Association of short-term exposure to ambient fine particulate matter and ozone with outpatient visits for anxiety disorders: A hospital-based case-crossover study in South China

• Published in: Journal of affective disorders 2024-09, Vol.361, p.277-284
• Main Authors: Xu, Ruijun, Luo, Lu, Yuan, Ting, Chen, Wangni, Wei, Jing, Shi, Chunxiang, Wang, Sirong, Liang, Sihan, Li, Yingxin, Zhong, Zihua, Liu, Likun, Zheng, Yi, Deng, Xinyi, Liu, Tingting, Fan, Zhaoyu, Liu, Yuewei, Zhang, Jie
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Air Pollutants - adverse effects; Air Pollutants - analysis; Air Pollution - adverse effects; Air Pollution - statistics & numerical data; Ambulatory Care - statistics & numerical data; Anxiety disorders; Anxiety Disorders - epidemiology; Case-crossover study; China - epidemiology; Cross-Over Studies; Environmental Exposure - adverse effects; Environmental Exposure - statistics & numerical data; Female; Fine particulate matter; Humans; Male; Middle Aged; Outpatient visit; Outpatients - statistics & numerical data; Ozone; Ozone - adverse effects; Particulate Matter - adverse effects; Young Adult
• ISSN: 0165-0327; 1573-2517; 1573-2517
• DOI: 10.1016/j.jad.2024.06.007

The short-term adverse effects of ambient fine particulate matter (PM2.5) and ozone (O3) on anxiety disorders (ADs) remained inconclusive. We applied an individual-level time-stratified case-crossover study, which including 126,112 outpatient visits for ADs during 2019–2021 in Guangdong province, China, to investigate the association of short-term exposure to PM2.5 and O3 with outpatient visits for ADs, and estimate excess outpatient visits in South China. Daily residential air pollutant exposure assessments were performed by extracting grid data (spatial resolution: 1 km × 1 km) from validated datasets. We employed the conditional logistic regression model to quantify the associations and excess outpatient visits. The results of the single-pollutant models showed that each 10 μg/m3 increase of PM2.5 and O3 exposures was significantly associated with a 3.14 % (95 % confidence interval: 2.47 %, 3.81 %) and 0.88 % (0.49 %, 1.26 %) increase in odds of outpatient visits for ADs, respectively. These associations remained robust in 2-pollutant models. The proportion of outpatient visits attributable to PM2.5 and O3 exposures was up to 7.20 % and 8.93 %, respectively. Older adults appeared to be more susceptible to PM2.5 exposure, especially in cool season, and subjects with recurrent outpatient visits were more susceptible to O3 exposure. As our study subjects were from one single hospital in China, it should be cautious when generalizing our findings to other regions. Short-term exposure to ambient PM2.5 and O3 was significantly associated with a higher odds of outpatient visits for ADs, which can contribute to considerable excess outpatient visits. •Exposure to ambient PM2.5 and O3 was associated with an increased odds of outpatient visits for anxiety disorders.•PM2.5 and O3 exposures were attributable to considerable excess outpatient visits.•Older adults were more susceptible to PM2.5 exposure, especially in cool season.•Subjects with recurrent outpatient visits were more susceptible to O3 exposure.