The Effect of Ambient Air Pollution and Temperature on Acute Pediatric Mental Health Outcomes in Los Angeles, CA: A Case-Crossover Study Restricted; Files Only

Olson, Caroline (Spring 2021)

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Purpose: Previous epidemiologic studies support an association between ambient air pollutants and mental health events. However, further research should be conducted to assess whether there is a measurable effect of pollutants on the mental health of children, who may be more vulnerable to the physiologic effects of pollutants. Similarly, little is known about the effect of temperature on children’s mental health.

Methods: A case-crossover study was conducted using psychiatric emergency department visits from 2005 to 2014 in Los Angeles, California among children aged 5 to 17 (n=233,043). Concentrations of three air pollutants (NO2, PM2.5, and O3) and ambient maximum temperature were derived from the U.S. EPA’s Community Multiscale Air Quality (CMAQ) model. Odds ratios were calculated using conditional logistic regression for same- day and 3-day moving averages of daily pollutant concentrations and daily maximum temperature.

Results: Positive associations were only found between NO2 and two categories of mental health disorder: all mental health disorders and affective disorders. No positive associations were detected between ozone or PM2.5 and mental health outcomes. Strong positive associations were found between maximum temperature and pediatric mental health ED visits; associations were found across all categories and both single day and 3- day lag. No discernible differences were observed between those with public insurance and those with private insurance.

Conclusion: These findings provide mixed evidence to the emerging body of work documenting the association between air pollutants and mental health in children. This is one of the first reports of an association between temperature and children’s mental health outcomes. 

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