Abstract
Aim of the current study is to investigate the associations between daily levels of air pollutants (particulate matter, ozone, carbon monoxide, nitrogen dioxide) and daily admissions for mental disorders to the emergency department of two general hospitals in Umbria region (Italy). We collected data about daily admissions to psychiatric emergency services of two general hospitals, air pollutants' levels and meteorological data for the time period 1 January 2015 until 31 December 2016. We assessed the impact of an increase in air pollutants on the number of daily admissions using a time-series econometric framework. A total of 1860 emergency department admissions for mental disorders were identified. We observed a statistically significant impact of ozone levels on daily admissions. The estimated coefficient of O3 is statistically significant at the 1% level. All other pollutants were not significantly associated with the number of daily admissions. Short-term exposure to ozone may be associated with increased psychiatric emergency services admissions. Findings add to previous literature on existing evidence for air pollution to have an impact on mental health. Ozone may be considered a potential environmental risk factor for impaired mental health.
Highlights
Air pollution is a major environmental risk to health, concerning both developed and developing countries, with diverse and substantial public health implications (WHO, 2018a)
The aim of the current study is to investigate the associations between daily levels of five air pollutants and daily admissions for mental disorders to the emergency department of two general hospitals in Umbria region (Italy)
The number of daily admissions was negatively correlated with daily concentration levels of PM10, PM2.5, NO2 and carbon monoxide (CO), while they were positively correlated with O3 levels
Summary
Air pollution is a major environmental risk to health, concerning both developed and developing countries, with diverse and substantial public health implications (WHO, 2018a). Ambient (outdoor) air pollution in both cities and rural areas was estimated to cause 4.2 million premature deaths worldwide in 2016. It has been recently hypothesised that exposure to xenobiotic heavy metals such as lead and cadmium – constituents of air pollution such as particulate matter and nitrogen and sulphur oxides, organic solvents and other environmental pollutants – could be component causes for schizophrenia and other psychotic disorders (Attademo et al, 2017). Long-term exposure to ambient air pollution could be an independent risk factor for mental health disorders ranging from subjective stress to depressive disorders and suicidal ideation (Shin et al, 2018). Recent studies analysing the association between daily levels of air pollutants and hospital admissions for mental disorders showed significant results for different pollutants considered both for admissions for generic mental disorders (Chen et al, 2018; Kim et al, 2018; Song et al, 2018; Lee et al, 2019; Qiu et al, 2019) and for specific diagnoses such
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