2014—2018年天津市气温对儿童手足口病发病的短期效应研究

目的 分析气温对天津市2014—2018年≤15岁儿童手足口病发病的短期效应。方法 通过收集天津市≤15岁儿童逐日手足口病日发病数、气象及环境污染因素数据,使用时间序列的分布滞后非线性模型,在调整潜在的混杂因素的基础上进行模型筛选,以相对危险度（RR）作为估计气温对儿童手足口病发生影响的指标。结果 共纳入研究70 027例≤15岁手足口病儿童,男童41 561例,女童28 466例,性别比为1.46∶1。日平均气温与手足口发病在滞后16 d内的总体累积-反应关系曲线呈近似“m”形,在25.6 ℃达到峰值,RR为1.45（95％CI：1.21~1.73）。女童组在26.1 ℃（RR=1.60,95％CI：1.26~2.03）和散居组在25.9 ℃（RR=1.60,95％CI：1.28~1.99）的气温与手足口病发病的关联更大。滞后16 d时,≤15岁人群在极低温环境（-6.3 ℃）对手足口病发病有一定的保护效应（RR=0.49,95%CI：0.28~0.87）,在高温环境（24.7 ℃、31.8 ℃）对手足口发病均有一定的危险效应（均RR>1,P<0.05）。结论 日平均气温与儿童手足口病呈非线性关系,应重点关注女童及散居儿童。

Short-term effect of air temperature on the incidence of hand-foot-mouth disease in children in Tianjin,2014-2018

Objective To analyze the short-term effect of air temperature on the incidence of hand-foot-mouth disease （HFMD） in children in Tianjin from 2014 to 2018. Methods By collecting the data of daily incidence of HFMD, meteorological and environmental pollution factors, and using the distribution lag nonlinear model of time series, the model was screened on the basis of adjusting the potential confounding factors, and the relative risk （RR） was used as the index to estimate the impact of temperature on the incidence of HFMD in children. Results There were 70 027 children aged 0-15 years old with HFMD, including 41 561 boys and 28 466 girls. The sex ratio was 1.46：1. The overall cumulative response curve between daily mean temperature and incidence of HFMD within 16 days of lag time showed an approximate “m” shape, reaching a peak at 25.6 ℃, with RR=1.45 （95% CI： 1.21-1.73）. The temperature at 26.1 ℃ （RR=1.60, 95% CI： 1.26-2.03） in the girl group and 25.9 ℃ （RR=1.60, 95% CI： 1.28-1.99） in the scattered group were more associated with HFMD. When the lag time was 16 days, extreme low temperature environment（-6.3 ℃） had a certain protective effect on HFMD （RR=0.49, 95% CI： 0.28-0.87）, and high temperature environment （24.7 ℃, 31.8 ℃） had a certain risk effect on HFMD （all RR>1, P<0.05）. Conclusion The correlation between daily mean temperature and HFMD is non-linear, and the attention should be paid to girls and scattered children.