Influence of meteorological factors and air pollution on the outbreak of severe acute respiratory syndrome
Identifieur interne : 003812 ( Main/Merge ); précédent : 003811; suivant : 003813Influence of meteorological factors and air pollution on the outbreak of severe acute respiratory syndrome
Auteurs : Quan-Cai Cai [République populaire de Chine] ; Jian Lu [République populaire de Chine] ; Qin-Feng Xu [République populaire de Chine] ; Qiang Guo [République populaire de Chine] ; De-Zhong Xu [République populaire de Chine] ; Qing-Wen Sun [République populaire de Chine] ; Hua Yang [République populaire de Chine] ; Gen-Ming Zhao [République populaire de Chine] ; Qing-Wu Jiang [République populaire de Chine]Source :
- Public Health [ 0033-3506 ] ; 2007.
Abstract
To understand the association between the outbreak of severe acute respiratory syndrome (SARS) and meteorological factors and air pollution.
An ecological study was conducted.
Three hundred and fifty primary probable SARS cases diagnosed in mainland China between 1 January and 31 May 2003, and their 6727 close contacts during the period of their clinical symptoms before admission, were included in this study. Of the 6727 close contacts, 135 (2.0%) later developed clinical symptoms and were diagnosed as probable SARS cases. The daily meteorological data and daily air pollution data during the same SARS outbreak period in mainland China were used in the data analysis. Logistic regression analyses were conducted to explore the association between the secondary attack rate of SARS and meteorological factors and air pollution.
In univariate analyses, daily average temperature (DAT), daily average air pressure (DAAP), and daily average relative humidity (DARH) were inversely associated with secondary attack rate (
Our results suggest that the SARS outbreak was significantly associated with DAWV, and that DAAP, DARH and DHS may also have influenced the SARS outbreak to some extent. However, because of ecological fallacy and uncontrolled confounding effects that may have biased the results, the association between the SARS outbreak and these meteorological factors and air pollution deserve further investigation.
Url:
DOI: 10.1016/j.puhe.2006.09.023
PubMed: 17307207
PubMed Central: 7118752
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Shanghai 200032</wicri:regionArea><wicri:noRegion>Shanghai 200032</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">Department of Epidemiology, Second Military Medical University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Second Military Medical University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Lu, Jian" sort="Lu, Jian" uniqKey="Lu J" first="Jian" last="Lu">Jian Lu</name><affiliation wicri:level="1"><nlm:aff id="aff3">Department of Statistics, Second Military Medical University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Statistics, Second Military Medical University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Xu, Qin Feng" sort="Xu, Qin Feng" uniqKey="Xu Q" first="Qin-Feng" last="Xu">Qin-Feng Xu</name><affiliation wicri:level="1"><nlm:aff id="aff4">Department of Statistics, Fudan University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Statistics, Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Guo, Qiang" sort="Guo, Qiang" uniqKey="Guo Q" first="Qiang" last="Guo">Qiang Guo</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Training, Second Military Medical University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Training, Second Military Medical University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Xu, De Zhong" sort="Xu, De Zhong" uniqKey="Xu D" first="De-Zhong" last="Xu">De-Zhong Xu</name><affiliation wicri:level="1"><nlm:aff id="aff6">Department of Epidemiology, Fourth Military Medical University, Xian, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, Fourth Military Medical University, Xian</wicri:regionArea><wicri:noRegion>Xian</wicri:noRegion></affiliation></author><author><name sortKey="Sun, Qing Wen" sort="Sun, Qing Wen" uniqKey="Sun Q" first="Qing-Wen" last="Sun">Qing-Wen Sun</name><affiliation wicri:level="1"><nlm:aff id="aff7">Department of Mathematics and Physics, Second Military Medical University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Mathematics and Physics, Second Military Medical University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Hua" sort="Yang, Hua" uniqKey="Yang H" first="Hua" last="Yang">Hua Yang</name><affiliation wicri:level="1"><nlm:aff id="aff8">Changhai Hospital, Second Military Medical University, Shanghai, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Changhai Hospital, Second Military Medical University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Zhao, Gen Ming" sort="Zhao, Gen Ming" uniqKey="Zhao G" first="Gen-Ming" last="Zhao">Gen-Ming Zhao</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032</wicri:regionArea><wicri:noRegion>Shanghai 200032</wicri:noRegion></affiliation></author><author><name sortKey="Jiang, Qing Wu" sort="Jiang, Qing Wu" uniqKey="Jiang Q" first="Qing-Wu" last="Jiang">Qing-Wu Jiang</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Epidemiology, School of Public Health, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032</wicri:regionArea><wicri:noRegion>Shanghai 200032</wicri:noRegion></affiliation></author></analytic><series><title level="j">Public Health</title><idno type="ISSN">0033-3506</idno><idno type="eISSN">1476-5616</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Summary</title><sec><title>Objectives</title><p>To understand the association between the outbreak of severe acute respiratory syndrome (SARS) and meteorological factors and air pollution.</p></sec><sec><title>Study design</title><p>An ecological study was conducted.</p></sec><sec><title>Methods</title><p>Three hundred and fifty primary probable SARS cases diagnosed in mainland China between 1 January and 31 May 2003, and their 6727 close contacts during the period of their clinical symptoms before admission, were included in this study. Of the 6727 close contacts, 135 (2.0%) later developed clinical symptoms and were diagnosed as probable SARS cases. The daily meteorological data and daily air pollution data during the same SARS outbreak period in mainland China were used in the data analysis. Logistic regression analyses were conducted to explore the association between the secondary attack rate of SARS and meteorological factors and air pollution.</p></sec><sec><title>Results</title><p>In univariate analyses, daily average temperature (DAT), daily average air pressure (DAAP), and daily average relative humidity (DARH) were inversely associated with secondary attack rate (<italic>P</italic><0.001); a significant positive association was found for daily hours of sunshine (DHS) (<italic>P</italic><0.001). In multivariate analyses, factors associated with secondary attack rate were DAAP (odds ratio (OR)=0.53, 95% confidence interval (CI): 0.42, 0.66), DARH (OR=0.73, 95% CI: 0.53, 1.00), and daily average wind velocity (DAWV; OR=0.81, 95% CI: 0.68, 0.96). Adjustment for the onset time of a primary case led to little change in the results. In addition, in Hebei Province, a major affected area in China, only DAWV (OR=0.38, 95% CI: 0.20, 0.72) was a significant predictor of secondary attack rate with adjustment for the onset time of primary case. In Inner Mongolia, another major affected area in China, DAWV (OR=0.50, 95% CI: 0.26, 0.94) and DHS (OR=0.27, 95% CI: 0.09, 0.81) were significant predictors of secondary attack rate with adjustment for the onset time of primary case.</p></sec><sec><title>Conclusions</title><p>Our results suggest that the SARS outbreak was significantly associated with DAWV, and that DAAP, DARH and DHS may also have influenced the SARS outbreak to some extent. However, because of ecological fallacy and uncontrolled confounding effects that may have biased the results, the association between the SARS outbreak and these meteorological factors and air pollution deserve further investigation.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Dowell, S F" uniqKey="Dowell S">S.F. Dowell</name></author><author><name sortKey="Ho, M S" uniqKey="Ho M">M.S. Ho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hendley, J O" uniqKey="Hendley J">J.O. Hendley</name></author><author><name sortKey="Fishburne, H B" uniqKey="Fishburne H">H.B. Fishburne</name></author><author><name sortKey="Gwaltney, J M" uniqKey="Gwaltney J">J.M. Gwaltney</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tan, J" uniqKey="Tan J">J. Tan</name></author><author><name sortKey="Mu, L" uniqKey="Mu L">L. 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