Exposure to air pollution and scarlet fever resurgence in China: a six-year surveillance study.
Where this comes from
- Record sourced from PubMed, PMID 32843631.
- Also identified by DOI 10.1038/s41467-020-17987-8 and PMC identifier 7447791.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
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<sub>2</sub> (r = 0.21) and O<sub>3</sub> (r = 0.11). A 10 μg/m<sup>3</sup> increase of NO<sub>2</sub> and O<sub>3</sub> 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<sub>2</sub> and O<sub>3</sub> may be associated with an increased risk of scarlet fever incidence, but direct causality is not established.
Medical subject headings
- Air Pollutants
- Air Pollution
- Environmental Exposure
- Scarlet Fever