Disclosures: The authors report no relevant financial disclosures.
May 11, 2020
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Short-term ambient air pollution exposure may increase daily hospital admissions for depression

Disclosures: The authors report no relevant financial disclosures.
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Xinbiao Guo
 
Shaowei Wu

The general urban population in China exhibited increased risk for daily hospital admission for depression associated with short-term ambient air pollution exposure, according to study results published in American Journal of Psychiatry.

These findings may have significant implications for improving mental health among the public, researchers noted.

The evidence is still lacking for the potential impact of short-term exposure on different ambient air pollutants on hospital admission of depression, a more severe form of depressive episode," Xinbiao Guo, MD, PhD, and Shaowei Wu, PhD, of the department of occupational and environmental health sciences at Peking University’s School of Public Health in Beijing, told Healio Psychiatry. “Few previous studies have investigated multiple major ambient air pollutants, including particulate matter and gaseous air pollutants, simultaneously. In addition, although the concentrations of ambient air pollution and prevalence rates of depression may vary geographically, few studies have paid attention to the variation among pollutant-depression associations across different regions. The large variations in both ambient air pollution levels and depression prevalence rates across China thus provide a unique opportunity to investigate the relationship between ambient air pollution and depression in different regions. Therefore, additional research evidence, especially in areas with a wide range of ambient air pollution levels, is needed to clarify the above issues.”

Despite these studies, evidence is lacking of an association between hospital admissions for depression and short-term exposure to ambient air pollutants, according to the researchers. Moreover, few studies have investigated multiple major ambient air pollutants simultaneously, nor the variation in pollutant-depression associations across different regions.

Gu and colleagues conducted a two-stage time-series analysis using data from Chinese national insurance databases to investigate the associations of short-term exposure to major ambient air pollutants — including fine particles, sulfur dioxide, nitrogen dioxide, inhalable particles, ozone and carbon monoxide — and daily hospital admission risk for depression in 75 Chinese cities between 2013 and 2017.

Results showed 111,620 hospital admissions for depression. Single-pollutant models revealed that the effect estimates of all included air pollutants, except for ozone, were significant at several lags within 1 week. The researchers noted associations between 10 g/m3 increases in fine particles, inhalable particles and nitrogen dioxide at 2-day average and increases of 0.52% (95% CI, 0.03-1.01), 0.41% (95% CI, 0.05-0.79) and 1.78% (95% CI, 0.73-2.83), respectively, in daily hospital admissions for depression. Subgroup, sensitivity and two-pollutant model analyses revealed the robustness of the effect estimates for nitrogen dioxide, according to Gu and colleagues.

Special attention should be paid to individuals with a tendency toward depressive symptoms, as they are more likely to be hospitalized in the context of increasing air pollution," Guo and Wu told Healio Psychiatry. "Hospitals should also be prepared in advance for the treatment of patients with depression in the event of an air pollution episode, which may increase the number of patients substantially. In addition, targeted strategies such as more stringent air pollution guidelines and air quality control measures may be helpful for promoting public mental health. Our study also highlights that people need to take personal protection measures when the air pollution level is high, and adjust their mentality in time in order to reduce the incidence of depression.” – by Joe Gramigna

Disclosures: The authors report no relevant financial disclosures.