Skip to main content

Advertisement

Springer Nature Link
Log in

Particulate matter pollution associated with schizophrenia hospital re-admissions: a time-series study in a coastal Chinese city

  • Research Article
  • Published:
Environmental Science and Pollution Research Aims and scope Submit manuscript

Abstract

Schizophrenia (SCZ) hospital re-admissions constitute a serious disease burden worldwide. Some studies have reported an association between air pollutants and hospital admissions for SCZ. However, evidence is scarce regarding the effects of ambient particulate matter (PM) on SCZ hospital re-admissions, especially in coastal cities in China. The purpose of this study was to examine whether PM affects the risk of SCZ hospital re-admission in the coastal Chinese city of Qingdao. Daily SCZ hospital re-admissions, daily air pollutants, and meteorological factors from 2015 to 2019 were collected. A quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was applied to model the exposure-lag-response relationship between PM and SCZ hospital re-admissions. The relative risks (RRs) were estimated for an inter-quartile range (IQR) increase in PM concentrations. Subgroup analyses by age and gender were conducted to identify the vulnerable subgroups. There were 6220 SCZ hospital re-admissions during 2015–2019. The results revealed that PM, including PM10 (particles with an aerodynamic diameter ≤10 μm), PMc (particles >2.5 μm but <10 μm), and PM2.5 (particles ≤2.5 μm), was positively correlated with SCZ hospital re-admissions. The strongest single-day effects all occurred on lag3 day, and the corresponding RRs were 1.07 (95% CI: 1.02–1.11) for PM10, 1.03 (95% CI: 1.00–1.07) for PMc, and 1.05 (95% CI: 1.01–1.09) for PM2.5 per IQR increase. Stronger associations were observed in males and younger individuals (<45 years). Our findings suggest that PM exposure is associated with increased risk of SCZ hospital re-admission. Active intervention measures against PM exposure should be taken to reduce the risk of SCZ hospital re-admission, especially for males and younger individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  • Alvarez-Jimenez M, Priede A, Hetrick SE, Bendall S, Killackey E, Parker AG, McGorry PD, Gleeson JF (2012) Risk factors for relapse following treatment for first episode psychosis: a systematic review and meta-analysis of longitudinal studies. Schizophr Res 139:116–128. https://doi.org/10.1016/j.schres.2012.05.007

    Article  CAS  Google Scholar 

  • Bai L, Yang J, Zhang Y, Zhao D, Su H (2020) Durational effect of particulate matter air pollution wave on hospital admissions for schizophrenia. Environ Res 187:109571. https://doi.org/10.1016/j.envres.2020.109571

    Article  CAS  Google Scholar 

  • Baxter AJ, Charlson FJ, Cheng HG, Shidhaye R, Ferrari AJ, Whiteford HA (2016) Prevalence of mental, neurological, and substance use disorders in China and India: a systematic analysis. Lancet Psychiatry 3:832–841. https://doi.org/10.1016/S2215-0366(16)30139-0

    Article  Google Scholar 

  • Berry JG (2011) Hospital utilization and characteristics of patients experiencing recurrent readmissions within children’s hospitals. JAMA:305–682. https://doi.org/10.1001/jama.2011.122

  • Buoli M, Grassi S, Caldiroli A, Carnevali GS, Mucci F, Iodice S, Cantone L, Pergoli L, Bollati V (2018) Is there a link between air pollution and mental disorders? Environ Int 118:154–168. https://doi.org/10.1016/j.envint.2018.05.044

    Article  CAS  Google Scholar 

  • Chan KY et al (2015) Prevalence of schizophrenia in China between 1990 and 2010. J Glob Health 5:10410. https://doi.org/10.7189/jogh.05.010410

    Article  Google Scholar 

  • Coburn JL, Cole TB, Dao KT, Costa LG (2018) Acute exposure to diesel exhaust impairs adult neurogenesis in mice: prominence in males and protective effect of pioglitazone. Arch Toxicol 92:1815–1829. https://doi.org/10.1007/s00204-018-2180-5

    Article  CAS  Google Scholar 

  • Costa LG, Cole TB, Coburn J, Chang Y, Dao K, Roque P (2014) Neurotoxicants are in the air: convergence of human, animal, and in vitro studies on the effects of air pollution on the brain. Biomed Res Int:1–8. https://doi.org/10.1155/2014/736385

  • Duan J, Cheng Q, Luo XL, Bai LJ, Zhang H, Wang SS, Xu ZH, Gao JJ, Zhang YW, Su H (2018) Is the serious ambient air pollution associated with increased admissions for schizophrenia? Sci Total Environ 644:14–19. https://doi.org/10.1016/j.scitotenv.2018.06.218

    Article  CAS  Google Scholar 

  • Gao Q, Xu Q, Guo X, Fan H, Zhu H (2017) Particulate matter air pollution associated with hospital admissions for mental disorders: a time-series study in Beijing, China. Eur Psychiat 44:68–75. https://doi.org/10.1016/j.eurpsy.2017.02.492

    Article  CAS  Google Scholar 

  • Gao J, Wei Q, Pan R, Yi W, Xu Z, Duan J, Tang C, He Y, Liu X, Song S, Su H (2021) Elevated environmental PM2.5 increases risk of schizophrenia relapse: Mediation of inflammatory cytokines. Sci Total Environ:753–142008. https://doi.org/10.1016/j.scitotenv.2020.142008

  • Gasparrini A, Armstrong B, Kenward MG (2010) Distributed lag non-linear models. Stat Med 29:2224–2234. https://doi.org/10.1002/sim.3940

    Article  CAS  Google Scholar 

  • Genc S, Zadeoglulari Z, Fuss SH, Genc K (2012) The adverse effects of air pollution on the nervous system. J Toxicol 2012:1–23. https://doi.org/10.1155/2012/782462

    Article  CAS  Google Scholar 

  • He H, Liu Q, Li N, Guo L, Gao F, Bai L, Gao F, Lyu J (2020) Trends in the incidence and DALYs of schizophrenia at the global, regional and national levels: results from the Global Burden of Disease Study 2017. Epidemiol Psych Sci 29:e91. https://doi.org/10.1017/S2045796019000891

    Article  Google Scholar 

  • Kahn RS, Sommer IE, Murray RM, Meyer-Lindenberg A, Weinberger DR, Cannon TD, O'Donovan M, Correll CU, Kane JM, van Os J, Insel TR (2015) Schizophrenia. Nat Rev Dis Primers 1. https://doi.org/10.1038/nrdp.2015.67

  • Kelly FJ (2003) Oxidative stress: its role in air pollution and adverse health effects. Occup Environ Med 60:612–616. https://doi.org/10.1136/oem.60.8.612

    Article  Google Scholar 

  • Kelly BD, O'Callaghan E, Waddington JL, Feeney L, Browne S, Scully PJ, Clarke M, Quinn JF, McTigue O, Morgan MG, Kinsella A, Larkin C (2010) Schizophrenia and the city: a review of literature and prospective study of psychosis and urbanicity in Ireland. Schizophr Res 116:75–89. https://doi.org/10.1016/j.schres.2009.10.015

    Article  Google Scholar 

  • Laurens KR, Luo L, Matheson SL, Carr VJ, Raudino A, Harris F, Green MJ (2015) Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psych 15:205. https://doi.org/10.1186/s12888-015-0562-2

    Article  CAS  Google Scholar 

  • Laursen TM, Nordentoft M, Mortensen PB (2014) Excess early mortality in schizophrenia. Annu Rev Clin Psychol 10:425–448. https://doi.org/10.1146/annurev-clinpsy-032813-153657

    Article  Google Scholar 

  • Lee S, Lee W, Kim D, Kim E, Myung W, Kim S, Kim H (2019) Short-term PM2.5 exposure and emergency hospital admissions for mental disease. Environ Res 171:313–320. https://doi.org/10.1016/j.envres.2019.01.036

    Article  CAS  Google Scholar 

  • Liang Z, Xu C, Cao Y, Kan HD, Chen RJ, Yao CY, Liu XL, Xiang Y, Wu N, Wu L, Li YF, Ji AL, Cai TJ (2019) The association between short-term ambient air pollution and daily outpatient visits for schizophrenia: a hospital-based study. Environ Pollut 244:102–108. https://doi.org/10.1016/j.envpol.2018.09.142

    Article  CAS  Google Scholar 

  • Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, AlMazroa MA, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C, Buchbinder R, Bull F, Burnett RT, Byers TE, Calabria B, Carapetis J, Carnahan E, Chafe Z, Charlson F, Chen H, Chen JS, Cheng ATA, Child JC, Cohen A, Colson KE, Cowie BC, Darby S, Darling S, Davis A, Degenhardt L, Dentener F, Des Jarlais DC, Devries K, Dherani M, Ding EL, Dorsey ER, Driscoll T, Edmond K, Ali SE, Engell RE, Erwin PJ, Fahimi S, Falder G, Farzadfar F, Ferrari A, Finucane MM, Flaxman S, Fowkes FGR, Freedman G, Freeman MK, Gakidou E, Ghosh S, Giovannucci E, Gmel G, Graham K, Grainger R, Grant B, Gunnell D, Gutierrez HR, Hall W, Hoek HW, Hogan A, Hosgood HD III, Hoy D, Hu H, Hubbell BJ, Hutchings SJ, Ibeanusi SE, Jacklyn GL, Jasrasaria R, Jonas JB, Kan H, Kanis JA, Kassebaum N, Kawakami N, Khang YH, Khatibzadeh S, Khoo JP, Kok C, Laden F, Lalloo R, Lan Q, Lathlean T, Leasher JL, Leigh J, Li Y, Lin JK, Lipshultz SE, London S, Lozano R, Lu Y, Mak J, Malekzadeh R, Mallinger L, Marcenes W, March L, Marks R, Martin R, McGale P, McGrath J, Mehta S, Memish ZA, Mensah GA, Merriman TR, Micha R, Michaud C, Mishra V, Hanafiah KM, Mokdad AA, Morawska L, Mozaffarian D, Murphy T, Naghavi M, Neal B, Nelson PK, Nolla JM, Norman R, Olives C, Omer SB, Orchard J, Osborne R, Ostro B, Page A, Pandey KD, Parry CDH, Passmore E, Patra J, Pearce N, Pelizzari PM, Petzold M, Phillips MR, Pope D, Pope CA III, Powles J, Rao M, Razavi H, Rehfuess EA, Rehm JT, Ritz B, Rivara FP, Roberts T, Robinson C, Rodriguez-Portales JA, Romieu I, Room R, Rosenfeld LC, Roy A, Rushton L, Salomon JA, Sampson U, Sanchez-Riera L, Sanman E, Sapkota A, Seedat S, Shi P, Shield K, Shivakoti R, Singh GM, Sleet DA, Smith E, Smith KR, Stapelberg NJC, Steenland K, Stöckl H, Stovner LJ, Straif K, Straney L, Thurston GD, Tran JH, van Dingenen R, van Donkelaar A, Veerman JL, Vijayakumar L, Weintraub R, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams W, Wilson N, Woolf AD, Yip P, Zielinski JM, Lopez AD, Murray CJL, Ezzati M (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2224–2260. https://doi.org/10.1016/S0140-6736(12)61766-8

    Article  Google Scholar 

  • Pun VC, Yu ITS, Qiu H, Ho KF, Sun Z, Louie PKK, Wong TW, Tian L (2014) Short-term associations of cause-specific emergency hospitalizations and particulate matter chemical components in Hong Kong. Am J Epidemiol 179:1086–1095. https://doi.org/10.1093/aje/kwu026

    Article  Google Scholar 

  • Qiu H, Zhu X, Wang L, Pan J, Pu X, Zeng X, Zhang L, Peng Z, Zhou L (2019) Attributable risk of hospital admissions for overall and specific mental disorders due to particulate matter pollution: a time-series study in Chengdu, China. Environ Res 170:230–237. https://doi.org/10.1016/j.envres.2018.12.019

    Article  CAS  Google Scholar 

  • Qu F, Liu F, Zhang H, Chao L, Guan J, Li R, Yu F, Yan X (2019) The hospitalization attributable burden of acute exacerbations of chronic obstructive pulmonary disease due to ambient air pollution in Shijiazhuang, China. Environ Sci Pollut R 26:30866–30875. https://doi.org/10.1007/s11356-019-06244-1

    Article  CAS  Google Scholar 

  • Roqué PJ, Dao K, Costa LG (2016) Microglia mediate diesel exhaust particle-induced cerebellar neuronal toxicity through neuroinflammatory mechanisms. Neurotoxicology 56:204–214. https://doi.org/10.1016/j.neuro.2016.08.006

    Article  CAS  Google Scholar 

  • Schizophrenia Working Group of the Psychiatric Genomics Consortium (2014) Biological insights from 108 schizophrenia-associated genetic loci. Nature 511:421–427. https://doi.org/10.1038/nature13595

    Article  CAS  Google Scholar 

  • Simeone JC, Ward AJ, Rotella P, Collins J, Windisch R (2015) An evaluation of variation in published estimates of schizophrenia prevalence from 1990─2013: a systematic literature review. BMC Psych 15:193. https://doi.org/10.1186/s12888-015-0578-7

    Article  Google Scholar 

  • Song J, Zheng L, Lu M, Gui L, Xu D, Wu W, Liu Y (2018) Acute effects of ambient particulate matter pollution on hospital admissions for mental and behavioral disorders: a time-series study in Shijiazhuang, China. Sci Total Environ 636:205–211. https://doi.org/10.1016/j.scitotenv.2018.04.187

    Article  CAS  Google Scholar 

  • West JJ, Cohen A, Dentener F, Brunekreef B, Zhu T, Armstrong B, Bell ML, Brauer M, Carmichael G, Costa DL, Dockery DW, Kleeman M, Krzyzanowski M, Künzli N, Liousse C, Lung SCC, Martin RV, Pöschl U, Pope CA III, Roberts JM, Russell AG, Wiedinmyer C (2016) What we breathe impacts our health: improving understanding of the link between air pollution and health. Environ Sci Technol 50:4895–4904. https://doi.org/10.1021/acs.est.5b03827

    Article  CAS  Google Scholar 

  • Zhang P, Zhou X (2020) Health and economic impacts of particulate matter pollution on hospital admissions for mental disorders in Chengdu, Southwestern China. Sci Total Environ 733:139114. https://doi.org/10.1016/j.scitotenv.2020

    Article  CAS  Google Scholar 

  • Zhong P, Huang S, Zhang X, Wu S, Zhu Y, Li Y, Ma L (2018) Individual-level modifiers of the acute effects of air pollution on mortality in Wuhan, China. Global Health Res Policy 3:27. https://doi.org/10.1186/s41256-018-0080-0

    Article  Google Scholar 

Download references

Acknowledgements

Not applicable.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Funding

This study was funded by grants from the National Natural Science Foundation of China (NO.71774001)

Author information

Authors and Affiliations

  1. Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China

    Yanhu Ji, Jian Song, Rubing Pan, Jian Cheng, Hong Su & Heng Wang

  2. Qingdao Mental Health Center, Qingdao, Shandong, China

    Bin Liu

  3. The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui Province, China

    Heng Wang

Authors
  1. Yanhu Ji
    View author publications

    Search author on:PubMed Google Scholar

  2. Bin Liu
    View author publications

    Search author on:PubMed Google Scholar

  3. Jian Song
    View author publications

    Search author on:PubMed Google Scholar

  4. Rubing Pan
    View author publications

    Search author on:PubMed Google Scholar

  5. Jian Cheng
    View author publications

    Search author on:PubMed Google Scholar

  6. Hong Su
    View author publications

    Search author on:PubMed Google Scholar

  7. Heng Wang
    View author publications

    Search author on:PubMed Google Scholar

Contributions

YHJ, JC, JS, HS, and HW conceptualized the study, participated in the study design, and revised the manuscript. YHJ wrote the manuscript. BL and RBP collected the data and participated in the study design. YHJ and JC conducted the statistical analysis. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Heng Wang.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the Ethical Committee of Anhui Medical University (Hefei, Anhui, China).

Consent for publication

Not applicable (This study does not contain any individual person’s data in any form).

Competing interests

The authors declare no competing interests.

Additional information

Responsible Editor: Lotfi Aleya

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(DOCX 459 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ji, Y., Liu, B., Song, J. et al. Particulate matter pollution associated with schizophrenia hospital re-admissions: a time-series study in a coastal Chinese city. Environ Sci Pollut Res 28, 58355–58363 (2021). https://doi.org/10.1007/s11356-021-14816-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11356-021-14816-3

Keywords