TY  - JOUR
PY  - 2018//
TI  - Air pollution and suicide in 10 cities in Northeast Asia: a time-stratified case-crossover analysis
JO  - Environmental health perspectives
A1  - Kim, Yoonhee
A1  - Ng, Chris Fook Sheng
A1  - Chung, Yeonseung
A1  - Kim, Ho
A1  - Honda, Yasushi
A1  - Guo, Yue Leon
A1  - Lim, Youn-Hee
A1  - Chen, Bing-Yu
A1  - Page, Lisa A.
A1  - Hashizume, Masahiro
SP  - e037002
EP  - e037002
VL  - 126
IS  - 3
N2  - 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>
LA  - en
SN  - 0091-6765
UR  - http://dx.doi.org/10.1289/EHP2223
ID  - ref1
ER  -