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Association of short-term particulate matter exposure with suicide death among major depressive disorder patients: a time-stratified case-crossover analysis.

ABSTRACT: There is growing evidence that suggests a potential association between particulate matter (PM) and suicide. However, it is unclear that PM exposure and suicide death among major depressive disorder (MDD) patients, a high-risk group for suicide. We aimed to assess the effect of short-term exposure to PM on the risk of suicide in MDD patients who are at high risk for suicide. We investigated the risk of suicide among 922,062 newly-diagnosed MDD patients from 2004 to 2017 within the Korean National Health Insurance Service (NHIS) database. We identified 3,051 suicide cases from January 1, 2015, to December 31, 2017, within the death statistics database of the Korean National Statistical Office. PMs with aerodynamic diameter less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 2.5-10 μm (PM2.5-10) were considered, which were provided from the National Ambient Air Monitoring System in South Korea. Time-stratified case-crossover analysis was performed to investigate the association of particulate matter exposure to suicide events. The risk of suicide was significantly high upon the high level of exposure to PM2.5, PM2.5-10 (coarse particle) and PM10 on lag 1 (p for trend < 0.05). Short-term exposure to a high level of PM was associated with an elevated risk for suicide among MDD patients. There is a clear dose-response relationship between short-term PM exposures with suicide death among MDD patients. This result will be used as an essential basis for consideration when establishing an air pollution alarm system for reducing adverse health outcomes by PM.

SUBMITTER: Hwang IY

PROVIDER: S-EPMC9120445 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Association of short-term particulate matter exposure with suicide death among major depressive disorder patients: a time-stratified case-crossover analysis.

Hwang In Young IY Choi Daein D Kim Jihoon Andrew JA Choi Seulggie S Chang Jooyoung J Goo Ae Jin AJ Ko Ahryoung A Lee Gyeongsil G Kim Kyae Hyung KH Son Joung Sik JS Park Sang Min SM

Scientific reports 20220519 1

There is growing evidence that suggests a potential association between particulate matter (PM) and suicide. However, it is unclear that PM exposure and suicide death among major depressive disorder (MDD) patients, a high-risk group for suicide. We aimed to assess the effect of short-term exposure to PM on the risk of suicide in MDD patients who are at high risk for suicide. We investigated the risk of suicide among 922,062 newly-diagnosed MDD patients from 2004 to 2017 within the Korean Nationa ...[more]

PMID: 35589851

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Project description:BackgroundAir pollution can cause various respiratory and neurological diseases and continuous exposure can lead to death. Previous studies have reported that particulate matter (PM) exposure increases the risk of depression, suicidal thoughts, and suicidal death; however, the results are inconsistent and limited. This study aimed to examine the relationship between short-term PM exposure and suicide deaths, as well as investigate the short-term effects of PM on suicide death within vulnerable groups based on factors such as sex, age group, suicide-related information (note, method, and cause), psychiatric disorders, and physical diseases.MethodsData on a total of 28,670 suicide deaths from 2013 to 2017, provided by the Korea Foundation for Suicide Prevention, were analyzed. The study design employed a time-series analysis with a two-stage approach. In the first step, a generalized additive model combined with a distributed lag nonlinear model was used to estimate the short-term effect of PM exposure on suicide risk specific to each city. In the second step, the estimated results from each city were pooled through a meta-analysis to derive the overall effect. We determined the effects of single lag, cumulative lag, and moving average PM concentrations from days 0-7 before suicide.ResultsWe confirmed an association between exposure to PM10 (≤ 10 μm in diameter) and deaths due to suicide. In particular, among individuals with psychiatric disorders and those who employed non-violent suicide methods, increased exposure to PM10 was associated with a higher risk of death by suicide, with percentage changes of 5.92 (95% confidence interval [CI]: 3.95-7.92) and 11.47 (95% CI: 7.95-15.11), respectively. Furthermore, in the group with psychiatric disorders, there was an observed tendency of increasing suicide risk as PM10 levels increased up to 120 µg/m3, whereas in the group with non-violent suicide deaths, there was a pronounced trend of rapid increase in suicide risk with an increase in PM10 up to 100 µg/m3.ConclusionsThese results show an association between short-term exposure to PM and suicide. Our study adds evidence for the benefits of reducing PM in preventing diseases and improving mental health.

Project description:Objective: To assess risks and costs of hospital admission associated with short term exposure to fine particulate matter with diameter less than 2.5 µm (PM2.5) for 214 mutually exclusive disease groups.Design: Time stratified, case crossover analyses with conditional logistic regressions adjusted for non-linear confounding effects of meteorological variables.Setting: Medicare inpatient hospital claims in the United States, 2000-12 (n=95 277 169).Participants: All Medicare fee-for-service beneficiaries aged 65 or older admitted to hospital.Main outcome measures: Risk of hospital admission, number of admissions, days in hospital, inpatient and post-acute care costs, and value of statistical life (that is, the economic value used to measure the cost of avoiding a death) due to the lives lost at discharge for 214 disease groups.Results: Positive associations between short term exposure to PM2.5 and risk of hospital admission were found for several prevalent but rarely studied diseases, such as septicemia, fluid and electrolyte disorders, and acute and unspecified renal failure. Positive associations were also found between risk of hospital admission and cardiovascular and respiratory diseases, Parkinson's disease, diabetes, phlebitis, thrombophlebitis, and thromboembolism, confirming previously published results. These associations remained consistent when restricted to days with a daily PM2.5 concentration below the WHO air quality guideline for the 24 hour average exposure to PM2.5. For the rarely studied diseases, each 1 µg/m3 increase in short term PM2.5 was associated with an annual increase of 2050 hospital admissions (95% confidence interval 1914 to 2187 admissions), 12 216 days in hospital (11 358 to 13 075), US$31m (£24m, €28m; $29m to $34m) in inpatient and post-acute care costs, and $2.5bn ($2.0bn to $2.9bn) in value of statistical life. For diseases with a previously known association, each 1 µg/m3 increase in short term exposure to PM2.5 was associated with an annual increase of 3642 hospital admissions (3434 to 3851), 20 098 days in hospital (18 950 to 21 247), $69m ($65m to $73m) in inpatient and post-acute care costs, and $4.1bn ($3.5bn to $4.7bn) in value of statistical life.Conclusions: New causes and previously identified causes of hospital admission associated with short term exposure to PM2.5 were found. These associations remained even at a daily PM2.5 concentration below the WHO 24 hour guideline. Substantial economic costs were linked to a small increase in short term PM2.5.

Project description:Background: Major Depressive Disorder (MDD) is a moderately heritable disorder with a high lifetime prevalence. At present, laboratory blood tests to support MDD diagnosis are not available. Methods: We used a classifier approach on blood gene expression profiles of a unique set of non-medicated subjects (MDD patients and controls) to select genes of which expression is predictive for disease status. To reveal blood gene expression changes related to MDD disease, we applied a powerful ex vivo stimulus to the blood, i.e. incubation with lipopolysaccharide (LPS; 10 ng/ml blood). Results: Based on LPS-stimulated blood gene expression using whole-genome microarrays in 42 subjects (primary cohort; 21 MDD patients (mean age 42.3 years), 21 healthy controls (mean age 41.9 years)), we identified a set of genes (CAPRIN1, CLEC4A, KRT23, MLC1, PLSCR1, PROK2, ZBTB16) that serves as a molecular signature of MDD. These findings were validated for the primary cohort using an independent quantitative PCR method (P = 0.007). The difference between depressive patients and controls was confirmed (P = 0.019) in a replication cohort of 13 patients with MDD (mean age 42.8 years) and 14 controls (mean age 45.6 years). The MDD-signature score comprised of expression levels of 7 genes could discriminate depressive patients from controls with sensitivity of 76.9% and specificity of 71.8%. Conclusions: We show for the first time that molecular analysis of stimulated blood cells can be used as an endophenotype for MDD diagnosis, which is a milestone in establishing biomarkers for neuropsychiatric disorders with moderate heritability in general. Our results may provide a new entry point for following and predicting treatment outcome, as well as prediction of severity and recurrence of MDD. In total, 33 MDD patients and 34 healthy controls were analyzed using basal gene expression in whole blood, and gene expression from whole blood that was stimulated with LPS for 5-6 h, using microarrays. Patients were arbitrarily selected from all patients to serve as primary cohort (nMDD = 21 (MDD01-MDD21); nControls = 21 (Con01-Con21)), or replication cohort (nMDD = 12 (MDD22-MDD35); nControls = 13 (Con22-Con37)) using microarrays. This submission does not include Samples CON21_LPS or CON30_LPS.

Project description:BackgroundAssociations between short-term exposure to ambient particulate matter (PM) air pollutants and mortality or hospital admissions have been well-documented in previous studies. Less is known about the associations of hourly exposure to PM air pollutants with ambulance emergency calls (AECs) for all causes and specific causes by conducting a case-crossover study. In addition, different patterns of AECs may be attributed to different seasons and daytime or nighttime periods.ObjectiveIn this study, we quantified the risk of all-cause and cause-specific AECs associated with hourly PM air pollutants between January 1, 2013, and December 31, 2019, in Shenzhen, China. We also examined whether the observed associations of PM air pollutants with AECs for all causes differed across strata defined by sex, age, season, and the time of day.MethodsWe used ambulance emergency dispatch data and environmental data between January 1, 2013, and December 31, 2019, from the Shenzhen Ambulance Emergency Centre and the National Environmental Monitor Station to conduct a time-stratified case-crossover study to estimate the associations of air pollutants (ie, PM with an aerodynamic diameter less than 2.5 µm [PM2.5] or 10 µm [PM10]) with all-cause and cause-specific AECs. We generated a well-established, distributed lag nonlinear model for nonlinear concentration response and nonlinear lag-response functions. We used conditional logistic regression to estimate odds ratios with 95% CIs, adjusted for public holidays, season, the time of day, the day of the week, hourly temperature, and hourly humidity, to examine the association of all-cause and cause-specific AECs with hourly air pollutant concentrations.ResultsA total of 3,022,164 patients were identified during the study period in Shenzhen. Each IQR increase in PM2.5 (24.0 µg/m3) and PM10 (34.0 µg/m3) concentrations over 24 hours was associated with an increased risk of AECs (PM2.5: all-cause, 1.8%, 95% CI 0.8%-2.4%; PM10: all-cause, 2.0%, 95% CI 1.1%-2.9%). We observed a stronger association of all-cause AECs with PM2.5 and PM10 in the daytime than in the nighttime (PM2.5: daytime, 1.7%, 95% CI 0.5%-3.0%; nighttime, 1.4%, 95% CI 0.3%-2.6%; PM10: daytime, 2.1%, 95% CI 0.9%-3.4%; nighttime, 1.7%, 95% CI 0.6%-2.8%) and in the older group than in the younger group (PM2.5: 18-64 years, 1.4%, 95% CI 0.6%-2.1%; ≥65 years, 1.6%, 95% CI 0.6%-2.6%; PM10: 18-64 years, 1.8%, 95% CI 0.9%-2.6%; ≥65 years, 2.0%, 95% CI 1.1%-3.0%).ConclusionsThe risk of all-cause AECs increased consistently with increasing concentrations of PM air pollutants, showing a nearly linear relationship with no apparent thresholds. PM air pollution increase was associated with a higher risk of all-cause AECs and cardiovascular diseases-, respiratory diseases-, and reproductive illnesses-related AECs. The results of this study may be valuable to air pollution attributable to the distribution of emergency resources and consistent air pollution control.

Dataset Information

Association of short-term particulate matter exposure with suicide death among major depressive disorder patients: a time-stratified case-crossover analysis.

Publications

Association of short-term particulate matter exposure with suicide death among major depressive disorder patients: a time-stratified case-crossover analysis.

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