Abstract
BackgroundExtreme ambient temperatures and air quality have been directly associated with various human diseases from several studies around the world. However, few analyses involving the association of these environmental circumstances with mental and behavioral disorders (MBD) have been carried out, especially in developing countries such as Brazil.MethodsA time series study was carried out to explore the associations between daily air pollutants (SO2, NO2, O3, and PM10) concentrations and meteorological variables (temperature and relative humidity) on hospital admissions for mental and behavioral disorders for Curitiba, Brazil. Daily hospital admissions from 2010 to 2016 were analyzed by a semi-parametric generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM).ResultsSignificant associations between environmental conditions (10 μg/m3 increase in air pollutants and temperature °C) and hospitalizations by MBD were found. Air temperature was the environmental variable with the highest relative risk (RR) at 0-day lag for all ages and sexes analyzed, with RR values of 1.0182 (95% CI: 1.0009–1.0357) for men, and 1.0407 (95% CI: 1.0230–1.0587) for women. Ozone exposure was a risk for all women groups, being higher for the young group, with a RR of 1.0319 (95% CI: 1.0165–1.0483). Elderly from both sexes were more susceptible to temperature variability, with a RR of 1.0651 (95% CI: 1.0213–1.1117) for women, and 1.0215 (95% CI: 1.0195–1.0716) for men.ConclusionsThis study suggests that temperatures above and below the thermal comfort threshold, in addition to high concentrations of air pollutants, present significant risks on hospitalizations by MBD; besides, there are physiological and age differences resulting from the effect of this exposure.Graphical abstract
Highlights
Extreme ambient temperatures and air quality have been directly associated with various human diseases from several studies around the world
Highlights The highest relative risks occurred in the same day of the exposure
Women are more affected by air pollutants and temperature variability than men
Summary
Extreme ambient temperatures and air quality have been directly associated with various human diseases from several studies around the world. There are several strong evidences concerning the negative impacts of air pollution and extreme temperature on human health [1,2,3]. The complex mixture of chemical substances in polluted air associated with meteorological variables imposes various damages on circulatory and respiratory human system, as well as causes aggravation of diseases [4]. Epidemiological studies concerning the mental diseases associations with air pollution and meteorological variables have been conducted in the last years for short-term [6, 19,20,21,22] and long-term exposure [23, 24]. Almendra [20] found that the hospital admissions by mental disorders increase with high temperatures, and they pointed out that low temperatures can be a protective factor for Lisbon population [25]. observed associations between traffic-related air pollution and dementia incidence in Northern Sweden
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