Ambient air pollution exposure and emergency department visits for substance abuse
- DOI
- Language of the publication
- English
- Date
- 2018-06-29
- Type
- Article
- Author(s)
- Szyszkowicz, Mieczysław
- Thomson, Errol M.
- Colman, Ian
- Rowe, Brian H.
- Publisher
- Public Library of Science
Abstract
There is growing evidence supporting the notion that exposure to air pollution can contribute to cognitive and psychiatric disorders, including depression and suicide. Given the relationship between exposure to acute stressors and substance abuse, the present study assessed the association between exposure to ambient air pollution and emergency department (ED) visits for alcohol and drug abuse. ED visit data selected according to International Classification of Disease (ICD-9) coding 303 (alcohol dependence syndromes) and 305 (non-dependent abuse of drugs) were collected in five hospitals in Edmonton, Canada. A time-stratified case crossover design was used. Conditional logistic regression was applied to calculate odds ratios (OR) and 95% confidence intervals (95% CI). Season, temperature, and relative humidity were adjusted for using natural splines. Results are reported for an increase in pollutant concentrations equivalent to one interquartile range (IQR). Statistically significant positive associations with substance abuse were observed for CO, NO2 and particulate matter with an aerodynamic diameter less than 10 μm (PM10) and 2.5 μm (PM2.5). The strongest results were obtained in the cold period (October–March) for 1-day lagged CO (OR = 1.03, 95% CI: 1.01, 1.05, IQR = 0.4 ppm) and NO2 (OR = 1.04, 95% CI: 1.01, 1.07, IQR = 12.8 ppb); ORs were also significant for CO and NO2 with lags of 2 to 6 days and 2 to 7 days, respectively. The study suggests that, even at low levels, increases in ambient CO, NO2, and PMs are associated with increased hospital admissions for substance abuse, possibly as a result of impacts of air quality on mental health or depression.
Plain language summary
Health Canada is responsible for conducting risk assessments on air pollution as part of the Clean Air Regulatory Agenda. There is growing evidence suggesting that air pollution can contribute to cognitive and psychiatric disorders. Health Canada, in collaboration with researchers at the University of Ottawa and the University of Alberta, carried out a study to examine whether air pollution levels are associated with substance abuse. Admissions to emergency departments for alcohol and drug abuse were related to air pollution levels on the day of admission and in the week preceding admission. The study found that air pollutants, notably carbon monoxide, nitrogen dioxide, and particulate matter, were associated with increased hospitalisation for substance abuse, particularly in colder months. The results suggests that ambient air pollutants may contribute to emergency department visits for substance abuse, possibly reflecting acute impacts on mental health. These data add to the body of knowledge used in assessing population health impacts and in identifying vulnerable sub-populations.
Subject
- Health,
- Health and safety