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

• Kim, Yoonhee

• Ng, Chris Fook Sheng

• Chung, Yeonseung

• Kim, Ho

• Honda, Yasushi

• Guo, Yue Leon

• Lim, Youn-Hee

• Chen, Bing-Yu

• Page, Lisa A.

• Hashizume, Masahiro

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 ?10 μm (PM10), aerodynamic diameter ?2.5 μm (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.

Environmental Health Perspectives, 126(3), 037002; 2018

Journal

• Environmental Health Perspectives

  Environmental Health Perspectives 126 (3), 037002-, 2018-03

  Public Health Services, US Dept of Health and Human Services

Keywords

• Health, Toxicology and Mutagenesis
• Public Health, Environmental and Occupational Health

Details

• CRID: 1050005822263715712
• NII Article ID: 120006987318
• ISSN: 00916765
• ISSN: 15529924
• DOI: 10.1289/ehp2223
• HANDLE: 10069/38235
• Web Site: https://nagasaki-u.repo.nii.ac.jp/records/2991
• Web Site: https://ehp.niehs.nih.gov/doi/pdf/10.1289/EHP2223
• Text Lang: en
• Article Type: journal article
• Data Source:
  • IRDB
  • Crossref
  • CiNii Articles
  • KAKEN