Air pollution’s numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from China

Abstract Background While stationary links between childhood hand, foot and mouth disease (HFMD) and air pollution are known, a comprehensive study on their heterogeneous relationships (nonstationarity), jointly considering numerical, temporal and spatial dimensions, has not been reported. Methods M...

Full description

Saved in:
Bibliographic Details
Main Authors: Zhangying Tang, Qi Sun, Jay Pan, Mingyu Xie, Zhoufeng Wang, Xiaojun Lin, Xiuli Wang, Yumeng Zhang, Qingping Xue, Yanchen Bo, Jinfeng Wang, Xin Liu, Chao Song
Format: Article
Language:English
Published: BMC 2024-10-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-024-20342-x
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850181564057518080
author Zhangying Tang
Qi Sun
Jay Pan
Mingyu Xie
Zhoufeng Wang
Xiaojun Lin
Xiuli Wang
Yumeng Zhang
Qingping Xue
Yanchen Bo
Jinfeng Wang
Xin Liu
Chao Song
author_facet Zhangying Tang
Qi Sun
Jay Pan
Mingyu Xie
Zhoufeng Wang
Xiaojun Lin
Xiuli Wang
Yumeng Zhang
Qingping Xue
Yanchen Bo
Jinfeng Wang
Xin Liu
Chao Song
author_sort Zhangying Tang
collection DOAJ
description Abstract Background While stationary links between childhood hand, foot and mouth disease (HFMD) and air pollution are known, a comprehensive study on their heterogeneous relationships (nonstationarity), jointly considering numerical, temporal and spatial dimensions, has not been reported. Methods Monthly HFMD incidence and air pollution data were collected at the county level from Sichuan-Chongqing, China (2009–2011), alongside meteorological and social environmental covariates. Key influential factors were identified using random forest (RF) under the stationary assumption. Factors’ numerically, temporally, and spatially heterogeneous relationships with HFMD were assessed using generalized additive model (GAM) and geographically and temporally weighted regression (GTWR). Results Our findings highlighted the relatively higher stationary contributions of fine particulate matter (PM2.5) and ozone (O3) to HFMD incidence across Sichuan-Chongqing counties. We further uncovered heterogeneous impacts of PM2.5 and O3 from three nonstationary perspectives. Numerically, PM2.5 showed an inverse ‘V’-shaped relationship with HFMD incidence, while O3 exhibited a complex pattern, with increased HFMD incidence at low PM2.5 and moderate O3 concentrations. Temporally, PM2.5’s impact peaked in autumn and was weakest in spring, whereas O3’s effect was strongest in summer. Spatially, hotspot mapping revealed high-risk clusters for PM2.5 impact across all seasons, with notable geographical variations, and for O3 in spring, summer, and autumn, concentrated in specific regions of Sichuan-Chongqing. Conclusions This study underscores the nuanced and three-perspective heterogeneous influences of air pollution on HFMD in small areas, emphasizing the need for differentiated, localized, and time-sensitive prevention and control strategies to enhance the precision of dynamic early warnings and predictive models for HFMD and other infectious diseases, particularly in the fields of environmental and spatial epidemiology.
format Article
id doaj-art-6496c17316e24cb3bea11a60d9bf68dc
institution OA Journals
issn 1471-2458
language English
publishDate 2024-10-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj-art-6496c17316e24cb3bea11a60d9bf68dc2025-08-20T02:17:52ZengBMCBMC Public Health1471-24582024-10-0124111210.1186/s12889-024-20342-xAir pollution’s numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from ChinaZhangying Tang0Qi Sun1Jay Pan2Mingyu Xie3Zhoufeng Wang4Xiaojun Lin5Xiuli Wang6Yumeng Zhang7Qingping Xue8Yanchen Bo9Jinfeng Wang10Xin Liu11Chao Song12State Key Laboratory of Oil and Gas Reservoir Geology and Exploitation, School of Geoscience and Technology, Southwest Petroleum UniversityState Key Laboratory of Oil and Gas Reservoir Geology and Exploitation, School of Geoscience and Technology, Southwest Petroleum UniversityWest China Health & Medical Geography Group within HEOA Think Tank, West China School of Public Health and West China Fourth Hospital, Sichuan UniversitySchool of Public Health, Xi’an Jiaotong UniversityState Key Laboratory of Oil and Gas Reservoir Geology and Exploitation, School of Geoscience and Technology, Southwest Petroleum UniversityWest China Health & Medical Geography Group within HEOA Think Tank, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China Health & Medical Geography Group within HEOA Think Tank, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityWest China Health & Medical Geography Group within HEOA Think Tank, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityDepartment of Epidemiology and Biostatistics, School of Public Health, Chengdu Medical CollegeState Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal UniversityState Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of SciencesState Key Laboratory of Oil and Gas Reservoir Geology and Exploitation, School of Geoscience and Technology, Southwest Petroleum UniversityWest China Health & Medical Geography Group within HEOA Think Tank, West China School of Public Health and West China Fourth Hospital, Sichuan UniversityAbstract Background While stationary links between childhood hand, foot and mouth disease (HFMD) and air pollution are known, a comprehensive study on their heterogeneous relationships (nonstationarity), jointly considering numerical, temporal and spatial dimensions, has not been reported. Methods Monthly HFMD incidence and air pollution data were collected at the county level from Sichuan-Chongqing, China (2009–2011), alongside meteorological and social environmental covariates. Key influential factors were identified using random forest (RF) under the stationary assumption. Factors’ numerically, temporally, and spatially heterogeneous relationships with HFMD were assessed using generalized additive model (GAM) and geographically and temporally weighted regression (GTWR). Results Our findings highlighted the relatively higher stationary contributions of fine particulate matter (PM2.5) and ozone (O3) to HFMD incidence across Sichuan-Chongqing counties. We further uncovered heterogeneous impacts of PM2.5 and O3 from three nonstationary perspectives. Numerically, PM2.5 showed an inverse ‘V’-shaped relationship with HFMD incidence, while O3 exhibited a complex pattern, with increased HFMD incidence at low PM2.5 and moderate O3 concentrations. Temporally, PM2.5’s impact peaked in autumn and was weakest in spring, whereas O3’s effect was strongest in summer. Spatially, hotspot mapping revealed high-risk clusters for PM2.5 impact across all seasons, with notable geographical variations, and for O3 in spring, summer, and autumn, concentrated in specific regions of Sichuan-Chongqing. Conclusions This study underscores the nuanced and three-perspective heterogeneous influences of air pollution on HFMD in small areas, emphasizing the need for differentiated, localized, and time-sensitive prevention and control strategies to enhance the precision of dynamic early warnings and predictive models for HFMD and other infectious diseases, particularly in the fields of environmental and spatial epidemiology.https://doi.org/10.1186/s12889-024-20342-xHFMDHeterogeneous impactsSpatiotemporal nonstationarityNumerical nonlinearitySmall areaChina
spellingShingle Zhangying Tang
Qi Sun
Jay Pan
Mingyu Xie
Zhoufeng Wang
Xiaojun Lin
Xiuli Wang
Yumeng Zhang
Qingping Xue
Yanchen Bo
Jinfeng Wang
Xin Liu
Chao Song
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
HFMD
Heterogeneous impacts
Spatiotemporal nonstationarity
Numerical nonlinearity
Small area
China
title Air pollution’s numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from China
title_full Air pollution’s numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from China
title_fullStr Air pollution’s numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from China
title_full_unstemmed Air pollution’s numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from China
title_short Air pollution’s numerical, spatial, and temporal heterogeneous impacts on childhood hand, foot and mouth disease: a multi-model county-level study from China
title_sort air pollution s numerical spatial and temporal heterogeneous impacts on childhood hand foot and mouth disease a multi model county level study from china
topic HFMD
Heterogeneous impacts
Spatiotemporal nonstationarity
Numerical nonlinearity
Small area
China
url https://doi.org/10.1186/s12889-024-20342-x
work_keys_str_mv AT zhangyingtang airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT qisun airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT jaypan airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT mingyuxie airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT zhoufengwang airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT xiaojunlin airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT xiuliwang airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT yumengzhang airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT qingpingxue airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT yanchenbo airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT jinfengwang airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT xinliu airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina
AT chaosong airpollutionsnumericalspatialandtemporalheterogeneousimpactsonchildhoodhandfootandmouthdiseaseamultimodelcountylevelstudyfromchina