Association of short-term particulate matter exposure with suicide death among major depressive disorder patients: a time-stratified case-crossover analysis

Abstract

There is growing evidence that suggests a potential association between particulate matter (PM) and suicide. However, it is unclear that PM exposure and suicide death among major depressive disorder (MDD) patients, a high-risk group for suicide. We aimed to assess the effect of short-term exposure to PM on the risk of suicide in MDD patients who are at high risk for suicide. We investigated the risk of suicide among 922,062 newly-diagnosed MDD patients from 2004 to 2017 within the Korean National Health Insurance Service (NHIS) database. We identified 3,051 suicide cases from January 1, 2015, to December 31, 2017, within the death statistics database of the Korean National Statistical Office. PMs with aerodynamic diameter less than 2.5 μm (PM2.5), less than 10 μm (PM10), and 2.5–10 μm (PM2.5–10) were considered, which were provided from the National Ambient Air Monitoring System in South Korea. Time-stratified case-crossover analysis was performed to investigate the association of particulate matter exposure to suicide events. The risk of suicide was significantly high upon the high level of exposure to PM2.5, PM2.5–10 (coarse particle) and PM10 on lag 1 (p for trend < 0.05). Short-term exposure to a high level of PM was associated with an elevated risk for suicide among MDD patients. There is a clear dose–response relationship between short-term PM exposures with suicide death among MDD patients. This result will be used as an essential basis for consideration when establishing an air pollution alarm system for reducing adverse health outcomes by PM.

Neuro‐Glia‐Vascular‐on‐a‐Chip System to Assess Aggravated Neurodegeneration via Brain Endothelial Cells upon Exposure to Diesel Exhaust Particles

“…Individuals exposed to PM show several notable features, such as impaired brain development, cognitive deficits, inflammation in the blood-brain barrier (BBB), and the accumulation of neurotoxic protein aggregates. [8] The exposure of brain tissue to PM has a negative effect on the central nervous system (CNS) and can cause dementia, [10] stroke, [11] depression, [12] and schizophrenia. [13] To investigate PM toxicity, 2D culture systems and animal models have been widely used.…”

The short-term effect of ambient particulate matter on suicide death

“…The neurotoxic effects of air pollution can be particularly dangerous to vulnerable populations such as people with mental illnesses. In patients with major depressive disorder, a high-risk group for suicide, there was an association between short-term exposure to PM and suicide, and a clear dose-response relationship between short-term exposure to PM and suicide-related death was confirmed [ 23 ]. Furthermore, an association has been reported between long-term PM exposure and suicide in patients with physical or mental diseases, and a dose-response relationship has been confirmed [ 24 ].…”

“…Several studies have identified an association between PM and suicide stratified by sex and age group. Compared to men, the association between PM and suicide was stronger in women [ 16 , 23 ]. Although no significant association in individuals aged 20–39 years was found, in those aged 40 years or older, the suicide risk tended to increase when both particulate matter ≤ 10 μm in diameter (PM 10 ) and particulate matter ≤ 2.5 μm in diameter (PM 2.5 ) concentrations increased [ 23 ].…”

“…Compared to men, the association between PM and suicide was stronger in women [ 16 , 23 ]. Although no significant association in individuals aged 20–39 years was found, in those aged 40 years or older, the suicide risk tended to increase when both particulate matter ≤ 10 μm in diameter (PM 10 ) and particulate matter ≤ 2.5 μm in diameter (PM 2.5 ) concentrations increased [ 23 ]. However, these relationships vary across studies, and the evidence supporting the association between PM and suicide is limited.…”

The Relationship between Ambient Fine Particulate Matter (PM2.5) Pollution and Depression: An Analysis of Data from 185 Countries

“…Air pollution, particularly exposure to fine particulate matter (PM2.5) and nitrogen oxides (NOx), has been associated with depression in youth [7], adults in the general population [8,9], women in the post-partum period [10,11] and the elderly [12]. Exposure to these forms of air pollution has also been associated with worse outcomes in patients with depression, such as suicide [13] and increased use of mental health services [14].…”