Ambient coarse particulate matter pollution and hospital admissions for schizophrenia

Objective: To investigate the association between ambient coarse particulate matter (PM2.5-10) pollution and risk of acute schizophrenia episodes. Methods: A time-stratified case-crossover study with a two-stage analytical approach was conducted to investigate the association between ambient PM2.5-10 pollution and schizophrenia admissions (an indicator for acute schizophrenia episodes) across 259 Chinese cities of prefecture-level or above during 2013-2017. A conditional logistic regression model was constructed to estimate city-specific changes in hospital admissions for schizophrenia associated with per interquartile range (IQR) increase in ambient PM2.5-10, and the overall associations were obtained by pooling the city-specific associations using the random-effects model. Results: A total of 817,296 schizophrenia admissions were included in the analysis. Per IQR increase (28.43 mu g/m(3)) in PM2.5-10 at lag01 was associated with an increase of 1.66 % (95 % CI: 0.68 %, 2.65 %) in schizophrenia admissions. Compared to concentrations <30 mu g/m(3), PM2.5-10 concentrations of 30-49 mu g/m(3) and >= 50 mu g/m(3) were associated with increases of 2.25 % (95 % CI: 0.73 %%, 3.79 %) and 4.03 % (95 % CI: 1.92 %, 6.18 %) in schizophrenia admissions, respectively. City-level urbanization has the potential to attenuate the association between ambient PM2.5-10 and schizophrenia admissions (P = 0.0002). Conclusions: Our study provides novel evidence for the acute adverse effects of ambient PM2.5-10 on schizophrenia and calls for special attention on the control of high PM2.5-10 pollution in disease prevention.