Pediatric Psychiatric Emergency Department Utilization and Fine Particulate Matter: A Case-Crossover Study.

BACKGROUND: Acute exposure to ambient particulate matter <2:5 lm in aerodynamic diameter (PM2:5) 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 PM2:5 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 PM2:5 exposures, estimated at residential addresses using a spatiotemporal model. RESULTS: A 10-lg=m³ increase in PM2:5 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. [ABSTRACT FROM AUTHOR]

Copyright of Environmental Health Perspectives is the property of National Institute of Environmental Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)