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Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, Brazil.

ABSTRACT: BACKGROUND:Extreme 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. METHODS:A 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). RESULTS:Significant associations between environmental conditions (10??g/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. CONCLUSIONS:This 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.

SUBMITTER: da Silva I

PROVIDER: S-EPMC7336420 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, Brazil.

da Silva Iara I de Almeida Daniela Sanches DS Hashimoto Elizabeth Mie EM Martins Leila Droprinchinski LD

Environmental health : a global access science source 20200706 1

<h4>Background</h4>Extreme 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.<h4>Methods</h4>A time series study was carried out to explore the associations between daily air pollutants (SO<sub>2</sub>, NO<sub>2</su ...[more]

PMID: 32631375

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Project description:BackgroundExposure to air pollutants has been linked to the exacerbation of asthma, and it has become a risk to human welfare and health throughout the globe. Previous works did not achieve a systematic study by considering interactive effects of age, gender, and meteorological factors on the exposure-effect relationship between air pollutants and asthma. We aimed to quantitatively investigate the effects of air pollutants on hospitalizations for asthma in Chengdu, China.MethodsThis is a retrospective and population-based study. Data of asthma hospitalization records for residents, the average daily concentrations of air pollutants including SO2, CO, NO2, O3, PM10, and PM2.5, and meteorological variables from 1 January 2014 to 31 December 2014 in Chengdu, China, were obtained from several government departments. A generalized additive model (GAM) was used to analyze the exposure-effect relationship between air pollutants and daily asthma hospitalizations after controlling the long-time seasonal trend, "day-of-week (DOW)" effect, holiday effect, and confounding meteorological factors.ResultsA total of 7,503 hospitalizations were assessed. Significant associations between hospitalizations and air pollutants were found. The relative risk (RR) for hospitalizations for every 10 µg/m3 increase in PM2.5 and PM10 for the male group were 1.0121 [95% confidence interval (CI): 1.0012-1.0232] and 1.0075 (95% CI: 1.0001-1.015), respectively. The elderly (≥65 years old) tended to have a higher RR (1.0022; 95% CI: 1.0001-1.0043) for each 10 mg/m3 increase in CO than the other age groups. All pollutants had slightly protective effects on the younger age group (≤14 years old). O3 had more significant effects in cold season, whereas SO2 impacted more significantly in warm seasons, particularly for females and adults (14-65 years old).ConclusionsAdverse effects of ambient concentrations of air pollutants on hospitalizations for asthma are evident, especially in specific population groups. Male patients were more susceptible to PM2.5 and PM10, and the elderly were more sensitive to CO. The effects of O3 in China were significant in the cold season, whereas SO2 impacted more significantly in the warm season particularly on females and adults. The study would be meaningful for asthma intervention and corresponding healthcare resource management.

Project description:ObjectivesQuantify the risk of mental health (MH)-related emergency department visits (EDVs) due to heat, in the city of Curitiba, Brazil.DesignDaily time series analysis, using quasi-Poisson combined with distributed lag non-linear model on EDV for MH disorders, from 2017 to 2021.SettingAll nine emergency centres from the public health system, in Curitiba.Participants101 452 EDVs for MH disorders and suicide attempts over 5 years, from patients residing inside the territory of Curitiba.Main outcome measureRelative risk of EDV (RREDV) due to extreme mean temperature (24.5°C, 99th percentile) relative to the median (18.02°C), controlling for long-term trends, air pollution and humidity, and measuring effects delayed up to 10 days.ResultsExtreme heat was associated with higher single-lag EDV risk of RREDV 1.03(95% CI 1.01 to 1.05-single-lag 2), and cumulatively of RREDV 1.15 (95% CI 1.05 to 1.26-lag-cumulative 0-6). Strong risk was observed for patients with suicide attempts (RREDV 1.85, 95% CI 1.08 to 3.16) and neurotic disorders (RREDV 1.18, 95% CI 1.06 to 1.31). As to demographic subgroups, females (RREDV 1.20, 95% CI 1.08 to 1.34) and patients aged 18-64 (RREDV 1.18, 95% CI 1.07 to 1.30) were significantly endangered. Extreme heat resulted in lower risks of EDV for patients with organic disorders (RREDV 0.60, 95% CI 0.40 to 0.89), personality disorders (RREDV 0.48, 95% CI 0.26 to 0.91) and MH in general in the elderly ≥65 (RREDV 0.77, 95% CI 0.60 to 0.98). We found no significant RREDV among males and patients aged 0-17.ConclusionThe risk of MH-related EDV due to heat is elevated for the entire study population, but very differentiated by subgroups. This opens avenue for adaptation policies in healthcare: such as monitoring populations at risk and establishing an early warning systems to prevent exacerbation of MH episodes and to reduce suicide attempts. Further studies are welcome, why the reported risk differences occur and what, if any, role healthcare seeking barriers might play.

Dataset Information

Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, Brazil.

Publications

Risk assessment of temperature and air pollutants on hospitalizations for mental and behavioral disorders in Curitiba, Brazil.

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