DOE OSTI2026
Background: Individual components of the ambient environment, such as temperature and air pollution, exist as part of a complex mixture and have been associated with suicide; however, their interactive effects remain poorly understood. This study examined the independent and interactive effects of wet bulb globe temperature (WBGT), nitrogen dioxide (NO 2 ), and fine particulate matter (PM 2.5 ) on suicide mortality. Methods: We identified 7,551 suicide cases in Utah, USA, from 2000 to 2016 and assigned exposure to daily maximum WBGT (sourced from the European Center for Medium-Range Weather Forecasts) and PM 2.5 and NO 2 concentrations (sourced from a national spatiotemporal ensemble model) using decedent’s residential address at the time of death. A case-crossover design with conditional logistic regression was used to estimate the independent and interactive effects of WBGT max , PM 2.5 , and NO 2 on suicide. For exposure windows, we considered single days preceding suicide (lag 0 to 6) and their averages across preceding days (lag 0–1, 0–3, and 0–6). Analyses were stratified by season. Results: We identified a significant association between WBGT max and suicide across all seasons (odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01, 1.10; per 5 °C increase on lag 0–3 days). The associations were stronger in the warm season (March 22 to September 21), with ORs and 95% CIs ranging from 1.08 (1.02, 1.15) to 1.20 (1.10, 1.30) per 5 °C increase depending on the lag periods. We observed synergistic interactions between WBGT max and PM 2.5 and NO 2 in the warm season, associated with higher odds of suicide. The associations of WBGT max with suicide were most pronounced at high NO 2 levels. Conclusions: We found evidence of synergistic interactions between WBGT max and PM 2.5 and NO 2 on suicide in the warm season, emphasizing the need for considering the combined effects of heat stress and air pollution in suicide prevention strategies.