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Air pollution and increased number of psychiatric emergency room visits : A case-crossover study for identifying susceptible groups

Muhsin, Huda Ahmed ; Steingrimsson, Steinn ; Oudin, Anna LU ; Åström, Daniel Oudin LU and Carlsen, Hanne Krage (2022) In Environmental Research 204.
Abstract

Background: Ambient particulate matter is a leading risk factor for disease globally. Particulate matter 10 (PM10) and particulate matter 2.5 (PM2.5) are derived from different sources, including operating motor vehicles as well as from industrial activities. In this study we investigate the association between increased concentrations of PM and total daily visits to the psychiatric emergency unit (PEV). Further, the aim is to identify specific risk groups who are more susceptible to the effects of air pollution exposure by studying sex, age, ongoing psychiatric follow-up and diagnoses of depression/anxiety or substance use. Material and methods: The sample was comprised of data from 2740 days to 81 548 PEVs at... (More)

Background: Ambient particulate matter is a leading risk factor for disease globally. Particulate matter 10 (PM10) and particulate matter 2.5 (PM2.5) are derived from different sources, including operating motor vehicles as well as from industrial activities. In this study we investigate the association between increased concentrations of PM and total daily visits to the psychiatric emergency unit (PEV). Further, the aim is to identify specific risk groups who are more susceptible to the effects of air pollution exposure by studying sex, age, ongoing psychiatric follow-up and diagnoses of depression/anxiety or substance use. Material and methods: The sample was comprised of data from 2740 days to 81 548 PEVs at Sahlgrenska University Hospital in Gothenburg and daily mean concentrations of PM10 and PM2.5. A time-stratified case-crossover design was used to analyse associations between air pollution and PEVs. Results: Mean number of daily PEVs were 35 and sex distribution was even. PM exposure was associated with total PEV at lag 0 (the same day), by RR 1.016 (95% confidence interval [CI] 1.004–1.028) and RR 1.020 (95%CI 1.003–1.038) per 10 μg/m3 increase in PM10 and PM2.5, respectively. In females, PEV were increased at lag 0 and lag 1, and in males at lag 1 and lag 2. In the age-stratified analysis, PEVs significantly increased following PM exposure amongst individuals aged 35–65 years by lag 0–2 and in individuals who had contact with outpatient care at lag 0 to lag 1. There were no associations between air pollution and PEVs for any specific diagnostic group evaluated (amongst depression, anxiety and substance use disorder). Conclusions: The results indicate that acute exposure to PM10 and PM2.5 may trigger acute worsening in mental health in both males and females, especially among 35–65 year old individuals. However, in subgroups of the most common psychiatric diagnoses, we did not observe statistically significant associations with PM exposure.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Air pollution, Depression, Mental health, Risk factors, Substance abuse
in
Environmental Research
volume
204
article number
112001
publisher
Elsevier
external identifiers
  • scopus:85122488615
  • pmid:34499892
ISSN
0013-9351
DOI
10.1016/j.envres.2021.112001
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Authors
id
ffc3bc8e-4f1f-4370-8bb4-3e334fe2096a
date added to LUP
2022-02-18 11:41:45
date last changed
2024-06-18 05:24:45
@article{ffc3bc8e-4f1f-4370-8bb4-3e334fe2096a,
  abstract     = {{<p>Background: Ambient particulate matter is a leading risk factor for disease globally. Particulate matter 10 (PM<sub>10</sub>) and particulate matter 2.5 (PM<sub>2.5</sub>) are derived from different sources, including operating motor vehicles as well as from industrial activities. In this study we investigate the association between increased concentrations of PM and total daily visits to the psychiatric emergency unit (PEV). Further, the aim is to identify specific risk groups who are more susceptible to the effects of air pollution exposure by studying sex, age, ongoing psychiatric follow-up and diagnoses of depression/anxiety or substance use. Material and methods: The sample was comprised of data from 2740 days to 81 548 PEVs at Sahlgrenska University Hospital in Gothenburg and daily mean concentrations of PM<sub>10</sub> and PM<sub>2.5</sub>. A time-stratified case-crossover design was used to analyse associations between air pollution and PEVs. Results: Mean number of daily PEVs were 35 and sex distribution was even. PM exposure was associated with total PEV at lag 0 (the same day), by RR 1.016 (95% confidence interval [CI] 1.004–1.028) and RR 1.020 (95%CI 1.003–1.038) per 10 μg/m<sup>3</sup> increase in PM<sub>10</sub> and PM<sub>2.5</sub>, respectively. In females, PEV were increased at lag 0 and lag 1, and in males at lag 1 and lag 2. In the age-stratified analysis, PEVs significantly increased following PM exposure amongst individuals aged 35–65 years by lag 0–2 and in individuals who had contact with outpatient care at lag 0 to lag 1. There were no associations between air pollution and PEVs for any specific diagnostic group evaluated (amongst depression, anxiety and substance use disorder). Conclusions: The results indicate that acute exposure to PM<sub>10</sub> and PM<sub>2.5</sub> may trigger acute worsening in mental health in both males and females, especially among 35–65 year old individuals. However, in subgroups of the most common psychiatric diagnoses, we did not observe statistically significant associations with PM exposure.</p>}},
  author       = {{Muhsin, Huda Ahmed and Steingrimsson, Steinn and Oudin, Anna and Åström, Daniel Oudin and Carlsen, Hanne Krage}},
  issn         = {{0013-9351}},
  keywords     = {{Air pollution; Depression; Mental health; Risk factors; Substance abuse}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Environmental Research}},
  title        = {{Air pollution and increased number of psychiatric emergency room visits : A case-crossover study for identifying susceptible groups}},
  url          = {{http://dx.doi.org/10.1016/j.envres.2021.112001}},
  doi          = {{10.1016/j.envres.2021.112001}},
  volume       = {{204}},
  year         = {{2022}},
}