title: Ambient ozone concentration and emergency department visits for panic attacks.
abstract: The effect of ambient air pollution on panic disorder in the general population has not yet been thoroughly elucidated, although the occurrence of panic disorder in workers exposed to organic solvents has been reported previously. We investigated the association of ambient air pollution with the risk of panic attack-related emergency department visits. Using health insurance claims, we collected data from emergency department visits for panic attacks in Seoul, Republic of Korea (2005-2009). Daily air pollutant concentrations were obtained using automatic monitoring system data. We conducted a time-series study using a generalized additive model with Poisson distribution, which included spline variables (date of visit, daily mean temperature, and relative humidity) and parametric variables (daily mean air pollutant concentration, national holiday, and day of the week). In addition to single lag models (lag1 to lag3), cumulative lag models (lag0-1 to lag0-3) were constructed using moving-average concentrations on the days leading up to the visit. The risk was expressed as relative risk (RR) per one standard deviation of each air pollutant and its 95% confidence interval (95% CI). A total of 2320 emergency department visits for panic attacks were observed during the study period. The adjusted RR of panic attack-related emergency department visits was 1.051 (95% CI, 1.014-1.090) for same-day exposure to ozone. In cumulative models, adjusted RRs were 1.068 (1.029-1.107) in lag0-2 and 1.074 (1.035-1.114) in lag0-3. The ambient ozone concentration was significantly associated with emergency department visits for panic attacks.
authors: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jaelim
authors: J
authors: Cho
authors: Research and Development Center, Health Insurance Review and Assessment Service, Seoul, Republic of Korea.
authors: Yoon Jung
authors: YJ
authors: Choi
authors: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Jungwoo
authors: J
authors: Sohn
authors: National Cancer Center, Koyang, Republic of Korea.
authors: Mina
authors: M
authors: Suh
authors: Division of Environmental Health, Korea Environment Institute, Seoul, Republic of Korea.
authors: Seong-Kyung
authors: SK
authors: Cho
authors: Department of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Kyoung Hwa
authors: KH
authors: Ha
authors: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: preman@yuhs.ac.
authors: Changsoo
authors: C
authors: Kim
authors: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Public Health, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Environmental Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors: Dong Chun
authors: DC
authors: Shin
mesh_terms: D000328:Adult; D000397:Air Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010083:Oxidants, Photochemical; D010126:Ozone; D016584:Panic Disorder / Q000453:epidemiology* / Q000209:etiology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D010083:Oxidants, Photochemical; D010126:Ozone
keywords: Air pollution; Ozone; Panic disorder