Meteorological and airborne pollution exposure that potentially affects the incidence of Kawasaki disease.
- 1Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China.
Abstract
Kawasaki disease (KD) is a systemic vasculitis of unknown etiology that mainly affects children under 5 years of age. Few studies have evaluated meteorological and air pollution risk factors for KD. This study aimed to evaluate the association between environmental exposures and KD incidence in Suzhou, China. A time-series analysis was conducted on KD patients in Suzhou, China [2014-2024]. The study cohort was divided into a modeling cohort [2014-2020] and an independent temporal validation cohort [2021-2024]. Quasi-Poisson generalized linear model (GLM) combined with distributed lag non-linear model (DLNM) was conducted to assess delayed effects of environmental exposure over a month, controlling for potential confounders. In the validation cohort, daily population-level respiratory pathogen burden was additionally adjusted. Abrupt temperature elevation was significantly associated with increased KD risk, peaking at lag day 15 [relative risk (RR) =1.48; 95% confidence interval (CI): 1.15-1.90]. The cumulative RR across lags 0-30 following an inter-day temperature change (ΔT) event of +1 ℃ was 2.25 (95% CI: 1.22-4.17). In the validation cohort [2021-2024], adjusting for respiratory infection burden, abrupt warming remained associated with KD (lag 15 RR: 1.52; 95% CI: 1.12-2.07), and extreme cooling emerged as a transient risk (lag 30 RR: 1.63; 95% CI: 1.20-2.21). These findings reveal a biphasic pattern of environmental susceptibility independent of infection. Rapid warming events (day-to-day temperature increases) were significantly associated with an elevated KD risk, with a peak effect observed approximately two weeks after exposure. In the post-pandemic context, extreme cooling exhibited a specific transient risk. These findings support integrating meteorological indicators into pediatric environmental health surveillance.
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BibTeX
@article{zhong2026meteorological,
title = {{Meteorological and airborne pollution exposure that potentially affects the incidence of Kawasaki disease.}},
author = {Xichen Zhong and Shuhui Wang and Wenjuan Shu and Wanping Zhou and Bo Wang and Qiuqin Xu and Guanghui Qian and Zhiheng Liu and Jin Ma and Haitao Lv and Xuan Li},
journal = {Translational pediatrics},
year = {2026},
month = sep,
doi = {10.21037/tp-2026-0666},
url = {https://europepmc.org/article/MED/42996388},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Meteorological and airborne pollution exposure that potentially affects the incidence of Kawasaki disease.
AU - Xichen Zhong
AU - Shuhui Wang
AU - Wenjuan Shu
AU - Wanping Zhou
AU - Bo Wang
AU - Qiuqin Xu
AU - Guanghui Qian
AU - Zhiheng Liu
AU - Jin Ma
AU - Haitao Lv
AU - Xuan Li
PY - 2026
DA - 2026/09/29
JO - Translational pediatrics
DO - 10.21037/tp-2026-0666
UR - https://europepmc.org/article/MED/42996388
AB - Kawasaki disease (KD) is a systemic vasculitis of unknown etiology that mainly affects children under 5 years of age. Few studies have evaluated meteorological and air pollution risk factors for KD. This study aimed to evaluate the association between environmental exposures and KD incidence in Suzhou, China. A time-series analysis was conducted on KD patients in Suzhou, China [2014-2024]. The study cohort was divided into a modeling cohort [2014-2020] and an independent temporal validation cohort [2021-2024]. Quasi-Poisson generalized linear model (GLM) combined with distributed lag non-linear model (DLNM) was conducted to assess delayed effects of environmental exposure over a month, controlling for potential confounders. In the validation cohort, daily population-level respiratory pathogen burden was additionally adjusted. Abrupt temperature elevation was significantly associated with increased KD risk, peaking at lag day 15 [relative risk (RR) =1.48; 95% confidence interval (CI): 1.15-1.90]. The cumulative RR across lags 0-30 following an inter-day temperature change (ΔT) event of +1 ℃ was 2.25 (95% CI: 1.22-4.17). In the validation cohort [2021-2024], adjusting for respiratory infection burden, abrupt warming remained associated with KD (lag 15 RR: 1.52; 95% CI: 1.12-2.07), and extreme cooling emerged as a transient risk (lag 30 RR: 1.63; 95% CI: 1.20-2.21). These findings reveal a biphasic pattern of environmental susceptibility independent of infection. Rapid warming events (day-to-day temperature increases) were significantly associated with an elevated KD risk, with a peak effect observed approximately two weeks after exposure. In the post-pandemic context, extreme cooling exhibited a specific transient risk. These findings support integrating meteorological indicators into pediatric environmental health surveillance.
SN - 2224-4336
SN - 2224-4344
ER -