文章基本信息

标题：Pediatric Psychiatric Emergency Department Utilization and Fine Particulate Matter: A Case-Crossover Study
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作者：Cole Brokamp ; Jeffrey R. Strawn ; Andrew F. Beck 等
期刊名称：Environmental Health Perspectives
印刷版ISSN：0091-6765
电子版ISSN：1552-9924
出版年度：2019
卷号：127
期号：9
页码：1-7
DOI：10.1289/EHP4815
出版社：OCR Subscription Services Inc
摘要：Background: Acute exposure to ambient particulate matter < 2.5 μ m in aerodynamic diameter ( PM 2.5 ) has been associated with adult psychiatric exacerbations but has not been studied in children. Objectives: Our objectives were to estimate the association between acute exposures to ambient PM 2.5 and psychiatric emergency department (ED) utilization and to determine if it is modified by community deprivation. Methods: We used a time-stratified case-crossover design to analyze all pediatric, psychiatric ED encounters at Cincinnati Children’s Hospital Medical Center in Cincinnati, Ohio, from 2011 to 2015 ( n = 13,176 ). Conditional logistic regression models adjusted for temperature, humidity, and holiday effects were used to estimate the odds ratio (OR) for a psychiatric ED visit 0–3 d after ambient PM 2.5 exposures, estimated at residential addresses using a spatiotemporal model. Results: A 10 - μ g / m 3 increase in PM 2.5 was associated with a significant increase in any psychiatric ED utilization 1 [ OR = 1.07 (95% CI: 1.02, 1.12)] and 2 [ OR = 1.05 (95% CI: 1.00, 1.10)] d later. When stratified by visit reason, associations were significant for ED visits related to adjustment disorder {e.g., 1-d lag [ OR = 1.24 (95% CI: 1.02, 1.52)] and suicidality 1-d lag [ OR = 1.44 (95% CI: 1.03, 2.02)]}. There were significant differences according to community deprivation, with some lags showing stronger associations among children in high versus low deprivation areas for ED visits for anxiety {1-d lag [ OR = 1.39 (95% CI: 0.96, 2.01) vs. 0.85 (95% CI: 0.62, 1.17)] and suicidality same day [ OR = 1.98 (95% CI: 1.22, 3.23) vs. 0.93 (95% CI: 0.60, 1.45)]}. In contrast, for some lags, associations with ED visits for adjustment disorder were weaker for children in high-deprivation areas {1-d lag [ OR = 1.00 (95% CI: 0.76, 1.33) vs. 1.50 (95% CI: 1.16, 1.93)]}. Discussion: These findings warrant additional research to confirm the associations in other populations.