{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:21:31Z","timestamp":1784650891890,"version":"3.55.0"},"reference-count":33,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Foundation of Anhui Educational Committee","award":["KJ2020A0223"],"award-info":[{"award-number":["KJ2020A0223"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study sought to investigate the relationship between meteorological factors and outpatient visits for herpes zoster. In this time-series analysis, we used data from two major hospitals in Hefei, collected between 2015 and 2019, to evaluate the impact of meteorological factors on the risk of herpes zoster. After controlling for confounders, we adopted a distributed lag nonlinear model to probe the relationship between meteorological factors and outpatient visits for herpes zoster. The analysis was stratified according to age (&lt;40 years, \u226540 years) and sex (male, female). A total of 43,547 cases of herpes zoster were reported, and compared with the median value, a high temperature and high relative humidity had a significant risk effect on the incidence of herpes zoster. The maximum harmful effect of high temperature on herpes zoster occurred on the lag0 (RR: 1.027, 95% CI: 1.002\u20131.053) and further declined over the following days. The cumulative effect increased with the extension of lag days, and the cumulative RR was the largest on the sixth day of lag (RR1.031, 95% CI: 1.006\u20131.056) when the relative humidity was 85.7% (77.0% as the reference). The stratified analysis results reveal that females and the elderly (\u226540 years) were more susceptible to temperature and relative humidity. This study shows that high-temperatures may lead to herpes zoster, indicating that those infected with varicella zoster virus need to take measures over the course of several days when not exposed to the best appropriate temperature conditions.<\/jats:p>","DOI":"10.3390\/ijerph20032097","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T01:29:45Z","timestamp":1674523785000},"page":"2097","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association between Meteorological Factors and Outpatient Visits for Herpes Zoster in Hefei, China: A Time-Series Analysis"],"prefix":"10.3390","volume":"20","author":[{"given":"Xiaojie","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyu","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan 523000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinguang","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongqing","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China"},{"name":"Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei 230032, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"ITC19","DOI":"10.7326\/L18-0558","article-title":"Herpes Zoster","volume":"169","author":"Schmader","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e15037","DOI":"10.1097\/MD.0000000000015037","article-title":"Segmental Zoster Abdominal Paresis Mimicking an Abdominal Hernia","volume":"98","author":"Yu","year":"2019","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1016\/j.jpain.2005.01.359","article-title":"Pain, Medication Use, and Health-Related Quality of Life in Older Persons with Postherpetic Neuralgia: Results from a Population-Based Survey","volume":"6","author":"Oster","year":"2005","journal-title":"J. Pain"},{"key":"ref_4","first-page":"730","article-title":"The study on the relationship between herpes zoster and depression on Health Big Data-real word research examples","volume":"25","author":"Ding","year":"2021","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e004833","DOI":"10.1136\/bmjopen-2014-004833","article-title":"Systematic Review of Incidence and Complications of Herpes Zoster: Towards a Global Perspective","volume":"4","author":"Kawai","year":"2014","journal-title":"BMJ Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/cid\/ciw296","article-title":"Increasing Incidence of Herpes Zoster Over a 60-Year Period from a Population-Based Study","volume":"63","author":"Kawai","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Marra, F., Chong, M., and Najafzadeh, M. (2016). Increasing Incidence Associated with Herpes Zoster Infection in British Columbia, Canada. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1898-z"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/S0140-6736(21)01787-6","article-title":"The 2021 Report of the Lancet Countdown on Health and Climate Change: Code Red for a Healthy Future","volume":"398","author":"Romanello","year":"2021","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"k4306","DOI":"10.1136\/bmj.k4306","article-title":"Association between Ambient Temperature and Mortality Risk and Burden: Time Series Study in 272 Main Chinese Cities","volume":"363","author":"Chen","year":"2018","journal-title":"BMJ"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3376","DOI":"10.1038\/s41467-019-11283-w","article-title":"Tens of Thousands Additional Deaths Annually in Cities of China between 1.5 \u00b0C and 2.0 \u00b0C Warming","volume":"10","author":"Wang","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_11","first-page":"1117","article-title":"Promoting research on air pollution, climate change and population health under the goal of carbon neutrality and at the peak carbon dioxide emissions","volume":"25","author":"Shi","year":"2021","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref_12","first-page":"879","article-title":"Research advance on the role of meteorolgical factors in inflammatory immune diseases","volume":"25","author":"Chen","year":"2021","journal-title":"Chin. J. Dis. Control Prev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1002\/jmv.21599","article-title":"Epidemiology of Herpes Zoster and Its Relationship to Varicella in Japan: A 10-Year Survey of 48,388 Herpes Zoster Cases in Miyazaki Prefecture","volume":"81","author":"Toyama","year":"2009","journal-title":"J. Med. Virol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Korostil, I.A., and Regan, D.G. (2016). Varicella-Zoster Virus in Perth, Western Australia: Seasonality and Reactivation. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0151319"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1097\/CM9.0000000000001290","article-title":"Effects of Meteorological Factors on Daily Outpatient Visits for Skin Diseases: A Time Series Study in a Chinese Population","volume":"134","author":"Zhang","year":"2021","journal-title":"Chin. Med. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.jaad.2015.07.015","article-title":"The Effects of Ambient Temperature on Outpatient Visits for Varicella and Herpes Zoster in Shanghai, China: A Time-Series Study","volume":"73","author":"Yang","year":"2015","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"12254","DOI":"10.1038\/s41598-019-48673-5","article-title":"Elevation of Ambient Temperature Is Associated with an Increased Risk of Herpes Zoster: A Time-Series Analysis","volume":"9","author":"Choi","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e13854","DOI":"10.1111\/ijcp.13854","article-title":"The Impacts of Ambient Temperature and Ultraviolet Radiation on the Incidence of Herpes Zoster: An Ecological Study in Taiwan","volume":"75","author":"Lai","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1002\/sim.3940","article-title":"Distributed Lag Non-Linear Models","volume":"29","author":"Gasparrini","year":"2010","journal-title":"Stat. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"104306","DOI":"10.1016\/j.jcv.2020.104306","article-title":"Seasonality of Herpes Zoster and Herpes Zoster Ophthalmicus","volume":"126","author":"Berlinberg","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3344\/kjp.2015.28.3.193","article-title":"Epidemiological Study on the Incidence of Herpes Zoster in Nearby Cheonan","volume":"28","author":"Jung","year":"2015","journal-title":"Korean J. Pain"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1006\/smim.2001.0293","article-title":"Immune Evasion as a Pathogenic Mechanism of Varicella Zoster Virus","volume":"13","author":"Abendroth","year":"2001","journal-title":"Semin. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"15016","DOI":"10.1038\/nrdp.2015.16","article-title":"Varicella Zoster Virus Infection","volume":"1","author":"Gershon","year":"2015","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3971","DOI":"10.1128\/JVI.02592-07","article-title":"Mechanisms of Varicella-Zoster Virus Neuropathogenesis in Human Dorsal Root Ganglia","volume":"82","author":"Reichelt","year":"2008","journal-title":"J. Virol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7000","DOI":"10.1038\/ncomms8000","article-title":"Widespread Seasonal Gene Expression Reveals Annual Differences in Human Immunity and Physiology","volume":"6","author":"Dopico","year":"2015","journal-title":"Nat. Commun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"S149","DOI":"10.1016\/j.jaad.2007.04.035","article-title":"Broad-Spectrum Sunscreens Provide Better Protection from Solar Ultraviolet-Simulated Radiation and Natural Sunlight-Induced Immunosuppression in Human Beings","volume":"58","author":"Moyal","year":"2008","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.jaad.2007.06.027","article-title":"Human Herpes Simplex Virus Infections: Epidemiology, Pathogenesis, Symptomatology, Diagnosis, and Management","volume":"57","author":"Fatahzadeh","year":"2007","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1001\/archderm.1964.01590300086023","article-title":"Influence of Temperature on Ultraviolet Injury","volume":"89","author":"Freeman","year":"1964","journal-title":"Arch. Dermatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"434","DOI":"10.3389\/fimmu.2014.00434","article-title":"The Role of Environmental Factors in Modulating Immune Responses in Early Life","volume":"5","author":"MacGillivray","year":"2014","journal-title":"Front. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1046\/j.1523-1747.1998.00333.x","article-title":"Exposure to a Dry Environment Enhances Epidermal Permeability Barrier Function","volume":"111","author":"Denda","year":"1998","journal-title":"J. Investig. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0950268803001523","article-title":"Gender Difference in the Incidence of Shingles","volume":"132","author":"Fleming","year":"2004","journal-title":"Epidemiol. Infect."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.annepidem.2005.12.002","article-title":"Gender as an Independent Risk Factor for Herpes Zoster: A Population-Based Prospective Study","volume":"16","author":"Opstelten","year":"2006","journal-title":"Ann. Epidemiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s13365-018-0687-4","article-title":"Herpes Zoster Increased Risk of Neuralgic Amyotrophy: A Retrospective, Population-Based Matched Cohort Study","volume":"25","author":"Ho","year":"2019","journal-title":"J. Neurovirol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/3\/2097\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:14:26Z","timestamp":1760120066000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/3\/2097"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20032097"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20032097","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,23]]}}}