Ambient coarse particulate matter pollution and hospital admissions for schizophrenia

Abstract

Objective

To investigate the association between ambient coarse particulate matter (PM_2.5–10) pollution and risk of acute schizophrenia episodes.

Methods

A time-stratified case-crossover study with a two-stage analytical approach was conducted to investigate the association between ambient PM_2.5–10 pollution and schizophrenia admissions (an indicator for acute schizophrenia episodes) across 259 Chinese cities of prefecture-level or above during 2013–2017. A conditional logistic regression model was constructed to estimate city-specific changes in hospital admissions for schizophrenia associated with per interquartile range (IQR) increase in ambient PM_2.5–10, and the overall associations were obtained by pooling the city-specific associations using the random-effects model.

Results

A total of 817,296 schizophrenia admissions were included in the analysis. Per IQR increase (28.43 μg/m³) in PM_2.5–10 at lag01 was associated with an increase of 1.66 % (95 % CI: 0.68 %, 2.65 %) in schizophrenia admissions. Compared to concentrations <30 μg/m³, PM_2.5–10 concentrations of 30–49 μg/m³ and ≥50 μg/m³ were associated with increases of 2.25 % (95 % CI: 0.73 %%, 3.79 %) and 4.03 % (95 % CI: 1.92 %, 6.18 %) in schizophrenia admissions, respectively. City-level urbanization has the potential to attenuate the association between ambient PM_2.5–10 and schizophrenia admissions (P = 0.0002).

Conclusions

Our study provides novel evidence for the acute adverse effects of ambient PM_2.5–10 on schizophrenia and calls for special attention on the control of high PM_2.5–10 pollution in disease prevention.