Ambient ozone concentration and emergency department visits for panic attacks

Jaelim Cho, Yoon Jung Choi, Jungwoo Sohn, Mina Suh, Seong Kyung Cho, Kyoung Hwa Ha, Changsoo Kim, Dong Chun Shin

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16 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)130-135
Number of pages6
JournalJournal of Psychiatric Research
Publication statusPublished - 2015 Mar 1

Bibliographical note

Funding Information:
This subject is supported by Korea Ministry of Environment (MOE) as “the Environmental Health Action Program” (grant number 2014001360002 ) and by the Yonsei University College of Medicine, Seoul, Republic of Korea (grant number 6-2014-0106 ). The researchers conducted this study independently from the funding sponsors. The sponsors had no involvement in the design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation, review, and approval of the manuscript.

Publisher Copyright:
© 2015 Elsevier Ltd.

All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Biological Psychiatry


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