Suicide and Ambient Temperature: A Multi-Country Multi-City Study.
- Kim Y Department of Global Environmental Health, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
- Kim H Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
- Gasparrini A Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom.
- Armstrong B Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom.
- Honda Y Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan.
- Chung Y Department of Mathematical Sciences, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
- Ng CFS School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
- Tobias A Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain.
- Íñiguez C Department of Statistics and Computational Research, Universitat de València, Spain.
- Lavigne E School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
- Sera F Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom.
- Vicedo-Cabrera AM Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom.
- Ragettli MS Department of Epidemiology and Public Health, Environmental Exposures and Health Unit, Swiss Tropical and Public Health Institute, Basel, Switzerland.
- Scovronick N Department of Environmental Health, Emory Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
- Acquaotta F Department of Earth Sciences, University of Turin, Turin, Italy.
- Chen BY Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
- Guo YL Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
- Seposo X Department of Environmental Engineering, Kyoto University, Kyoto, Japan.
- Dang TN Institute of Research and Development, Duy Tan University, Da Nang, Vietnam.
- de Sousa Zanotti Stagliorio Coelho M Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.
- Saldiva PHN Institute of Advanced Studies, University of São Paulo, São Paulo, Brazil.
- Kosheleva A Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
- Zanobetti A Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
- Schwartz J Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
- Bell ML School of Forestry and Environmental Studies, Yale University, New Haven, Connecticut, USA.
- Hashizume M School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
- 2019-11-27
Published in:
- Environmental health perspectives. - 2019
Brazil
Canada
Cities
Hot Temperature
Humans
Japan
Philippines
Republic of Korea
Risk
South Africa
Spain
Suicide
Switzerland
Taiwan
United Kingdom
United States
Vietnam
English
BACKGROUND
Previous literature suggests that higher ambient temperature may play a role in increasing the risk of suicide. However, no multi-country study has explored the shape of the association and the role of moderate and extreme heat across different locations.
OBJECTIVES
We examined the short-term temperature-suicide relationship using daily time-series data collected for 341 locations in 12 countries for periods ranging from 4 to 40 y.
METHODS
We conducted a two-stage meta-analysis. First, we performed location-specific time-stratified case-crossover analyses to examine the temperature-suicide association for each location. Then, we used a multivariate meta-regression to combine the location-specific lag-cumulative nonlinear associations across all locations and by country.
RESULTS
A total of 1,320,148 suicides were included in this study. Higher ambient temperature was associated with an increased risk of suicide in general, and we observed a nonlinear association (inverted J-shaped curve) with the highest risk at 27°C. The relative risk (RR) for the highest risk was 1.33 (95% CI: 1.30, 1.36) compared with the risk at the first percentile. Country-specific results showed that the nonlinear associations were more obvious in northeast Asia (Japan, South Korea, and Taiwan). The temperature with the highest risk of suicide ranged from the 87th to 88th percentiles in the northeast Asian countries, whereas this value was the 99th percentile in Western countries (Canada, Spain, Switzerland, the UK, and the United States) and South Africa, where nearly linear associations were estimated. The country-specific RRs ranged from 1.31 (95% CI: 1.19, 1.44) in the United States to 1.65 (95% CI: 1.40, 1.93) in Taiwan, excluding countries where the results were substantially uncertain.
DISCUSSION
Our findings showed that the risk of suicide increased with increasing ambient temperature in many countries, but to varying extents and not necessarily linearly. This temperature-suicide association should be interpreted cautiously, and further evidence of the relationship and modifying factors is needed. https://doi.org/10.1289/EHP4898.
Previous literature suggests that higher ambient temperature may play a role in increasing the risk of suicide. However, no multi-country study has explored the shape of the association and the role of moderate and extreme heat across different locations.
OBJECTIVES
We examined the short-term temperature-suicide relationship using daily time-series data collected for 341 locations in 12 countries for periods ranging from 4 to 40 y.
METHODS
We conducted a two-stage meta-analysis. First, we performed location-specific time-stratified case-crossover analyses to examine the temperature-suicide association for each location. Then, we used a multivariate meta-regression to combine the location-specific lag-cumulative nonlinear associations across all locations and by country.
RESULTS
A total of 1,320,148 suicides were included in this study. Higher ambient temperature was associated with an increased risk of suicide in general, and we observed a nonlinear association (inverted J-shaped curve) with the highest risk at 27°C. The relative risk (RR) for the highest risk was 1.33 (95% CI: 1.30, 1.36) compared with the risk at the first percentile. Country-specific results showed that the nonlinear associations were more obvious in northeast Asia (Japan, South Korea, and Taiwan). The temperature with the highest risk of suicide ranged from the 87th to 88th percentiles in the northeast Asian countries, whereas this value was the 99th percentile in Western countries (Canada, Spain, Switzerland, the UK, and the United States) and South Africa, where nearly linear associations were estimated. The country-specific RRs ranged from 1.31 (95% CI: 1.19, 1.44) in the United States to 1.65 (95% CI: 1.40, 1.93) in Taiwan, excluding countries where the results were substantially uncertain.
DISCUSSION
Our findings showed that the risk of suicide increased with increasing ambient temperature in many countries, but to varying extents and not necessarily linearly. This temperature-suicide association should be interpreted cautiously, and further evidence of the relationship and modifying factors is needed. https://doi.org/10.1289/EHP4898.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1289/EHP4898
- PMID 31769300
- Persistent URL
- https://folia.unifr.ch/global/documents/135530
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