Long-term effects of weather condition and air pollution on acute hemorrhagic conjunctivitis in China: A nationalwide surveillance study in China

Li Zhang; Hui Jiang; Kehan Wang; Yuan Yuan; Qiuli Fu; Xiuming Jin; Na Zhao; Xiaodan Huang; Supen Wang; Tao Zhang; Ke Yao; Ta-Chien Chan; Wangli Xu; Shelan Liu

doi:10.1016/j.envres.2021.111616

Long-term effects of weather condition and air pollution on acute hemorrhagic conjunctivitis in China: A nationalwide surveillance study in China

Environ Res. 2021 Oct:201:111616. doi: 10.1016/j.envres.2021.111616. Epub 2021 Jul 4.

Authors

Li Zhang¹, Hui Jiang², Kehan Wang³, Yuan Yuan⁴, Qiuli Fu¹, Xiuming Jin¹, Na Zhao⁵, Xiaodan Huang¹, Supen Wang⁶, Tao Zhang⁷, Ke Yao⁸, Ta-Chien Chan⁹, Wangli Xu¹⁰, Shelan Liu¹¹

Affiliations

¹ Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China.
² Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China; Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, 101149, China.
³ Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China.
⁴ Department of Geriatrics, Beijing Jishuitan Hospital, Beijing, 100035, China.
⁵ Collaborative Innovation Center of Recovery and Reconstruction of Degraded Ecosystem in Wanjiang Basin Co-founded by Anhui Province and Ministry of Education, School of Ecology and Environment, Anhui Normal University, Wuhu, Anhui Province, 241002, China.
⁶ Anhui Provincial Key Laboratory of the Conservation and Exploitation of Biological Resources, College of Life Sciences, Anhui Normal University, Wuhu, Anhui Province, 241000, China.
⁷ Nanjing Jiliang Information Technology Co., Ltd, Nanjing, Jiangsu Provice, 210002, China.
⁸ Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310009, China. Electronic address: xlren@zju.edu.cn.
⁹ Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, 115, Taiwan. Electronic address: dachianpig@gmail.com.
¹⁰ Center for Applied Statistics, School of Statistics, Renmin University of China, Beijing, 100872, China. Electronic address: wlxu@ruc.edu.cn.
¹¹ Department of Infectious Diseases, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, 310051, China. Electronic address: liushelan@126.com.

PMID: 34233156
DOI: 10.1016/j.envres.2021.111616

Abstract

Background: Global climate change could have potential impact on enterovirus (EV)-induced infectious diseases. However, the environmental factors promoting acute hemorrhagic conjunctivitis (AHC) circulation remain inconclusive. This study aimed to quantify the relationship between the environment and AHC.

Methods: We retrieved the monthly counts and incidence of AHC, meteorological variables and air quality in mainland China between 2013 and 2018. Exposure risks were evaluated by multivariate distributed lag nonlinear models.

Results: A total of 219,599 AHC cases were reported in 31 provinces of China, predominantly in southern and central China, seasonally increased in summer. AHC incidence increased by 7% between 2013 and 2018, from 2.6873 to 2.7570 per 100,000 people. A moderate positive correlation was seen between AHC and monthly mean temperature, relative humidity (RH) and precipitation. Each unit increment was associated with a relative risk for AHC of 1.058 at 17°-32 °C at lag 0 months, 1.017 at 65-71% RH at lag 1.4 months, and 1.039 at 400-569 mm at lag 2.4 months. By contrast, a negative correlation was seen between monthly ambient NO₂ and AHC.

Conclusion: Long-term exposure to higher mean temperature, RH and precipitation were associated with an increased risk of AHC. The general public, especially susceptible populations, should pay close attention to weather changes and take protective measures in advance to any AHC outbreak as the above situations occur.

Keywords: Acute hemorrhagic conjunctivitis; Air pollution; Environment factors; Exposure-response relationship; Human enteroviruses; Weather condition.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollution* / adverse effects
China / epidemiology
Conjunctivitis, Acute Hemorrhagic* / epidemiology
Humans
Meteorology
Weather

Associated data

figshare/10.6084/m9.figshare.13566803.v3