Ambient air pollution and emergency department visits for psychiatric disorders

Abstract

Objective: Recent epidemiological studies suggested the relationships between ambient air pollution and mental health problems such as suicide and depression. However, there are few studies on psychiatric disorders other than suicide behavior and depression. This study concentrated on the short-term effect of ambient air pollutants on emergency department (ED) visits for psychiatric disorders in Seoul, Republic of Korea.Methods: The ED data was obtained from the Health Insurance Review and Assessment Service from 2005 to 2009. Air pollutants considered in this study were PM10, SO2, NO2, O3, and CO by the Ministry of Environment. Meteorological data such as temperature and relative humidity was obtained from the National Meteorological Office. We used a time-series design and a generalized additive model with Poisson distribution, and we put spline variables (date of visit, daily mean temperature, relative humidity) and parametric variables (day of the week, national holiday) into the model. The risk was expressed as a relative risk (RR) per increment in one standard deviation of each air pollutant and its 95% confidence interval (95% CI).Results: Study period was 1,826 days and the number of visits for any psychiatric disorders was 49,678 cases (1.14%). The RR of ED visits for any psychiatric disorders was 1.016 (95% CI, 1.006-1.027) per 10.04 ppb increment of O3. In mood disorder, the RRs were 1.030 (1.011-1.049) per 36.70 μg/m3 increment of PM10 and 1.032 (1.010-1.055) per 0.24 ppm increment of CO. Conclusion: The present study suggested that ambient O3 concentration was significantly correlated with ED visits for any psychiatric disorders. Among psychiatric disorders, neurosis and panic disorder were positively correlated with O3 concentration on the same day. PM10 and CO concentrations were positively correlated with ED visits for mood disorder including depressive episode.