{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:47:25Z","timestamp":1789706845787,"version":"4.0.1"},"reference-count":59,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T00:00:00Z","timestamp":1715731200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key Projects of Research and Development of China","award":["2016YFC0900605"],"award-info":[{"award-number":["2016YFC0900605"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The evidence on the effects of extreme meteorological conditions and high air pollution levels on incidence of hand, foot and mouth disease (HFMD) is limited. Moreover, results of the available studies are inconsistent. Further investigations are imperative to elucidate the specific issue.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Data on the daily cases of HFMD, meteorological factors and air pollution were obtained from 2017 to 2022 in Jining City. We employed distributed lag nonlinear model (DLNM) incorporated with Poisson regression to explore the impacts of extreme meteorological conditions and air pollution on HFMD incidence.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>We found that there were nonlinear relationships between temperature, wind speed, PM<jats:sub>2.5<\/jats:sub>, SO<jats:sub>2<\/jats:sub>, O<jats:sub>3<\/jats:sub> and HFMD. The cumulative risk of extreme high temperature was higher at the 95th percentile (<jats:italic>P<jats:sub>95<\/jats:sub><\/jats:italic>th) than at the 90th percentile(<jats:italic>P<jats:sub>90<\/jats:sub><\/jats:italic>th), and the <jats:italic>RR<\/jats:italic> values for both reached their maximum at 10-day lag (<jats:italic>P<jats:sub>95<\/jats:sub><\/jats:italic>th <jats:italic>RR<\/jats:italic> = 1.880 (1.261\u20132.804), <jats:italic>P<jats:sub>90<\/jats:sub><\/jats:italic>th <jats:italic>RR<\/jats:italic> = 1.787 (1.244\u20132.569)), the hazardous effect of extreme low temperatures on HFMD is faster than that of extreme high temperatures. The cumulative effect of extreme low wind speeds reached its maximum at 14-day lag (<jats:italic>P<jats:sub>95<\/jats:sub><\/jats:italic>th <jats:italic>RR<\/jats:italic> = 1.702 (1.389-2.085), <jats:italic>P<jats:sub>90<\/jats:sub><\/jats:italic>th <jats:italic>RR<\/jats:italic> = 1.498(1.283\u20131.750)). The cumulative effect of PM<jats:sub>2.5<\/jats:sub> concentration at the P<jats:sub>90<\/jats:sub>th was largest at 14-day lag (<jats:italic>RR<\/jats:italic> = 1.637 (1.069\u20132.506)), and the cumulative effect at the <jats:italic>P<jats:sub>95<\/jats:sub><\/jats:italic>th was largest at 10-day lag (<jats:italic>RR<\/jats:italic> = 1.569 (1.021\u20132.411)). High SO<jats:sub>2<\/jats:sub> concentration at the <jats:italic>P<jats:sub>95<\/jats:sub><\/jats:italic>th at 14-day lag was associated with higher risk for HFMD (<jats:italic>RR<\/jats:italic>: 1.425 (1.001\u20132.030)).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our findings suggest that high temperature, low wind speed, and high concentrations of PM2.5 and SO2 are associated with an increased risk of HFMD. This study not only adds insights to the understanding of the impact of extreme meteorological conditions and high levels of air pollutants on HFMD incidence but also holds practical significance for the development and enhancement of an early warning system for HFMD.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.17163","type":"journal-article","created":{"date-parts":[[2024,5,15]],"date-time":"2024-05-15T07:25:47Z","timestamp":1715757947000},"page":"e17163","source":"Crossref","is-referenced-by-count":3,"title":["Effects of extreme meteorological factors and high air pollutant concentrations on the incidence of hand, foot and mouth disease in Jining, China"],"prefix":"10.7717","volume":"12","author":[{"given":"Haoyue","family":"Cao","sequence":"first","affiliation":[{"name":"School of Public Health, North China University of Science and Technology, Tangshan, Hebei Province, 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