Associations of bee sting injuries with environmental and social factors: an exploratory study

Introduction: Bee stings are a significant public health concern, yet their spatial and temporal patterns have been rarely examined. Because such analyses are important for developing control strategies, this study investigated the associations between bee sting injuries and various environmental and social factors in South Korea. Methods: An ecological study was conducted at the administrative district level, encompassing 250 districts across South Korea from 2014 to 2021. Annual counts of emergency department visits for bee sting injuries were analyzed in relation to meteorological, environmental, and demographic variables using a zero-inflated negative binomial (ZINB) regression model to account for excess zeros and overdispersion. Results: Significant positive associations were observed between bee sting injuries and relative humidity [relative risk (RR) = 1.012, 95% confidence interval (CI): 1.005-1.019] as well as forest coverage (RR = 1.024, 95% CI: 1.017-1.032) and deforested area (RR = 1.092, 95% CI: 1.028-1.160). Negative associations were found with temperature (RR = 0.982, 95% CI: 0.975-0.989) and urbanization (RR = 0.974, 95% CI: 0.969-0.980). The incidence of bee sting injuries showed a gradual decline over the study period, with an RR of 0.941 (95% CI: 0.910-0.974) per year. Discussion: Bee sting injuries are influenced by multiple environmental and social factors. Further research is warranted to confirm causal relationships and to guide evidence-based preventive strategies.