气象因素和PM_2.5及其交互作用对山东省流行性腮腺炎的影响

Impact of meteorological factors and PM_2.5 and their interaction on mumps in Shandong Province

摘要

目的 探究气象因素和PM_2.5对山东省0~14岁人群中流行性腮腺炎(简称“流腮”)发病的影响,并分析其交互作用,为制定有效的预防控制策略提供科学依据。 方法 描述2015—2022年山东省流腮病例的流行病学特征,使用分布滞后非线性模型分析气象因素和PM_2.5对流腮发病的非线性效应和滞后关系,计算相对超额危险度(relative excess risk due to interaction, RERI)和交互作用归因比(attributable proportion due to interaction, AP),以定量评估气象因素与PM_2.5之间的交互作用。 结果 2015—2022年期间,山东省0~14岁人群累计报告流腮38 330例,占总人群的82.89%,2015—2019年平均发病率为36.28/10万,高于2020—2022年平均发病率(19.27/10万);男女性别比为1.91∶1,学生和幼托儿童为主要感染对象。温度与流腮发病的总体效应呈“S”形,26 ℃时发病风险最大,RR值为1.38(95%CI:1.20~1.60);降水量的最大影响出现在累积降水量为3 mm且累积滞后4周时,RR值为1.31(95%CI:1.12~1.52);风速在3.9 m/s时对流腮发病的影响最高,RR值为1.41(95%CI:1.15~1.73);PM_2.5对流腮的发病风险随质量浓度的增加而增加。温度与PM_2.5、相对湿度与PM_2.5对流腮发病有协同作用,RERI分别为0.28(95%CI:0.22~0.34)、0.19(95%CI:0.14~0.24),AP分别为0.27(95%CI:0.21~0.33)、0.20(95%CI:0.15~0.25);风速和PM_2.5、气压和PM_2.5对流腮发病表现为拮抗作用,RERI分别为-0.13(95%CI: -0.19~-0.07)、-0.12(95%CI: -0.19~-0.06),AP分别为-0.14(95%CI: -0.20~-0.08)、-0.16(95%CI: -0.24~-0.07)。 结论 高温、低降水、高风速和高质量浓度的PM_2.5均是流腮发病的危险因素,温度与PM_2.5、相对湿度与PM_2.5之间存在协同作用,提示卫生部门应考虑气象条件和PM_2.5浓度在学校开展流腮的防控工作,学校和幼儿园在日常预防中应加强对儿童个人卫生的教育及监督。

Abstract

Objective To investigate the effects of meteorological factors and PM_2.5 on mumps incidence among children aged 0-14 years in Shandong Province, and analyze their interaction effects to provide evidence for prevention stra-tegies. Methods Described the epidemiological characteristics of mumps cases in Shandong Province from 2015 to 2022 and analyzed the nonlinear effects and lag relationships between meteorological factors and PM_2.5with mumps incidence using distributed lag nonlinear models. Relative excess risk due to interaction(RERI)and attributable proportion due to interaction(AP)were calculated to quantitatively evaluate interactions between meteorological factors and PM_2.5. Results A total of 38,330 mumps cases among children aged 0-14 years were reported in Shandong Province between 2015 and 2022,accounting for 82.89% of the total population. The average annual incidence during 2015-2019 was 36.28 per 100,000, higher than that of 2020-2022(19.27 per 100,000). The male-to-female ratio was 1.91:1,with students and children in preschools identified as the primary affected populations.Temperature exhibited an S-shaped overall effect on mumps incidence, with the maximum risk occurring at 26 ℃(RR=1.38; 95%CI: 1.20-1.60). Precipitation reached its peak effect at 3 mm with a cumulative lag of 4 weeks(RR=1.31; 95%CI: 1.12-1.52). Wind speed showed its highest impact on incidence at 3.9 m/s(RR=1.41; 95%CI: 1.15-1.73). PM_2.5mass concentration demonstrated a dose-dependent relationship with increased mumps risk.Synergistic interactions were observed both between temperature and PM_2.5 and between relative humidity and PM_2.5 for mumps incidence, with corresponding RERI values of 0.28(95%CI: 0.22-0.34)and 0.19(95%CI: 0.14-0.24), and AP values of 0.27(95%CI: 0.21-0.33)and 0.20(95%CI: 0.15-0.25); conversely, antagonistic effects were identified for wind speed and PM_2.5 along with atmospheric pressure and PM_2.5, reflected in RERI values of -0.13(95%CI: -0.19 - 0.07)and -0.12(95%CI: -0.19 - 0.06), and AP values of -0.14(95%CI: -0.20 - 0.08)and -0.16(95%CI: -0.24 - 0.07). Conclusions High temperatures, low precipitation, high wind speeds, and elevated PM_2.5mass concentrations constitute risk factors for mumps incidence. Synergistic interactions exist between temperature and PM_2.5 as well as relative humidity and PM_2.5. These findings indicate that health authorities should incorporate meteorological conditions and PM_2.5 levels when implementing preventive measures against mumps in schools. Simultaneously, educational institutions and kindergartens should reinforce hygiene education and strengthen supervision of children's personal hygiene practices in daily prevention efforts.

关键词

流行性腮腺炎 / 分布滞后非线性模型 / 气象因素 / PM_2.5 / 交互作用

Key words

Mumps / Distributed lag nonlinear model / Meteorological factors / PM_2.5 / Interaction

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基金资助

国家重点研发计划(2023YFC2604401)

国家自然科学基金(81673238)

山东省医药卫生科技青年项目(202412011070)