Format

Send to

Choose Destination
Environ Health Perspect. 2018 Mar 6;126(3):037002. doi: 10.1289/EHP2223.

Air Pollution and Suicide in 10 Cities in Northeast Asia: A Time-Stratified Case-Crossover Analysis.

Author information

1
Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
2
Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
3
Graduate School of Public Health, Seoul National University, Seoul, South Korea.
4
Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
5
Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan (Republic of China).
6
Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, South Korea.
7
Sussex Partnership NHS Foundation Trust , Brighton, East Sussex, UK.
8
Brighton and Sussex Medical School , Brighton, East Sussex, UK.

Abstract

BACKGROUND:

There is growing evidence suggesting an association between air pollution and suicide. However, previous findings varied depending on the type of air pollutant and study location.

OBJECTIVES:

We examined the association between air pollutants and suicide in 10 large cities in South Korea, Japan, and Taiwan.

METHODS:

We used a two-stage meta-analysis. First, we conducted a time-stratified case-crossover analysis to estimate the short-term association between nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter [aerodynamic diameter ≤10μm (PM10), aerodynamic diameter ≤2.5μm (PM2.5), and PM10–2.5] and suicide, adjusted for weather factors, day-of-week, long-term time trends, and season. Then, we conducted a meta-analysis to combine the city-specific effect estimates for NO2, SO2, and PM10 across 10 cities and for PM2.5 and PM10–2.5 across 3 cities. We first fitted single-pollutant models, followed by two-pollutant models to examine the robustness of the associations.

RESULTS:

Higher risk of suicide was associated with higher levels of NO2, SO2, PM10, and PM10–2.5 over multiple days. The combined relative risks (RRs) were 1.019 for NO2 (95% confidence interval [CI]: 0.999, 1.039), 1.020 for SO2 (95% CI: 1.005, 1.036), 1.016 for PM10 (95% CI: 1.004, 1.029), and 1.019 for PM10–2.5 (95% CI: 1.005, 1.033) per interquartile range (IQR) increase in the 0-1 d average level of each pollutant. We found no evidence of an association for PM2.5. Some of the associations, particularly for SO2 and NO2, were attenuated after adjusting for a second pollutant.

CONCLUSIONS:

Our findings suggest that higher levels of air pollution may be associated with suicide, and further research is merited to understand the underlying mechanisms. https://doi.org/10.1289/EHP2223.

Comment in

PMID:
29529596
PMCID:
PMC6071818
DOI:
10.1289/EHP2223
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center