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Air pollution linked to increased psychiatric symptoms in children
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Findings from a case-crossover study revealed an association between daily outdoor air pollution levels and increased symptoms of psychiatric disorders in children.
“Children may be particularly susceptible to neurotoxic effects of air pollution, but most epidemiologic studies to date have focused on the effects of long-term exposures and cognitive or behavioral outcomes,” Cole Brokamp, PhD, of Cincinnati Children’s Hospital Medical Center, and colleagues wrote in Environmental Health Perspectives.
Brokamp and colleagues examined the link between acute exposure to outdoor air pollution (ambient particulate matter less than 2.5 µm in aerodynamic diameter [PM2.5]) and psychiatric ED utilization among children and adolescents and examined whether community deprivation modified this association.
Using a time-stratified case-crossover design, they analyzed 13,176 pediatric psychiatric ED encounters at Cincinnati Children’s Hospital Medical Center from 2011 to 2015. After adjusting for temperature, humidity and holiday effects, they estimated the risk for a psychiatric ED visit 0 to 3 days after outdoor air pollution exposures.
The most frequent psychiatric ED encounters were for depressive disorders (n = 3,847), other mood disorders (n = 1,903), externalizing disorders (n = 1,850) and impulse control disorders (n = 1,755), according to the study.
The results showed that a 10-µg/m3 increase in PM2.5 was tied to a significant increase in psychiatric ED visits 1 day later (OR = 1.07; 95% CI, 1.02-1.12) and 2 days later (OR = 1.05; 95% CI, 1-1.1). When stratified by visit reason, increased air pollution exposure was significantly linked to pediatric ED visits related to:
- schizophrenia on the same day (OR = 1.25; 95% CI, 1-1.57);
- adjustment disorder 1 day later (OR = 1.24; 95% CI, 1.02-1.52) and 2 days later (OR = 1.24; 95% CI, 1.02-1.51);
- other mood disorders 2 days later (OR = 1.15; 95% CI, 1.02-1.3); and
- suicidality 1 day later (OR = 1.44; 95% CI, 1.03-2.02).
Brokamp and colleagues also reported significant differences depending on community deprivation: associations were stronger for children living in high- vs. low-poverty neighborhoods for anxiety- and suicidality-related ED visits, but weaker for adjustment disorder-related ED visits.
"More research is needed to confirm these findings, but it could lead to new prevention strategies for children experiencing symptoms related to a psychiatric disorder,” Brokamp said in a press release. “The fact that children living in high poverty neighborhoods experienced greater health effects of air pollution could mean that pollutant and neighborhood stressors can have synergistic effects on psychiatric symptom severity and frequency." – by Savannah Demko
Disclosure: The authors report no relevant financial disclosures.