title: Ambient air pollution and suicide in Tokyo, 2001-2011.
abstract: Some evidence suggests an association may exist between the level of air pollution and suicide mortality. However, this relation has been little studied to date. The current study examined the association in Tokyo, Japan.
  
  
  
  Suicide mortality data for Tokyo for the 11-year period 2001-2011 were obtained together with data on four air pollutants: fine particulate matter (PM2.5), suspended particulate matter (SPM), sulphur dioxide (SO2) and nitrogen dioxide (NO2). A time-stratified case-crossover study design was used to examine the daily association between the level of air pollution and suicide mortality.
  
  
  
  During the study period there were 29,939 suicide deaths. In stratified analyses an interquartile range (IQR) increase in the same-day concentration of NO2 was linked to increased suicide mortality among those aged under 30 (percentage change: 6.73%, 95% CI: 0.69-13.12%). An IQR increase in PM2.5 and SO2 was associated with a 10.55% (95% CI: 2.05-19.75%) and 11.47% (95% CI: 3.60-19.93%) increase, respectively, in suicide mortality among widowed individuals for mean exposure on the first four days (average lags 0-3). Positive associations were observed for the air pollutants in the summer although associations were reversed in autumn.
  
  
  
  We relied on monitoring data to approximate individual exposure to air pollutants.
  
  
  
  Higher levels of air pollution are associated with increased suicide mortality in some population subgroups in Tokyo. Further research is needed to elucidate the mechanisms linking air pollutants and suicide in this setting.
authors.affiliation: Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Electronic address: chrisng-tky@umin.ac.jp.
authors.forename: Chris Fook Sheng
authors.initials: CF
authors.lastname: Ng
authors.affiliation: Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; The Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, Huddinge, Sweden.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stickley
authors.affiliation: Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Anthropology, University of Washington, Seattle, WA, USA.
authors.forename: Shoko
authors.initials: S
authors.lastname: Konishi
authors.affiliation: Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Chiho
authors.initials: C
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000633:toxicity; D000397:Air Pollution / Q000706:statistics & numerical data*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D052638:Particulate Matter / Q000633:toxicity; D013405:Suicide / Q000706:statistics & numerical data*; D014041:Tokyo / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Air pollution; Case-crossover study; Japan; Mortality; Suicide