Li Huan, Zhang Shiyu, Qian Zhengmin Min, Xie Xin-Hui, Luo Yang, Han Rong, Hou Jiesheng, Wang Chongjian, McMillin Stephen Edward, Wu Shaowei, Tian Fei, Deng Wen-Feng, Lin Hualiang
Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA.
Environ Res. 2020 Dec;191:110214. doi: 10.1016/j.envres.2020.110214. Epub 2020 Sep 15.
The effects of ambient air pollution on specific mental disorders are rarely studied, and the reported results are inconsistent.
To assess the short-term effect of ambient air pollution on the morbidity of mental disorders in three subtropical Chinese cities.
Daily concentrations of air pollution were averaged from 19 fixed monitoring stations across each city, and data on patients were collected from three psychiatric specialty hospitals. A time-series study combined with a generalized additive Poisson model was conducted to investigate the association between air pollution and mental disorders. The exposure-response relationships were explored and stratified analyses by age and sex were conducted.
A total of 1,133,220 outpatient visits were recorded in three subtropical cities (Huizhou, Shenzhen, and Zhaoqing). The number of daily outpatient visits for mental disorders increased with higher air pollutant (PM, PM, SO and NO) concentrations, and the effect of NO appeared to be consistently significant across the three cities, with excess risk (ER) of 4.45% (95% CI: 2.90%, 6.04%) in Huizhou, 7.94% (95% CI: 6.28%, 9.62%) in Shenzhen, and 2.19% (95% CI: 0.51%, 3.89%) in Zhaoqing, respectively, at lag03. We also observed significant effect of PM at lag0 (ER = 1.20%, 95% CI: 0.28%, 2.13%), PM at lag0 (ER = 0.99%, 95% CI: 0.36%, 1.62%), and SO at lag0 (ER = 10.74%, 95% CI: 3.20%, 18.84%) in Shenzhen. For specific mental disorders, significant associations were found in all the air pollutants except between SO and affective disorder and between PM and schizophrenia. In addition, we found that air pollution exhibited stronger effects for males and adults (≥18 years).
Acute exposure to air pollution, especially NO, might be an important trigger of mental disorders.
很少有研究探讨环境空气污染对特定精神障碍的影响,且报告结果不一致。
评估中国三个亚热带城市环境空气污染对精神障碍发病率的短期影响。
对每个城市19个固定监测站的空气污染日浓度进行平均,并从三家精神科专科医院收集患者数据。采用时间序列研究结合广义相加泊松模型来调查空气污染与精神障碍之间的关联。探索暴露-反应关系,并按年龄和性别进行分层分析。
三个亚热带城市(惠州、深圳和肇庆)共记录了1,133,220次门诊就诊。精神障碍的每日门诊就诊次数随空气污染物(PM、PM、SO和NO)浓度升高而增加,NO的影响在三个城市中似乎一直显著,在滞后0-3天时,惠州的超额风险(ER)为4.45%(95%CI:2.90%,6.04%),深圳为7.94%(95%CI:6.28%,9.62%),肇庆为2.19%(95%CI:0.51%,3.89%)。我们还观察到,在深圳,滞后0天时PM的影响显著(ER = 1.20%,95%CI:0.28%,2.13%),滞后0天时PM的影响显著(ER = 0.99%,95%CI:0.36%,1.62%),滞后0天时SO的影响显著(ER = 10.74%,95%CI:3.20%,18.84%)。对于特定精神障碍,除了SO与情感障碍之间以及PM与精神分裂症之间外,在所有空气污染物中均发现显著关联。此外,我们发现空气污染对男性和成年人(≥18岁)的影响更强。
急性暴露于空气污染,尤其是NO,可能是精神障碍的重要触发因素。