HEOA Group, School of Public Health, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
HEOA Group, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China.
J Affect Disord. 2022 May 1;304:150-158. doi: 10.1016/j.jad.2022.02.064. Epub 2022 Feb 25.
Depression has become the most common mental disease globally and is a strong predictor for suicide. Studies have indicated that exposure to high levels of air pollution increased the risk of depression, but evidence in human populations is still limited. At present, a few studies estimated the impact of multi-pollutants on hospitalization for depression in multi-city in areas with severe air pollution. We aimed to examine the association between short-term exposure to common ambient air pollutants and hospital admissions (HAs) for depression based on statistics of inpatients with depression in multi-city.
The 10,459 records of HAs for depression from medical institutions in nine cities/prefectures, Sichuan Province, China, between January 1, 2017 and December 31, 2018 were collected. Air pollutant data including PM, PM, SO and NO from provincial ecological environment monitoring stations were obtained. Based on a time-stratified case-crossover design, we estimated the impact on relative risk (RR) of short-term exposure to air pollutants on hospitalization for depression, with stratification by sex, age, and economic level. The cost of illness method was used to further assess hospitalization costs.
The short-term exposure to air pollutants was positively associated with hospitalization for depression. The increase of air particulate matter (PM) had the strongest effect on lag 0 day (PM:1.037 (95% CI:1.022,1.052), PM:1.024 (95% CI:1.013,1.036)). The effects of SO reached the peak on lag 2 day (1.317 (95% CI:1.151,1.507)). Women and older people were more likely to be affected by air pollutants and prone to depression (P = 0.013, P = 0.006). During the study period, the economic cost of hospitalization for depression caused by PM pollution was US$ 8.36 million.
The air pollutant concentration level of the monitoring stations in the study area was regarded as personal pollutant exposure, which may not accurately reflect the patient's exposure level, resulting in a certain measurement error.
Short-term changes to ambient air pollution exposure may increase the risk of hospital admissions for depression and cause economic costs due to hospitalization.
抑郁症已成为全球最常见的精神疾病，也是自杀的一个强有力预测因子。研究表明，暴露于高水平的空气污染会增加患抑郁症的风险，但在人类群体中的证据仍然有限。目前，一些研究估计了多污染物对多城市重度空气污染地区抑郁症住院的影响。我们旨在根据多城市抑郁症住院患者的统计数据，检验短期暴露于常见环境空气污染物与抑郁症住院之间的关联。
收集了 2017 年 1 月 1 日至 2018 年 12 月 31 日期间，来自中国四川省九个城市/地区医疗机构的 10459 例抑郁症住院记录。从省级生态环境监测站获得了包括 PM、PM、SO 和 NO 在内的空气污染物数据。基于时间分层病例交叉设计，我们估计了短期暴露于空气污染物对抑郁症住院的相对风险（RR）的影响，并按性别、年龄和经济水平进行了分层。使用疾病成本法进一步评估了住院费用。
空气污染物的短期暴露与抑郁症住院呈正相关。空气颗粒物（PM）的增加对滞后 0 天的影响最强（PM：1.037（95%CI：1.022，1.052），PM：1.024（95%CI：1.013，1.036））。SO 的影响在滞后 2 天达到峰值（1.317（95%CI：1.151，1.507））。女性和老年人更容易受到空气污染物的影响，更容易患抑郁症（P=0.013，P=0.006）。在研究期间，由 PM 污染引起的抑郁症住院的经济成本为 836 万美元。
研究区域监测站的空气污染物浓度水平被视为个人污染物暴露水平，可能无法准确反映患者的暴露水平，因此存在一定的测量误差。
短期环境空气污染暴露的变化可能会增加抑郁症住院的风险，并因住院而导致经济成本。
