indoor PM concentrations were recorded during the winter season. Therefore, the maximum average daily concentration values in indoor air for the PM10, PM2.5, and PM1 fractions were 50, 42 and 23 µg/m3, respectively. In the case of outdoor air, the highest average daily concentrations of PM2.5 reached a value of 40 µg/m3. The analyses and backward trajectories of episodes of high PM concentrations showed the impact of supra-regional sources and the influx of pollutants from North Africa on the variability of PM concentrations. The correlation between selected meteorological parameters and PM concentrations shows the relationship between PM concentrations and wind speed. For example, the correlation coefficients between PM1(I) and PM1(O) concentrations and wind speed were - 0.8 and - 0.7 respectively. These factors determined episodes of high PM concentrations during winter periods in the outdoor air, which were then transferred to the indoor air. Elevated concentrations in indoor air during summer were also influenced by chimney/gravity ventilation and the appearance of reverse chimney effect.
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Affiliation(s)
- Beata Merenda
- Faculty of Environmental Engineering, Wrocław University of Science and Technology, Wybrzeże Stanisława Wyspiańskiego 27, 50-370, Wrocław, Poland.
- "Poltegor-Institute" Institute of Opencast Mining, Parkowa 25, 51-616, Wroclaw, Poland.
| | - Anetta Drzeniecka-Osiadacz
- Department of Climatology and Atmosphere Protection, University of Wroclaw, Kosiby 8 Str., 51-621, Wrocław, Poland
| | - Izabela Sówka
- Faculty of Environmental Engineering, Wrocław University of Science and Technology, Wybrzeże Stanisława Wyspiańskiego 27, 50-370, Wrocław, Poland
| | - Tymoteusz Sawiński
- Department of Climatology and Atmosphere Protection, University of Wroclaw, Kosiby 8 Str., 51-621, Wrocław, Poland
| | - Lucyna Samek
- AGH University of Krakow, Faculty of Physics and Applied Computer Science, Al. Mickiewicza 30, 30-059, Krakow, Poland
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Deng LL, Zhao F, Li ZW, Zhang WW, He GX, Ren X. Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014-2021. Infect Dis Poverty 2024; 13:34. [PMID: 38773558 PMCID: PMC11107005 DOI: 10.1186/s40249-024-01203-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 05/07/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a pressing public health issue, posing a significant threat to individuals' well-being and lives. This study delves into the TB incidence in Chinese mainland during 2014-2021, aiming to gain deeper insights into their epidemiological characteristics and explore macro-level factors to enhance control and prevention. METHODS TB incidence data in Chinese mainland from 2014 to 2021 were sourced from the National Notifiable Disease Reporting System (NNDRS). A two-stage distributed lag nonlinear model (DLNM) was constructed to evaluate the lag and non-linearity of daily average temperature (℃, Atemp), average relative humidity (%, ARH), average wind speed (m/s, AWS), sunshine duration (h, SD) and precipitation (mm, PRE) on the TB incidence. A spatial panel data model was used to assess the impact of demographic, medical and health resource, and economic factors on TB incidence. RESULTS A total of 6,587,439 TB cases were reported in Chinese mainland during 2014-2021, with an average annual incidence rate of 59.17/100,000. The TB incidence decreased from 67.05/100,000 in 2014 to 46.40/100,000 in 2021, notably declining from 2018 to 2021 (APC = -8.87%, 95% CI: -11.97, -6.85%). TB incidence rates were higher among males, farmers, and individuals aged 65 years and older. Spatiotemporal analysis revealed a significant cluster in Xinjiang, Qinghai, and Xizang from March 2017 to June 2019 (RR = 3.94, P < 0.001). From 2014 to 2021, the proportion of etiologically confirmed cases increased from 31.31% to 56.98%, and the time interval from TB onset to diagnosis shortened from 26 days (IQR: 10-56 days) to 19 days (IQR: 7-44 days). Specific meteorological conditions, including low temperature (< 16.69℃), high relative humidity (> 71.73%), low sunshine duration (< 6.18 h) increased the risk of TB incidence, while extreme low wind speed (< 2.79 m/s) decreased the risk. The spatial Durbin model showed positive associations between TB incidence rates and sex ratio (β = 1.98), number of beds in medical and health institutions per 10,000 population (β = 0.90), and total health expenses (β = 0.55). There were negative associations between TB incidence rates and population (β = -1.14), population density (β = -0.19), urbanization rate (β = -0.62), number of medical and health institutions (β = -0.23), and number of health technicians per 10,000 population (β = -0.70). CONCLUSIONS Significant progress has been made in TB control and prevention in China, but challenges persist among some populations and areas. Varied relationships were observed between TB incidence and factors from meteorological, demographic, medical and health resource, and economic aspects. These findings underscore the importance of ongoing efforts to strengthen TB control and implement digital/intelligent surveillance for early risk detection and comprehensive interventions.
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Affiliation(s)
- Le-le Deng
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Fei Zhao
- Department of Pharmacy, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Science; Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing, 100730, China
| | - Zhuo-Wei Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Wei-Wei Zhang
- Miyun District Center for Disease Control and Prevention, Beijing, 101500, China
| | - Guang-Xue He
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
- School Of Public Health, Binzhon Medical University, Yantai, 264000, China
| | - Xiang Ren
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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Cheng C, Liu Y, Han C, Fang Q, Cui F, Li X. Effects of extreme temperature events on deaths and its interaction with air pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170212. [PMID: 38246371 DOI: 10.1016/j.scitotenv.2024.170212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/17/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Both extreme temperature events (ETEs) and air pollution affected human health, and their effects were often not independent. Previous studies have provided limited information on the interactions between ETEs and air pollution. METHODS We collected data on deaths (non-accidental, cardiovascular, and respiratory) in Zibo City along with daily air pollution and meteorological data from January 2015 to December 2019. Distributed lag non-linear model was used to explore the health effects of ETEs on deaths. Non-parametric binary response model, hierarchical model and joint effect model were used to further explore the interaction between ETEs and air pollution in different seasons. Meanwhile, subgroup analysis by gender and age (≥ 65 years old and < 65 years old) was conducted to identify the vulnerable population. RESULTS ETEs increased death risk, especially for cardiovascular and respiratory deaths. Heat waves had a stronger impact than cold spells. Cold spells had a longer lag and fluctuating trend. Heat waves had a short-term impact, followed by a decrease. Females and those aged ≥ 65 were more affected, but subgroup differences were not significant. During ETEs and non-ETEs, there were different effects on deaths with per IQR increase in air pollutant concentrations. Joint effect models revealed that there was a significant interaction between ETEs and air pollution on non-accidental deaths. The interaction between PM2.5 and cold spells was antagonistic in the cold season. In the warm season, the health effects of heat waves and high O3 concentration were enhanced. The relative excess risk due to interaction (RERI) of cold spells and PM2.5 in total population was -0.09 (95 % CI: -0.17, -0.01), and 9 % (95 % CI: 1 %, 17 %) of the total effect was attributable to interaction. Subgroup analysis confirmed the interactions in females and those aged ≥ 65. CONCLUSIONS Significant association observed between ETEs and deaths. Females and ≥ 65 age groups were vulnerable. There were interactions between ETEs and air pollution. The effect of PM2.5 on deaths decreased during cold spells, while the effect of O3 increased during heat waves. In addition to improving air quality, it is necessary to further strengthen the prevention and control of ETEs.
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Affiliation(s)
- Chuanlong Cheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Ma'anshan Center for Disease Control and Prevention, Ma'anshan 243000, Anhui, China
| | - Chuang Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qidi Fang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Feng Cui
- Zibo Center for Disease Control and Prevention, Zibo, Shandong, China
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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Zhang C, Wang X, Sun D, Li Y, Feng Y, Zhang R, Zheng Y, Kou Z, Liu Y. 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. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 272:116060. [PMID: 38310825 DOI: 10.1016/j.ecoenv.2024.116060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/06/2024]
Abstract
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.
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Affiliation(s)
- Chao Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Dapeng Sun
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yan Li
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yiping Feng
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Rongguo Zhang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Yongxiao Zheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China
| | - Zengqiang Kou
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Yunxia Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250000, China; Climate Change and Health Center, Shandong University, Jinan, Shandong 250012, China.
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Bouzon Nagem Assad D, Gomes Ferreira da Costa P, Spiegel T, Cara J, Ortega-Mier M, Monteiro Scaff A. Comparing the current short-term cancer incidence prediction models in Brazil with state-of-the-art time-series models. Sci Rep 2024; 14:4566. [PMID: 38403643 PMCID: PMC10894878 DOI: 10.1038/s41598-024-55230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/21/2024] [Indexed: 02/27/2024] Open
Abstract
The World Health Organization has highlighted that cancer was the second-highest cause of death in 2019. This research aims to present the current forecasting techniques found in the literature, applied to predict time-series cancer incidence and then, compare these results with the current methodology adopted by the Instituto Nacional do Câncer (INCA) in Brazil. A set of univariate time-series approaches is proposed to aid decision-makers in monitoring and organizing cancer prevention and control actions. Additionally, this can guide oncological research towards more accurate estimates that align with the expected demand. Forecasting techniques were applied to real data from seven types of cancer in a Brazilian district. Each method was evaluated by comparing its fit with real data using the root mean square error, and we also assessed the quality of noise to identify biased models. Notably, three methods proposed in this research have never been applied to cancer prediction before. The data were collected from the INCA website, and the forecast methods were implemented using the R language. Conducting a literature review, it was possible to draw comparisons previous works worldwide to illustrate that cancer prediction is often focused on breast and lung cancers, typically utilizing a limited number of time-series models to find the best fit for each case. Additionally, in comparison to the current method applied in Brazil, it has been shown that employing more generalized forecast techniques can provide more reliable predictions. By evaluating the noise in the current method, this research shown that the existing prediction model is biased toward two of the studied cancers Comparing error results between the mentioned approaches and the current technique, it has been shown that the current method applied by INCA underperforms in six out of seven types of cancer tested. Moreover, this research identified that the current method can produce a biased prediction for two of the seven cancers evaluated. Therefore, it is suggested that the methods evaluated in this work should be integrated into the INCA cancer forecast methodology to provide reliable predictions for Brazilian healthcare professionals, decision-makers, and oncological researchers.
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Affiliation(s)
- Daniel Bouzon Nagem Assad
- Department of Industrial Engineering, Universidade do Estado do Rio de Janeiro, São Francisco Xavier, 524, Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil.
- Escuela Técnica Superior de Ingenieros Industriales, Universidad Politécnica De Madrid, Jose Gutierrez Abascal, 2, 28006, Madrid, Madrid, Spain.
| | - Patricia Gomes Ferreira da Costa
- Department of Industrial Engineering, Universidade do Estado do Rio de Janeiro, São Francisco Xavier, 524, Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil
| | - Thaís Spiegel
- Department of Industrial Engineering, Universidade do Estado do Rio de Janeiro, São Francisco Xavier, 524, Rio de Janeiro, Rio de Janeiro, 20550-900, Brazil
| | - Javier Cara
- Escuela Técnica Superior de Ingenieros Industriales, Universidad Politécnica De Madrid, Jose Gutierrez Abascal, 2, 28006, Madrid, Madrid, Spain
| | - Miguel Ortega-Mier
- Escuela Técnica Superior de Ingenieros Industriales, Universidad Politécnica De Madrid, Jose Gutierrez Abascal, 2, 28006, Madrid, Madrid, Spain
| | - Alfredo Monteiro Scaff
- Fundação Ary Frauzino para Pesquisa e Controle do Câncer, Inválidos, 212, Rio de Janeiro, Rio de Janeiro, 20231-048, Brazil
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Wang H, Huang S, Wang Z, Zhen H, Li Z, Fan W, Lu M, Han X, Du L, Zhao M, Yan Y, Zhang X, Zhen Q, Shui T. Association between meteorological factors and varicella incidence: a multicity study in Yunnan Province, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:117817-117828. [PMID: 37874521 DOI: 10.1007/s11356-023-30457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
This multicenter study aimed to investigate the relationship between varicella incidence and meteorological factors including mean temperature, relative humidity, sunshine duration, diurnal temperature difference, wind speed, and rainfall, as previous studies have produced varying results. Our study also sought to identify potential sources of heterogeneity. Data on reported daily varicella numbers and meteorological factors were collected for 14 cities in Yunnan Province from 2017 to 2021. A distribution-lagged nonlinear model was constructed to explore the relationship between meteorological conditions and varicella incidence in each included city. We then used multiple meta-regression to explore sources of heterogeneity using demographic economics indicators, air pollutants, and geographic location as potential modifiers. The cumulative hazard effect plot showed an inverted S-shape for the relationship between temperature and varicella, with the smallest RR (relative risk) (0.533, 95% CI: 0.401-0.708) at temperatures up to 27.2 °C. The maximum RR (1.171, 95% CI: 1.001-1.371) was obtained when the relative humidity was equal to 98.5%. The RR (1.164, 95% CI: 1.002-1.352) was greatest at a diurnal temperature range of 2 °C (1.164, 95% CI: 1.002-1.352) and least (0.913, 95% CI: 0.834-0.999) at a diurnal temperature range of 16.1 °C. The maximum RR (1.214, 95% CI: 1.089-1.354) was obtained at 0 h of sunshine, and the minimum RR (0.808, 95% CI: 0.675-0.968) was obtained at 12.4 h of sunshine. The RR (0.792, 95% CI: 0.633-0.992) was minimum at a wind velocity of 4.8 m/s. Residual heterogeneity ranged from 1 to 42.7%, with PM10 (particles with an aerodynamic diameter less than 10 μm), GDP (gross domestic product), and population density explaining some of this heterogeneity. The temperature has a dual effect on varicella incidence. Varicella cases are negatively correlated with diurnal temperature range, sunshine duration, and wind speed, and positively correlated with relative humidity. GDP and PM10 may have a significant role in altering the association between temperature and varicella, while PM10 and population density may alter the association between wind velocity and varicella.
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Affiliation(s)
- Hao Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, China
| | - Shanjun Huang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhaohan Wang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Hua Zhen
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Zhuo Li
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Wenqi Fan
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Menghan Lu
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xin Han
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Lanping Du
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Meifang Zhao
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Yuke Yan
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Xinyao Zhang
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China
- Department of Social Medicine and Health Care Management, School of Public Health, Jilin University, Changchun, China
| | - Qing Zhen
- Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, China.
- State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases, Key Laboratory for Zoonoses Research of the Ministry of Education, Changchun, China.
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
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Cai W, Luo C, Geng X, Zha Y, Zhang T, Zhang H, Yang C, Yin F, Ma Y, Shui T. 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. Front Public Health 2023; 11:1140639. [PMID: 37601186 PMCID: PMC10433208 DOI: 10.3389/fpubh.2023.1140639] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/26/2023] [Indexed: 08/22/2023] Open
Abstract
Background Several studies have examined the effects of city-level meteorological conditions on the associations between meteorological factors and hand, foot, and mouth disease (HFMD) risk. However, evidence that city-level meteorological conditions modify air pollutant-HFMD associations is lacking. Methods For each of the 17 cities in the Sichuan Basin, we obtained estimates of the relationship between exposures to multiple air pollutants and childhood HFMD risk by using a unified distributed lag nonlinear model (DLNM). Multivariate meta-regression models were used to identify the effects of city-level meteorological conditions as effect modifiers. Finally, we conducted subgroup analyses of age and sex to explore whether the modification effects varied in different subgroups. Results The associations between PM2.5/CO/O3 and HFMD risk showed moderate or substantial heterogeneity among cities (I 2 statistics: 48.5%, 53.1%, and 61.1%). Temperature conditions significantly modified the PM2.5-HFMD association, while relative humidity and rainfall modified the O3-HFMD association. Low temperatures enhanced the protective effect of PM2.5 exposure against HFMD risk [PM2.5 <32.7 μg/m3 or PM2.5 >100 μg/m3, at the 99th percentile: relative risk (RR) = 0.14, 95% CI: 0.03-0.60]. Low relative humidity increased the adverse effect of O3 exposure on HFMD risk (O3 >128.7 μg/m3, at the 99th percentile: RR = 2.58, 95% CI: 1.48-4.50). However, high rainfall decreased the risk of HFMD due to O3 exposure (O3: 14.1-41.4 μg/m3). In addition, the modification effects of temperature and relative humidity differed in the female and 3-5 years-old subgroups. Conclusion Our findings revealed moderate or substantial heterogeneity in multiple air pollutant-HFMD relationships. Temperature, relative humidity, and rainfall modified the relationships between PM2.5 or O3 exposure and HFMD risk.
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Affiliation(s)
- Wennian Cai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Caiying Luo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaoran Geng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuanyi Zha
- Graduate School of Kunming Medical University, Kunming, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Huadong Zhang
- Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Changhong Yang
- Sichuan Center for Disease Control and Prevention, Chengdu, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Tiejun Shui
- Yunnan Center for Disease Control and Prevention, Kunming, China
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9
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Zaw W, Lin Z, Ko Ko J, Rotejanaprasert C, Pantanilla N, Ebener S, Maude RJ. Dengue in Myanmar: Spatiotemporal epidemiology, association with climate and short-term prediction. PLoS Negl Trop Dis 2023; 17:e0011331. [PMID: 37276226 PMCID: PMC10270578 DOI: 10.1371/journal.pntd.0011331] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 06/15/2023] [Accepted: 04/24/2023] [Indexed: 06/07/2023] Open
Abstract
Dengue is a major public health problem in Myanmar. The country aims to reduce morbidity by 50% and mortality by 90% by 2025 based on 2015 data. To support efforts to reach these goals it is important to have a detailed picture of the epidemiology of dengue, its relationship to meteorological factors and ideally to predict ahead of time numbers of cases to plan resource allocations and control efforts. Health facility-level data on numbers of dengue cases from 2012 to 2017 were obtained from the Vector Borne Disease Control Unit, Department of Public Health, Myanmar. A detailed analysis of routine dengue and dengue hemorrhagic fever (DHF) incidence was conducted to examine the spatial and temporal epidemiology. Incidence was compared to climate data over the same period. Dengue was found to be widespread across the country with an increase in spatial extent over time. The temporal pattern of dengue cases and fatalities was episodic with annual outbreaks and no clear longitudinal trend. There were 127,912 reported cases and 632 deaths from 2012 and 2017 with peaks in 2013, 2015 and 2017. The case fatality rate was around 0.5% throughout. The peak season of dengue cases was from May to August in the wet season but in 2014 peak dengue season continued until November. The strength of correlation of dengue incidence with different climate factors (total rainfall, maximum, mean and minimum temperature and absolute humidity) varied between different States and Regions. Monthly incidence was forecasted 1 month ahead using the Auto Regressive Integrated Moving Average (ARIMA) method at country and subnational levels. With further development and validation, this may be a simple way to quickly generate short-term predictions at subnational scales with sufficient certainty to use for intervention planning.
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Affiliation(s)
- Win Zaw
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Zaw Lin
- Vector Borne Disease Control, Department of Public Health, Ministry of Health, Nay Pyi Taw, Myanmar
| | - July Ko Ko
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chawarat Rotejanaprasert
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Neriza Pantanilla
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Steeve Ebener
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Richard James Maude
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- The Open University, Milton Keynes, United Kingdom
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10
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Li C, Wang Z, Yan Y, Qu Y, Hou L, Li Y, Chu C, Woodward A, Schikowski T, Saldiva PHN, Liu Q, Zhao Q, Ma W. Association Between Hydrological Conditions and Dengue Fever Incidence in Coastal Southeastern China From 2013 to 2019. JAMA Netw Open 2023; 6:e2249440. [PMID: 36598784 PMCID: PMC9857674 DOI: 10.1001/jamanetworkopen.2022.49440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
IMPORTANCE Dengue fever is a climate-sensitive infectious disease. However, its association with local hydrological conditions and the role of city development remain unclear. OBJECTIVE To quantify the association between hydrological conditions and dengue fever incidence in China and to explore the modification role of city development in this association. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study collected data between January 1, 2013, and December 31, 2019, from 54 cities in 4 coastal provinces in southeast China. The Standardized Precipitation Evapotranspiration Index (SPEI) was calculated from ambient temperature and precipitation, with SPEI thresholds of 2 for extreme wet conditions and -2 for extreme dry conditions. The SPEI-dengue fever incidence association was examined over a 6-month lag, and the modification roles of 5 city development dimensions were assessed. Data were analyzed in May 2022. EXPOSURES City-level monthly temperature, precipitation, SPEI, and annual city development indicators from 2013 to 2019. MAIN OUTCOMES AND MEASURES The primary outcome was city-level monthly dengue fever incidence. Spatiotemporal bayesian hierarchal models were used to examine the SPEI-dengue fever incidence association over a 6-month lag period. An interaction term between SPEI and each city development indicator was added into the model to assess the modification role of city development. RESULTS Included in the analysis were 70 006 dengue fever cases reported in 54 cities in 4 provinces in China from 2013 to 2019. Overall, a U-shaped cumulative curve was observed, with wet and dry conditions both associated with increased dengue fever risk. The relative risk [RR] peaked at a 1-month lag for extreme wet conditions (1.27; 95% credible interval [CrI], 1.05-1.53) and at a 6-month lag for extreme dry conditions (1.63; 95% CrI, 1.29-2.05). The RRs of extreme wet and dry conditions were greater in areas with limited economic development, health care resources, and income per capita. Extreme dry conditions were higher and prolonged in areas with more green space per capita (RR, 1.84; 95% CrI, 1.37-2.46). Highly urbanized areas had a higher risk of dengue fever after extreme wet conditions (RR, 1.80; 95% CrI, 1.26-2.56), while less urbanized areas had the highest risk of dengue fever in extreme dry conditions (RR, 1.70; 95% CrI, 1.11-2.60). CONCLUSIONS AND RELEVANCE Results of this study showed that extreme hydrological conditions were associated with increased dengue fever incidence within a 6-month lag period, with different dimensions of city development playing various modification roles in this association. These findings may help in developing climate change adaptation strategies and public health interventions against dengue fever.
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Affiliation(s)
- Chuanxi Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
| | - Zhendong Wang
- Dezhou Center for Disease Control and Prevention, Dezhou, China
| | - Yu Yan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
| | - Yinan Qu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
| | - Liangyu Hou
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
| | - Yijie Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
| | - Cordia Chu
- Centre for Environment and Population Health, School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - Alistair Woodward
- Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tamara Schikowski
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | | | - Qiyong Liu
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong University Climate Change and Health Center, Shandong University, Jinan, China
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11
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Ismail A, Saahath A, Ismail Y, Ismail MF, Zubair Z, Subbaram K. 'Tomato flu' a new epidemic in India: Virology, epidemiology, and clinical features. New Microbes New Infect 2022; 51:101070. [PMID: 36582550 PMCID: PMC9792351 DOI: 10.1016/j.nmni.2022.101070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 12/14/2022] Open
Abstract
This article aims to highlight the current update on the 'tomato flu' outbreak in India. Recently there was an outbreak of a new illness in some parts of India. The disease was very contagious and it manifested with a rash mainly noticed in children younger than nine years. The rash was very painful and blisters were the size of small tomatoes, hence it was termed 'tomato flu'. A detailed literature review was performed on the virology, replication, epidemiology, and clinical features of this disease. The current outbreak was compared with similar other diseases of the past. The affected children exhibited severe rash in the palms, soles, oral cavity, and other body parts. They developed febrile illness with a sore throat, and myalgia followed by blisters on the tongue, gums, and cheeks. The affected children did not develop any complications leading to death. The therapy involved mainly symptomatic, supportive treatment with isolation and maintaining hygienic practices. The causative agent was identified to be Coxsackievirus A16, an RNA virus belonging to the family, Picornaviridae. We conclude that the recent Indian epidemic of this disease might be due to a new variant of Coxsackievirus A16 actually causing HFMD.
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Affiliation(s)
| | | | | | | | | | - Kannan Subbaram
- Corresponding author. School of Medicine, The Maldives National University, Male’, Maldives.
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