Association of Kawasaki disease with tropospheric winds in Central Chile: Is wind-borne desert dust a risk factor? |
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| Institution: | 1. Departamento de Ingeniería Química y Bioprocesos, Pontificia Universidad Católica de Chile, Santiago, Chile;2. Centro de Desarrollo Urbano Sustentable (CEDEUS), Chile;3. Unidad de Inmunología, Alergia y Reumatología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile;4. Instituto Milenio de Inmunología e Inmunoterapia, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile;1. Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, HSPH-BWH-301W, Boston, MA 02215, USA;2. Institute of Environmental Medicine, Karolinska Institutet, Box 210, Nobelsväg 13, Solna 171 77, Sweden;3. Centre for Studies on Human Stress, Research Center of the Mental Health Institute, 7401 Rue Hochelaga, Montreal, Quebec, H1N 3M5, Canada;4. Etholabs, School of Psychoeducation, University of Montreal, C. P. 6128, succursale Centre-ville, Montreal, Quebec, H3C 3J7, Canada;5. Département de psychologie, Université du Québec à Montréal, 320 Sainte-Catherine Est Pavillon J.A. De Sève, local DS5775, Montreal, Quebec H2X 1L7, Canada;6. INSERM U1085, Université Rennes I, 263 Avenue du Général Leclerc, 35042 Rennes, France;7. Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, 2375 ch. de la Cote-Sainte-Catherine, Montreal, Quebec, H3T 1A8, Canada;8. Université de Montréal Public Health Research Institute, Université de Montréal, 7101 avenue du Parc, office 3187-03, Montreal, Quebec, H3N 1X9, Canada;9. Centre de recherche du CHU de Québec, Université Laval, 2875 Laurier, Quebec, Quebec G1V 2M2, Canada;1. School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China;3. Tianping Community Health Service Center, Xuhui District, Shanghai, China;1. Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander Universität Erlangen-Nürnberg, Schillerstr. 25/29, D-91054 Erlangen, Germany;2. Berlin-Brandenburg State Laboratory, Department of Environmental Health Protection, Invalidenstr. 60, D-10557 Berlin, Germany;3. North Rhine-Westphalia State Agency for Nature, Environment and Consumer Protection, Leibnizstr. 10, D-45659 Recklinghausen, Germany;4. Department of Chemical Safety and Toxicology, Bavarian Health and Food Safety Authority, Pfarrstr. 3, D-80538 Munich, Germany;5. Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Ludwig-Maximilians-University, Ziemssenstrasse 1, D-80336 Munich, Germany;1. Community Health and Humanities, Faculty of Medicine, Memorial University, St John''s, NL A1B 3V6, Canada;2. Newfoundland and Labrador Centre for Health Information, St John''s, NL A1B 2C7, Canada |
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| Abstract: | It has been found that Kawasaki disease (KD) cases diagnosed in Japan, Hawaii and San Diego, USA increase when tropospheric wind patterns arrive from central Asia, suggesting a common, wind-borne causal agent. We analyzed KD cases hospitalized in Santiago, Chile to look for associations with local, regional and large scale meteorological variables. We compiled monthly data of KD incidence rates, local meteorological variables, large scale wind patterns and several El Niño Southern Oscillation (ENSO) indices for 2001–2010; we considered standardized anomalies in all analyses and used linear time series models to account for data autocorrelation. We found that meteorological variables explain 38% of variance in KD rates. A unit increase in northerly wind at 3 lagged months, temperature at 1 and 3 lagged months and monthly change of ENSO 4 index are associated with changes in KD rates of 0.203 (95% CI 0.049–0.358), 0.181 (95% CI 0.014–0.347), 0.192 (95% CI 0.030–0.353) and ? 0.307 (95% CI ? 0.458–0.156), respectively. These results are robust when northerly wind level is changed or when a shorter period (2005–2010) is used to estimate model parameters. We found a statistical association of KD at Santiago, Chile with tropospheric, northerly wind patterns suggesting that dust transported from the Atacama Desert could include a causative agent. A novel result is that ENSO dynamics also explain part of KD variability with a decrease in KD when La Niña is dissipating or El Niño is on the rise; hence climate scale dynamics might be taken into account in future studies worldwide — at least as a potential explanatory variable that may confound KD seasonality on a global scale. |
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