The impact of hazes on schizophrenia admissions and the synergistic effect with the combined atmospheric oxidation capacity in Hefei, China

Jiajun Yuan; Weiwei Chang; Zhenhai Yao; Liying Wen; Jintao Liu; Rubing Pan; Weizhuo Yi; Jian Song; Shuangshuang Yan; Xuanxuan Li; Li Liu; Ning Wei; Rong Song; Xiaoyu Jin; Yudong Wu; Yuxuan Li; Yunfeng Liang; Xiaoni Sun; Lu Mei; Jian Cheng; Hong Su

doi:10.1016/j.envres.2022.115203

The impact of hazes on schizophrenia admissions and the synergistic effect with the combined atmospheric oxidation capacity in Hefei, China

Environ Res. 2023 Mar 1:220:115203. doi: 10.1016/j.envres.2022.115203. Epub 2022 Dec 31.

Authors

Jiajun Yuan¹, Weiwei Chang², Zhenhai Yao³, Liying Wen², Jintao Liu¹, Rubing Pan¹, Weizhuo Yi¹, Jian Song¹, Shuangshuang Yan¹, Xuanxuan Li¹, Li Liu¹, Ning Wei¹, Rong Song¹, Xiaoyu Jin¹, Yudong Wu¹, Yuxuan Li¹, Yunfeng Liang¹, Xiaoni Sun¹, Lu Mei¹, Jian Cheng¹, Hong Su⁴

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China.
² Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, 241002, Wuhu, Anhui, China.
³ Anhui Public Meteorological Service Center, Hefei, Anhui, China.
⁴ Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Anhui Province Key Laboratory of Major Autoimmune Diseases, Hefei, Anhui, 230032, China. Electronic address: suhong5151@sina.com.

PMID: 36592807
DOI: 10.1016/j.envres.2022.115203

Abstract

Objectives: Currently, most epidemiological studies on haze focus on respiratory diseases, cardiovascular diseases, etc. However, the relationship between haze and mental health has not been adequately explored. The purpose of this study was to investigate the influence of hazes on schizophrenia admissions and to further explore the potential interaction effect with the combined atmospheric oxidative indices (O_x and O_x^wt).

Methods: We collected 5328 cases during the cold season from 2013 to 2015 in Hefei, China. By integrating the Poisson Generalized Linear Models with the Distributed Lag Non-linear Models, the association between haze and schizophrenia admissions was evaluated. The interaction between hazes and two combined oxidation indexes was tested by stratifying hazes and O_x, and O_x^wt.

Results: Haze was found to be significantly linked to an increased risk of hospitalization for schizophrenia, and a 9-day lag effect on schizophrenia (lag 3-lag 11), with the largest effect on lag 6 (RR = 1.080, 95% confidence interval (CI): 1.046-1.116). Males, females, and <40 y (people under 40 years old) were sensitive to hazes. Furthermore, in the stratified analysis, we found synergies between two combined oxidation indexes and hazes. The interaction relative risk (IRR) and relative excess risk due to interaction (RERI) between O_x and hazes were 1.170 (95% CI: 1.071-1.277) and 0.149 (95% CI: 0.045-0.253), respectively. For O_x^wt, the IRR and RERI were 1.179 (95% CI: 1.087-1.281) and 0.159 (95% CI: 0.056-0.263), respectively. It is noteworthy that this synergistic effect was significant in males and <40 y when examining the various subgroups in the interaction analysis.

Conclusions: Our findings suggest that exposure to haze significantly increases the risk of hospitalization for schizophrenia. More significant public health benefits can be obtained by prioritizing haze periods with high combined atmospheric oxidation capacity.

Keywords: Combined oxidative capacity; Haze; Interaction effect; Redox-weighted oxidant capacity; Schizophrenia.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Air Pollution* / analysis
China / epidemiology
Female
Hospitalization
Humans
Male
Oxidation-Reduction
Respiration Disorders*
Schizophrenia* / epidemiology