TY - JOUR
T1 - Impacts of PM2.5 before and after COVID-19 outbreak on emergency mental disorders
T2 - A population-based quasi-experimental and case-crossover study
AU - Tao, Junwen
AU - Yan, Junwei
AU - Su, Hong
AU - Huang, Cunrui
AU - Tong, Shilu
AU - Ho, Hung Chak
AU - Xia, Qingrong
AU - Zhu, Cuizhen
AU - Zheng, Hao
AU - Hossain, Mohammad Zahid
AU - Cheng, Jian
PY - 2023/10/1
Y1 - 2023/10/1
N2 - The ongoing COVID-19 pandemic is a great challenge to mental health, but fine particulate matter (PM2.5), an increasingly reported risk factor for mental disorders, has been greatly alleviated during the pandemic in many countries. It remains unknown whether COVID-19 outbreak can affect the association between PM2.5 exposure and the risk of mental disorders. This study aimed to investigate the associations of total and cause-specific mental disorders with PM2.5 exposure before and after the COVID-19 outbreak in China. Data on daily emergency department visits (EDVs) and hospitalizations of mental disorders from 2016 to 2021 were obtained from Anhui Mental Health Center for Hefei city. An interrupted time series analysis was used to quantify the impact of COVID-19 outbreak on EDVs and hospitalizations of mental disorders. A time-stratified case-crossover analysis was employed to evaluate the association of mental disorders with PM2.5 exposure before and after the COVID-19 outbreak, especially in the three months following the COVID-19 outbreak. After COVID-19 outbreak, there was an immediate and significant decrease in total mental disorders, including a reduction of 15% (95% CI: 3%–26%) in EDVs and 44% (95% CI: 36%–51%) in hospitalizations. PM2.5 exposure was associated with increased risk of EDVs and hospitalizations for total and cause-specific mental disorders (schizophrenia, schizotypal and delusional disorders; neurotic, stress-related, and somatoform disorders) before COVID-19 outbreak, but this PM2.5-related risk elevation significantly decreased after COVID-19 outbreak, with greater risk reduction at the first month after the outbreak. However, young people (0–45 years) were still vulnerable to PM2.5 exposure after the COVID-19 outbreak. This study first reveals that the risk of PM2.5-related emergency mental disorders decreased after the COVID-19 outbreak in China. The low concentration of PM2.5 might benefit mental health and greater efforts are required to mitigate air pollution in the post-COVID-19 era. © 2023 Elsevier Ltd
AB - The ongoing COVID-19 pandemic is a great challenge to mental health, but fine particulate matter (PM2.5), an increasingly reported risk factor for mental disorders, has been greatly alleviated during the pandemic in many countries. It remains unknown whether COVID-19 outbreak can affect the association between PM2.5 exposure and the risk of mental disorders. This study aimed to investigate the associations of total and cause-specific mental disorders with PM2.5 exposure before and after the COVID-19 outbreak in China. Data on daily emergency department visits (EDVs) and hospitalizations of mental disorders from 2016 to 2021 were obtained from Anhui Mental Health Center for Hefei city. An interrupted time series analysis was used to quantify the impact of COVID-19 outbreak on EDVs and hospitalizations of mental disorders. A time-stratified case-crossover analysis was employed to evaluate the association of mental disorders with PM2.5 exposure before and after the COVID-19 outbreak, especially in the three months following the COVID-19 outbreak. After COVID-19 outbreak, there was an immediate and significant decrease in total mental disorders, including a reduction of 15% (95% CI: 3%–26%) in EDVs and 44% (95% CI: 36%–51%) in hospitalizations. PM2.5 exposure was associated with increased risk of EDVs and hospitalizations for total and cause-specific mental disorders (schizophrenia, schizotypal and delusional disorders; neurotic, stress-related, and somatoform disorders) before COVID-19 outbreak, but this PM2.5-related risk elevation significantly decreased after COVID-19 outbreak, with greater risk reduction at the first month after the outbreak. However, young people (0–45 years) were still vulnerable to PM2.5 exposure after the COVID-19 outbreak. This study first reveals that the risk of PM2.5-related emergency mental disorders decreased after the COVID-19 outbreak in China. The low concentration of PM2.5 might benefit mental health and greater efforts are required to mitigate air pollution in the post-COVID-19 era. © 2023 Elsevier Ltd
KW - COVID-19 pandemic
KW - Mental disorder
KW - PM2.5
KW - Quasi-experimental design
UR - http://www.scopus.com/inward/record.url?scp=85164743840&partnerID=8YFLogxK
UR - https://www.scopus.com/record/pubmetrics.uri?eid=2-s2.0-85164743840&origin=recordpage
U2 - 10.1016/j.envpol.2023.122175
DO - 10.1016/j.envpol.2023.122175
M3 - RGC 21 - Publication in refereed journal
C2 - 37437758
SN - 0269-7491
VL - 334
JO - Environmental Pollution
JF - Environmental Pollution
M1 - 122175
ER -
