Short-term exposure to ambient air pollution and risk of daily hospital admissions for anxiety in China: A multicity study

The potential impact of short-term exposure to ambient air pollution on risk of anxiety remains uncertain. We performed a detailed evaluation based on data from national insurance databases in China. Daily hospital admissions for anxiety disorders were identified in 2013-2017 from the national insurance databases covering up to 261 million urban residents in 56 cities in China. A two-stage time-series study was conducted to evaluate the associations between short-term exposure to major ambient air pollutants, including fine particles, inhalable particles, nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone, and carbon monoxide, and risk of daily hospital admissions for anxiety. Significant associations between short-term exposures to ambient NO2 and SO2 and risk of daily hospital admissions for anxiety were found in the overall analysis. Per 10 μg/m3 increases in NO2 at lag0 and SO2 at lag6 were associated with significant increases of 1.37% (95% CI: 0.14%, 2.62%) and 1.53% (95% CI: 0.59%, 2.48%) in anxiety admissions, respectively. Stronger associations were found in the southern region and patients <65 years for SO2. Short-term exposure to ambient air pollution is associated with increased risk of anxiety admissions, which may provide important implications for promotion of mental health in the public.