Ambient coarse particulate matter pollution and hospital admissions for schizophrenia

Yating Ma; Lijun Bai; Yunxing Jiang; Jinxi Wang; Chen Wei; Yinxiang Li; Yumei Tian; Shaowei Wu

doi:10.1016/j.schres.2025.01.004

Ambient coarse particulate matter pollution and hospital admissions for schizophrenia

Schizophr Res. 2025 Jan 24:276:79-87. doi: 10.1016/j.schres.2025.01.004. Online ahead of print.

Authors

Yating Ma¹, Lijun Bai², Yunxing Jiang², Jinxi Wang³, Chen Wei³, Yinxiang Li⁴, Yumei Tian⁵, Shaowei Wu⁶

Affiliations

¹ Institute of Social Psychology, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
² Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
³ Yunyi Health Technology Co. Ltd., Beijing, China.
⁴ China-Europe Association for Technical and Economic Cooperation, Beijing, China.
⁵ Xi'an Mental Health Center, Xi'an, Shaanxi 710061, China. Electronic address: tym866@163.com.
⁶ Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China. Electronic address: shaowei_wu@xjtu.edu.cn.

PMID: 39862446
DOI: 10.1016/j.schres.2025.01.004

Abstract

Objective: To investigate the association between ambient coarse particulate matter (PM_2.5_-₁₀) pollution and risk of acute schizophrenia episodes.

Methods: A time-stratified case-crossover study with a two-stage analytical approach was conducted to investigate the association between ambient PM_2.5_-₁₀ pollution and schizophrenia admissions (an indicator for acute schizophrenia episodes) across 259 Chinese cities of prefecture-level or above during 2013-2017. A conditional logistic regression model was constructed to estimate city-specific changes in hospital admissions for schizophrenia associated with per interquartile range (IQR) increase in ambient PM_2.5_-₁₀, and the overall associations were obtained by pooling the city-specific associations using the random-effects model.

Results: A total of 817,296 schizophrenia admissions were included in the analysis. Per IQR increase (28.43 μg/m³) in PM_2.5_-₁₀ at lag01 was associated with an increase of 1.66 % (95 % CI: 0.68 %, 2.65 %) in schizophrenia admissions. Compared to concentrations <30 μg/m³, PM_2.5_-₁₀ concentrations of 30-49 μg/m³ and ≥50 μg/m³ were associated with increases of 2.25 % (95 % CI: 0.73 %%, 3.79 %) and 4.03 % (95 % CI: 1.92 %, 6.18 %) in schizophrenia admissions, respectively. City-level urbanization has the potential to attenuate the association between ambient PM_2.5_-₁₀ and schizophrenia admissions (P = 0.0002).

Conclusions: Our study provides novel evidence for the acute adverse effects of ambient PM_2.5_-₁₀ on schizophrenia and calls for special attention on the control of high PM_2.5_-₁₀ pollution in disease prevention.

Keywords: Air pollution; Case-crossover study; Coarse particulate matter; Schizophrenia.