宁波市气温变率与儿童手足口病的关联性分析

The Association between Temperature Variability and the Incidence of Childhood Hand,Foot,and Mouth Disease(HFMD) in Ningbo City

目的分析外界气温波动和儿童手足口病之间的短期关联。方法收集宁波市2010-2015年0~12岁儿童手足口病报告数据和同期的地面气象监测资料,采用气温变率(temperature variability,TV)作为气温波动的替代指标,利用时间序列分析方法定量评估气温变率和手足口病之间的关联,以及不同年龄组和不同季节时效应的差异。结果2010-2015年宁波市共收集到0~12岁儿童手足口病报告病例138190例,其中93.17%的病例集中于5岁及以下儿童。研究发现,气温变率与手足口病之间存在统计学关联(P<0.05),并在累积滞后0~3天(TV0-3)时效应值最大。TV0-3每升高1℃,0~12岁儿童手足口病发病风险升高1.47%(95%CI:0.56~2.39%);3~5岁组和6~12岁组儿童手足口发病风险分别增加2.03%(95%CI:0.64~3.45%)和3.18%(95%CI:0.52~5.91%)。不同滞后天数时均未发现0~2岁组儿童受到气温变率的影响。冷季和温季时,气温变率的影响显著;而热季时则未见气温变率的效应存在。结论外界气温波动剧烈可能会增加儿童手足口病的发病风险,年龄和季节是该效应的修饰因子。

Objective To analyse the short-term association ambient temperature variation and the incidence of childhood hand,foot,and mouth disease(HFMD).Methods The data of childhood HFMD cases(aged 0~12 years)and weather variables were collected in Ningbo city during 2010 to 2015.We used temperature variability(TV)as the proxy indicators of ambient temperature variation.A time series study was conducted to estimate the relationship between TV and childhood HFMD,and the association stratified by age and season.Results From 2010 to 2015,a total of 138190 reported cases of HFMD under 12 years old were collected in Ningbo city,and 93.17%of them were under 5 years old.The results showed that the association between TV and childhood HFMD was statistically significant(P<0.05),and the highest effect estimates appeared at lag 0~3 days(TV0-3).A 1℃increase of TV0-3 was associated with 1.47%(95%C/:0.56〜2.39%)increase in childhood HFMD under 12 years old.The excess risks were 2.03%(95%CI:0.64~3.45%)and 3.18%(95%C/:0.52~5.91%)in children aged 3~5 and aged 6~12 years old,respectively.No statistically significant was found in childhood HFMD under 2 years old.We also found that the effects of TV were statistically significant in cold season and warm season,but no effect was found in heat season.Conclusion The study indicated that ambient temperature variation may increase the incidence of childhood HFMD,and the effects were modified by age and season.