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Air Pollution and Emergency Department Visits for Mental Disorders among Youth

Author

Listed:
  • Mieczysław Szyszkowicz

    (Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada)

  • Roger Zemek

    (Department of Pediatrics and Emergency Medicine, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1N 6N5, Canada)

  • Ian Colman

    (School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada)

  • William Gardner

    (School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada)

  • Termeh Kousha

    (Department of Mathematics and Statistics, University of Ottawa, Ottawa, ON K1N 6N5, Canada)

  • Marc Smith-Doiron

    (Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada)

Abstract

Although exposure to ambient air pollution has been linked to mental health problems, little is known about its potential effects on youth. This study investigates the association between short-term exposure to air pollutants and emergency department (ED) visits for mental health disorders. The National Ambulatory Care Reporting System database was used to retrieve ED visits for young individuals aged 8–24 years in Toronto, Canada. Daily average concentrations of nitrogen dioxide (NO 2 ), fine particulate matter (PM 2.5 ), and daily maximum 8 h ozone (O 3 ) were calculated using measurement data from seven fixed stations. A case-crossover (CC) design was implemented to estimate the associations between ED visits and air pollution concentrations. Mental health ED visits were identified using International Classification of Diseases 10th Revision (ICD-10) codes, with seven categories considered. Models incorporating air pollutants and ambient temperature (with lags of 0–5 days) using a time-stratified CC technique were applied. Multivariable regression was performed by sex, three age groups, and seven types of mental health disorders to calculate relative risk (RR). The RRs were reported for one interquartile range (IQR) change in the air pollutant concentrations. Between April 2004 and December 2015 (4292 days), there were 83,985 ED visits for mental-health related problems in the target population. Several exposures to air pollutants were shown to have associations with ED visits for mental health including same day exposure to fine particulate matter (IQR = 6.03 μg/m 3 , RR = 1.01 (95% confidence interval: 1.00–1.02), RR = 1.02 (1.00–1.03)) for all and female-only patients, respectively. One-day lagged exposure was also associated with ED visits for PM 2.5 (RR = 1.02 (1.01–1.03)), for nitrogen dioxide (IQR = 9.1 ppb, RR = 1.02 (1.00–1.04)), and ozone (IQR = 16.0 ppb, RR = 1.06 (1.01–1.10)) for males. In this study, urban air pollution concentration—mainly fine particulate matter and nitrogen dioxide—is associated with an increased risk for ED visits for adolescents and young adults with diagnosed mental health disorders.

Suggested Citation

  • Mieczysław Szyszkowicz & Roger Zemek & Ian Colman & William Gardner & Termeh Kousha & Marc Smith-Doiron, 2020. "Air Pollution and Emergency Department Visits for Mental Disorders among Youth," IJERPH, MDPI, vol. 17(12), pages 1-13, June.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:12:p:4190-:d:370505
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    References listed on IDEAS

    as
    1. Mieczysław Szyszkowicz, 2019. "Case-Crossover Method with a Short Time-Window," IJERPH, MDPI, vol. 17(1), pages 1-7, December.
    2. Youngdon Kim & Woojae Myung & Hong-Hee Won & Sanghong Shim & Hong Jin Jeon & Junbae Choi & Bernard J Carroll & Doh Kwan Kim, 2015. "Association between Air Pollution and Suicide in South Korea: A Nationwide Study," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-10, February.
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    Cited by:

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