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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Meteorological factors, ambient air pollution, and daily hospital admissions for depressive disorder in Harbin: A time-series study
Ting Hu, Zhao-Yuan Xu, Jian Wang, Yao Su, Bing-Bing Guo
Ting Hu, Department of Five Therapy, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
Zhao-Yuan Xu, Medical Section, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
Jian Wang, Department of Out-Patient, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
Yao Su, Science and Education, The First Psychiatric Hospital of Harbin, Harbin 150026, Heilongjiang Province, China
Bing-Bing Guo, Department of 22 Therapy, Harbin Psychiatric Baiyupao Hospital, Harbin 150000, Heilongjiang Province, China
Author contributions: Hu T designed and performed the research and wrote the paper; Guo BB designed the research and supervised the report; and Xu ZY, Wang J, and Su Y provided clinical advice.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of The First Psychiatric Hospital of Harbin.
Informed consent statement: This paper is a retrospective study that collects information on cases that have already occurred in the past, is analysed anonymously, does not expose patients' private information, does not cause harm to patients, and successful application for waiver of informed consent has therefore been made.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Bing-Bing Guo, MBBS, Associate chief physician, Department of 22 Therapy, Harbin Psychiatric Baiyupao Hospital, No. 101 Qianjin Village, Juyuan Town, Daowai District, Harbin 150000, Heilongjiang Province, China. guobingbing27@126.com.
Received: September 21, 2023
Peer-review started: September 21, 2023
First decision: October 9, 2023
Revised: October 23, 2023
Accepted: November 8, 2023
Article in press: November 8, 2023
Published online: December 19, 2023
BACKGROUND
The literature has discussed the relationship between environmental factors and depressive disorders; however, the results are inconsistent in different studies and regions, as are the interaction effects between environmental factors. We hypothesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity.
AIM
To investigate the effects of meteorological factors and air pollution on depressive disorders, including their lagged effects and interactions.
METHODS
The samples were obtained from a class 3 hospital in Harbin, China. Daily hospital admission data for depressive disorders from January 1, 2015 to December 31, 2022 were obtained. Meteorological and air pollution data were also collected during the same period. Generalized additive models with quasi-Poisson regression were used for time-series modeling to measure the non-linear and delayed effects of environmental factors. We further incorporated each pair of environmental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders.
RESULTS
Data for 2922 d were included in the study, with no missing values. The total number of depressive admissions was 83905. Medium to high correlations existed between environmental factors. Air temperature (AT) and wind speed (WS) significantly affected the number of admissions for depression. An extremely low temperature (-29.0 ℃) at lag 0 caused a 53% [relative risk (RR)= 1.53, 95% confidence interval (CI): 1.23-1.89] increase in daily hospital admissions relative to the median temperature. Extremely low WSs (0.4 m/s) at lag 7 increased the number of admissions by 58% (RR = 1.58, 95%CI: 1.07-2.31). In contrast, atmospheric pressure and relative humidity had smaller effects. Among the six air pollutants considered in the time-series model, nitrogen dioxide (NO2) was the only pollutant that showed significant effects over non-cumulative, cumulative, immediate, and lagged conditions. The cumulative effect of NO2 at lag 7 was 0.47% (RR = 1.0047, 95%CI: 1.0024-1.0071). Interaction effects were found between AT and the five air pollutants, atmospheric temperature and the four air pollutants, WS and sulfur dioxide.
CONCLUSION
Meteorological factors and the air pollutant NO2 affect daily hospital admissions for depressive disorders, and interactions exist between meteorological factors and ambient air pollution.
Core Tip: This retrospective study assessed the influence of environmental factors on depressive disorders. Daily hospital admissions for depressive disorders at a hospital in Harbin, China from 2015 to 2022 were obtained. Four meteorological factors and six air pollutants were considered predictors in the time-series models. Air temperature, atmospheric pressure, wind speed, relative humidity, and nitrogen dioxide have effects on daily hospital admissions for depressive disorders, and interactions exist between meteorological factors and ambient air pollution.
