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Exposure–response relationship between temperature, relative humidity, and varicella: a multicity study in South China

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Abstract

Varicella is a rising public health issue. Several studies have tried to quantify the relationships between meteorological factors and varicella incidence but with inconsistent results. We aim to investigate the impact of temperature and relative humidity on varicella, and to further explore the effect modification of these relationships. In this study, the data of varicella and meteorological factors from 2011 to 2019 in 21 cities of Guangdong Province, China were collected. Distributed lag nonlinear models (DLNM) were constructed to explore the relationship between meteorological factors (temperature and relative humidity) and varicella in each city, controlling in school terms, holidays, seasonality, long-term trends, and day of week. Multivariate meta-analysis was applied to pool the city-specific estimations. And the meta-regression was used to explore the effect modification for the spatial heterogeneity of city-specific meteorological factors and social factors (such as disposable income per capita, vaccination coverage, and so on) on varicella. The results indicated that the relationship between temperature and varicella in 21 cities appeared nonlinear with an inverted S-shaped. The relative risk peaked at 20.8 ℃ (RR = 1.42, 95% CI: 1.22, 1.65). The relative humidity-varicella relationship was approximately L-shaped, with a peaking risk at 69.5% relative humidity (RR = 1.25, 95% CI: 1.04, 1.50). The spatial heterogeneity of temperature-varicella relationships may be caused by income or varicella vaccination coverage. And varicella vaccination coverage may contribute to the spatial heterogeneity of the relative humidity-varicella relationship. The findings can help us deepen the understanding of the meteorological factors-varicella association and provide evidence for develo** prevention strategy for varicella epidemic.

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Data availability

The data of daily meteorological variables from 2011 to 2019 can be accessed from the China Meteorological Data Sharing Service System (http://www.cma.gov.cn/), and city-specific socio-economic characteristics for 21 cities in Guangdong can be accessed from the official website of Guangdong Provincial Bureau of Statistics (http://stats.gd.gov.cn/gdtjnj/). The data of detailed surveillance generated during and/or analyzed during the current study are not publicly available due to the data management requirements but are available from the corresponding author on reasonable request.

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Acknowledgements

We are grateful for all people who diagnosed and submitted the varicella cases to the National Notifiable Infectious Disease Surveillance System. We thank the staffs at the hospitals, local health departments, and county-, district-, and prefecture-level Centers for Disease Control and Prevention for their valuable assistance in data collection.

Funding

This work was primarily supported by the National Key Research and Development Program of China (2018YFA0606200), Guangdong Medical Science and Technology Research Foundation (B2020105), the Key-Area Research and Development Program of Guangdong Province (2019B111103001), and the Science and Technology Program of Guangzhou (202102080554).

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Author notes

  1. Yihan Li and Jialing Li contributed equally to this work.

Authors and Affiliations

  1. School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Yihan Li, Yi Quan, Li Zhang, Yan Zhou, Qing Chen & Jianpeng **ao

  2. Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China

    Yihan Li, Zhihua Zhu, Weilin Zeng, Zuhua Rong, Jianxiong Hu, **ng Li, Guanhao He, Jianguo Zhao, Lihua Yin, Yi Quan, Qian Zhang, Manman Li, Li Zhang, Yan Zhou, Siqing Zeng & Jianpeng **ao

  3. Institute of Immunization Program, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, Guangdong, China

    Jialing Li, Qi Zhu & Limei Sun

  4. Department of Public Health and Preventive Medicine, School of Medicine, **an University, Guangzhou, 510632, Guangdong, China

    Tao Liu & Wenjun Ma

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  1. Yihan Li
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Contributions

All authors contributed to the study conception and design. Conceived and designed the experiments: Limei Sun, Jianpeng **ao. Analyzed the data: Yihan Li, Jianpeng **ao. Contributed reagents/materials/analysis tools: Yihan Li, Jialing Li, Zhihua Zhu, Weilin Zeng, Qi Zhu, Zuhua Rong, Jianxiong Hu, **ng Li, Guanhao He, Jianguo Zhao, Lihua Yin, Yi Quan, Qian Zhang, Manman Li, Li Zhang, Yan Zhou, Tao Liu, Wenjun Ma, Siqing Zeng, Qing Chen, Limei Sun, Jianpeng **ao. Wrote the paper: Yihan Li, Jianpeng **ao, Weilin Zeng. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jianpeng **ao.

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Ethical approval

The study was approved by the ethics committee of Guangdong Provincial Center for Disease Control and Prevention (No. W96-027E-201925).

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The authors declare no competing interests.

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Li, Y., Li, J., Zhu, Z. et al. Exposure–response relationship between temperature, relative humidity, and varicella: a multicity study in South China. Environ Sci Pollut Res 30, 7594–7604 (2023). https://doi.org/10.1007/s11356-022-22711-8

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