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Citation
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Kim Y, Ng CFS, Chung Y, Kim H, Honda Y, Guo YL, Lim YH, Chen BY, Page LA, Hashizume M. Environ. Health Perspect. 2018; 126(3): e037002. |
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Affiliation
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Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan. |
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Abstract
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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 forNO2,SO2, and PM10across 10 cities and for PM2.5and PM10-2.5across 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 ofNO2,SO2, PM10, and PM10-2.5over multiple days. The combined relative risks (RRs) were 1.019 forNO2(95% confidence interval [CI]: 0.999, 1.039), 1.020 forSO2(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 forSO2andNO2, 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.
Language: en |