The association between PM2.5 exposure and suicidal ideation: a prefectural panel study

Analysis of the situations and influencing factors of public anxiety in China: based on Baidu index data

Background

Anxiety disorders have emerged as one of the most prevalent mental health problems and health concerns. However, previous research has paid limited attention to measuring public anxiety from a broader perspective. Furthermore, while we know many factors that influence anxiety disorders, we still have an incomplete understanding of how these factors affect public anxiety. We aimed to quantify public anxiety from the perspective of Internet searches, and to analyze its spatiotemporal changing characteristics and influencing factors.

Methods

This study collected Baidu Index from 2014 to 2022 in 31 provinces in mainland China to measure the degree of public anxiety based on the Baidu Index from 2014 to 2022. The spatial autocorrelation analysis method was used to study the changing trends and spatial distribution characteristics of public anxiety. The influencing factors of public anxiety were studied using spatial statistical modeling methods.

Results

Empirical analysis shows that the level of public anxiety in my country has continued to rise in recent years, with significant spatial clustering characteristics, especially in the eastern and central-southern regions. In addition, we constructed ordinary least squares (OLS) and geographically weighted regression (GWR) spatial statistical models to examine the relationship between social, economic, and environmental factors and public anxiety levels. We found that the GWR model that considers spatial correlation and dependence is significantly better than the OLS model in terms of fitting accuracy. Factors such as the number of college graduates, Internet traffic, and urbanization rate are significantly positively correlated with the level of public anxiety.

Conclusion

Our research results draw attention to public anxiety among policymakers, highlighting the necessity for a more extensive examination of anxiety issues, especially among university graduates, by the public and relevant authorities.

The Effect of Kitchen Ventilation Modification on Independent and Combined Associations of Cooking Fuel Type and Cooking Duration with Suicidal Ideation: A Cross-Sectional Study

Although household air pollution (HAP) is associated with an increased risk of mental disorders, evidence remains scarce for the relationship between HAP and suicidal ideation. A total of 21,381 qualified participants were enrolled on the Henan Rural Cohort Study. HAP information including cooking fuel type, cooking duration and kitchen ventilation was collected by questionnaires. Suicidal ideation was evaluated by item nine of the Patient Health Questionnaire-9 (PHQ-9). Independent and combined associations of cooking fuel type and cooking duration with suicidal ideation were explored by logistic regression models. Analyses were conducted in different kitchen ventilation groups to detect the potential effect modification. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) of solid fuel users versus clean fuel users for suicidal ideation was 1.37 (1.16, 1.62), and the risk of suicidal ideation increased by 15% (95% CI: 5%, 26%) for each additional hour of the cooking duration. Participants cooking with solid fuel for long durations were related to the highest risk of suicidal ideation (OR (95% CI): 1.51 (1.22, 1.87)). However, all these associations were not observed in those cooking with mechanical ventilation. Mechanical ventilation ameliorated relationships between solid fuel use and long-duration cooking with suicidal ideation.

Examining the Benefits of Greenness on Reducing Suicide Mortality Rate: A Global Ecological Study

Objective

This study applied an ecological-based analysis aimed to evaluate on a global scale the association between greenness exposure and suicide mortality.

Methods

Suicide mortality data provided by the Institute for Health Metrics and Evaluation and the Normalized Difference Vegetation Index (NDVI) were employed. The generalized additive mixed model was applied to evaluate with an adjustment of covariates the association between greenness and suicide mortality. Sensitivity tests and positive-negative controls also were used to examine less overt insights. Subgroup analyses were then conducted to investigate the effects of greenness on suicide mortality among various conditions.

Results

The main finding of this study indicates a negative association between greenness exposure and suicide mortality, as greenness significantly decreases the risk of suicide mortality per interquartile unit increment of NDVI (relative risk = 0.69, 95%CI: 0.59–0.81). Further, sensitivity analyses confirmed the robustness of the findings. Subgroup analyses also showed a significant negative association between greenness and suicide mortality for various stratified factors, such as sex, various income levels, urbanization levels, etc.

Conclusions

Greenness exposure may contribute to a reduction in suicide mortality. It is recommended that policymakers and communities increase environmental greenness in order to mitigate the global health burden of suicide.

Associations of PM2.5 and road traffic noise with mental health: Evidence from UK Biobank

BACKGROUND

The associations of atmospheric particulate matter with diameters of 2.5 μm or less (PM2.5) and road traffic noise with mental disorders in men and women are not well studied.

OBJECTIVES

We aim to examine the cross-sectional associations of PM2.5 and road traffic noise with mental disorders in men and women.

METHODS

The baseline data of the UK Biobank study (2006-2010) were used. Mental disorders including symptoms of nerves, anxiety, tension or depression (NATD), major depression, and bipolar disorder were assessed by validated questions. Verified models were used to estimate PM2.5 and road traffic noise.

RESULTS

A total of 334,986 participants with measurements of NATD and 90,706 participants with measurements of major depression and bipolar disorder were included in the analysis. After adjusting for covariates, the odds for the risk of NATD symptoms increased by 2.31 (95% CI: 2.15-2.50) times per 10 μg/m³ increase in PM2.5. The odds for the risk of major depression and bipolar disorder increased by 2.26 and 4.99 times per 10 μg/m³ increase in PM2.5. On the other hand, higher road traffic noise exposure was significantly associated with a higher risk of NATD symptoms (Decile 6-8 (54.9-57.8 dB), OR: 1.03, 95% CI: 1.01-1.06; Decile 9-10 (≥57.8 dB), OR: 1.04, 95% CI: 1.01-1.07) and bipolar disorder (Decile 2-5 (52.1-54.9 dB), OR: 1.26, 95% CI: 1.00-1.59; Decile 6-8 (54.9-57.8 dB), OR: 1.30, 95% CI: 1.02-1.65; Decile 9-10 (≥57.8 dB), OR: 1.54, 95% CI: 1.21-1.97). Interestingly, a negative association was observed between moderate road traffic noise and major depression (Decile 2-5 (52.1-54.9 dB), OR: 0.95, 95% CI: 0.90-1.00). Interactions between PM2.5 exposure with age, gender, and sleeplessness for NATD symptoms were observed (P < 0.05), while interactions between road traffic noise exposure with age and gender were observed (P < 0.05).

CONCLUSIONS

We found a positive association between PM2.5 and mental disorders. Meanwhile, we found a positive association of road traffic noise with NATD symptoms and bipolar disorder and a negative association of moderate road traffic noise with major depression. Also, the effect modifications of these associations by age, gender, or sleeplessness may exist.

Can parkland mitigate mental health burden imposed by the COVID-19? A national study in China

The worldwide coronavirus disease 2019 (COVID-19) pandemic has seriously affected not only physical health but also mental wellbeing (i.e mental stress and suicide intention) of numerous urban inhabitants across the globe. While many studies have elucidated urban parkland enhances and mental wellbeing of urban residents, the potential for parkland to mitigate mental health burden imposed by the COVID-19 has received no attention. This nationwide study systematically explored the association between parkland, the COVID-19 pandemic situation and mental wellbeing from 296 cities in China. The study innovatively used big data from Baidu Search Engine to assess city-level mental wellbeing, thereby enabling comparisons among cities. The results show that the provision of parkland is positively associated with mental wellbeing during the COVID-19 epidemic. For COVID-19-related indicators, the geographical distance to Wuhan city, work resumption rate, and travel intensity within the city are also positively associated with mental wellbeing, while the number of COVID-19 infections and the proportion of migrants from Hubei Province for each city are negatively associated with mental wellbeing. Last, the most important finding is that parkland reduces the negative effect of COVID-19 on mental wellbeing during the COVID-19 epidemic. To achieve the goal of promoting mental wellbeing through urban planning and design during the future pandemics, policymakers and planners are advised to provide more well-maintained and accessible parkland and encourage residents to use them with proper precautions.

Hand Hygiene and Mask-Wearing Practices during COVID-19 among Healthcare Workers: Misinformation as a Predictor

Poor public health information is a hurdle in infectious disease control. The study aims to examine whether healthcare workers adhere to hand hygiene and mask-wearing guidelines during the COVID-19 pandemic and to explore their exposure to misinformation about the pandemic as a predictor. A cross-sectional survey was sent to 518 healthcare workers across Indonesia, the fourth largest nation in the world, in September 2020 during the COVID-19 pandemic. The respondents reported whether they adhered to the guidelines of hand hygiene and mask wearing and whether they believed in four pieces of misinformation about the origin, severity, contagion, and prevention of COVID-19. The association between misinformation and hand hygiene and mask wearing was tested with logistic regression models controlling for demographic and health-related covariates. Approximately 25% of healthcare workers did not always adhere to hand hygiene guidelines and approximately 5% did not adhere to mask-wearing guidelines. There are significant associations between all four pieces of misinformation and hand hygiene and mask wearing. It is important to improve public health information about COVID-19, which may hold key to healthcare workers' hand hygiene and mask wearing and to protect their health and patients' safety.

The association between ozone and fine particles and mental health-related emergency department visits in California, 2005-2013

Recent studies suggest that air pollutant exposure may increase the incidence of mental health conditions, however research is limited. We examined the association between ozone (O3) and fine particles (PM2.5) and emergency department (ED) visits related to mental health outcomes, including psychosis, neurosis, neurotic/stress, substance use, mood/affective, depression, bipolar, schizotypal/delusional, schizophrenia, self-harm/suicide, and homicide/inflicted injury, from 2005 through 2013 in California. Air monitoring data were provided by the U.S. EPA's Air Quality System Data Mart and ED data were provided by the California Office of Statewide Health Planning and Development. We used the time-series method with a quasi-Poisson regression, controlling for apparent temperature, day of the week, holidays, and seasonal/long-term trends. Per 10 parts per billion increase, we observed significant cumulative 7-day associations between O3 and all mental health [0.64%, 95% confidence interval (CI): 0.21, 1.07], depression [1.87%, 95% CI: 0.62, 3.15], self-harm/suicide [1.43%, 95% CI: 0.35, 2.51], and bipolar [2.83%, 95% CI: 1.53, 4.15]. We observed 30-day lag associations between O3 and neurotic disorder [1.22%, 95% CI: 0.48, 1.97] and homicide/inflicted injury [2.01%, 95% CI: 1.00, 3.02]. Same-day mean PM2.5 was associated with a 0.42% [95% CI: 0.14, 0.70] increase in all mental health, 1.15% [95% CI: 0.62, 1.69] increase in homicide/inflicted injury, and a 0.57% [95% CI: 0.22, 0.92] increase in neurotic disorders per 10 μg/m3 increase. Other outcomes not listed here were not statistically significant for O3 or PM2.5. Risk varied by age group and was generally greater for females, Asians, and Hispanics. We also observed seasonal variation for outcomes including but not limited to depression, bipolar, schizophrenia, self-harm/suicide, and homicide/inflicted injury. Ambient O3 or PM2.5 may increase the risk of mental health illness, though underlying biological mechanisms remain poorly understood. Findings warrant further investigation to better understand the impacts of air pollutant exposure among vulnerable groups.

PM2.5 exposure and anxiety in China: evidence from the prefectures

BACKGROUND

Anxiety disorders are among the most common mental health concerns today. While numerous factors are known to affect anxiety disorders, the ways in which environmental factors aggravate or mitigate anxiety are not fully understood.

METHODS

Baidu is the most widely used search engine in China, and a large amount of data on internet behavior indicates that anxiety is a growing concern. We reviewed the annual Baidu Indices of anxiety-related keywords for cities in China from 2013 to 2018 and constructed anxiety indices. We then employed a two-way fixed effect (FE) model to analyze the relationship between PM2.5 exposure and anxiety at the prefectural level.

RESULTS

The results indicated that there was a significant positive association between PM2.5 and anxiety index. The anxiety index increased by 0.1565258 for every unit increase in the PM2.5 level (P < 0.05), which suggested that current PM2.5 levels in China pose a considerable risk to mental health.

CONCLUSION

The enormous impact of PM2.5 exposure indicates that the macroscopic environment can shape individual mentality and social behavior, and that it can be extremely destructive in terms of societal mindset.

Meteorological Variables and Suicidal Behavior: Air Pollution and Apparent Temperature Are Associated With High-Lethality Suicide Attempts and Male Gender

This study analyzed the impact of meteorological variables and high-lethality suicide attempts (HLSA) to assess a potential time shift of HLSA affected by climate evolution to predict the suicide attempt cases over different periods of the year. After attempting suicide, 225 subjects were admitted to the emergency ward of the IRCCS Ospedale Policlinico San Martino and later to the psychiatric unit from March 2016 to July 2018. Socio-demographic and clinical characteristics as well as the meteorological variables were collected. The Mann-Kendall test as well as redundancy and cross-correlation analyses were performed to analyze the trends, statistically correlations, and correspondence of the trends, respectively between suicidal behaviors and climatic factors. Sixty-seven (29.8%) committed a HLSA. Our findings indicate a significant association between HLSA and male gender and apparent temperature with a strong correlation of 75% with a phase shift of -1 month. Solar radiation and air pollution (PM_2.5) have a positive correlation of 65 and 32%, respectively, with a zero-time lag. Limitations include that the data are limited to a single hospital; psychological factors, or other clinical variables that could be ruled out as a trigger have not been considered. Meteorological variables may not mirror the temperature that the patient is exposed to due to the air conditioning systems. Exploring those environmental factors associated with HLSA in a more detailed manner could lead to early intervention and prevention strategies for such distressing admissions.