Air Pollution (Particulate Matter) Exposure and Associations with Depression, Anxiety, Bipolar, Psychosis and Suicide Risk: A Systematic Review and Meta-Analysis

Abstract

BACKGROUND: Particulate air pollution's physical health effects are well known, but associations between particulate matter (PM) exposure and mental illness have not yet been established. However, there is increasing interest in emerging evidence supporting a possible etiological link. OBJECTIVES: This systematic review aims to provide a comprehensive overview and synthesis of the epidemiological literature to date by investigating quantitative associations between PM and multiple adverse mental health outcomes (depression, anxiety, bipolar disorder, psychosis, or suicide). METHODS: We undertook a systematic review and meta-analysis. We searched Medline, PsycINFO, and EMBASE from January 1974 to September 2017 for English-language human observational studies reporting quantitative associations between exposure to PM <1:0 lm in aerodynamic diameter (ultrafine particles) and PM <2:5 and <10 lm in aerodynamic diameter (PM 2:5 and PM 10 , respectively) and the above psychiatric outcomes. We extracted data, appraised study quality using a published quality assessment tool, summarized methodological approaches, and conducted metaanalyses where appropriate. RESULTS: Of 1,826 citations identified, 22 met our overall inclusion criteria, and we included 9 in our primary meta-analyses. In our meta-analysis of associations between long-term (>6 months) PM 2:5 exposure and depression (n = 5 studies), the pooled odds ratio was 1.102 per 10-lg=m 3 PM 2:5 increase (95% CI: 1.023, 1.189; I 2 = 0:00%). Two of the included studies investigating associations between long-term PM 2:5 exposure and anxiety also reported statistically significant positive associations, and we found a statistically significant association between short-term PM 10 exposure and suicide in meta-analysis at a 0-2 d cumulative exposure lag. DISCUSSION: Our findings support the hypothesis of an association between long-term PM 2:5 exposure and depression, as well as supporting hypotheses of possible associations between long-term PM 2:5 exposure and anxiety and between short-term PM 10 exposure and suicide. The limited literature and methodological challenges in this field, including heterogeneous outcome definitions, exposure assessment, and residual confounding, suggest further high-quality studies are warranted to investigate potentially causal associations between air pollution and poor mental health.

Ambient air pollution and cause-specific risk of hospital admission in China: A nationwide time-series study

“…Chronic ulcer of skin, which had a relatively small sample size (n = 61,605) among all minor disease categories, had one of the largest effect estimates of PM 2.5 among all minor disease categories. Overall, these findings are novel-some associations are supported by previous studies, e.g., PM 2.5 and anxiety disorders [54][55][56], while others are reported to our knowledge for the first time. Certain musculoskeletal diseases and mental disorders that were associated with PM 2.5 in this study contribute to the global burden of disease especially in terms of nonfatal consequences.…”

The clinical characterization of the adult patient with depression aimed at personalization of management

“…Stressors associated with depression include major life events (e.g., serious physical disease, natural disasters, intimate partner violence), chronic stressors (e.g., community violence, job insecurity, racial discrimination), and daily hassles. Other environmental factors reported to be associated with depression include negative aspects of the work environment 219 , increased social media and screen time 220,221 , unfavorable living environments 222 , increased air and noise pollution 223,224 , and higher ambient temperatures 225 .…”

Auswirkungen von Umweltrisikofaktoren wie Lärm und Luftverschmutzung auf die psychische Gesundheit: Was wissen wir?

“…Zudem war in derselben Studie das Ausmaß der Luftverschmutzung mit dem Auftreten von Depressionen assoziiert (OR 1,07; 95 %-KI 1,01-1,12). 95 %-KI 1,00-1,03 pro Zunahme um 10 μg/m 3 PM 10 ) assoziiert ist [31]. Kritisch muss hier angemerkt werden, dass fast ausschließlich Querschnittstudien analysiert wurden, jedoch mit moderater Qualität und Homogenität zwischen den Studien.…”