Effects Of Ambient Temperature Changes And Air Pollutants On The Admission Of Mental And Behavioral Disorders In Yancheng City

Objective（1）to analyze the correlation between the variation trend of different temperature indexes and admissions for mental and behavioral disorders;（2）analyze and compare the effects of various temperature indexes on the admission of mental and behavioral disorders,and find appropriate temperature indicator reflecting the risk of mental and behavioral disorders;（3）explore the influence of air pollutants on admission for mental and behavioral disorders,and identify the vulnerable populations,so as to provide basic information for the early warning of mental and behavioral disorders in the future.Methods Daily meteorological and air pollution data of Yancheng city,Jiangsu province were collected from January 1,2014 to December 31,2017,including temperature,relative humidity,duration of sunshine and rainfall,as well as particulate matter(PM_2.5,PM₁₀),sulfur dioxide（SO₂）,nitrogen dioxide（NO₂）and ozone（O₃）.Data were collected on daily psychiatric admissions at mental health centers during the same period,including admission dates,age,gender,occupation and other information.This study intends to use poisson generalized linear model（GLM）combined with Distributed lag non-linear mode（DLNM）,discussing environmental pollutants and temperature change（average temperature,the temperature difference between day and night and the apparent temperature）and the correlation of admissions for mental and behavioral disorders,controlling for the trend of time,the week effect,relative humidity,sunshine time,the influence of rainfall,holidays and other confounding factors.Results Overall,8,438 cases of mental and behavioral disorders admissions were collected in this study.Among them,5,889 were male,2,549 were female,the sex ratio was 2.31:1.5024 patients were under 45 years old,1911 patients aged 45-60 years,and489 patients aged older than 60 years.Our study found that both daily average temperature and daily apparent temperature were associated with admissions for mental and behavioral disorders.High average temperature and high apparent temperature present a risk for the onset of mental and behavioral disorders.In terms of daily average temperature,with 0.9℃as the reference temperature,the single effect of high temperature of 27℃(90^thpercentile temperature)last for the third day of lag.The corresponding relative risk was 1.214（95%CI:1.050-1.402）at lag 3,then gradually decreased.The cumulative effects of the high temperature of 27℃(P₉₀)continued increasing,and the cumulative effects for 14-day lag was 2.290（95%CI:1.120-4.354）.Moreover,high apparent temperature(90^thpercentile temperature)had similar effects to the average temperature.With-3.8℃as the reference temperature,the greatest risk impact appeared at lag 0（RR=1.225,95%CI:1.060-1.417）,and gradually disappeared on the third day（RR=1.064,95%CI:1.001-1.131）.The cumulative effect of high apparent temperature persisted to 14 days（RR=2.254,95%CI:1.162-4.372 for 0-14days）.Low daily average temperature,daily apparent temperature,and increased temperature difference between day and night had no significant effects on admissions for mental and behavioral disorders.Furthermore,subgroup analysis found that males and patients under 45 years of age were vulnerable groups with increased temperature.The effects of air pollution on the admission of mental and behavioral disorders was not significant in Yancheng city.Conclusions This study confirms that high daily average temperature and daily apparent temperature affect admissions for mental and behavioral disorders and have lag effects.At the same time,the subgroup analysis found that men and people under 45years of age may be more susceptible to the harmful effects of high temperature environments.In the future,the prevention process should be focused on these vulnerable groups.