Hospital admission risks and costs for neuropsychiatric disorders attributable to fine particulate matter in New York State: a community-level cross-sectional study

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BACKGROUND AND AIM Neuropsychiatric disorders are a huge and growing public health concern during the recent years. However, evidence is limited for air pollution and related excess medical costs for neuropsychiatric disorders. We aimed to investigate excess risks and costs of hospital admission for neuropsychiatric disorders associated with long-term exposure to fine particulate matter (PM2.5) in New York State and examine disproportionate impact of PM2.5 on neuropsychiatric disorders by individual characteristics. METHODS We collected non-elective annual hospital admission counts and costs for six neuropsychiatric disorders—fatigue, headache, behavior disorder, mood disorder, Parkinson’s diseases, and epilepsy— from the Statewide Planning and Research Cooperative System (SPARCS) database from 2010 to 2016. We also obtained county-level annual average of PM2.5 from the high-quality prediction model. We performed a generalized linear mixed model to estimate the association between annual average PM2.5 and the number of annual hospital admissions for neuropsychiatric disorders and calculated the excess medical costs attributable to PM2.5 based on the estimated association. RESULTS We found that higher exposure to PM2.5 was associated with higher hospital admission risks of neuropsychiatric disorders, and the risk was more evident in behavior disorder and Parkinson’s disease, RRs: 1.08 (95% CI: 1.02, 1.16) and 1.08 (95% CI: 1.00, 1.17). Meanwhile, the excess medical cost attributable to annual PM2.5 was the highest in mood disorder (309.8 million dollars with 95% CI: -48.4, 599.4 million dollars) and epilepsy (255.5 million dollars with 95% CI: 55.9, 405.2 million dollars). CONCLUSIONS This study provides the excess hospital admission risks due to exposure to long-term PM2.5 for neuropsychiatric disorders, together with the excess costs attributable to PM2.5 which have a different pattern from the estimated risks. KEYWORDS Fine particulate matter, PM2.5, Neuropsychiatric disorders, Economic burden.