| Objective:1.To investigate the time distribution of hospital admissions for schizophrenia in Hefei during 2014 to 2016;2.To explore the association of short-term exposure to extreme traffic-related air pollution and hospital admissions for schizophrenia and investigate the specific concentration-response?C-R?function for NO2,PM10 and CO;3.To evaluate risk effects of NO2,PM10 and CO on hospital admissions for schizophrenia and analyze the form of effects;4.To estimate the strength and lag time of associations and to identify potential effect modifiers.Method:Daily air quality data,including 24-hour average concentration of NO2,PM10and CO from January 1,2014 to December 31,2016 were obtained from Hefei Environmental Monitoring Center.Concentration of each air pollutant was measured at10 fixed-site monitoring stations.Daily meteorological data,including daily mean temperature?°C?and relative humidity?%?,were collected from Hefei Bureau of Meteorology.Daily number of admissions for of schizophrenia from January 1,2014to December 31,2016 was collected from the computerized medical record system of Anhui Mental Health Center.The available information of each case included date of admission,age,gender,residential address.Schizophrenia cases were defined according to the 10th version of the International Classification of Diseases?ICD10:F20-F29?.We excluded cases whose residential addresses are not in Hefei.Combine Poisson generalized linear regression with DLNM to investigate the relationship between exposure to extreme air pollution,including NO2,PM10 and CO and hospital admissions for schizophrenia,controlling for daily mean temperature,relative humidity,long-term,holiday and other possible confounding factors.Results:?1?A total of 11,373 HAs were recorded during the study period.People aged14-39 years accounted for 70.2%?7806 person-time?,far exceeding the number from other age groups.The sexes of patients were distributed evenly?2?There was a significant positive correlation between NO2 concentration and the risk of schizophrenia onset,presenting an acute effect.Refer to the minimum hospital admissions concentration of NO2?21.5?g/m3?,exposure to 95th?64.0?g/m3?and 99th?88.0?g/m3?percentiles of NO2 concentration could increase the risk of schizophrenia admissions,with 2-day?the day of exposure and the day after?accumulated RR being1.23?95%CI:1.10-1.37?and 1.29?95%CI:1.08-1.54?respectively.No significant difference of effect estimates from different genders,age groups and seasons were observed.?3?Exposure to high concentration of PM10 was associated with increased risk of admissions for schizophrenia.The association has a certain lag time,and the harmful effect lasted until the 11th day after exposure.Refer to the minimum hospital admissions concentration of PM10?58.4?g/m3?,exposure to 95th?180?g/m3?and 99th?272.6?g/m3?percentiles of PM10 concentration could increase the risk of schizophrenia admissions,with the RR on the 11th day being 1.05?95%CI:1.01-1.10?and1.07?95%CI:1.00-1.14?.Subgroup analysis showed that women and the people aged 14-39 years may be more susceptible to risk effect of PM10,but the difference was not statistically significant.?4?No significant association between CO and hospital admissions for schizophrenia was observed.Conclusion:Exposure to extremely high concentration of NO2 and PM10 may significantly increase the risk of schizophrenia admissions,and there may be a threshold effect.People aged 14-39 years and female may be more vulnerable to the adverse influence of high concentration of NO2 and PM10.However,exposure to high concentration of CO may not be significantly associated with hospital admissions for schizophrenia in Hefei. |
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