Reported association of air pollution and suicide rate could be confounded

Afshari, Reza

doi:10.1186/s12940-017-0219-3

Cited by 8 publications

(8 citation statements)

References 11 publications

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“…However, we did find significant “crude” associations when the preliminary data had not yet been adjusted for confounding factors, even when using a model that recognizes self-correlation of observations. Thus, these results suggest that some previous studies could have inaccurately reported positive associations when omitting important confounding factors, a possibility that has also been pointed out in other studies [ 18 , 19 ].…”

Section: Discussionsupporting

confidence: 68%

“…Due to poor methodological support and possible confounding factors, the epidemiological associations between air pollution and suicide are quite controversial and inconclusive [ 18 – 20 ]. As such, it is important not only to further explore this relationship in other socio-environmental contexts, but also to adjust for the main confounding factors.…”

Section: Introductionmentioning

confidence: 99%

“…As such, it is important not only to further explore this relationship in other socio-environmental contexts, but also to adjust for the main confounding factors. For instance, as shown in several studies, climate itself can be associated with pollution levels [ 18 – 20 ]. Furthermore, as in other air quality and health studies, the use of appropriate statistical techniques is highly important to control for seasonality and autocorrelation of observations [ 19 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between air pollution and suicide: a time series analysis in four Colombian cities

et al. 2018

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BackgroundRecent epidemiological studies have suggested that air pollution could be associated with suicide. However, other studies have criticized these results for being analytically weak and not taking into account potential confounding factors. As such, further studies examining the relationship under diverse contexts are necessary to help clarify this issue. This study explored the association between specific air pollutants (NO2, SO2, PM10, PM2.5, CO and O3) and suicide incidence in four Colombian cities after adjusting for climatic variables and holidays.MethodsA time series of daily suicides among men and women living in Bogota, Medellin, Cali and Bucaramanga was generated using information from the National Administrative Department of Statistics (DANE) for the years 2011–2014. At the same time, the average daily concentration of each air pollutant for each city was obtained from monitoring stations belonging to the National Air Quality Surveillance System. Using this information together, we generated conditional Poisson models (stratified by day, month and year) for the suicide rate in men and women, with air pollutants as the principal explanatory variable. These models were adjusted for temperature, relative humidity, precipitation and holidays.ResultsNo association was found between any of the examined pollutants and suicide: NO2 (IRR:0.99, 95% CI: 0.95–1.04), SO2 (IRR:0.99, 95% CI: 0.98–1.01), PM10 (IRR:0.99, 95% CI:0.95–1.03), PM2.5 (IRR:1.01, 95% CI: 0.98–1.05), CO (IRR:1.00, 95% CI:1.00–1.00) and O3 (IRR: 1.00, 95% CI: 0.96–1.04). In the same way, no association was found in stratified models by sex and age group neither in lagged and cumulative effects models.ConclusionsAfter adjusting for major confounding factors, we found no statistically significant association between air pollution and suicide in Colombia. These “negative” results provide further insight into the current discussion regarding the existence of such a relationship.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Association between air pollution and suicide: a time series analysis in four Colombian cities

et al. 2018

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“…Biases in routine data-for example regarding underreporting of suicide, case ascertainment in emergency departments, or approximating outcome incidence with hospital attendance-may further limit some studies' generalizability. The accuracy of register-based mortality data is affected by cultural and health system-related factors, as Afshari (2017) discussed in relation to the study by Lin et al (2016), in which underreporting of suicide appears pronounced. Nevertheless, routine data sets often represent the most complete data available, and although associations with registered suicides may not generalize fully to unregistered suicides, differential case ascertainment (with respect to PM exposure) appears unlikely.…”

Section: Environmental Health Perspectivesmentioning

confidence: 99%

Air Pollution (Particulate Matter) Exposure and Associations with Depression, Anxiety, Bipolar, Psychosis and Suicide Risk: A Systematic Review and Meta-Analysis

Braithwaite

Zhang

Kirkbride

et al. 2019

Environ Health Perspect

439

220

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BACKGROUND: Particulate air pollution's physical health effects are well known, but associations between particulate matter (PM) exposure and mental illness have not yet been established. However, there is increasing interest in emerging evidence supporting a possible etiological link. OBJECTIVES: This systematic review aims to provide a comprehensive overview and synthesis of the epidemiological literature to date by investigating quantitative associations between PM and multiple adverse mental health outcomes (depression, anxiety, bipolar disorder, psychosis, or suicide). METHODS: We undertook a systematic review and meta-analysis. We searched Medline, PsycINFO, and EMBASE from January 1974 to September 2017 for English-language human observational studies reporting quantitative associations between exposure to PM <1:0 lm in aerodynamic diameter (ultrafine particles) and PM <2:5 and <10 lm in aerodynamic diameter (PM 2:5 and PM 10 , respectively) and the above psychiatric outcomes. We extracted data, appraised study quality using a published quality assessment tool, summarized methodological approaches, and conducted metaanalyses where appropriate. RESULTS: Of 1,826 citations identified, 22 met our overall inclusion criteria, and we included 9 in our primary meta-analyses. In our meta-analysis of associations between long-term (>6 months) PM 2:5 exposure and depression (n = 5 studies), the pooled odds ratio was 1.102 per 10-lg=m 3 PM 2:5 increase (95% CI: 1.023, 1.189; I 2 = 0:00%). Two of the included studies investigating associations between long-term PM 2:5 exposure and anxiety also reported statistically significant positive associations, and we found a statistically significant association between short-term PM 10 exposure and suicide in meta-analysis at a 0-2 d cumulative exposure lag. DISCUSSION: Our findings support the hypothesis of an association between long-term PM 2:5 exposure and depression, as well as supporting hypotheses of possible associations between long-term PM 2:5 exposure and anxiety and between short-term PM 10 exposure and suicide. The limited literature and methodological challenges in this field, including heterogeneous outcome definitions, exposure assessment, and residual confounding, suggest further high-quality studies are warranted to investigate potentially causal associations between air pollution and poor mental health.

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“…Since Greenlanders in this region traditionally ingest significant quantities of adipose tissue from these species, they are among the Arctic people carrying the highest POP burdens [ 5 , 6 , 43 , 44 ]. Such high exposure is likely to pose a health risk based on available literature on dioxin toxic equivalency factor (TEQ) and tolerable daily intake (TDI) guidelines [ 44 , 45 ]. Human exposure to contaminants in Greenland has been evaluated from chemical analyses of prey species and food intake [ 5 , 46 , 47 ], showing that the TDI was exceeded for chlordane (CHL) by a factor of 3–6, while PCB exposure did not.…”

Section: Introductionmentioning

confidence: 99%

A veterinary perspective on One Health in the Arctic

et al. 2017

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Exposure to long-range transported industrial chemicals, climate change and diseases is posing a risk to the overall health and populations of Arctic wildlife. Since local communities are relying on the same marine food web as marine mammals in the Arctic, it requires a One Health approach to understand the holistic ecosystem health including that of humans. Here we collect and identify gaps in the current knowledge of health in the Arctic and present the veterinary perspective of One Health and ecosystem dynamics. The review shows that exposure to persistent organic pollutants (POPs) is having multiple organ-system effects across taxa, including impacts on neuroendocrine disruption, immune suppression and decreased bone density among others. Furthermore, the warming Arctic climate is suspected to influence abiotic and biotic long-range transport and exposure pathways of contaminants to the Arctic resulting in increases in POP exposure of both wildlife and human populations. Exposure to vector-borne diseases and zoonoses may increase as well through range expansion and introduction of invasive species. It will be important in the future to investigate the effects of these multiple stressors on wildlife and local people to better predict the individual-level health risks. It is within this framework that One Health approaches offer promising opportunities to survey and pinpoint environmental changes that have effects on wildlife and human health.

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Reported association of air pollution and suicide rate could be confounded

Cited by 8 publications

References 11 publications

Association between air pollution and suicide: a time series analysis in four Colombian cities

Association between air pollution and suicide: a time series analysis in four Colombian cities

Air Pollution (Particulate Matter) Exposure and Associations with Depression, Anxiety, Bipolar, Psychosis and Suicide Risk: A Systematic Review and Meta-Analysis

A veterinary perspective on One Health in the Arctic

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