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Exposure to air pollution and scarlet fever resurgence in China: a six-year surveillance study.
- Source :
-
Nature communications [Nat Commun] 2020 Aug 25; Vol. 11 (1), pp. 4229. Date of Electronic Publication: 2020 Aug 25. - Publication Year :
- 2020
-
Abstract
- Scarlet fever has resurged in China starting in 2011, and the environment is one of the potential reasons. Nationwide data on 655,039 scarlet fever cases and six air pollutants were retrieved. Exposure risks were evaluated by multivariate distributed lag nonlinear models and a meta-regression model. We show that the average incidence in 2011-2018 was twice that in 2004-2010 [RR = 2.30 (4.40 vs. 1.91), 95% CI: 2.29-2.31; p < 0.001] and generally lower in the summer and winter holiday (p = 0.005). A low to moderate correlation was seen between scarlet fever and monthly NO <subscript>2</subscript> (r = 0.21) and O <subscript>3</subscript> (r = 0.11). A 10 μg/m <superscript>3</superscript> increase of NO <subscript>2</subscript> and O <subscript>3</subscript> was significantly associated with scarlet fever, with a cumulative RR of 1.06 (95% CI: 1.02-1.10) and 1.04 (95% CI: 1.01-1.07), respectively, at a lag of 0 to 15 months. In conclusion, long-term exposure to ambient NO <subscript>2</subscript> and O <subscript>3</subscript> may be associated with an increased risk of scarlet fever incidence, but direct causality is not established.
- Subjects :
- Air Pollution adverse effects
China epidemiology
Environmental Exposure adverse effects
Geography
Humans
Incidence
Nitrogen Dioxide analysis
Nonlinear Dynamics
Ozone analysis
Particulate Matter analysis
Risk Factors
Scarlet Fever epidemiology
Scarlet Fever etiology
Seasons
Spatio-Temporal Analysis
Air Pollutants analysis
Air Pollution analysis
Environmental Exposure analysis
Scarlet Fever diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 2041-1723
- Volume :
- 11
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Nature communications
- Publication Type :
- Academic Journal
- Accession number :
- 32843631
- Full Text :
- https://doi.org/10.1038/s41467-020-17987-8