@article{ref1,
title="Air pollution and suicide in 10 cities in Northeast Asia: a time-stratified case-crossover analysis",
journal="Environmental health perspectives",
year="2018",
author="Kim, Yoonhee and Ng, Chris Fook Sheng and Chung, Yeonseung and Kim, Ho and Honda, Yasushi and Guo, Yue Leon and Lim, Youn-Hee and Chen, Bing-Yu and Page, Lisa A. and Hashizume, Masahiro",
volume="126",
number="3",
pages="e037002-e037002",
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. <br><br>OBJECTIVES: We examined the association between air pollutants and suicide in 10 large cities in South Korea, Japan, and Taiwan. <br><br>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 (<sub>NO</sub><sub>2</sub>), sulfur dioxide (<sub>SO</sub><sub>2</sub>), and particulate matter [aerodynamic diameter ≤10μm (PM<sub>10</sub>), aerodynamic diameter ≤2.5μm (PM<sub>2.5</sub>), and PM<sub>10</sub>-<sub>2.5</sub>] 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<sub>NO</sub><sub>2</sub>,<sub>SO</sub><sub>2</sub>, and PM<sub>10</sub>across 10 cities and for PM<sub>2.5</sub>and PM<sub>10</sub>-<sub>2.5</sub>across 3 cities. We first fitted single-pollutant models, followed by two-pollutant models to examine the robustness of the associations. <br><br>RESULTS: Higher risk of suicide was associated with higher levels of<sub>NO</sub><sub>2</sub>,<sub>SO</sub><sub>2</sub>, PM<sub>10</sub>, and PM<sub>10</sub>-<sub>2.5</sub>over multiple days. The combined relative risks (RRs) were 1.019 for<sub>NO</sub><sub>2</sub>(95% confidence interval [CI]: 0.999, 1.039), 1.020 for<sub>SO</sub><sub>2</sub>(95% CI: 1.005, 1.036), 1.016 for PM<sub>10</sub>(95% CI: 1.004, 1.029), and 1.019 for PM<sub>10</sub>-<sub>2.5</sub>(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 PM<sub>2.5</sub>. Some of the associations, particularly for<sub>SO</sub><sub>2</sub>and<sub>NO</sub><sub>2</sub>, were attenuated after adjusting for a second pollutant. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="0091-6765",
doi="10.1289/EHP2223",
url="http://dx.doi.org/10.1289/EHP2223"
}