Institute of Health and Environment, Seoul National University, Gwanak-gu, Seoul 08826, Republic of korea.
Department of Biostatistics and Epidemiology, Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, 08826, Republic of Korea.
Environ Res. 2019 Apr;171:313-320. doi: 10.1016/j.envres.2019.01.036. Epub 2019 Jan 25.
Epidemiologic studies regarding the relationship between short-term exposure to particulate matter with a median aerodynamic diameter < 2.5 µm (PM) and mental disease are limited. This study examined the effects of short-term exposure to PM on emergency admissions to the hospital for mental disease in Seoul, Korea. Data regarding 80,634 emergency admissions for mental diseases were collected from a nationally centralized healthcare claims database in Seoul during 2003-2013. Generalized linear models with climate variables were used to examine associations between short-term PM exposure and mental disease admissions. To comprehensively assess PM effects, we used single- and two-pollutant models, which considered other pollutants in combination with PM. The relative risk (RR) of emergency admissions for mental disease was 1.008 (95% confidence interval, 1.001-1.015) for each 10 μg/m increase in 2-day average PM concentration. This effect persisted or became slightly stronger in the two-pollutant models that included carbon monoxide, nitrogen dioxide, ozone, or sulfur dioxide (RR, 1.01-1.021), but association appeared to be limited to individuals < 65 years of age. Significant association was estimated only during the warm season (RR, 1.021-1.023) in the two-pollutant models. The exposure-response curve was steeper at lower concentrations, suggesting that the risk of mental disease at lower concentrations of pm2.5 (0-30 µg/m). PM was associated with increased admissions even when it was below the World Health Organization's Air Quality Guidelines (25 μg/m), but the association was not statistically significant. Thus, based on the data from a large database, exposure to PM was associated with increases in emergency admissions for mental diseases, and this association was significant during the warm season. PM may even affect mental disease at levels below the current air quality guidelines. These results provide substantial insight regarding the effects of air pollutants and have important implications for policy makers.
关于短期暴露于中值空气动力学直径<2.5μm 的颗粒物 (PM) 与精神疾病之间关系的流行病学研究有限。本研究检验了短期 PM 暴露对韩国首尔精神疾病急诊入院的影响。2003-2013 年期间，从首尔一个全国集中的医疗保健索赔数据库中收集了 80634 例精神疾病急诊入院的数据。使用考虑气候变量的广义线性模型来检验短期 PM 暴露与精神疾病入院之间的关联。为了全面评估 PM 的影响，我们使用了单污染物和双污染物模型，这些模型考虑了 PM 与其他污染物的组合。与每增加 10μg/m 的 2 天平均 PM 浓度相比，精神疾病急诊入院的相对风险 (RR) 为 1.008(95%置信区间，1.001-1.015)。这种效应在包含一氧化碳、二氧化氮、臭氧或二氧化硫的双污染物模型中持续存在或略有增强(RR，1.01-1.021)，但关联似乎仅限于<65 岁的个体。在双污染物模型中，仅在温暖季节 (RR，1.021-1.023) 中估计出显著关联。在较低浓度下，暴露-反应曲线更陡峭，这表明 pm2.5(0-30μg/m) 浓度较低时精神疾病的风险更高。即使 PM 低于世界卫生组织空气质量指南(25μg/m)，也与入院人数增加有关，但关联无统计学意义。因此，基于大型数据库的数据，PM 暴露与精神疾病急诊入院人数增加有关，这种关联在温暖季节更为显著。PM 甚至可能在低于当前空气质量指南的水平下影响精神疾病。这些结果提供了有关空气污染物影响的重要见解，并对决策者具有重要意义。
