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Qiu Y, Zhou J, Liao Y, Liu W, Song Z, Wang Z, Shan W, Guo H, Zheng D, Yang L, Ruan Z. Association between short-term ozone exposure and allergic conjunctivitis in China: A multi-city case-crossover study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 358:124506. [PMID: 38968983 DOI: 10.1016/j.envpol.2024.124506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/12/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024]
Abstract
Short-term exposure to ozone has been linked to multiple allergic diseases, but the relationship between ozone exposure and allergic conjunctivitis (AC) remains unclear. This study aimed to investigate the association between short-term exposure to ozone and the risk of AC. We conducted a time-stratified case-crossover study across five Chinese cities from 2014 to 2022. Daily outpatient visit records for AC were identified in five hospitals using either the diagnosis name or ICD-10 code H10.1. Data on air pollution and meteorological conditions were also collected. We first examined the city-specific association between short-term ozone exposure and AC using conditional logistic regression. A random-effects meta-analysis was then conducted to obtain overall estimates. During the study period, 130,093 outpatient visits for AC occurred, with 58.8% (76,482) being male and 41.2% (53,611) female. A one-standard-deviation (SD) increase in ozone was associated with an 8.3% increase (95% CI: 3.8%, 13.0%) in AC outpatient visits. Similar positive associations were observed when adjusting for other pollutants (PM2.5, CO, SO2 and NO2) in two-pollutant and multi-pollutant models. Furthermore, the positive association remained consistent when using mixed-effects regression models or further adjusting for meteorological conditions. In addition, no effect modification of the AC-ozone association by sex, age and season was apparent. This study provides evidence supporting a positive association between short-term ozone exposure and AC risk in China. This highlights the potential value of mitigating ozone pollution to reduce the risk of ocular surface disorders.
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Affiliation(s)
- Yun Qiu
- Department of Public Health, School of Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jin Zhou
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yanfeng Liao
- Huizhou First Maternal and Child Health Care Hospital, Huizhou, Guangdong, China
| | - Wenhui Liu
- Department of Ophthalmology, Jiangnan University Medical Center, Wuxi, China
| | - Zuqiong Song
- Huizhou First Maternal and Child Health Care Hospital, Huizhou, Guangdong, China
| | - Zhen Wang
- Department of Ophthalmology, Suzhou Municipal Hospital & the Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China
| | - Wei Shan
- Administrative Office, Suzhou Municipal Hospital & the Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, China
| | - Hui Guo
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China
| | - Dehui Zheng
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lihong Yang
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zengliang Ruan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, And Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, Nanjing, China; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
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Runkle JD, Sugg MM, Berry A, Reed C, Cowan K, Wertis L, Ryan S. Association of Psychiatric Emergency Visits and Warm Ambient Temperature during Pregnancy: A Time-Stratified Case-Crossover Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:67001. [PMID: 38829735 PMCID: PMC11166382 DOI: 10.1289/ehp13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Acute exposure to high ambient temperature and heat waves during the warm season has been linked with psychiatric disorders. Emerging research has shown that pregnant people, due to physiological and psychological changes, may be more sensitive to extreme heat, and acute exposure has been linked to increased risk of pregnancy complications; however, few studies have examined psychiatric complications. OBJECTIVE Our objective was to examine the association between acute exposure to warm ambient temperatures and emergency department (ED) visits for mental disorders during pregnancy. METHODS A time-stratified case-crossover design with conditional logistic regression was performed on ∼ 206,000 psychiatric ED visits for pregnant patients in North Carolina, from May to September 2016 to 2019. Daily average ambient temperature was the main exposure and was linked to daily visits by maternal zip code of residence for prenatal mood and anxiety disorders (PMAD), severe mental illness (SMI), mental disorder of pregnancy (MDP), suicidal thoughts (SUIC), and any psychiatric disorder (Any). Effect modification by trimester, residential segregation, economic segregation, urbanicity, and availability of greenspace was also investigated. RESULTS Each 5 ° C increase in same-day exposure to warm ambient temperature on case days was associated with an increase in incidence rate ratio (IRR) for any psychiatric disorder [IRR = 1.07; 95% confidence interval (CI): 1.01, 1.14] including anxiety (IRR = 1.14; 95% CI: 1.00, 1.30), bipolar disorder (IRR = 1.28; 95% CI: 0.98, 1.67), and suicidal thoughts (IRR = 1.28; 95% CI: 1.00, 1.65) compared to control days. In general, the associations were strongest for warm season temperatures on the same day of exposure or for temperatures averaged over the 3 or 6 d preceding the ED visit. The greatest risk of an incident ED admission for PMAD (RR = 1.20; 95% CI: 1.04, 1.39), particularly for anxiety (RR = 1.30; 95% CI: 1.07, 1.59), and any psychiatric disorder (RR = 1.17; 95% CI: 1.07, 1.28) occurred following cumulative exposure to hot temperatures the week before admission. Higher psychiatric burden from temperature was observed in urban areas and on extreme heat days. CONCLUSIONS For this pregnant population in the southeastern United States, short-term exposure to high ambient temperatures during the warm season was associated with a greater risk of ED visits for an array of psychiatric disorders. Findings show that climate-related increases in ambient temperature may contribute to psychiatric morbidity in pregnant people. https://doi.org/10.1289/EHP13293.
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Affiliation(s)
- Jennifer D. Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Margaret M. Sugg
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Anne Berry
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Charlie Reed
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Kristen Cowan
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, North Carolina, USA
| | - Luke Wertis
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
| | - Sophie Ryan
- Department of Geography and Planning, Appalachian State University, Boone, North Carolina, USA
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Cohen G, Rowland ST, Benavides J, Lindert J, Kioumourtzoglou MA, Parks RM. Daily temperature variability and mental health-related hospital visits in New York State. ENVIRONMENTAL RESEARCH 2024:119238. [PMID: 38815717 DOI: 10.1016/j.envres.2024.119238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/11/2024] [Accepted: 05/25/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Despite plausible behavioral and physiological pathways, limited evidence exists on how daily temperature variability is associated with acute mental health-related episodes. OBJECTIVES We aimed to explore associations between daily temperature range (DTR) and mental health-related hospital visits using data of all hospital records in New York State during 1995-2014. We further examined factors that may modify these associations, including age, sex, hospital visit type and season. METHODS Using a case-crossover design with distributed lag non-linear DTR terms (0-6 days), we estimated associations between ZIP Code-level DTR and hospital visits for mood (4.6 million hospital visits), anxiety (2.4 million), adjustment (∼368,000), and schizophrenia disorders (∼211,000), controlling for daily mean temperature, via conditional logistic regression models. We assessed potential heterogeneity by age, sex, hospital visit type (in-patient vs. out-patient), and season (summer, winter, and transition seasons). RESULTS For all included outcomes, we observed positive associations from period minimum DTR (0.1°C) until 25th percentile (5.2°C) and between mean DTR (7.7°C) and 90th percentile (12.2°C), beyond which we observed negative associations. For mood disorders, an increase in DTR from 0.1°C to 12.2°C was associated with a cumulative 16.0% increase (95% confidence interval [CI]: 12.8, 19.2%) in hospital visit rates. This increase was highest during transition seasons (32.5%; 95%CI: 26.4, 39.0%) compared with summer (10.7%; 95%CI: 4.8, 16.8%) and winter (-1.6%; 95%CI: -7.6, 4.7%). For adjustment and schizophrenia disorders, the strongest associations were seen among the youngest group (0-24 years) with almost no association in the oldest group (65+ years). We observed no evidence for modification by sex and hospital visit type. DISCUSSION Daily temperature variability was positively associated with mental health-related hospital visits within specific DTR ranges in New York State, after controlling for daily mean temperature. Given uncertainty on how climate change modifies temperature variability, additional research is crucial to comprehend the implications of these findings, particularly under different scenarios of future temperature variability.
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Affiliation(s)
- Gali Cohen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Israel
| | - Sebastian T Rowland
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jaime Benavides
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jutta Lindert
- Department of Health and Social Work, University of Applied Sciences Emden, Emden, Germany
| | | | - Robbie M Parks
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
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Wang W, Yang K, Li J, Jiang H, Zhang S, Lin Y, Zhang X, Jin M, Wang J, Tang M, Chen K. Association between ambient temperature and risk of notifiable infectious diseases in China from 2011 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-13. [PMID: 38713481 DOI: 10.1080/09603123.2024.2350609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 04/26/2024] [Indexed: 05/08/2024]
Abstract
Previous studies on temperature and infectious diseases primarily focused on individual disease types, yielding inconsistent conclusions. This study collected monthly data on notifiable infectious disease cases and meteorological variables across 7 provinces in China from 2011 to 2019. A distributed lag nonlinear model was used to evaluate the association between ambient temperature and infectious diseases within each province, and random meta-analysis was applied to evaluate the pooled effect. Extreme hot temperature (the 97.5th percentile) was positively associated with the risk of respiratory infectious diseases with the relative risk (RR) of 1.45 (95%CI: 1.01-2.08). Conversely, extreme cold temperature (the 2.5th percentile) was negatively associated with intestinal infectious diseases and zoonotic diseases and vector-borne diseases, reporting RRs of 0.43 (95%CI: 0.30-0.60) and 0.46 (95%CI: 0.38-0.57), respectively. This study described the nonlinear association between ambient temperature and infectious diseases with different transmission routes, informing comprehensive prevention and control strategies for temperature-related infectious diseases.
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Affiliation(s)
- Wenqing Wang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kaixuan Yang
- Department of Public Health, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China
| | - Jiayi Li
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiyan Jiang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Simei Zhang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaoyao Lin
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinhan Zhang
- Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mingjuan Jin
- Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbing Wang
- Department of Public Health, National Clinical Research Center for Child Health of Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mengling Tang
- Department of Public Health, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kun Chen
- Department of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Park J, Kim A, Bell ML, Kim H, Lee W. Heat and hospital admission via the emergency department for people with intellectual disability, autism, and mental disorders in South Korea: a nationwide, time-stratified, case-crossover study. Lancet Psychiatry 2024; 11:359-367. [PMID: 38631786 DOI: 10.1016/s2215-0366(24)00067-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/25/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Given the anticipated increase in ambient temperature due to climate change, the hazardous effects of heat on health have been extensively studied; however, its impact on people with intellectual disability, autism, and mental illness is largely unknown. We aimed to estimate the association between heat and hospitalisation through the emergency department (ED) among people with these mental disorders. METHODS In this nationwide study, we used data from the National Health Insurance Database (NHID) of the National Health Insurance Service, the single universal insurer in South Korea, the claims data for which is based on the ICD-10. We included individuals with identified intellectual disability, autism, and mental disorders (including schizophrenia, bipolar disorder, recurrent depressive disorder, schizoaffective disorder and persistent obsessive-compulsive disorder, Tourette's disorder, and narcolepsy) and we established two control groups of people without these disorders: one including 1 million systematically sampled individuals, and one matched to the cohort based on sex, age, and income group. Data on hospital admission via the ED were obtained from the NHID, including the primary cause of admission and corresponding medical costs, for the warm season (June-September) of the period 2006-2021. We used the Google Earth Engine with the ERA5-Land dataset to collect data on the daily mean temperature. We applied a time-stratified case-crossover design using a distributed lag non-linear model and performed a conditional logistic regression. The risk ratio was estimated as the odds ratio (OR) with calculated odds at the 99th percentile temperature compared with that at the local 75th percentile temperature. We did not include people with lived experience of mental illness in this study. FINDINGS Of the 456 946 people with intellectual disability, autism, or mental disorder in the NHID records, 99 845 were admitted to the ED, including 59 821 (59·9%) males and 40 024 (40·1%) females, and including 29 192 people with intellectual disability, 1428 people with autism, and 69 225 people with mental disorders. We were not able to collect data on ethnicity. The mean age at ED admission was 42·1 years (SD 17·9, range 0-102) for people with intellectual disability, 18·6 years (SD 10·4, range 1-72) for people with autism, and 50·8 years (SD 11·9, range 2-94) for people with mental disorders. The heat OR (odds at the 99th percentile vs 75th percentile of temperature) of ED admission was 1·23 (95% CI 1·11-1·36) for intellectual disability, 1·06 (0·68-1·63) for autism, and 1·20 (1·12-1·29) for mental disorders. People with intellectual disability, female individuals, people living in rural areas, or those with a low-income status were at increased risk of ED admission due to heat. The risk of ED admission due to genitourinary diseases was higher than that from other causes. Annual increase in medical costs attributable to heat among people with intellectual disability, autism, and mental disorders was US$ 224 970 per 100 000 person-years (95% empirical CI 139 784-305 770). INTERPRETATION People with intellectual disability, autism, and mental disorders should be included in groups considered at a high-risk for heat exposure, and heat adaptation policies should be implemented with consideration of these groups and their needs. FUNDING The National Research Foundation of Korea, Korean Ministry of Environment, and Korean Ministry of Education. TRANSLATION For the Korean translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jinah Park
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Ayoung Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven CT, USA
| | - Ho Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea; Institute of Health and 14 Environment, Seoul National University, Seoul, South Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, College of Information and Biomedical Engineering, Pusan National University, Yangsan, South Korea.
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Wu K, Tao J, Wu Q, Su H, Huang C, Xia Q, Zhu C, Wei J, Yang M, Yan J, Cheng J. A stronger association of mental disorders with smaller particulate matter and a modifying effect of air temperature. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 347:123677. [PMID: 38447653 DOI: 10.1016/j.envpol.2024.123677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/08/2024]
Abstract
Mental disorders (MDs) can be triggered by adverse weather conditions and particulate matter (PM) such as PM2.5 and PM10 (aerodynamic diameter ≤2.5 μm and ≤10 μm). However, there is a dearth of evidence on the role of smaller PM (e.g. PM1, aerodynamic diameter ≤1 μm) and the potential modifying effects of weather conditions. We aimed to collect daily data on emergency department visits and hospitalisations for schizophrenia-, mood-, and stress-related disorders in a densely populated Chinese city (Hefei) between 2016 and 2019. A time-stratified case-crossover analysis was used to examine the short-term association of MDs with PM1, PM2.5, and PM10. The potential modifying effects of air temperature conditions (cold and warm days) were also explored. The three size-fractioned PMs were all associated with an increased risk of MDs; however, the association differed between emergency department visit and hospitalisation. Specifically, PM1 was primarily associated with an increased risk of emergency department visit, whereas PM2.5 was primarily associated with an increased risk of hospitalisation, and PM10 was associated with an increased risk of both emergency department visit and hospitalisation. The PM-MD association appeared to be greatest (although not significant) for PM1 (odds ratio range: 1.014-1.055), followed by PM2.5 (odds ratio range: 1.001-1.009) and PM10 (odds ratio range: 1.001-1.006). Furthermore, the PM-MD association was observed on cold days; notably, the association between PM and schizophrenia-related disorders was significant on both cold and warm days. Our results suggest that the smaller the PM, the greater the risk of MDs, and that the PM-MD association could be determined by air temperature conditions.
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Affiliation(s)
- Keyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Qiyue Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Qingrong Xia
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Anhui Mental Health Center, Hefei, China; Hefei Fourth People's Hospital, Hefei, China; Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Cuizhen Zhu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Anhui Mental Health Center, Hefei, China; Hefei Fourth People's Hospital, Hefei, China; Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA
| | - Min Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Junwei Yan
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, China; Anhui Mental Health Center, Hefei, China; Hefei Fourth People's Hospital, Hefei, China; Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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Zhuang Z, Li D, Zhang S, Hu Z, Deng W, Lin H. Short-Term Exposure to PM 2.5 Chemical Components and Depression Outpatient Visits: A Case-Crossover Analysis in Three Chinese Cities. TOXICS 2024; 12:136. [PMID: 38393231 PMCID: PMC10892610 DOI: 10.3390/toxics12020136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND The association between specific chemical components of PM2.5 and depression remains largely unknown. METHODS We conducted a time-stratified case-crossover analysis with a distributed lag nonlinear model (DLNM) to evaluate the relationship of PM2.5 and its chemical components, including black carbon (BC), organic matter (OM), sulfate (SO42-), nitrate (NO3-), and ammonium (NH4+), with the depression incidence. Daily depression outpatients were enrolled from Huizhou, Shenzhen, and Zhaoqing. RESULTS Among 247,281 outpatients, we found the strongest cumulative effects of PM2.5 and its chemical components with the odd ratios (ORs) of 1.607 (95% CI: 1.321, 1.956) and 1.417 (95% CI: 1.245, 1.612) at the 50th percentile of PM2.5 and OM at lag 21, respectively. Furthermore, the ORs with SO42- and NH4+ at the 75th percentile on the same lag day were 1.418 (95% CI: 1.247, 1.613) and 1.025 (95% CI: 1.009, 1.140). Relatively stronger associations were observed among females and the elderly. CONCLUSIONS Our study suggests that PM2.5 and its chemical components might be important risk factors for depression. Reducing PM2.5 emissions, with a particular focus on the major sources of SO42- and OM, might potentially alleviate the burden of depression in South China.
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Affiliation(s)
- Zitong Zhuang
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Dan Li
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Shiyu Zhang
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Zhaoyang Hu
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Wenfeng Deng
- Huizhou Center for Disease Control and Prevention, No. 10 Jiangbei Fumin Road, Huizhou 516003, China;
| | - Hualiang Lin
- School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
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Hu T, Xu ZY, Wang J, Su Y, Guo BB. Meteorological factors, ambient air pollution, and daily hospital admissions for depressive disorder in Harbin: A time-series study. World J Psychiatry 2023; 13:1061-1078. [PMID: 38186723 PMCID: PMC10768489 DOI: 10.5498/wjp.v13.i12.1061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/23/2023] [Accepted: 11/08/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders; however, the results are inconsistent in different studies and regions, as are the interaction effects between environmental factors. We hypothesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity. AIM To investigate the effects of meteorological factors and air pollution on depressive disorders, including their lagged effects and interactions. METHODS The samples were obtained from a class 3 hospital in Harbin, China. Daily hospital admission data for depressive disorders from January 1, 2015 to December 31, 2022 were obtained. Meteorological and air pollution data were also collected during the same period. Generalized additive models with quasi-Poisson regression were used for time-series modeling to measure the non-linear and delayed effects of environmental factors. We further incorporated each pair of environmental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders. RESULTS Data for 2922 d were included in the study, with no missing values. The total number of depressive admissions was 83905. Medium to high correlations existed between environmental factors. Air temperature (AT) and wind speed (WS) significantly affected the number of admissions for depression. An extremely low temperature (-29.0 ℃) at lag 0 caused a 53% [relative risk (RR)= 1.53, 95% confidence interval (CI): 1.23-1.89] increase in daily hospital admissions relative to the median temperature. Extremely low WSs (0.4 m/s) at lag 7 increased the number of admissions by 58% (RR = 1.58, 95%CI: 1.07-2.31). In contrast, atmospheric pressure and relative humidity had smaller effects. Among the six air pollutants considered in the time-series model, nitrogen dioxide (NO2) was the only pollutant that showed significant effects over non-cumulative, cumulative, immediate, and lagged conditions. The cumulative effect of NO2 at lag 7 was 0.47% (RR = 1.0047, 95%CI: 1.0024-1.0071). Interaction effects were found between AT and the five air pollutants, atmospheric temperature and the four air pollutants, WS and sulfur dioxide. CONCLUSION Meteorological factors and the air pollutant NO2 affect daily hospital admissions for depressive disorders, and interactions exist between meteorological factors and ambient air pollution.
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Affiliation(s)
- Ting Hu
- Department of Five Therapy, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
| | - Zhao-Yuan Xu
- Medical Section, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
| | - Jian Wang
- Department of Out-Patient, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
| | - Yao Su
- Science and Education, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
| | - Bing-Bing Guo
- Department of 22 Therapy, Harbin Psychiatric Baiyupao Hospital, Harbin 150000, Heilongjiang Province, China
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Hu J, Feng Y, Su H, Xu Z, Ho HC, Zheng H, Zhang W, Tao J, Wu K, Hossain MZ, Zhang Y, Hu K, Huang C, Cheng J. Seasonal peak and the role of local weather in schizophrenia occurrence: A global analysis of epidemiological evidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 899:165658. [PMID: 37478950 DOI: 10.1016/j.scitotenv.2023.165658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/07/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Many studies have shown that the onset of schizophrenia peaked in certain months within a year and the local weather conditions could affect the morbidity risk of schizophrenia. This study aimed to conduct a systematic analysis of schizophrenia seasonality in different countries of the world and to explore the effects of weather factors globally. METHODS We searched three databases (PubMed, Web of Science, and China National Knowledge Infrastructure) for eligible studies published up to September 2022. Schizophrenia seasonality was compared between hemispheres and within China. A meta-analysis was conducted to pool excess risk (ER, absolute percentage increase in risk) of the onset of schizophrenia associated with various weather factors including temperature (an increase or decrease of temperature as a reflection of high or low temperature; heatwave; temperature variation), precipitation, etc. RESULTS: We identified 84 relevant articles from 22 countries, mainly in China. The seasonality analysis found that the onset of schizophrenia mostly peaked in the cold season in the southern hemisphere but in the warm season in the northern hemisphere. Interestingly in China, schizophrenia seasonality presented two peaks, respectively in the late cold and warm seasons. The meta-analysis further revealed an increased risk of schizophrenia after short-term exposure to high temperature [ER%: 0.45 % (95 % confidence interval (CI): 0.14 % to 0.76 %)], low temperature [ER%: 0.52 % (95%CI: 0.29 % to 0.75 %)], heatwave [ER%: 7.26 % (95%CI: 4.45 % to 10.14 %)], temperature variation [ER%: 1.02 % (95%CI: 0.55 % to 1.50 %)], extreme precipitation [ER%: 3.96 % (95%CI: 2.29 % to 5.67 %)]. The effect of other weather factors such as sunlight on schizophrenia was scarcely investigated with inconsistent findings. CONCLUSION This study provided evidence of intra- and inter-country variations in schizophrenia seasonality, especially the double-peak seasons in China. Exposure to local weather conditions mainly temperature changes and precipitation could affect the onset risk of schizophrenia.
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Affiliation(s)
- Jihong Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Yufan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Hong Su
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Zhiwei Xu
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Hung Chak Ho
- Department of Public and International Affairs, City University of Hong Kong, Hong Kong, China
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Junwen Tao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Keyu Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China
| | - Mohammad Zahid Hossain
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China.
| | - Jian Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Major Autoimmune Disease, Hefei, China.
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10
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Hartinger SM, Yglesias-González M, Blanco-Villafuerte L, Palmeiro-Silva YK, Lescano AG, Stewart-Ibarra A, Rojas-Rueda D, Melo O, Takahashi B, Buss D, Callaghan M, Chesini F, Flores EC, Gil Posse C, Gouveia N, Jankin S, Miranda-Chacon Z, Mohajeri N, Helo J, Ortiz L, Pantoja C, Salas MF, Santiago R, Sergeeva M, Souza de Camargo T, Valdés-Velásquez A, Walawender M, Romanello M. The 2022 South America report of The Lancet Countdown on health and climate change: trust the science. Now that we know, we must act. LANCET REGIONAL HEALTH. AMERICAS 2023; 20:100470. [PMID: 37125022 PMCID: PMC10122119 DOI: 10.1016/j.lana.2023.100470] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Stella M. Hartinger
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
- Corresponding author. Av. Honorio Delgado 430, San Martín de Porres, 15102, Lima, Peru.
| | - Marisol Yglesias-González
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Luciana Blanco-Villafuerte
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Yasna K. Palmeiro-Silva
- Pontificia Universidad Católica de Chile, Santiago, Chile
- University College London, London, UK
| | - Andres G. Lescano
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | - Oscar Melo
- Centro Interdisciplinario de Cambio Global, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Daniel Buss
- Pan American Health Organization, Washington, DC, USA
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany
| | | | - Elaine C. Flores
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
- Centre on Climate Change and Planetary Health, LSHTM, London, UK
| | | | | | | | | | | | | | | | - Chrissie Pantoja
- Duke University, Durham, NC, USA
- Universidad del Pacífico, Lima, Peru
| | | | - Raquel Santiago
- Universidade de São Paulo, São Paulo, Brazil
- Universidade Federal de Goiás, Goiás, Brazil
| | | | | | - Armando Valdés-Velásquez
- Centro Latino Americano de Excelencia en Cambio Climático y Salud, Universidad Peruana Cayetano Heredia, Lima, Peru
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11
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Minor T, Sugg M, Runkle JD. Short-term exposure to temperature and mental health in North Carolina: a distributed lag nonlinear analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:573-586. [PMID: 36779999 DOI: 10.1007/s00484-023-02436-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
Adverse mental health outcomes have been associated with high temperatures in studies worldwide. Few studies explore a broad range of mental health outcomes, and to our knowledge, none are specific to NC, USA. This ecological study explored the relationship between ambient temperature and mental health outcomes (suicide, self-harm and suicide ideation, anxiety and stress, mood disorders, and depression) in six urban counties across the state of NC, USA. We applied a quasi-Poisson generalized linear model combined with a distributed lag nonlinear model (DLNM) to examine the short-term effects of daily ambient temperature on emergency admissions for mental health conditions (2016 to 2018) and violent deaths (2004 to 2018). The results were predominately insignificant, with some key exceptions. The county with the greatest temperature range (Wake) displays higher levels of significance, while counties with the lowest temperature ranges (New Hanover and Pitt) are almost entirely insignificant. Self-harm and suicidal ideation peak in the warm months (July) and generally exhibit a protective effect at lower temperatures and shorter lag intervals. Whereas anxiety, depression, and major depressive disorders peak in the cooler months (May and September). Suicide is the only outcome that favored a 20-day lag period in the sensitivity analysis, although the association with temperature was insignificant. Our findings suggest additional research is needed across a suite of mental health outcomes to fully understand the effects of temperatures on mental health.
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Affiliation(s)
- Tyler Minor
- Department of Geography and Planning, Appalachian State University, Boone, NC, USA
| | - Margaret Sugg
- Department of Geography and Planning, Appalachian State University, Boone, NC, USA.
| | - Jennifer D Runkle
- North Carolina Institute for Climate Studies, North Carolina State University, Asheville, NC, USA
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12
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Liu H, Zhao H, Huang J, He M. Air pollution associated with hospital visits for mental and behavioral disorders in Northeast China. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1090313. [PMID: 38455902 PMCID: PMC10910900 DOI: 10.3389/fepid.2023.1090313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/10/2023] [Indexed: 03/09/2024]
Abstract
Background Related studies have found that air pollution is an important factor affecting mental and behavioral disorders. Thus, we performed this time-series study to evaluate the relationship between short-term exposure to ambient air pollutants and visits to hospital by patients with mental and behavioral disorders in northeastern China. Methods We used quasi-Poisson regression models and generalized additive models to probe the links between air pollution and mental and behavioral disorders. The possible influences were also explored stratified by season, age and gender. Results We found that sulfur dioxide (SO2) had a cumulative effect on mental and behavioral disorders at lag04-lag07 and had the greatest effect at lag07 [Relative risk (RR) = 1.068, 95%CI = 1.021-1.117]. Particulate matter of size 2.5 μm (PM2.5) and SO2 had a cumulative effect on depression and both had the largest effect at lag07 (RR = 1.021, 95%CI = 1.002-1.041; RR = 1.103, 95%CI = 1.032-1.178); SO2 also had a cumulative effect on anxiety disorders, with the largest effect at lag06 (RR = 1.058, 95%CI = 1.009-1.110). In the stratified analysis, people are more susceptible in the cold season compared to the warm season and females and the 18-60-year age group are more sensitive to air pollutants. It is suggested to strengthen management and preventive measures to decrease air pollution exposure. Conclusion This study found an association between increased concentrations of air pollutants and increased outpatient visits for mental and behavioral disorders. We recommend that preventive and protective measures should be strengthened in an effort to reduce exposure to air pollution in order to maintain physical and mental health.
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Affiliation(s)
- Huo Liu
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, China
| | - Hang Zhao
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, China
| | - Jinling Huang
- Department of Hospital Management Office, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Miao He
- Liaoning Key Laboratory of Environmental Health Damage Research and Assessment, Department of Environmental Health, School of Public Health, China Medical University, Shenyang, China
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13
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Yuan J, Chang W, Yao Z, Wen L, Liu J, Pan R, Yi W, Song J, Yan S, Li X, Liu L, Wei N, Song R, Jin X, Wu Y, Li Y, Liang Y, Sun X, Mei L, Cheng J, Su H. The impact of hazes on schizophrenia admissions and the synergistic effect with the combined atmospheric oxidation capacity in Hefei, China. ENVIRONMENTAL RESEARCH 2023; 220:115203. [PMID: 36592807 DOI: 10.1016/j.envres.2022.115203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/15/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Currently, most epidemiological studies on haze focus on respiratory diseases, cardiovascular diseases, etc. However, the relationship between haze and mental health has not been adequately explored. The purpose of this study was to investigate the influence of hazes on schizophrenia admissions and to further explore the potential interaction effect with the combined atmospheric oxidative indices (Ox and Oxwt). METHODS We collected 5328 cases during the cold season from 2013 to 2015 in Hefei, China. By integrating the Poisson Generalized Linear Models with the Distributed Lag Non-linear Models, the association between haze and schizophrenia admissions was evaluated. The interaction between hazes and two combined oxidation indexes was tested by stratifying hazes and Ox, and Oxwt. RESULTS Haze was found to be significantly linked to an increased risk of hospitalization for schizophrenia, and a 9-day lag effect on schizophrenia (lag 3-lag 11), with the largest effect on lag 6 (RR = 1.080, 95% confidence interval (CI): 1.046-1.116). Males, females, and <40 y (people under 40 years old) were sensitive to hazes. Furthermore, in the stratified analysis, we found synergies between two combined oxidation indexes and hazes. The interaction relative risk (IRR) and relative excess risk due to interaction (RERI) between Ox and hazes were 1.170 (95% CI: 1.071-1.277) and 0.149 (95% CI: 0.045-0.253), respectively. For Oxwt, the IRR and RERI were 1.179 (95% CI: 1.087-1.281) and 0.159 (95% CI: 0.056-0.263), respectively. It is noteworthy that this synergistic effect was significant in males and <40 y when examining the various subgroups in the interaction analysis. CONCLUSIONS Our findings suggest that exposure to haze significantly increases the risk of hospitalization for schizophrenia. More significant public health benefits can be obtained by prioritizing haze periods with high combined atmospheric oxidation capacity.
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Affiliation(s)
- Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Weiwei Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, 241002, Wuhu, Anhui, China
| | - Zhenhai Yao
- Anhui Public Meteorological Service Center, Hefei, Anhui, China
| | - Liying Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, 241002, Wuhu, Anhui, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China.
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Zhao S, Xu J, Li W, Lu Y, Huang L, Xu H, Shi M, Wang Y, Zhu Q, Xu Q. High-temperature exposure and risk of spontaneous abortion during early pregnancy: a case-control study in Nanjing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:29807-29813. [PMID: 36418820 DOI: 10.1007/s11356-022-24315-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/15/2022] [Indexed: 06/16/2023]
Abstract
As one of the most common complications of early pregnancy, spontaneous abortion is associated with environmental factors, but reports estimating the effect of ambient temperature on spontaneous abortion are still inconclusive. Herein, a case-control study (1002 cases and 2004 controls) in Nanjing, China, from 2017 to 2021 was conducted to evaluate the association between temperature exposure and the risk of spontaneous abortion by using distributed lag nonlinear model (DLNM). As a result, daily mean temperature exposure and early spontaneous abortion showed a nonlinear relationship in 14-day lag periods. Moreover, taking the median temperature (17 °C) as a reference, gradually increased positive effects of high temperature on spontaneous abortion could be found during the 4 days prior to hospitalization, and the highest odds ratio (OR) of 2.07 (95% confidence interval (CI): 1.36, 3.16) at extremely hot temperature (33 °C) was observed at 1 lag day. The results suggested that high-temperature exposure in short times during early pregnancy might increase the risk of SAB. Thus, our findings highlight the potential risk of short-term high-temperature exposure during early pregnancy, and more evidence was given for the effects of climate change on maternal health.
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Affiliation(s)
- Shuangshuang Zhao
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Jie Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Wen Li
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Yingying Lu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Linxiang Huang
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Haoyi Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Mingxia Shi
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Yan Wang
- Department of Prenatal Diagnosis, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, Jiangsu Province, China
| | - Qiaoying Zhu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China
| | - Qing Xu
- Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210004, China.
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15
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Zhou J, Fan L, Lin H, Zheng D, Yang L, Zhuo D, Zhuoma J, Li H, Zhang S, Ruan Z. Size-specific particulate matter and outpatient visits for allergic conjunctivitis in children: a time-stratified case-crossover study in Guangzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:33949-33959. [PMID: 36502478 DOI: 10.1007/s11356-022-24564-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
This time-stratified case-crossover study aims to quantify the risk of allergic conjunctivitis (AC) associated with short-term exposure to PMs (i.e., PM1, PM2.5, PMc, and PM10) among children in Guangzhou, China. We collected data on children's daily AC outpatient visits from the Guangzhou Women and Children Medical Center during February 20, 2016 to December 31, 2018, and also extracted air pollution and meteorological data in the same time frame. We used conditional logistic regression model to estimate the associations between PMs and AC outpatient visits, and conducted subgroup analyses stratified by sex, age, and season. During the study period, we recorded 39,330 children's outpatient visits for AC, including 27,638 boys and 11,692 girls. The associations between PMs and AC were general linear with no clear threshold, which were largest at the current days but remained positive for lag 1 to 3 days. For every 10 μg/m3 increase in daily PM1, PM2.5, PMc, and PM10 concentrations, the estimated risks of AC outpatient visits at the current days increased by 2.5% (OR = 1.025, 95% CI: 1.011-1.039), 1.8% (OR = 1.018, 95% CI: 1.009-1.027), 2.1% (OR = 1.021, 95% CI: 1.004-1.039), and 1.3% (OR = 1.013, 95% CI: 1.007-1.020), respectively. In addition, our stratified analyses revealed that girls and children aged 1 to 6 years were more sensitive to PM exposure, and the PM-associated risks for AC were more apparent in autumn and winter. Our study suggests that short-term exposure to PMs may induce AC in children.
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Affiliation(s)
- Jin Zhou
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lijun Fan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou District, Jiangsu, 210096, Nanjing, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangdong, 510080, Guangzhou, China
| | - Dehui Zheng
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lihong Yang
- Department of Ophthalmology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dan Zhuo
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou District, Jiangsu, 210096, Nanjing, China
| | - Jiayang Zhuoma
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou District, Jiangsu, 210096, Nanjing, China
| | - Huan Li
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangdong, 510080, Guangzhou, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangdong, 510080, Guangzhou, China
| | - Zengliang Ruan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, and Department of Epidemiology & Health Statistics, School of Public Health, Southeast University, 87 Dingjiaqiao, Gulou District, Jiangsu, 210096, Nanjing, China.
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Guangdong, 510080, Guangzhou, China.
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Lavigne E, Maltby A, Côté JN, Weinberger KR, Hebbern C, Vicedo-Cabrera AM, Wilk P. The effect modification of extreme temperatures on mental and behavior disorders by environmental factors and individual-level characteristics in Canada. ENVIRONMENTAL RESEARCH 2023; 219:114999. [PMID: 36565843 DOI: 10.1016/j.envres.2022.114999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/17/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Ambient extreme temperatures have been associated with mental and behavior disorders (MBDs). However, few studies have assesed whether vulnerability factors such as ambient air pollution, pre-existing mental health conditions and residential environmental factors increase susceptibility. This study aims to evaluate the associations between short-term variations in outdoor ambient extreme temperatures and MBD-related emergency department (ED) visits and how these associations are modified by vulnerability factors. METHODS We conducted a case-crossover study of 9,958,759 MBD ED visits in Alberta and Ontario, Canada made between March 1st, 2004 and December 31st, 2020. Daily average temperature was assigned to individual cases with ED visits for MBD using gridded data at a 1 km × 1 km spatial resolution. Conditional logistic regression was used to estimate associations between extreme temperatures (i.e., risk of ED visit at the 2.5th percentile temperature for cold and 97.5th percentile temperature for heat for each health region compared to the minimal temperature risk) and MBD ED visits. Age, sex, pre-existing mental health conditions, ambient air pollution (i.e. PM2.5, NO2 and O3) and residential environmental factors (neighborhood deprivation, residential green space exposure and urbanization) were evaluated as potential effect modifiers. RESULTS Cumulative exposure to extreme heat over 0-5 days (odds ratio [OR] = 1.145; 95% CI: 1.121-1.171) was associated with ED visits for any MBD. However, cumulative exposure to extreme cold was associated with lower risk of ED visits for any MBD (OR = 0.981; 95% CI: 0.976-0.987). We also found heat to be associated with ED visits for specific MBDs such as substance use disorders, dementia, neurotic disorders, schizophrenia and personality behavior disorder. Individuals with pre-existing mental health conditions, those exposed to higher daily concentrations of NO2 and O3 and those residing in neighborhoods with greater material and social deprivation were at higher risk of heat-related MBD ED visits. Increasing tree canopy coverage appeared to mitigate risks of the effect of heat on MBD ED visits. CONCLUSIONS Findings provide evidence that the impacts of heat on MBD ED visits may vary across different vulnerability factors.
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Affiliation(s)
- Eric Lavigne
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, Canada.
| | - Alana Maltby
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jean-Nicolas Côté
- Department of Applied Geomatics, Sherbrooke University, Sherbrooke, Quebec, Canada
| | - Kate R Weinberger
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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17
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Jin J, Xu Z, Cao R, Wang Y, Zeng Q, Pan X, Huang J, Li G. Long-Term Apparent Temperature, Extreme Temperature Exposure, and Depressive Symptoms: A Longitudinal Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3229. [PMID: 36833923 PMCID: PMC9962105 DOI: 10.3390/ijerph20043229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
Temperature is increasingly understood to impact mental health. However, evidence of the long-term effect of temperature exposure on the risk of depressive symptoms is still scarce. Based on the China Health and Retirement Longitudinal Study (CHARLS), this study estimated associations between long-term apparent temperature, extreme temperature, and depressive symptoms in middle-aged and older adults. Results showed that a 1 °C increase or decrease from optimum apparent temperature (12.72 °C) was associated with a 2.7% (95% CI: 1.3%, 4.1%) and 2.3% (95% CI: 1.1%, 3.5%) increased risk of depressive symptoms, respectively. This study also found that each percent increase in annual change in ice days, cool nights, cool days, cold spell durations, and tropical nights was associated with higher risk of depressive symptoms, with HRs (95%CI) of 1.289 (1.114-1.491), 2.064 (1.507-2.825), 1.315 (1.061-1.631), 1.645 (1.306-2.072), and 1.344 (1.127-1.602), respectively. The results also indicated that people living in northern China have attenuated risk of low apparent temperature. Older people were also observed at higher risk relating to more cool nights. Middle-aged people, rural residents, and people with lower household income might have higher related risk of depressive symptoms due to increased tropical nights. Given the dual effect of climate change and global aging, these findings have great significance for policy making and adaptive strategies for long-term temperature and extreme temperature exposure.
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Affiliation(s)
- Jianbo Jin
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Ru Cao
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Qiang Zeng
- Department of Occupational Disease Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing 100191, China
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18
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Corvetto JF, Helou AY, Dambach P, Müller T, Sauerborn R. A Systematic Literature Review of the Impact of Climate Change on the Global Demand for Psychiatric Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1190. [PMID: 36673946 PMCID: PMC9858749 DOI: 10.3390/ijerph20021190] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Climate Change (CC) imposes important global health risks, including on mental health (MH). They are related mostly to psychological suffering caused by climate-related events and to the heat-vulnerability caused by psychiatric disorders. This growing burden may press MH services worldwide, increasing demand on public and private systems in low-, middle-, and high-income countries. According to PRISMA, two independent reviewers searched four databases for papers published before May 2022 that associated climate-related events with healthcare demand for psychiatric conditions. Of the 7432 papers retrieved, we included 105. Only 29 were carried out in low- and middle-income countries. Twelve related the admission numbers to (i) extreme events, while 93 to (ii) meteorological factors-mostly heat. Emergency visits and hospitalizations were significantly higher during hot periods for MH disorders, especially until lag 5-7. Extreme events also caused more consultations. Suicide (completed or attempted), substance misuse, schizophrenia, mood, organic and neurotic disorders, and mortality were strongly affected by CC. This high healthcare demand is evidence of the burden patients may undergo. In addition, public and private services may face a shortage of financial and human resources. Finally, the increased use of healthcare facilities, in turn, intensifies greenhouse gas emissions, representing a self-enforcing cycle for CC. Further research is needed to better clarify how extreme events affect MH services and, in addition, if services in low- and middle-income countries are more intensely demanded by CC, as compared to richer countries.
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Affiliation(s)
- Julia Feriato Corvetto
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Ammir Yacoub Helou
- Department of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Thomas Müller
- Private Clinic Meiringen, 3860 Meiringen, Switzerland
- Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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19
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Xin L, Zhu Y, Zhao J, Fang Y, Xie J. Association between short-term exposure to extreme humidity and painful diabetic neuropathy: a case-crossover analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:13174-13184. [PMID: 36125681 DOI: 10.1007/s11356-022-23095-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 09/14/2022] [Indexed: 06/15/2023]
Abstract
Painful diabetic neuropathy (PDN) is a common complication of diabetes mellitus, which reduces the quality of life. However, the association between PDN and environmental factors, especially ambient humidity, remains unclear. Therefore, this study investigated the impact of extreme humidity events on PDN. Data on PDN-related hospital admissions to two tertiary hospitals in Hefei, China (2014-2019) were obtained. A distributed lag non-linear model with a case-crossover design was used to quantitatively estimate the effects of ambient humidity on PDN, and the results were stratified by sex and age. The 1st, 10th, 90th, and 99th percentiles of relative humidity (RHU) were defined as extreme humidity, and the average relative humidity (74.94%) was set as the reference value. Non-linear exposure-response curves between the RHU and PDN cases were obtained. Extreme humidity (92%) had a significant effect on PDN with a relative risk (RR) of 1.13 (95% confidence interval (CI): 1.01-1.26) on a particular day, which increased with the RHU (RR: 1.21, 95% CI: 1.02-1.45 at 98% extreme humidity). Stratification analysis showed that women (RR: 1.38, 95% CI: 1.07-1.77) and patients aged < 65 years (RR: 1.26, 95% CI: 1.01-1.57) were highly susceptible to this effect on the same day. The results suggest that extreme humidity is a crucial trigger for PDN onset in diabetes patients. Furthermore, the effects vary with sex and age. This study provides detailed evidence of the adverse effects of extreme weather on diabetes patients.
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Affiliation(s)
- Ling Xin
- The First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Mei Shan Road, Shushan District, Hefei, 230031, Anhui, People's Republic of China.
| | - Yongjian Zhu
- School of Management, University of Science and Technology of China, 96 Jin Zhai Road, Bao He District, Hefei, 230026, Anhui, People's Republic of China
| | - Jindong Zhao
- The First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Mei Shan Road, Shushan District, Hefei, 230031, Anhui, People's Republic of China
| | - Yanyan Fang
- The First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Mei Shan Road, Shushan District, Hefei, 230031, Anhui, People's Republic of China
| | - Jingui Xie
- School of Management, Technical University of Munich, Bildungscampus 9, 74076, Heilbronn, Germany
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20
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Fang W, Li Z, Gao J, Meng R, He G, Hou Z, Zhu S, Zhou M, Zhou C, Xiao Y, Yu M, Huang B, Xu X, Lin L, Xiao J, Jin D, Qin M, Yin P, Xu Y, Hu J, Liu T, Huang C, Ma W. The joint and interaction effect of high temperature and humidity on mortality in China. ENVIRONMENT INTERNATIONAL 2023; 171:107669. [PMID: 36508749 DOI: 10.1016/j.envint.2022.107669] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Although many studies have reported the mortality effect of temperature, there were few studies on the mortality risk of humidity, let alone the joint effect of temperature and humidity. This study aimed to investigate the joint and interaction effect of high temperature and relative humidity on mortality in China, which will deepen understanding the health risk of mixture climate exposure. METHODS The mortality and meteorological data were collected from 353 locations in China (2013-2017 in Jilin, Hunan, Guangdong and Yunnan provinces, 2009-2017 in Zhejiang province, and 2006-2011 in other Provinces). We defined location-specific daily mean temperature ≥ 75th percentile of distribution as high temperature, while minimum mortality relative humidity as the threshold of high relative humidity. A time-series model with a distributed lag non-linear model was first employed to estimate the location-specific associations between humid-hot events and mortality, then we conducted meta-analysis to pool the mortality effect of humid-hot events. Finally, an additive interaction model was used to examine the interactive effect between high temperature and relative humidity. RESULTS The excess rate (ER) of non-accidental mortality attributed to dry-hot events was 10.18% (95% confidence interval (CI): 8.93%, 11.45%), which was higher than that of wet-hot events (ER = 3.21%, 95% CI: 0.59%, 5.89%). The attributable fraction (AF) of mortality attributed to dry-hot events was 10.00% (95% CI: 9.50%, 10.72%) with higher burden for females, older people, central China, cardiovascular diseases and urban city. While for wet-hot events, AF was much lower (3.31%, 95% CI: 2.60%, 4.30%). We also found that high temperature and low relative humidity had synergistic additive interaction on mortality risk. CONCLUSION Dry-hot events may have a higher risk of mortality than wet-hot events, and the joint effect of high temperature and low relative humidity may be greater than the sum of their individual effects.
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Affiliation(s)
- Wen Fang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Zhixing Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Jinghua Gao
- School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Ruilin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Zhulin Hou
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Sui Zhu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Chunliang Zhou
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Yize Xiao
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Min Yu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310009, China
| | - Biao Huang
- Jilin Provincial Center for Disease Control and Prevention, Changchun 130062, China
| | - Xiaojun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lifeng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Donghui Jin
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Mingfang Qin
- Yunnan Provincial Center for Disease Control and Prevention, Kunming 650034, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Yiqing Xu
- Hunan Provincial Center for Disease Control and Prevention, Changsha 410005, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
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21
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Lee S, Salvador C, Tuel A, Vicedo-Cabrera AM. Exploring the association between precipitation and hospital admission for mental disorders in Switzerland between 2009 and 2019. PLoS One 2023; 18:e0283200. [PMID: 37093854 PMCID: PMC10124868 DOI: 10.1371/journal.pone.0283200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/03/2023] [Indexed: 04/25/2023] Open
Abstract
While several studies proved the relationship between increasing temperatures and poor mental health, limited evidence exists on the effect of other weather factors, such as precipitation. This study assessed the impact of precipitation on hospital admissions for mental disorders in Switzerland between 2009-2019. We defined different precipitation events based on the duration (daily precipitation ≥1mm for 2, 3, or 4 days; PP.2/PP.3/PP.4) and intensity (≥90th percentile for 2 consecutive days; PEP90.2). First, we conducted aggregated time-stratified case-crossover analysis in eight main Swiss cities with distributed lag models to assess the association up to 3 days after the exposure. Then, we pooled the estimates in each city using a multivariate random effects meta-analysis for all hospital admissions and by subgroups (sex, age, diagnosis). Evidence of an association between precipitation and hospital admission for mental disorders was not found in Switzerland (PP.2: 1.003[0.978-1.029]; PP.3: 1.005[0.985-1.026]; PP.4: 0.994[0.960-1.030]; PEP90.2: 1.000[0.953-1.050]). Although the results were highly uncertain, we found an indication of increasing risks of hospital admission with increasing intensity of precipitation in warmer seasons (PP.2: 1.001[0.971-1.032] vs PEP90.2: 1.014[0.955-1.078]), while the risks of hospital admission slightly increased by the duration in colder season (PP.2: 1.009[0.981-1.039]; PP.3: 1.008[0.980-1.036]; PP.4: 1.017[0.956-1.081]). Overall, risks tend to be higher in people aged < 65 years. Duration of the events may influence more than intensity in females, while opposite patterns were observed in males. Risks tended to be larger but still uncertain for schizophrenia, mood disorders, and adult personality disorders. An indication of a negative association was found in neurotic disorders and null risks in the remaining groups. Although our findings did not show a clear association between precipitation and mental disorders, further research is required to clarify the role of precipitation and the potential implications of climate change and extreme precipitation events on mental health.
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Affiliation(s)
- Sujung Lee
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Coral Salvador
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Environmental Physics Laboratory (EPhysLab), Centro de Investigación Mariña, Universidade de Vigo, Ourense, Spain
| | - Alexandre Tuel
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Institute of Geography, University of Bern, Bern, Switzerland
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
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22
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Short-term effects of extreme meteorological factors on daily outpatient visits for anxiety in Suzhou, Anhui Province, China: a time series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:12672-12681. [PMID: 36114961 DOI: 10.1007/s11356-022-23008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/09/2022] [Indexed: 02/07/2023]
Abstract
Anxiety disorders are a major public health concern in China. Previous studies have provided evidence for associations between ambient temperature and anxiety outpatient visits, but no studies have examined short-term effects of other meteorological factors such as sunshine duration, wind speed, and precipitation on increased anxiety outpatient visits. We aimed to assess the association between climatic factors and outpatient visits for anxiety in Suzhou, a city with a temperate climate in Anhui Province, China. Daily anxiety outpatient visits, meteorological factors, and air pollutants from 2017 to 2019 were collected. A quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was used to quantify the effects of extreme meteorological factors (sunshine duration, wind speed, and precipitation) on anxiety outpatient visits. All effects were presented as relative risk (RR), with the 90th and 10th percentiles of meteorological factors compared to the median. Subgroup analyses by age and gender were performed to identify susceptible subgroups. A total of 11,323 anxiety outpatient visits were reported. Extremely low sunshine duration and low and high wind speed increased the risk of anxiety outpatient visits. The strongest cumulative effects occurred at lag 0-14 days, and the corresponding RRs of extremely low sunshine duration and low and high wind speed were 1.417 (95% CI: 1.056-1.901), 1.529 (95% CI: 1.028-2.275), and 1.396 (95% CI: 1.007-1.935), respectively. Subgroup analyses showed that males and people aged ≥45 years appeared to be more susceptible to the cumulative effects of extremely low sunshine duration. In addition, the adverse effects of extreme wind speed were more pronounced in the cold season. This study provides evidence that extreme climatic factors have a lagged effect on anxiety outpatient visits. In the context of climate change, these findings may help develop weather-based early warning systems to minimize the effects of extreme meteorological factors on anxiety.
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23
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Xue X, Hu J, Peng L, Li H, Jiang Y, Gao C, Chen Y, Chen J, Fu X, Yang L, Kong X, Chen M, Kan H, Xiang D, Chen R. Low ambient temperature might trigger the symptom onset of pulmonary embolism: A nationwide case-crossover study at hourly level in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158524. [PMID: 36063940 DOI: 10.1016/j.scitotenv.2022.158524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 08/18/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Pulmonary embolism (PE) is an important cause of death and its seasonality has long been observed. Very few epidemiological studies have explored the potential role of ambient temperature in PE symptom onset, especially at the hourly level. METHODS We conducted a time-stratified case-crossover study among 17,903 PE patients with hourly onset of symptom from 1590 hospitals across China between January 2015 and September 2020. Conditional logistic regression model combined with distributed lag non-linear models were used to explore the associations between hourly ambient temperature and PE symptom onset. The attributable fractions due to non-optimum temperature were calculated. RESULTS The exposure-response relationship curve was inverse and almost linear. Lower temperature was significantly associated with higher risk of PE symptom onset when temperature was below 18 °C. This risk occurred immediately at the same hour, attenuated thereafter, and became nonsignificant at approximately 72 h after exposure. Compared with the referent temperature (P99, 34.1 °C), the odds ratio of PE symptom onset associated with extremely low temperature (P1, -16.1 °C) over lag 0-72 h was 1.63 (95%CI: 1.23, 2.16). Low temperature may account for 16.19 % of the symptom onset nationally with higher proportion in the south of China. The effects were stronger in older adults, males, and cold seasons. CONCLUSIONS We provided the first-hand robust evidence that transient exposure (at the hourly level) to low temperature might trigger the symptom onset of PE and constitute a considerable burden for PE patients. Targeted protections and health education are needed for susceptible populations.
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Affiliation(s)
- Xiaowei Xue
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China
| | - Li Peng
- Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H.Chan School of Public Health, Boston, MA, USA
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Chuanyu Gao
- Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Beijing, China
| | - Yuguo Chen
- Department of Cardiology, Qilu Hospital of Shandong University, Shandong, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xianghua Fu
- Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lixia Yang
- Department of Cardiology, The 920th Hospital of Chinese People's Liberation Army Joint Support Force, Kunming, China
| | - Xiangqing Kong
- Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Dingcheng Xiang
- Department of Cardiology, General Hospital of the PLA Southern Theater Command, Guangzhou, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, China.
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da Silva I, Wikuats CFH, Hashimoto EM, Martins LD. Effects of Environmental and Socioeconomic Inequalities on Health Outcomes: A Multi-Region Time-Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16521. [PMID: 36554402 PMCID: PMC9778807 DOI: 10.3390/ijerph192416521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The gradual increase in temperatures and changes in relative humidity, added to the aging and socioeconomic conditions of the population, may represent problems for public health, given that future projections predict even more noticeable changes in the climate and the age pyramid, which require analyses at an appropriate spatial scale. To our knowledge, an analysis of the synergic effects of several climatic and socioeconomic conditions on hospital admissions and deaths by cardiorespiratory and mental disorders has not yet been performed in Brazil. Statistical analyses were performed using public time series (1996-2015) of daily health and meteorological data from 16 metropolitan regions (in a subtropical climate zone in South America). Health data were stratified into six groups according to gender and age ranges (40-59; 60-79; and ≥80 years old) for each region. For the regression analysis, two distributions (Poisson and binomial negative) were tested with and without zero adjustments for the complete series and percentiles. Finally, the relative risks were calculated, and the effects based on exposure-response curves were evaluated and compared among regions. The negative binomial distribution fit the data best. High temperatures and low relative humidity were the most relevant risk factors for hospitalizations for cardiovascular diseases (lag = 0), while minimum temperatures were important for respiratory diseases (lag = 2 or 3 days). Temperature extremes, both high and low, were the most important risk factors for mental illnesses at lag 0. Groups with people over 60 years old presented higher risks for cardiovascular and respiratory diseases, while this was observed for the adult group (40-59 years old) in relation to mental disorders. In general, no major differences were found in the results between men and women. However, regions with higher urbanization levels presented risks, mainly for respiratory diseases, while the same was observed for cardiovascular diseases for regions with lower levels of urbanization. The Municipal Human Development Index is an important factor for the occurrence of diseases and deaths for all regions, depending on the evaluated group, representing high risks for health outcomes (the value for hospitalization for cardiovascular diseases was 1.6713 for the female adult group in the metropolitan region Palmas, and the value for hospitalization for respiratory diseases was 1.7274 for the female adult group in the metropolitan region Campo Mourão). In general, less developed regions have less access to adequate health care and better living conditions.
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Affiliation(s)
- Iara da Silva
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo 05508-090, São Paulo, Brazil
| | - Caroline Fernanda Hei Wikuats
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
- Department of Atmospheric Sciences, Institute of Astronomy, Geophysics and Atmospheric Sciences, University of São Paulo, Rua do Matão, 1226, São Paulo 05508-090, São Paulo, Brazil
| | - Elizabeth Mie Hashimoto
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
| | - Leila Droprinchinski Martins
- Graduate Program in Environmental Engineering, Campus Londrina, Federal University of Technology—Paraná, Av. Dos Pioneiros, 3131, Londrina 86036-370, Paraná, Brazil
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Lin X, Luo J, Liao M, Su Y, Lv M, Li Q, Xiao S, Xiang J. Wearable Sensor-Based Monitoring of Environmental Exposures and the Associated Health Effects: A Review. BIOSENSORS 2022; 12:1131. [PMID: 36551098 PMCID: PMC9775571 DOI: 10.3390/bios12121131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Recent advances in sensor technology have facilitated the development and use of personalized sensors in monitoring environmental factors and the associated health effects. No studies have reviewed the research advancement in examining population-based health responses to environmental exposure via portable sensors/instruments. This study aims to review studies that use portable sensors to measure environmental factors and health responses while exploring the environmental effects on health. With a thorough literature review using two major English databases (Web of Science and PubMed), 24 eligible studies were included and analyzed out of 16,751 total records. The 24 studies include 5 on physical factors, 19 on chemical factors, and none on biological factors. The results show that particles were the most considered environmental factor among all of the physical, chemical, and biological factors, followed by total volatile organic compounds and carbon monoxide. Heart rate and heart rate variability were the most considered health indicators among all cardiopulmonary outcomes, followed by respiratory function. The studies mostly had a sample size of fewer than 100 participants and a study period of less than a week due to the challenges in accessing low-cost, small, and light wearable sensors. This review guides future sensor-based environmental health studies on project design and sensor selection.
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Affiliation(s)
- Xueer Lin
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Jiaying Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Minyan Liao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Yalan Su
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Mo Lv
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Qing Li
- College of Medicine and Biological Information Engineering, Northeastern University, Shenyang 110819, China
| | - Shenglan Xiao
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen 518107, China
| | - Jianbang Xiang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
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Li B, Huang W, Chen P, Chen J, Biviano I, Wang Z. Effect of ambient temperature on daily hospital admissions for acute pancreatitis in Nanchang, China: A time-series analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2260-2270. [PMID: 34260330 DOI: 10.1080/09603123.2021.1952166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
The aim of this study was to evaluate the short-term effect of temperature on the risk of acute pancreatitis (AP) in southern China. We performed a time-series study of 2822 patients admitted with a first episode of AP in Nanchang between May 2014 and June 2017. A generalized additive model combined with a distributed lag non-linear model was applied to assess the association of temperature and AP. In subgroup analysis, according to different etiologies of pancreatitis, significant associations were found between daily average temperature and non-biliary pancreatitis hospitalization at lags of 0-7 days, but not for biliary pancreatitis or total AP. Higher daily average temperature tended to increase the occurrence of non-biliary pancreatitis at lags of 0-7 days. These findings suggest that high temperature is associated with higher non-biliary pancreatitis risk in Nanchang, China. In the context of global warming, the morbidity of non-biliary pancreatitis may increase.
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Affiliation(s)
- Bozhen Li
- Jiangxi Ecological Meteorology Center, Jiangxi Meteorological Bureau, Nanchang, China
| | - Wenzhong Huang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Pengguo Chen
- Department of Gastroenterology and Hepatology, Jiangxi Provincial People's Hospital, Nanchang University, Nanchang, China
| | - Jianyong Chen
- Department of Gastroenterology and Hepatology, Jiangxi Provincial People's Hospital, Nanchang University, Nanchang, China
| | - Ivano Biviano
- Gastroenterology and Operative Endoscopy Unit, Siena University Hospital, Siena, Italy
| | - Zhaohan Wang
- Department of Gastroenterology and Hepatology, Jiangxi Provincial People's Hospital, Nanchang University, Nanchang, China
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He Y, Zhang X, Gao J, Gao H, Cheng J, Xu Z, Pan R, Yi W, Song J, Liu X, Tang C, Song S, Su H. The impact of cold spells on schizophrenia admissions and the synergistic effect with the air quality index. ENVIRONMENTAL RESEARCH 2022; 212:113243. [PMID: 35398316 DOI: 10.1016/j.envres.2022.113243] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 03/20/2022] [Accepted: 04/01/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Under current global climate conditions, there are insufficient studies on the health influences of cold spells, especially on mental health. This study aimed to examine the effect of cold spells on schizophrenia admissions and to analyze the potential interaction effect with the air quality index (AQI). METHODS Daily data on schizophrenia admissions and climatic variables in Hefei were collected from 2013 to 2019. Based on 20 definitions, the impacts of cold spells were quantified separately to find the most appropriate definition for the region, and meta-regression was used to explore the different effect sizes of the different days in a cold spell event. In addition, the potential interaction effect was tested by introducing a categorical variable, CSH, reflecting the cold spell and AQI level. RESULTS The cold spell defined by temperature below the 6th centile while lasting for at least three days produced the optimum model fit performance. In general, the risk of schizophrenia admissions increased on cold spell days. The largest single-day effect occurred on the 12th day with RR = 1.081 (95% CI: 1.044, 1.118). In a single cold spell event, the effect of the 3rd and subsequent days of a cold spell (RR = 1.082, 95% CI: 1.036, 1.130) was higher than that on the 2nd day (RR = 1.054, 95% CI: 1.024, 1.085). Similarly, the effect of the 2nd day was also higher than that of the 1st day (RR = 1.027, 95% CI: 1.012, 1.042). We found a synergistic effect between cold spells and high AQI in the male group, and the relative excess risk due to interaction (RERI) was 0.018 (95% CI: 0.005-0.030). CONCLUSIONS This study suggested that the impacts of cold spells should be considered based on the definition of the most appropriate for the region when formulating targeted measures of schizophrenia. The discovery of the synergistic effect was referred to help the selection of the timing of precautions for susceptible people.
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Affiliation(s)
- Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xulai Zhang
- Anhui Mental Health Center, Hefei, Anhui, China
| | - Jiaojiao Gao
- Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Hua Gao
- Anhui Mental Health Center, Hefei, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shasha Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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Deng X, Brotzge J, Tracy M, Chang HH, Romeiko X, Zhang W, Ryan I, Yu F, Qu Y, Luo G, Lin S. Identifying joint impacts of sun radiation, temperature, humidity, and rain duration on triggering mental disorders using a high-resolution weather monitoring system. ENVIRONMENT INTERNATIONAL 2022; 167:107411. [PMID: 35870379 DOI: 10.1016/j.envint.2022.107411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Mental disorders (MDs) are behavioral or mental patterns that cause significant distress or impairment of personal functioning. Previously, temperature has been linked to MDs, but most studies suffered from exposure misclassification due to limited monitoring sites. We aimed to assess whether multiple meteorological factors could jointly trigger MD-related emergency department (ED) visits in warm season, using a highly dense weather monitoring system. METHODS We conducted a time-stratified, case-crossover study. MDs-related ED visits (primary diagnosis) from May-October 2017-2018 were obtained from New York State (NYS) discharge database. We obtained solar radiation (SR), relative humidity (RH), temperature, heat index (HI), and rainfall from Mesonet, a real-time monitoring system spaced about 17 miles (126 stations) across NYS. We used conditional logistic regression to assess the weather-MD associations. RESULTS For each interquartile range (IQR) increase, both SR (excess risk (ER): 4.9%, 95% CI: 3.2-6.7%) and RH (ER: 4.0%, 95% CI: 2.6-5.4%) showed the largest risk for MD-related ED visits at lag 0-9 days. While temperature presented a short-term risk (highest ER at lag 0-2 days: 3.7%, 95% CI: 2.5-4.9%), HI increased risk over a two-week period (ER range: 3.7-4.5%), and rainfall hours showed an inverse association with MDs (ER: -0.5%, 95% CI: 0.9-(-0.1)%). Additionally, we observed stronger association of SR, RH, temperature, and HI in September and October. Combination of high SR, RH, and temperature displayed the largest increase in MDs (ER: 7.49%, 95% CI: 3.95-11.15%). The weather-MD association was stronger for psychoactive substance usage, mood disorders, adult behavior disorders, males, Hispanics, African Americans, individuals aged 46-65, or Medicare patients. CONCLUSIONS Hot and humid weather, especially the joint effect of high sun radiation, temperature and relative humidity showed the highest risk of MD diseases. We found stronger weather-MD associations in summer transitional months, males, and minority groups. These findings also need further confirmation.
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Affiliation(s)
- Xinlei Deng
- Department of Environmental Health Sciences, School of Public Health, University at Albany, the State University of New York, Rensselaer, NY, USA
| | - Jerald Brotzge
- Program Manager, New York State Mesonet, University at Albany, the State University of New York, Albany, NY, USA
| | - Melissa Tracy
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, the State University of New York, Rensselaer, NY, USA
| | - Howard H Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Xiaobo Romeiko
- Department of Environmental Health Sciences, School of Public Health, University at Albany, the State University of New York, Rensselaer, NY, USA
| | - Wangjian Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ian Ryan
- Department of Environmental Health Sciences, School of Public Health, University at Albany, the State University of New York, Rensselaer, NY, USA
| | - Fangqun Yu
- Department of Earth and Atmospheric Sciences, Atmospheric Sciences Research Center, University at Albany, the State University of New York, Rensselaer, NY, USA
| | - Yanji Qu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
| | - Gan Luo
- Department of Earth and Atmospheric Sciences, Atmospheric Sciences Research Center, University at Albany, the State University of New York, Rensselaer, NY, USA
| | - Shao Lin
- Department of Environmental Health Sciences, School of Public Health, University at Albany, the State University of New York, Rensselaer, NY, USA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Recent Techniques in Determining the Effects of Climate Change on Depressive Patients: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:1803401. [PMID: 35978588 PMCID: PMC9377838 DOI: 10.1155/2022/1803401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/03/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
Climate change is amongst the most serious issues nowadays. Climate change has become a concern for the scientific community as it could affect human health. Researchers have found that climate change potentially impacts human mental health, especially among depressive patients. However, the relationship is still unclear and needs further investigation. The purpose of this systematic review is to systematically evaluate the evidence of the association between climate change effects on depressive patients, investigate the effects of environmental exposure related to climate change on mental health outcomes for depressive patients, analyze the current technique used to determine the relationship, and provide the guidance for future research. Articles were identified by searching specified keywords in six electronic databases (Google Scholar, PubMed, Scopus, Springer, ScienceDirect, and IEEE Digital Library) from 2012 until 2021. Initially, 1823 articles were assessed based on inclusion criteria. After being analyzed, only 15 studies fit the eligibility criteria. The result from included studies showed that there appears to be strong evidence of the association of environmental exposure related to climate change in depressive patients. Temperature and air pollution are consistently associated with increased hospital admission of depressive patients; age and gender became the most frequently considered vulnerability factors. However, the current evidence is limited, and the output finding between each study is still varied and does not achieve a reasonable and mature conclusion regarding the relationship between the variables. Therefore, more evidence is needed in this domain study. Some variables might have complex patterns, and hard to identify the relationship. Thus, technique used to analyze the relationship should be strengthened to identify the relevant relationship.
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Li H, Li M, Zhang S, Qian ZM, Zhang Z, Zhang K, Wang C, Arnold LD, McMillin SE, Wu S, Tian F, Lin H. Interactive effects of cold spell and air pollution on outpatient visits for anxiety in three subtropical Chinese cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 817:152789. [PMID: 34990686 PMCID: PMC8907861 DOI: 10.1016/j.scitotenv.2021.152789] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/13/2021] [Accepted: 12/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although low temperature and air pollution exposures have been associated with the risk of anxiety, their combined effects remain unclear. OBJECTIVE To investigate the independent and interactive effects of low temperature and air pollution exposures on anxiety. METHOD Using a case-crossover study design, the authors collected data from 101,636 outpatient visits due to anxiety in three subtropical Chinese cities during the cold season (November to April in 2013 through 2018), and then built conditional logistic regression models based on individual exposure assessments [temperature, relative humidity, particulate matter (PM2.5, PM10), sulfur dioxide (SO2), and nitrogen dioxide (NO2)] and twelve cold spell definitions. Additive-scale interactions were assessed using the relative excess risk due to interaction (RERI). RESULTS Both cold spell and air pollution were significantly associated with outpatients for anxiety. The effects of cold spell increased with its intensity, ranging from 8.98% (95% CI: 2.02%, 16.41%) to 15.24% (95% CI: 6.75%, 24.39%) in Huizhou. Additionally, each 10 μg/m3 increase of PM2.5, PM10, NO2 and SO2 was associated with a 1.51% (95% CI: 0.61%, 2.43%), 1.58% (95% CI: 0.89%, 2.28%), 13.95% (9.98%, 18.05%) and 11.84% (95% CI: 8.25%, 15.55%) increase in outpatient visits for anxiety. Synergistic interactions (RERI >0) of cold spell with all four air pollutants on anxiety were observed, especially for more intense cold spells. For particulate matters, these interactions were found even under mild cold spell definitions [RERI: 0.11 (95% CI: 0.02, 0.21) for PM2.5, and 0.24 (95% CI: 0.14, 0.33) for PM10]. Stratified analyses yielded a pronounced results in people aged 18-65 years. CONCLUSIONS These findings indicate that both cold spell and air pollution are important drivers of the occurrence of anxiety, and simultaneous exposure to these two factors might have synergistic effects on anxiety. These findings highlight the importance of controlling air pollution and improving cold-warning systems.
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Affiliation(s)
- Huan Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Min Li
- Department of Preventive Medicine, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, The Third Clinical Medical Institute Affiliated to Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, USA
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, China
| | - Lauren D Arnold
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, USA
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, USA
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710000, China
| | - Fei Tian
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Qiu X, Danesh-Yazdi M, Wei Y, Di Q, Just A, Zanobetti A, Weisskopf M, Dominici F, Schwartz J. Associations of short-term exposure to air pollution and increased ambient temperature with psychiatric hospital admissions in older adults in the USA: a case-crossover study. Lancet Planet Health 2022; 6:e331-e341. [PMID: 35397221 PMCID: PMC9044858 DOI: 10.1016/s2542-5196(22)00017-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Little is known about the associations between ambient environmental exposures and the risk of acute episodes of psychiatric disorders. We aimed to estimate the link between short-term exposure to atmospheric pollutants, temperature, and acute psychiatric hospital admissions in adults aged 65 years and older in the USA. METHODS For this study, we included all people (aged ≥65 years) enrolled in the Medicare programme in the USA who had an emergency or urgent hospital admission for a psychiatric disorder recorded between Jan 31, 2000, and Dec 31, 2016. We applied a case-crossover design to study the associations between short-term exposure to air pollution (fine particulate matter [PM2·5], ozone, and nitrogen dioxide [NO2]), ambient temperature, and the risk of acute hospital admissions for depression, schizophrenia, and bipolar disorder in this population. The percentage change in the risk of hospital admission and annual absolute risk differences were estimated. FINDINGS For each 5°C increase in short-term exposure to cold season temperature, the relative risk of acute hospital admission increased by 3·66% (95% CI 3·06-4·26) for depression, by 3·03% (2·04-4·02) for schizophrenia, and by 3·52% (2·38-4·68) for bipolar disorder in the US Medicare population. Increased short-term exposure to PM2·5 and NO2 was also associated with a significant increase in the risk of acute hospital admissions for psychiatric disorders. Each 5 μg/m3 increase in PM2·5 was associated with an increase in hospital admission rates of 0·62% (95% CI 0·23-1·02) for depression, 0·77% (0·11-1·44) for schizophrenia, and 1·19% (0·49-1·90) for bipolar disorder; each 5 parts per billion (ppb) increase in NO2, meanwhile, was linked to an increase in hospital admission rates of 0·35% (95% CI 0·03-0·66) for depression and 0·64% (0·20-1·08) for schizophrenia. No such associations were found with warm season temperature. INTERPRETATION In the US Medicare population, short-term exposure to elevated concentrations of PM2·5 and NO2 and cold season ambient temperature were significantly associated with an increased risk of hospital admissions for psychiatric disorders. Considering the increasing burden of psychiatric disorders in the US population, these findings suggest that intervening on air pollution and ambient temperature levels through stricter environmental regulations or climate mitigation could help ease the psychiatric health-care burden. FUNDING US National Institute of Environmental Health Sciences, US Environmental Protection Agency, and US National Institute on Aging.
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Affiliation(s)
- Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Mahdieh Danesh-Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Allan Just
- Icahn School of Medicine at Mount Sinai, New York City, New York, NY, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Nori-Sarma A, Sun S, Sun Y, Spangler KR, Oblath R, Galea S, Gradus JL, Wellenius GA. Association Between Ambient Heat and Risk of Emergency Department Visits for Mental Health Among US Adults, 2010 to 2019. JAMA Psychiatry 2022; 79:341-349. [PMID: 35195664 PMCID: PMC8867392 DOI: 10.1001/jamapsychiatry.2021.4369] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/30/2021] [Indexed: 11/28/2022]
Abstract
IMPORTANCE The implications of extreme heat for physical health outcomes have been well documented. However, the association between elevated ambient temperature and specific mental health conditions remains poorly understood. OBJECTIVE To investigate the association between ambient heat and mental health-related emergency department (ED) visits in the contiguous US among adults overall and among potentially sensitive subgroups. DESIGN, SETTING, AND PARTICIPANTS This case-crossover study used medical claims data obtained from OptumLabs Data Warehouse (OLDW) to identify claims for ED visits with a primary or secondary discharge psychiatric diagnosis during warm-season months (May to September) from 2010 through 2019. Claims for adults aged 18 years or older with commercial or Medicare Advantage health insurance who were living in 2775 US counties were included in the analysis. Emergency department visits were excluded if the Clinical Classifications Software code indicated that the visits were for screening for mental health outcomes and impulse control disorders. EXPOSURES County-specific daily maximum ambient temperature on a continuous scale was estimated using the Parameter-Elevation Relationships on Independent Slopes model. Extreme heat was defined as the 95th percentile of the county-specific warm-season temperature distribution. MAIN OUTCOMES AND MEASURES The daily incidence rate of cause-specific mental health diagnoses and a composite end point of any mental health diagnosis were assessed by identifying ED visit claims using primary and secondary discharge diagnosis International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. Conditional logistic regression models were used to estimate the incidence rate ratio (IRR) and 95% CIs for the association between daily temperature and incidence rates of ED visits. RESULTS Data from 3 496 762 ED visits among 2 243 395 unique individuals were identified (56.8% [1 274 456] women; mean [SD] age, 51.0 [18.8] years); of these individuals, 14.3% were aged 18 to 26 years, 25.6% were aged 27 to 44 years, 33.3% were aged 45 to 64 years, and 26.8% were aged 65 years or older. Days of extreme heat were associated with an IRR of 1.08 (95% CI, 1.07-1.09) for ED visits for any mental health condition. Associations between extreme heat and ED visits were found for specific mental health conditions, including substance use disorders (IRR, 1.08; 95% CI, 1.07-1.10); anxiety, stress-related, and somatoform disorders (IRR, 1.07; 95% CI, 1.05-1.09); mood disorders (IRR, 1.07; 95% CI, 1.05-1.09); schizophrenia, schizotypal, and delusional disorders (IRR, 1.05; 95% CI, 1.03-1.07); self-harm (IRR, 1.06; 95% CI, 1.01-1.12); and childhood-onset behavioral disorders (IRR, 1.11; 95% CI, 1.05-1.18). In addition, associations were higher among men (IRR, 1.10; 95% CI, 1.08-1.12) and in the US Northeast (IRR, 1.10; 95% CI, 1.07-1.13), Midwest (IRR, 1.11; 95% CI, 1.09-1.13), and Northwest (IRR, 1.12; 95% CI, 1.03-1.21) regions. CONCLUSIONS AND RELEVANCE In this case-crossover study of a large population of US adults with health insurance, days of extreme heat were associated with higher rates of mental health-related ED visits. This finding may be informative for clinicians providing mental health services during periods of extreme heat to prepare for increases in health service needs when times of extreme heat are anticipated.
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Affiliation(s)
- Amruta Nori-Sarma
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Shengzhi Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
- OptumLabs Visiting Scholar, Eden Prairie, Minnesota
| | - Yuantong Sun
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Keith R. Spangler
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
| | - Rachel Oblath
- Department of Psychiatry, Boston Medical Center, Boston, Massachusetts
| | - Sandro Galea
- Boston University School of Public Health, Boston, Massachusetts
| | - Jaimie L. Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Gregory A. Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts
- OptumLabs Visiting Scholar, Eden Prairie, Minnesota
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Tang C, Ji Y, Li Q, Yao Z, Cheng J, He Y, Liu X, Pan R, Wei Q, Yi W, Su H. Effects of different heat exposure patterns (accumulated and transient) and schizophrenia hospitalizations: a time-series analysis on hourly temperature basis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:69160-69170. [PMID: 34286435 DOI: 10.1007/s11356-021-15371-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
Growing studies have shown that high temperature is a potential risk factor of schizophrenia occurrence. Therefore, elaborate analysis of different temperature exposure patterns, such as cumulative heat exposure within a time period and transient exposure at a particular time point, is of important public health significance. This study aims to utilize hourly temperature data to better capture the effects of cumulative and transient heat exposures on schizophrenia during the warm season in Hefei, China. We included the daily mean temperature and daily schizophrenia hospitalizations into the distributed lag non-linear model (DLNM) to simulate the exposure-response curve and determine the heat threshold (19.4 °C). We calculated and applied a novel indicator-daily excess hourly heat (DEHH)-to examine the effects of cumulative heat exposure over a day on schizophrenia hospitalizations. Temperature measurements at each time point were also incorporated in the DLNM as independent exposure indicators to analyze the impact of transient heat exposure on schizophrenia. Each increment of interquartile range (IQR) in DEHH was associated with elevated risk of schizophrenia hospitalizations from lag 1 (RR = 1.036, 95% confidence interval (CI): 1.016, 1.057) to lag 4 (RR = 1.025, 95% CI: 1.005, 1.046). Men and people over 40 years old were more susceptible to DEHH. Besides, we found a greater risk of heat-related schizophrenia hospitalizations between 0 a.m. and 6 a.m. This study revealed the adverse effects of accumulated and transient heat exposures on schizophrenia hospitalizations. Our findings need to be further tested in other regions with distinct regional features.
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Affiliation(s)
- Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Yifu Ji
- Anhui Mental Health Center, Hefei, 230032, Anhui, China
| | - Qingru Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Zhenhai Yao
- Anhui Public Meteorological Service Center, Hefei, 230011, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Qiannan Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, 230032, Anhui, China.
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Yoo EH, Eum Y, Roberts JE, Gao Q, Chen K. Association between extreme temperatures and emergency room visits related to mental disorders: A multi-region time-series study in New York, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 792:148246. [PMID: 34144243 DOI: 10.1016/j.scitotenv.2021.148246] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/21/2021] [Accepted: 05/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND There is growing evidence suggesting that extreme temperatures have an impact on mental disorders. We aimed to explore the effect of extreme temperatures on emergency room (ER) visits for mental health disorders using 2.8 million records from New York State, USA (2009-2016), and to examine potential effect modifications by individuals' age, sex, and race/ethnicity through a stratified analysis to determine if certain populations are more susceptible. METHOD To assess the short-term impact of daily average temperature on ER visits related to mental disorders, we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, as well as long-term and seasonal time trends. We also conducted a meta-analysis to pool the region-specific risk estimates and construct the overall cumulative exposure-response curves for all regions. RESULTS We found positive associations between short-term exposure to extreme heat (27.07 ∘C) and increased ER visits for total mental disorders, as well as substance abuse, mood and anxiety disorders, schizophrenia, and dementia. We did not find any statistically significant difference among any subgroups of the population being more susceptible to extreme heat than any other. CONCLUSIONS Our findings suggest that there is a positive association between short-term exposure to extreme heat and increased ER visits for total mental disorders. This extreme effect was also found across all sub-categories of mental disease, although further research is needed to confirm our finding for specific mental disorders, such as dementia, which accounted for less than 1% of the total mental disorders in this sample.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, NY, USA.
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, NY, USA
| | - John E Roberts
- Department of Psychology, State University of New York at Buffalo, NY, USA
| | - Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Zhao Q, Wigmann C, Areal AT, Altug H, Schikowski T. Effect of non-optimum ambient temperature on cognitive function of elderly women in Germany. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 285:117474. [PMID: 34087635 DOI: 10.1016/j.envpol.2021.117474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
Non-optimum ambient temperature has been associated with a variety of health outcomes in the elderly population. However, few studies have examined its adverse effects on neurocognitive function. In this study, we explored the temperature-cognition association in elderly women. We investigated 777 elderly women from the German SALIA cohort during the 2007-2010 follow-up. Cognitive function was evaluated using the CERAD-Plus test battery. Modelled data on daily weather conditions were assigned to the residential addresses. The temperature-cognition association over lag 0-10 days was estimated using multivariable regression with distributed lag non-linear model. The daily mean temperature ranged between -6.7 and 26.0 °C during the study period for the 777 participants. We observed an inverse U-shaped association in elderly women, with the optimum temperature (15.3 °C) located at the 68th percentile of the temperature range. The average z-score of global cognitive function declined by -0.31 (95%CI: 0.73, 0.11) for extreme cold (the 2.5th percentile of temperature range) and -0.92 (95%CI: 1.50, -0.33) for extreme heat (the 97.5th percentile of temperature range), in comparison to the optimum temperature. Episodic memory was more sensitive to heat exposure, while semantic memory and executive function were the two cognitive domains sensitive to cold exposure. Individuals living in an urban area and those with a low educational level were particularly sensitive to extreme heat. In summary, non-optimum temperature was inversely associated with cognitive function in elderly women, with the effect size for heat exposure particularly substantial. The strength of association varied by cognitive domains and individual characteristics.
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Affiliation(s)
- Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Claudia Wigmann
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Ashtyn Tracey Areal
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Hicran Altug
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Tamara Schikowski
- Department of Epidemiology, IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
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Liu J, Varghese BM, Hansen A, Xiang J, Zhang Y, Dear K, Gourley M, Driscoll T, Morgan G, Capon A, Bi P. Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 153:106533. [PMID: 33799230 DOI: 10.1016/j.envint.2021.106533] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mental health is an important public health issue globally. A potential link between heat exposure and mental health outcomes has been recognised in the scientific literature; however, the associations between heat exposure (both high ambient temperatures and heatwaves) and mental health-related mortality and morbidity vary between studies and locations. OBJECTIVE To fill gaps in knowledge, this systematic review aims to summarize the epidemiological evidence and investigate the quantitative effects of high ambient temperatures and heatwaves on mental health-related mortality and morbidity outcomes, while exploring sources of heterogeneity. METHODS A systematic search of peer-reviewed epidemiological studies on heat exposure and mental health outcomes published between January 1990 and November 2020 was conducted using five databases (PubMed, Embase, Scopus, Web of Science and PsycINFO). We included studies that examined the association between high ambient temperatures and/or heatwaves and mental health-related mortality and morbidity (e.g. hospital admissions and emergency department visits) in the general population. A range of mental health conditions were defined using ICD-10 classifications. We performed random effects meta-analysis to summarize the relative risks (RRs) in mental health outcomes per 1 °C increase in temperature, and under different heatwaves definitions. We further evaluated whether variables such as age, sex, socioeconomic status, and climate zone may explain the observed heterogeneity. RESULTS The keyword search yielded 4560 citations from which we identified 53 high temperatures/heatwaves studies that comprised over 1.7 million mental health-related mortality and 1.9 million morbidity cases in total. Our findings suggest associations between heat exposures and a range of mental health-related outcomes. Regarding high temperatures, our meta-analysis of study findings showed that for each 1 °C increase in temperature, the mental health-related mortality and morbidity increased with a RR of 1.022 (95%CI: 1.015-1.029) and 1.009 (95%CI: 1.007-1.015), respectively. The greatest mortality risk was attributed to substance-related mental disorders (RR, 1.046; 95%CI: 0.991-1.101), followed by organic mental disorders (RR, 1.033; 95%CI: 1.020-1.046). A 1 °C temperature rise was also associated with a significant increase in morbidity such as mood disorders, organic mental disorders, schizophrenia, neurotic and anxiety disorders. Findings suggest evidence of vulnerability for populations living in tropical and subtropical climate zones, and for people aged more than 65 years. There were significant moderate and high heterogeneities between effect estimates in overall mortality and morbidity categories, respectively. Lower heterogeneity was noted in some subgroups. The magnitude of the effect estimates for heatwaves varied depending on definitions used. The highest effect estimates for mental health-related morbidity was observed when heatwaves were defined as "mean temperature ≥90th percentile for ≥3 days" (RR, 1.753; 95%CI: 0.567-5.421), and a significant effect was also observed when the definition was "mean temperature ≥95th percentile for ≥3 days", with a RR of 1.064 (95%CI: 1.006-1.123). CONCLUSIONS Our findings support the hypothesis of a positive association between elevated ambient temperatures and/or heatwaves and adverse mental health outcomes. This problem will likely increase with a warming climate, especially in the context of climate change. Further high-quality studies are needed to identify modifying factors of heat impacts.
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Affiliation(s)
- Jingwen Liu
- School of Public Health, The University of Adelaide, Australia
| | | | - Alana Hansen
- School of Public Health, The University of Adelaide, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Australia; School of Public Health, Fujian Medical University, China
| | - Ying Zhang
- Sydney School of Public Health, The University of Sydney, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Australia
| | - Michelle Gourley
- Burden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Australia
| | - Timothy Driscoll
- Sydney School of Public Health, The University of Sydney, Australia
| | - Geoffrey Morgan
- Sydney School of Public Health, The University of Sydney, Australia
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Australia
| | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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Yoo EH, Eum Y, Gao Q, Chen K. Effect of extreme temperatures on daily emergency room visits for mental disorders. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:39243-39256. [PMID: 33751353 DOI: 10.1007/s11356-021-12887-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
Relatively few studies investigated the effects of extreme temperatures (both heat and cold) on mental health (ICD-9: 290-319; ICD-10: F00-F99) and the potential effect modifications by individuals' age, sex, and race. We aimed to explore the effect of extreme temperatures of both heat and cold on the emergency room (ER) visits for mental health disorders, and conducted a stratified analysis to identify possible susceptible population in Erie and Niagara counties, NY, USA. To assess the short-term impacts of daily maximum temperature on ER visits related to mental disorders (2009-2015), we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, long-term time trend, and seasonality. We found that there were positive associations between short-term exposure to extreme ambient temperatures and increased ER visits for mental disorders, and the effects can vary by individual factors. We found heat effect (relative risk (RR) = 1.16; 95% confidence intervals (CI), 1.06-1.27) on exacerbated mental disorders became intense in the study region and subgroup of population (the elderly) being more susceptible to extreme heat than any other age group. For extreme cold, we found that there is a substantial delay effect of 14 days (RR = 1.25; 95% CI = 1.08-1.45), which is particularly burdensome to the age group of 50-64 years old and African-Americans. Our findings suggest that there is a positive association between short-term exposure to extreme ambient temperature (heat and cold) and increased ER visits for mental disorders, and the effects vary as a function of individual factors, such as age and race.
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Affiliation(s)
- Eun-Hye Yoo
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA.
| | - Youngseob Eum
- Department of Geography, State University of New York at Buffalo, Buffalo, NY, USA
| | - Qi Gao
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, China
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
- Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, USA
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Pan R, Wang Q, Yi W, Wei Q, Cheng J, Su H. Temporal trends of the association between extreme temperatures and hospitalisations for schizophrenia in Hefei, China from 2005 to 2014. Occup Environ Med 2021; 78:oemed-2020-107181. [PMID: 33737328 DOI: 10.1136/oemed-2020-107181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/06/2021] [Accepted: 02/03/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We aimed to examine the temporal trends of the association between extreme temperature and schizophrenia (SCZ) hospitalisations in Hefei, China. METHODS We collected time-series data on SCZ hospitalisations for 10 years (2005-2014), with a total of 36 607 cases registered. We used quasi-Poisson regression and distributed lag non-linear model (DLNM) to assess the association between extreme temperature (cold and heat) and SCZ hospitalisations. A time-varying DLNM was then used to explore the temporal trends of the association between extreme temperature and SCZ hospitalisations in different periods. Subgroup analyses were conducted by age (0-39 and 40+ years) and gender, respectively. RESULTS We found that extreme cold and heat significantly increased the risk of SCZ hospitalisations (cold: 1st percentile of temperature 1.19 (95% CI 1.04 to 1.37) and 2.5th percentile of temperature 1.16 (95% CI 1.03 to 1.31); heat: 97.5th percentile of temperature 1.37 (95% CI 1.13 to 1.66) and 99th percentile of temperature 1.38 (95% CI 1.13 to 1.69)). We found a slightly decreasing trend in heat-related SCZ hospitalisations and a sharp increasing trend in cold effects from 2005 to 2014. However, the risk of heat-related hospitalisation has been rising since 2008. Stratified analyses showed that age and gender had different modification effects on temporal trends. CONCLUSIONS The findings highlight that as temperatures rise the body's adaptability to high temperatures may be accompanied by more threats from extreme cold. The burden of cold-related SCZ hospitalisations may increase in the future.
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Affiliation(s)
- Rubing Pan
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Qizhi Wang
- Chinese Academy of Agricultural Sciences, Haidian District, Beijing, China
| | - Weizhuo Yi
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Qiannan Wei
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Jian Cheng
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
| | - Hong Su
- Epidemiology and Health Statistics, Anhui Medical University, Hefei, Anhui, China
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Li H, Zhang S, Qian ZM, Xie XH, Luo Y, Han R, Hou J, Wang C, McMillin SE, Wu S, Tian F, Deng WF, Lin H. Short-term effects of air pollution on cause-specific mental disorders in three subtropical Chinese cities. ENVIRONMENTAL RESEARCH 2020; 191:110214. [PMID: 32946889 DOI: 10.1016/j.envres.2020.110214] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/25/2020] [Accepted: 09/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The effects of ambient air pollution on specific mental disorders are rarely studied, and the reported results are inconsistent. OBJECTIVE To assess the short-term effect of ambient air pollution on the morbidity of mental disorders in three subtropical Chinese cities. METHODS 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. RESULTS 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 (PM2.5, PM10, SO2 and NO2) concentrations, and the effect of NO2 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 PM2.5 at lag0 (ER = 1.20%, 95% CI: 0.28%, 2.13%), PM10 at lag0 (ER = 0.99%, 95% CI: 0.36%, 1.62%), and SO2 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 SO2 and affective disorder and between PM2.5 and schizophrenia. In addition, we found that air pollution exhibited stronger effects for males and adults (≥18 years). CONCLUSION Acute exposure to air pollution, especially NO2, might be an important trigger of mental disorders.
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Affiliation(s)
- Huan Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, USA
| | - Xin-Hui Xie
- Brain Function and Psychosomatic Medicine Institute, The Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Yang Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Rong Han
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Jiesheng Hou
- The Third People's Hospital of Zhaoqing, Guangdong, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, China
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, USA
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, China
| | - Fei Tian
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wen-Feng Deng
- Brain Function and Psychosomatic Medicine Institute, The Second People's Hospital of Huizhou, Huizhou, Guangdong, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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