Ambient air pollution exposure and depressive symptoms: Findings from the French CONSTANCES cohort

Do social economic status modify the association between air pollution and depressive or anxiety symptoms? A big sample cross-sectional study from the rural areas of Central China

BACKGROUND

Fewer studies have examined the relationship between air pollution and depressive or anxiety symptoms in rural residents. Social economic status (SES), as an important indicator of the current state of socioeconomic development, we know little about how it modifies the relationship between air pollution and symptoms of depression or anxiety.

METHODS

The patient health questionnaire (PHQ-2) and generalized anxiety scale (GAD-2) were used to learn about the prevalence of depressive and anxiety symptoms, the social economic status of the participants was categorized into two levels: lower and higher, and a binary logistic regression model was used to analyze the relationship between air pollution and residents' symptoms of depression or anxiety.

RESULTS

A total of 10,670 adults were enrolled in this study, of which a total of 1292 participants suffered from depressive symptoms and 860 suffered from anxiety symptoms. Short-term exposure to PM2.5 and O3, singly or in combination, may be associated with the onset of depression symptoms, and there was a significant interaction between SES and exposure to PM2.5 or O3. Residents of areas with higher SES may have a lower risk of suffering from anxiety symptoms after O3 exposure compared to participants living in lower SES.

LIMITATIONS

The study was a cross-sectional study, which may have lowered the quality level of the evidence.

CONCLUSIONS

Short-term PM2.5 and O3 exposure may be associated with an increased prevalence risk of depressive symptoms. Higher levels of SES may reduce the adverse effects of air pollution on depressive or anxiety symptoms.

Long-term effects of fine particulate matter components on depression among middle-aged and elderly adults in China: A nationwide cohort study

BACKGROUND

Fine particulate matter (PM2.5) has been implicated in various health concerns. However, a comprehensive understanding of the specific PM2.5 components affecting depression remains limited.

METHODS

This study conducted a Cox proportional-hazards model to assess the effect of PM2.5 components on the incidence of depression based on the China Health and Retirement Longitudinal Study (CHARLS). Participants with 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) score of 10 or higher were classified as exhibiting depression.

RESULTS

Our findings demonstrated a significant positive correlation between long-term exposure to black carbon (BC), sulfate (SO42-), and organic matter (OM) components of PM2.5 and the prevalence of depression. Per 1 Interquartile Range (IQR) increment in 3-year average concentrations of BC, OM, and SO42- were associated with the hazard ratio (HR) of 1.54 (95 % confidence intervals (CI): 1.44, 1.64), 1.24 (95%CI: 1.16, 1.34) and 1.25 (95%CI: 1.16, 1.35). Notably, females, younger individuals, those with lower educational levels, urban residents, individuals who were single, widowed, or divorced, and those living in multi-story houses exhibited heightened vulnerability to the adverse effects of PM2.5 components on depression.

LIMITATIONS

Firstly, pollutant data is confined to subjects' fixed addresses, overlooking travel and international residence history. Secondly, the analysis only incorporates five fine particulate components, leaving room for further investigation into the remaining fine particulate components in future studies.

CONCLUSIONS

This study provides robust evidence supporting the detrimental impact of PM2.5 components on depression. The identification of specific vulnerable populations contributes to a deeper understanding of the underlying mechanisms involved in the relationship between PM2.5 components and depression.

Association between green space and multiple ambient air pollutants with depressive and anxiety symptoms among Chinese adolescents: The role of physical activity

OBJECTIVE

To explore the association between green space, multiple ambient air pollutants and depressive/anxiety symptoms and the mediating role of physical activity (PA) in Chinese adolescents.

METHOD

A school-based health survey was conducted in eight provinces in China in 2021. 22,868 students aged 14.64 (±1.77) years completed standard questionnaires to record details of depressive, anxiety symptoms and PA. We calculated the average normalized difference vegetation index (NDVI) in circular buffers of 200 m, 500 m and 1000 m and estimated the concentrations of PM10, PM2.5, CO, NO2, O3, SO2 around the adolescents' school addresses.

RESULTS

The exposure-response curves showed that the lower the NDVI value, the higher the risk of depressive and anxiety symptoms. CO, PM2.5 and SO2 and air pollution score were associated with increased risk of depressive and anxiety symptoms. NDVI in all circular buffers decreased the risk of depressive and anxiety symptoms at low levels of PA, but the associations were not significant at high levels of PA. In the subgroup analysis, PM10, PM2.5, CO, NO2, SO2, AQI and air pollution score increased the risk of depressive and anxiety symptoms at low PA levels, but the associations were not significant at high levels of PA. Mediation analysis indicated that the mediating effect of PA on the association between NDVI, NDVI-200 m NDVI-500 m, CO, PM10, PM2.5, SO2, AQI and depressive/anxiety symptoms was statistically significant（p < 0.05）.

CONCLUSION

Middle-high level PA could reduce the strength of association between air pollution and depressive and anxiety symptoms. Meanwhile, the association between green space/air pollution and depressive/anxiety symptoms was partly mediated by PA.

Effects of short- and long-term exposures to multiple air pollutants on depression among the labor force: A nationwide longitudinal study in China

BACKGROUND

Depression prevalence has surged within the labor force population in recent years. While links between air pollutants and depression were explored, there was a notable scarcity of research focusing on the workforce.

METHODS

This nationwide longitudinal study analyzed 27,457 workers aged 15-64. We estimated monthly mean concentrations of fine particulate matter (PM2.5), its primary components, and Ozone (O3) at participants' residences using spatiotemporal models. To assess the relationship between short- (1 to 3 months) and long-term (1 to 2 years) exposure to various air pollutants and depressive levels and occurrences, we employed linear mixed-effects models and mixed-effects logistic regression. We considered potential occupational moderators, such as labor contracts, overtime compensation, and total annual income.

RESULTS

We found significant increases in depression risks within the workforce linked to both short- and long-term air pollution exposure. A 10 μg/m3 rise in 2-year average PM2.5, black carbon (BC), and O3 concentrations correlated with increments in depressive scores of 0.009, 0.173, and 0.010, and a higher likelihood of depression prevalence by 0.5 %, 12.6 %, and 0.7 %. The impacts of air pollutants and depression were more prominent in people without labor contracts, overtime compensation, and lower total incomes.

CONCLUSION

Exposures to air pollutants could increase the risk of depression in the labor force population. The mitigating effects of higher income, benefits, and job security against depression underscore the need for focused mental health interventions.

Prevalence and associated factors for depressive symptoms among the general population from 31 provinces in China: The utility of social determinants of health theory

BACKGROUND

Depression is one of the most common types of mental disorders. Guided by the theory of social determinants of health (SDH), the study aimed to assess the prevalence of depressive symptoms and to identify factors related to depressive symptoms in the general population of China.

METHODS

A cross-sectional, online survey was conducted among 101,392 residents from 31 provinces of mainland China from January to March 2019, and 97,126 survey responses were included in the final analysis. Multilevel linear regression models were used to identify SDH associated with depressive symptoms.

RESULTS

The prevalence of depressive symptoms (PHQ-9 scores ≥10) in Chinese residents was 15.81 %. The results of the multilevel analysis demonstrated that depressive symptoms were affected by various factors on five levels, including individual characteristics, behavioral lifestyle, community support network, social structural factors, and macro social factors.

LIMITATIONS

The cross-sectional design of the study makes it difficult to establish causality between variables.

CONCLUSIONS

The prevalence of depressive symptoms is high among general population in China. According to the theory of SDH, the study shows that the depressive symptoms are complex and involves all areas of social life. Therefore, adopting a multi-level, cross-sectoral intervention approach will be instrumental to improving the mental health of residents in China.

Heatwave characteristics complicate the association between PM2.5 components and schizophrenia hospitalizations in a changing climate: Leveraging of the individual residential environment

BACKGROUND

In the era characterized by global environmental and climatic changes, understanding the effects of PM2.5 components and heatwaves on schizophrenia (SCZ) is essential for implementing environmental interventions at the population level. However, research in this area remains limited, which highlights the need for further research and effort. We aim to assess the association between exposure to PM2.5 components and hospitalizations for SCZ under different heatwave characteristics.

METHODS

We conducted a 16 municipalities-wide, individual exposure-based, time-stratified, case-crossover study from January 1, 2017, to December 31, 2020, encompassing 160736 hospitalizations in Anhui Province, China. Daily concentrations of PM2.5 components were obtained from the Tracking Air Pollution in China dataset. Conditional logistic regression models were used to investigate the association between PM2.5 components and hospitalizations. Additionally, restricted cubic spline models were used to identify protective thresholds of residential environment in response to environmental and climate change.

RESULTS

Our findings indicate a positive correlation between PM2.5 and its components and hospitalizations. Significantly, a 1 μg/m3 increase in black carbon (BC) was associated with the highest risk, at 1.58% (95%CI: 0.95-2.25). Exposure to heatwaves synergistically enhanced the impact of PM2.5 components on hospitalization risks, and the interaction varied with the intensity and duration of heatwaves. Under the 99th percentile heatwave events, the impact of PM2.5 and its components on hospitalizations was most pronounced, which were PM2.5 (2-4d: 4.59%, 5.09%, and 5.09%), sulfate (2-4d: 21.73%, 23.23%, and 25.25%), nitrate (2-4d: 17.51%, 16.93%, and 20.31%), ammonium (2-4d: 27.49%, 31.03%, and 32.41%), organic matter (2-4d: 32.07%, 25.42%, and 24.48%), and BC (2-4d: 259.36%, 288.21%, and 152.52%), respectively. Encouragingly, a protective effect was observed when green and blue spaces comprised more than 17.6% of the residential environment.

DISCUSSION

PM2.5 components and heatwave exposure were positively associated with an increased risk of hospitalizations, although green and blue spaces provided a mitigating effect.

Association between ambient particulate matters and anhedonia among patients with depression

Recent studies have linked ambient air pollution to depression. Anhedonia is a core symptom of depression which severely impacts on prognosis. The present study aims to investigate the association of PM2.5 and PM10 exposure with anhedonia in depressed patients. A total of 538 patients with depression who were hospitalized at the Fourth People's Hospital of Hefei between June 2017 and December 2021 were included. We estimated ambient particulate matters exposure, including PM2.5 and PM10, using a satellite-based spatiotemporal model at a resolution of 1 km2. The revised Physical Anhedonia Scale (RPAS) and the revised Social Anhedonia Scale (RSAS) were evaluated. The association of ambient particulate matters and anhedonia was examined using multiple linear regression models, adjusted for potential confounders. We observed that exposure to PM2.5 were significantly associated with increased RSAS score and RPAS score, with the major effect in the 12-month exposure window (β = 1.238; 95%CI, 0.353, 2.123) and 18-month exposure window (β = 1.888; 95%CI, 0.699, 3.078), respectively. Meanwhile, PM10 levels were also significantly associated with increased RSAS score and RPAS score, with the major effect in the 18-month exposure window (β = 1.220; 95%CI, 0.439, 2) and 3-month exposure window (β = 1.602; 95%CI, 0.062, 3.143), respectively. Subgroup analysis showed that both PM2.5 and PM10 were significantly associated with anhedonia in females, patients < 40 years old, low family income group, and those who had a higher educational level. Our study suggests that long-term PM2.5 and PM10 exposure are associated with more severe anhedonia in patients with depression. These associations were different in subgroup by age, gender, family income, and educational level.

Affective disorder and brain alterations in children and adolescents exposed to outdoor air pollution

BACKGROUND

Childhood and adolescence are critical periods for the development of the brain. However, a limited number of studies have explored how air pollution may associate with affective symptoms in youth.

METHODS

We performed a comprehensive review of the existing research on the associations between outdoor air pollution and affective disorders, suicidality, and the evidence for brain changes in youth. PRISMA guidelines were followed and PubMed, Embase, Web of Science, Cochrane Library, and PsychINFO databases were searched from their inception to June 2022.

RESULTS

From 2123 search records, 28 papers were identified as being relevant for studying the association between air pollution and affective disorders (n = 14), suicide (n = 5), and neuroimaging-based evidence of brain alterations (n = 9). The exposure levels and neuropsychological performance measures were highly heterogeneous and confounders including traffic-related noise, indoor air pollution, and social stressors were not consistently considered. Notwithstanding, 10 out of the 14 papers provide evidence that air pollution is associated with increased risk of depression symptoms, and 4 out of 5 papers provide evidence that air pollution might trigger suicidal attempts and behaviors. Besides, 5 neuroimaging studies revealed decreased gray-matter volume in the Cortico-Striato-Thalamo-Cortical neurocircuitry, and two found white matter hyperintensities in the prefrontal lobe.

CONCLUSIONS

Outdoor air pollution is associated with increased risks of affective disorders and suicide in youth, and there is evidence for associated structural and functional brain abnormalities. Future studies should determine the specific effects of each air pollutant, the critical exposure levels, and population susceptibility.