Abstract This study examined associations between short-term ambient environmental exposures and suicide (n = 3210) and overdose mortality (n = 4293; 2226 opioid-related) among U.S. Veterans from 2018–2019. Daily exposure to 24-hour maximum temperature, average atmospheric pressure, average PM2.5, 1-hour maximum NO2, and 8-hour maximum O3 was assessed at the decedent’s county of residence on the day of death and up to six days prior. A national bi-directional, time-stratified case-crossover design was applied. Conditional logistic regression models estimated associations between each exposure and suicide or overdose deaths, overall, and stratified by season, region, elevation, and urbanicity. Over lag days 0–1, an interquartile range increase in maximum temperature was associated with increased suicide (19%) and overdose (27%) mortality, with stronger summer effects for suicide (55%) and overdose (71%). In winter, interquartile range increases in atmospheric pressure, PM2.5, and NO2 were associated with 104%, 15%, and 19% increases in suicide mortality. Maximum temperature was associated with a 22% increase in suicide risk in metropolitan areas and 57% in the Western U.S., while NO2 was associated with a 26% increase in overdose mortality in nonmetropolitan areas. Findings suggest environmental stressors contribute to suicide and overdose mortality among Veterans, supporting environmentally informed prevention efforts.
Peluso et al. (Sat,) studied this question.