Environmental pollution and mental health: a narrative review of literature

The impact of water pollution on the health of older people

Water pollution exerts a negative impact on the health of both women and men, inducing hormonal changes, accelerating aging, and consequently leading to the premature onset of age-related health problems. Water pollutants can in general be classified as chemical (both organic and inorganic), physical, and biological agents. Certain chemical pollutants have been found to disrupt hormonal balance by blocking, mimicking, or disrupting functions within the intricate homeostasis of the human body. Moreover, certain water pollutants, including specific pesticides and industrial chemicals, have been associated with neurological and psychiatric disorders, such as mood swings, depression, cognitive decline, and anxiety, impacting both women and men. Water pollution is also associated with physical ailments, such as diarrhea, skin diseases, malnutrition, and cancer. Exposure to specific pollutants may promote premature menopause and vasomotor symptoms, elevate the risk of cardiovascular disease, and reduce bone density. In men, exposure to water pollution has been shown to reduce LH, FSH, and testosterone serum levels. The oxidative stress induced by pollutants prompts apoptosis of Sertoli and germ cells, inhibiting spermatogenesis and altering the normal morphology and concentration of sperm. Environmental estrogens further contribute to reduced sperm counts, reproductive system disruptions, and the feminization of male traits. Studies affirm that men generally exhibit a lower susceptibility than women to hormonal changes and health issues attributed to water pollutants. This discrepancy may be attributed to the varied water-related activities which have traditionally been undertaken by women, as well as differences in immune responses between genders. The implementation of effective measures to control water pollution and interventions aimed at safeguarding and enhancing the well-being of the aging population is imperative. The improvement of drinking water quality has emerged as a potential public health effort with the capacity to curtail the onset of cognitive impairment and dementia in an aging population.

Validity of Mobility-Based Exposure Assessment of Air Pollution: A Comparative Analysis with Home-Based Exposure Assessment

Air pollution exposure is typically assessed at the front door where people live in large-scale epidemiological studies, overlooking individuals' daily mobility out-of-home. However, there is limited evidence that incorporating mobility data into personal air pollution assessment improves exposure assessment compared to home-based assessments. This study aimed to compare the agreement between mobility-based and home-based assessments with personal exposure measurements. We measured repeatedly particulate matter (PM2.5) and black carbon (BC) using a sample of 41 older adults in the Netherlands. In total, 104 valid 24 h average personal measurements were collected. Home-based exposures were estimated by combining participants' home locations and temporal-adjusted air pollution maps. Mobility-based estimates of air pollution were computed based on smartphone-based tracking data, temporal-adjusted air pollution maps, indoor-outdoor penetration, and travel mode adjustment. Intraclass correlation coefficients (ICC) revealed that mobility-based estimates significantly improved agreement with personal measurements compared to home-based assessments. For PM2.5, agreement increased by 64% (ICC: 0.39-0.64), and for BC, it increased by 21% (ICC: 0.43-0.52). Our findings suggest that adjusting for indoor-outdoor pollutant ratios in mobility-based assessments can provide more valid estimates of air pollution than the commonly used home-based assessments, with no added value observed from travel mode adjustments.

Construction of urban low-carbon development and sustainable evaluation system based on the internet of things

Low-carbon (LC) cities are the cities that people long for today. LC environmental protection plays a very important role in people's health. The construction of a city in LC is a great cause that contributes to the present and benefits the future. In this study, we propose a development and sustainability evaluation system for building low-carbon cities based on the Internet of Things (IoT). The study is novel in that it considers key areas such as urban planning, environmental issues and solutions, and how the Internet of Things can optimize low-carbon logistics and smart grids, with the aim of promoting the formation of low-carbon city models. This comprehensive approach not only presents problems and solutions in low-carbon urban planning but also focuses on how the Internet of Things can be used as a key technology to promote low-carbon urban development. The urban development of LC was constructed with a sustainable evaluation system, so that people could experience the life of LC. Through the investigation of the degree of atmospheric pollution of LC cities using the Internet of Things, this article found that the highest degree of atmospheric pollution was 30. The highest degree of atmospheric pollution in cities in LC without IoT was 53. The severity of water pollution in cities in LC using IoT technology ranged from 10 to 25, while those without IoT ranged from 30 to 60. The degree of soil pollution in LC cities using IoT technology was concentrated in 10-30, while those without using IoT were concentrated in 30-50. Through these experimental data, it could be seen that IoT technology could reduce environmental pollution, thus achieving the effect of LC cities. This shows that the use of IoT technology in LC cities was highly feasible.

Low-Level Visual Features of Window Views Contribute to Perceived Naturalness and Mental Health Outcomes

Previous studies have shown that natural window views are beneficial for mental health, but it is still unclear which specific features constitute a 'natural' window view. On the other hand, studies on image analysis found that low-level visual features (LLVFs) are associated with perceived naturalness, but mainly conducted experiments with brief stimulus presentations. In this study, research on the effects of window views on mental health was combined with the detailed analysis of LLVFs. Healthy adults rated window views from their home and sent in photographs of those views for analysis. Content validity of the 'ecological' view assessment was evaluated by checking correlations of LLVFs with window view ratings. Afterwards, it was explored which of the LLVFs best explained variance in perceived percentage of nature and man-made elements, and in ratings of view quality. Criterion validity was tested by investigating which variables were associated with negative affect and impulsive decision-making. The objective and subjective assessments of nature/sky in the view were aligned but objective brightness was unreliable. The perceived percentage of nature was significantly explained by green pixel ratio, while view quality was associated with fractals, saturation, sky pixel ratio and straight edge density. The higher subjective brightness of rooms was associated with a lower negative affect, whereas results for impulsive decision-making were inconsistent. The research highlights the validity to apply LLVFs analysis to ecological window views. For affect, subjective brightness seemed to be more relevant than LLVFs. For impulsive decision-making, performance context needs to be controlled in future studies.

'Environmental standard limit concentration' arsenic exposure is associated with anxiety, depression, and autism-like changes in early-life stage zebrafish

Arsenic is a worldwide environmental pollutant that can impair human health. Previous studies have identified mental disorders induced by arsenic, but the environmental exposure concentrations in the early life stages associated with these disorders are poorly understood. In the present study, early-life stage zebrafish were used to explore the effects on mental disorders under 'environmental standard limit concentrations' arsenic exposures of 5, 10, 50, 150, and 500 μg/L. The results showed that arsenic exposure at these concentrations changed the locomotor behavior in larval zebrafish and was further associated with anxiety, depression, and autism-like behavior in both larval and juvenile zebrafish. Changes were noted at benchmark dose limit (BMDL) concentrations as low as 0.81 μg/L. Transcriptomics showed that immediate early genes (IEGs) fosab, egr1, egr2a, ier2b, egr3, and jund were decreased after arsenic exposure in larval and juvenile zebrafish. Nervous system impairment and anxiety, depression, and autism-like behaviors in early-life stage zebrafish at 'environmental standard limit concentrations' may be attributed to the downregulation of IEGs. These findings in zebrafish provided new experimental support for an arsenic toxicity threshold for mental disorders, and they suggest that low levels of environmental chemicals may be causative developmental factors for mental disorders.

Perceived urban green spaces and youth mental health in the post-COVID-19 era

Introduction

The urban green space (UGS) is one of the most significant urban spaces with unique visual and social features, including pleasant air, low noise, and vitality, making it a recreational place for citizens, especially the youth. According to previous studies, perceived green space and the interaction with it is associated with mental health and lower symptoms of anxiety and depression. Although the presence of urban and blue-green spaces in Isfahan has a long history, the UGSs have been out of reach, causing a significant impact on youth mental health due to the spread of COVID-19 and the forcing of the Iranian government to severe and long-term lockdown. This study investigates the relationship between the long-term isolation of youth and being away from UGSs on their mental health in Isfahan city.

Methods

In September 2022, the youth (n = 273) in 12 neighborhoods with similar socio-economic status were asked to answer the online questionnaire. To investigate the correlation between perceived UGS and the mental health of the youth, Structural Equation Modeling (SEM) is done.

Results

The results show that the perceived UGSs negatively relate to the youth's fear of the reoccurrence of COVID-19 infection, anxiety, and depression. Moreover, the model shows that perceived UGS has an inverse correlation with anxiety (β = -0.24, p = 0.00), and no meaningful correlation exists with depression.

Discussion

These results point to a practical solution for designing UDGs in residential areas for youth according to their benefits for mental health during the epidemic era.

Sex difference in the non-linear relationship between ethylene oxide exposure and depressive symptoms: A cross-sectional study

BACKGROUND

Ethylene oxide (EO) has been recognized as an animal carcinogen and environmental EO exposure was linked to several diseases. However, the association of EO exposure with depression prevalence is still not clear.

METHODS

We included 6016 participants with complete data on HbEO concentrations, depression diagnosis, and necessary covariates using the 2013-2020 National Health and Nutrition Examination Survey. Weighted multivariable logistic model was applied to examine the association of HbEO concentrations with depression risk. Weighted restricted cubic spline model was applied to draw the dose-response curve.

RESULTS

In the total population, individuals in the second, third, and fourth quartile of HbEO respectively had an adjusted OR of 0.99 (95%CI: 0.60, 1.63), 1.13 (95%CI: 0.73, 1.75), and 2.87 (95%CI: 1.86, 4.45) (Ptrend < 0.001) for depression with a significant "J" shaped non-linear dose-response relationship (Pnon-linear < 0.001). Females, drinkers, and smokers were susceptible to the depressive effect of EO. Doubling the HbEO concentrations was respectively associated with a 1.50-fold (95%CI: 1.25, 1.79), 1.29-fold (1.15, 1.44), and 1.17-fold (1.04, 1.33) increased risk of depression for females, drinkers, and smokers.

LIMITATIONS

Cross-sectional study design and self-reported depressive symptoms.

CONCLUSIONS

Environmental EO exposure was associated with increased depression risk, especially among females, drinkers, and smokers. Further prospective studies are required to affirm these findings.

Critical factors influencing visitor emotions: analysis of "restorativeness" in urban park visits in Fuzhou, China

Objective

To date, a comprehensive analysis of urban green space (UGS) visitors' emotional remains largely unexplored. In this study, we focus on how UGS environmental preferences, restorativeness, other physical factors (sound, air, and thermal environments), and individual characteristics affecting visitor emotions. Such a comprehensive analysis would allow relevant practitioners to check the environmental quality of UGSs and improve certain conditions to promote visitor emotions.

Methods

A total of 904 questionnaire responses with concurrently monitored physical factors were analyzed by independent sample t-tests, one-way ANOVA and path analysis.

Results

The thermal evaluation had the largest impact on positive emotions (β = 0.474), followed by perceived restorativeness (β = 0.297), which had β values of -0.120 and -0.158, respectively, on negative emotions. Air evaluation was more effective for increasing positive emotions (β = 0.293) than reducing negative emotions (β = -0.115). Sound evaluation also had similar results (β = 0.330 vs. β = -0.080). Environmental preference significantly influenced only positive emotions (β = 0.181) but could still indirectly impact negative emotions. Moreover, objective physical factors can indirectly affect visitors' emotions by enhancing their evaluations..

Conclusion

The influence of different UGS environmental factors on visitors' emotions vary, as does their impacts on positive versus negative emotions. Positive emotions were generally more affected than negative emotions by UGS. Visitor emotions were mainly influenced by physical and psychological factors. Corresponding suggestions are proposed for UGS design and management in this study.

Associations between urinary heavy metals and anxiety among adults in the National Health and Nutrition Examination Survey (NHANES), 2007-2012

BACKGROUND

Few studies have investigated the associations between heavy metals and anxiety. The purpose of this study was to examine the associations between single and combined exposure to heavy metals and anxiety.

METHODS

This study employed data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012. Anxiety was assessed by patients self-reporting the number of anxious days per month. First, we evaluated the associations between 10 heavy metals single exposure and anxiety by multivariable logistic regression. We then selected 5 heavy metals (cadmium, antimony, cobalt, tungsten, and uranium) for further analysis by elastic net regression. Subsequently, principal component analysis (PCA), weighted quantile regression (WQS), and Bayesian kernel machine regression (BKMR) were utilized to evaluate the associations between 5 heavy metals co-exposure and anxiety.

RESULTS

This study included 4512 participants, among whom 1206 participants were in an anxiety state. Urinary cadmium and antimony were separately related to an increased risk of anxiety (p for trend <0.01 and < 0.01, respectively). In PCA analysis, PC1 was associated with an increased risk of anxiety (p for trend <0.001). In WQS analysis, the positive WQS index was substantially linked with the risk of anxiety (OR (95%CI): 1.23 (1.04,1.39)). In BKMR analysis, the overall effects of co-exposure to heavy metals were positively connected with anxiety.

CONCLUSION

Our study identified a positive correlation between individual exposure to cadmium and antimony and the risk of anxiety. Additionally, the co-exposure to cadmium, antimony, cobalt, tungsten, and uranium was associated with an increased risk of anxiety.

The effects of long-term exposure to air pollution on incident mental disorders among patients with prediabetes and diabetes: Findings from a large prospective cohort

BACKGROUND

The association between air pollution and mental disorders has been widely documented in the general population. However, the evidence among susceptible populations, such as individuals with prediabetes or diabetes, is still insufficient.

METHODS

We analyzed data from 48,515 participants with prediabetes and 24,393 participants with diabetes from the UK Biobank. Annual pollution data were collected for fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2), and nitrogen dioxides (NOx) during 2006-2021. The exposure to air pollution and temperature for each participant were estimated by the bilinear interpolation approach and time-weighted method based on their geocoded home addresses and time spent at each address. We employed the generalized propensity score model based on the generalized estimating equation and the time-varying covariates Cox model to assess the effects of air pollution.

RESULTS

We observed causal links between air pollutants and mental disorders among both prediabetic and diabetic participants, with stronger effects among those with diabetes than prediabetes. The hazard ratios were 1.18 (1.12, 1.24), 1.15 (1.10, 1.20), 1.18 (1.13, 1.23), and 1.15 (1.11, 1.19) in patients with prediabetes, and 1.21 (1.13, 1.29), 1.17 (1.11, 1.24), 1.19 (1.13, 1.25), and 1.17 (1.12, 1.23) in patients with diabetes per interquartile range elevation in PM2.5, PM10, NO2, and NOx. Furthermore, the effects were more pronounced among people who were older, alcohol drinkers, and living in urban areas.

CONCLUSIONS

Our study indicates the potential causal links between long-term exposure to air pollution and incident mental disorders among those with prediabetes and diabetes. Reducing air pollution levels would significantly benefit this vulnerable population by reducing the incidence of mental disorders.

Chinese sapindaceous tree species (Sapindus mukorosii) exhibits lead tolerance and long-term phytoremediation potential for moderately contaminated soils

Heavy metal pollution in metropolitan soils poses significant risks to human health and the entire ecosystem. Effective mitigation strategies and technologies are crucial for addressing these environmental issues. Fast-growing trees are an essential part of phytoremediation projects all over the world and provide long-term ecological benefits to mankind. This study assessed the lead tolerance and phytoremediation potential of a fast-growing soapberry tree species (Sapindus mukorossi) in moderately contaminated soil. Two independent experiments were conducted to assess its tolerance at (i) germination level and (ii) prolonged growth stage. In the germination experiments, seeds were exposed to lead (II) nitrate Pb (NO₃)₂ at various concentrations (0, 5, 10, 20, 50, 100, 200, 300, 400 and 500 μM) for 120 days. Results showed significant differences in germination time, germination index, seedling vigor index, energy of germination, final germination, germination inhibition, seedling height and root/shoot weight compared to the control experiments. In the prolonged growth experiments, seedlings were grown for six months in soils amended/spiked with different Pb concentrations (T0 = 0, T1 = 20, T2 = 50, T3 = 100, T4 = 150 and T5 = 200 mg kg-1 soil) and their biomass was determined. The highest biomass achieved in six months (T0: 12.62 g plant-1), followed by (T1: 12.33 g plant-1), (T2: 12.42 g plant-1), (T3: 11.86 g plant-1), (T4: 10.86 g plant-1) and (T5: 10.06 g plant-1) respectively. S. mukorossi showed no visible signs of Pb toxicity over a six-month period. During six months of exposure, the total Pb content in S. mucrossi tissues were classified as roots > leaves > stems. The highest cumulative absorption of Pb occurred between the fourth and fifth months of exposure. Maximum transfer factor (TF) was detected during the fourth month ranging from 0.888 to 1.012 for the different Pb concentrations. Furthermore, the growth behavior, lead accumulation, bioconcentration factors (BCF) and tolerance index (TI) indicated that S. mucrossi may tolerate moderate Pb concentrations for longer periods. These findings suggest that S. mukorossi may be deployed for long-term phytoremediation coupled with urban forest applications in the future.

Protective effect of restorative possibilities on cognitive function and mental health in children and adolescents: A scoping review including the role of physical activity

Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.

Effects of Noise Exposure and Ageing on Anxiety and Social Behaviour in Zebrafish

Noise pollution is creating a wide range of health problems related to physiological stress and anxiety that impact the social life of vertebrates, including humans. Ageing is known to be associated with changes in susceptibility to acoustic stimuli; however, the interaction between noise effects and senescence is not well understood. We tested the effects of 24 h continuous white noise (150 dB re 1 Pa) on both young adults and old zebrafish in terms of anxiety (novel tank diving test), social interactions (with mirror/conspecific attraction), and shoaling behaviour. Both noise and ageing induced higher anxiety responses in a novel environment. Since the old zebrafish showed longer bottom dwelling, acoustic treatment induced the opposite pattern with an initial increase in vertical exploration in the aged individuals. Both noise- and age-related anxiety responses were lowered when individuals were tested within a group. Regarding social interactions, both noise and ageing seemed to cause an increase in their proximity to a mirror. Although the results were not statistically significant, noise exposure seemed to further enhance conspecific attraction. Moreover, the interindividual distance within a shoal decreased with noise treatment in the aged individuals. This study is a first attempt to investigate the effects of both noise and ageing on zebrafish behaviour, suggesting the age-dependent physiological coping mechanisms associated with environmental stress.

Developing a National-Scale Exposure Index for Combined Environmental Hazards and Social Stressors and Applications to the Environmental Influences on Child Health Outcomes (ECHO) Cohort

Tools for assessing multiple exposures across several domains (e.g., physical, chemical, and social) are of growing importance in social and environmental epidemiology because of their value in uncovering disparities and their impact on health outcomes. Here we describe work done within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort Study to build a combined exposure index. Our index considered both environmental hazards and social stressors simultaneously with national coverage for a 10-year period. Our goal was to build this index and demonstrate its utility for assessing differences in exposure for pregnancies enrolled in the ECHO-wide Cohort Study. Our unitless combined exposure index, which collapses census-tract level data into a single relative measure of exposure ranging from 0-1 (where higher values indicate higher exposure to hazards), includes indicators for major air pollutants and air toxics, features of the built environment, traffic exposures, and social determinants of health (e.g., lower educational attainment) drawn from existing data sources. We observed temporal and geographic variations in index values, with exposures being highest among participants living in the West and Northeast regions. Pregnant people who identified as Black or Hispanic (of any race) were at higher risk of living in a "high" exposure census tract (defined as an index value above 0.5) relative to those who identified as White or non-Hispanic. Index values were also higher for pregnant people with lower educational attainment. Several recommendations follow from our work, including that environmental and social stressor datasets with higher spatial and temporal resolutions are needed to ensure index-based tools fully capture the total environmental context.

Examining individual-level tri-exposure to greenspace and air/noise pollution using individual-level GPS-based real-time sensing data

OBJECTIVE

Although exposure to air/noise pollution and greenspace has been found to significantly affect people's physical and mental health outcomes, there is still a lack of knowledge on what built-environment and socioeconomic factors are significantly associated with people's tri-exposure to air/noise pollution and greenspace. This study analyzes the associations between built-environment and socioeconomic factors and the tri-exposure to greenspace and air/noise pollution in Hong Kong.

METHOD

Based on individual-level activity data, real-time GPS trajectories, and exposure data collected by portable sensors as well as remote sensing satellite imagery, we employ multinomial logistic regression to determine the socioeconomic and built-environment factors that are significantly associated with the type of participants' tri-exposure at the grid cell level.

RESULTS

The results show that higher transit nodal accessibility, building density, building height and land-use mix are significantly associated with a higher likelihood of being disadvantaged in terms of tri-exposure to air/noise pollution and greenspace. While more advantageous tri-exposures are significantly related to higher median monthly household income and sky view factor.

CONCLUSION

Old high-rise high-density neighborhoods are more likely to be triply disadvantaged with low greenspace exposure but high air pollution and noise pollution exposure. The findings provide policymakers with critical reference in terms of addressing the inequalities in the tri-exposure outcomes.

Urbanization and residents' health: from the perspective of environmental pollution

The development of urbanization has important implications for the environment and the human health. However, it is still lacking a comprehensive analysis between urbanization, environmental pollution, and residents' health based on a unified research system. In this study, we assessed the integrated level of urbanization by the entropy method based on the representative indicators. It has been found that there is a significant progress in the urbanization level in the provinces from 2005 to 2020. The impact of urbanization development on environmental pollution was analyzed using the system GMM (Generalized Method of Moments), and the results show an inverted U-shaped relationship between urbanization and environmental pollution. Fixed effect regression model analysis infers that urbanization has a dual impact on population health. Urbanization promotes residents' health by improving medical conditions, but the environmental pollution caused by urbanization is harmful to residents' health. This paper integrated urbanization, environmental pollution, and residents' health into a research system to analyze the impact of urbanization on environmental pollution and residents' health. Some policy recommendations have been proposed based on the research results for promoting high-quality development of urbanization, reducing environmental pollution, and improving residents' health.

Significant association between increased risk of emergency department visits for psychiatric disorders and air pollutants in South Korea

BACKGROUND

The association between air pollutants and psychiatric disorders has been investigated in many countries. However, results for the association between air pollutants and emergency room (ER) visits for psychiatric disorders are inconsistent. Further, systematic large-scale studies relating to the same are lacking, especially in South Korea.

OBJECTIVE

We aimed to investigate the acute and short-term cumulative effect of air pollutants on ER visits for psychiatric disorders in South Korea.

METHODS

The data on nitrogen dioxide (NO2) and particulate matter (PM2.5 and PM10) and ER visits due to nine representative psychiatric disorders were collected from eight major cities in South Korea for three years. We estimated the relative risk (RR) at lag 0 and a cumulative 11-day RR by increasing a 10-unit for PM and 0.01-unit for NO2 using the Distributed Lag Nonlinear Model.

RESULTS

During the study period, a total of 79,092 ER visits for psychiatric disorders were identified and tested for association with NO2, PM2.5, and PM10. The RR at lag 0 of depression per 0.01-unit increase in NO2 was the highest (3.127; 95% confidence interval [CI] 2.933 to 3.332) among the psychiatric disorders. The RRs at lag 0 of anxiety disorders per 10-unit increase in PM2.5 (1.709; 95% CI 1.424 to 2.053) and PM10 (2.168; 95% CI 1.957 to 2.403) were the highest among the psychiatric disorders.

SIGNIFICANCE

Air pollutants increased ER visits for psychiatric disorders with the highest RR of depression due to NO2 and anxiety disorder due to PM2.5 and PM10. These results contribute evidence to the positive association between ambient exposure to air pollution and aggravation of psychiatric disorders, indicating air pollution may be a modifiable risk factor in mental health management.

IMPACT STATEMENT

We investigated the effect of air pollution on emergency room visits caused by major psychiatric disorders in prominent cities in South Korea. Using the Distributed Lag Nonlinear Model, an advanced analysis method, we calculated the acute effect and short-term cumulative effect. Air pollutants increased ER visits for psychiatric disorders with the highest relative risk of depression due to NO2 and anxiety disorder due to PM2.5 and PM10. These results reveal an association between ambient exposure to air pollution and aggravation of psychiatric disorders and suggest that air pollution may be a modifiable risk factor in mental health management.

Global mental health and climate change: A geo-psychiatry perspectiv

Climate changes affect planet ecosystems, living beings, humans, including their lives, rights, economy, housing, migration, and both physical and mental health. Geo-psychiatry is a new discipline within the field of psychiatry studying the interface between various geo-political factors including geographical, political, economic, commercial and cultural determinants which affect society and psychiatry: it provides a holistic overview on global issues such as climate changes, poverty, public health and accessibility to health care. It identifies geopolitical factors and their effects at the international and national levels, as well as considers the politics of climate changes and poverty within this context. This paper then introduces the Compassion, Assertive Action, Pragmatism, and Evidence Vulnerability Index (CAPE-VI) as a global foreign policy index: CAPE-VI calculates how foreign aid should be prioritised for countries that are at risk or already considered to be fragile. These countries are characterised by various forms of conflict, disadvantaged by extremes of climate change, poverty, human rights abuses, and suffering from internal warfare or terrorism.

Social Isolation, Healthy Habits, Inequality and Mental Health in the United States

The objective of this work is to deepen the analysis of the socioeconomic determinants of mental health, paying special attention to the impact of inequality, not only in income distribution but also in gender, racial, health and education inequality, social isolation, including new variables to measure loneliness, and healthy habits, on the mental health status. For this purpose, a cross-sectional model for a sample of 2735 counties in the United States is estimated using Ordinary Least Squares in its robust version to solve the detected heteroscedasticity problems. The results obtained show that inequality, social isolation and certain lifestyles, such as smoking or insomnia, are detrimental to mental health, while sexual activity prevents mental distress. On the other hand, poor counties suffer more cases of suicide, with food insecurity being the main problem for mental health. Finally, we found detrimental effects of pollution on mental health.

Association of urinary heavy metals co-exposure and adult depression: Modification of physical activity

OBJECTIVE

This study aimed to evaluate the association between urinary heavy metal mixture exposure and depression, and the modifying role of physical activity in the effects of heavy metal mixture on depression risk was also considered.

METHODS

Data of this study were derived from the National Health and Nutrition Examination Survey 2011-2016. Depression was measured by the Patient Health Questionnaire. We first selected 6 (cadmium, cobalt, tin, antimony, thallium, and mercury) from 14 heavy metals through elastic net regression for further analysis. Then binomial logistic regression, generalized additive model, environment risk score (ERS), and weighted quantile sum (WQS) regression were adopted to assess the effects of six metals individual and cumulative exposure on depression risk. Finally, we also examined whether physical activity could mitigate the effects of heavy metal co-exposure on depression risk.

RESULTS

Totally, 4212 participants were included and 7.40% of subjects were with depression. We found urinary tin and antimony were separately associated with increased odds of depression (Sb: OR = 1.285, 95% CI: 1.064-1.553; Sn: OR = 1.281, 95% CI: 1.097-1.495), and a linear dose-response relationship between tin and depression was also noticed (P < 0.05). Meanwhile, urinary heavy metals co-exposure was positively related to depression risk (ERS_Q4: OR = 2.691, 95% CI: 1.399-5.174; WQS_positive: OR = 1.465, 95% CI: 1.063-2.021), in which tin, antimony, and cadmium were identified with greater contributions to the overall mixture effect. In both ERS and WQS models, the significant positive association between the metal mixture and depression risk remained only in those who were inactive in physical activity.

CONCLUSION

Our study concluded the detrimental effect of heavy metals in combined exposure on the risk of depression, which might be attenuated by physical activity.

The Emerging Role of Autophagy as a Target of Environmental Pollutants: An Update on Mechanisms

Autophagy is an evolutionarily conserved cellular system crucial for cellular homeostasis that protects cells from a broad range of internal and extracellular stresses. Autophagy decreases metabolic load and toxicity by removing damaged cellular components. Environmental contaminants, particularly industrial substances, can influence autophagic flux by enhancing it as a protective response, preventing it, or converting its protective function into a pro-cell death mechanism. Environmental toxic materials are also notorious for their tendency to bioaccumulate and induce pathophysiological vulnerability. Many environmental pollutants have been found to influence stress which increases autophagy. Increasing autophagy was recently shown to improve stress resistance and reduce genetic damage. Moreover, suppressing autophagy or depleting its resources either increases or decreases toxicity, depending on the circumstances. The essential process of selective autophagy is utilized by mammalian cells in order to eliminate particulate matter, nanoparticles, toxic metals, and smoke exposure without inflicting damage on cytosolic components. Moreover, cigarette smoke and aging are the chief causes of chronic obstructive pulmonary disease (COPD)-emphysema; however, the disease's molecular mechanism is poorly known. Therefore, understanding the impacts of environmental exposure via autophagy offers new approaches for risk assessment, protection, and preventative actions which will counter the harmful effects of environmental contaminants on human and animal health.

Fine particle components and risk of psychiatric hospitalization in the U.S

BACKGROUND

There is a lack of evidence for the associations between atmospheric particle components exposure and psychiatric health. We aimed to identify the most toxic particle component(s) and source(s) related with psychiatric illness.

METHODS

Using Health Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs), we analyzed the relative risk (RR) of psychiatric hospitalization associated with increased residential exposure to 14 particle components (Zn, V, Si, Pb, Ni, K, Fe, Cu, Ca, Br, sulfate (SO42-), nitrate (NO3-), organic carbon (OC), and elemental carbon (EC)). We covered the residents of eight U.S. states, who contributed to 5,012,041 psychiatric admissions over 2002-2018. Single component models were conducted via fitting zero-inflated negative binomial regression for each component with aggregated counts of total psychiatric hospitalizations per ZIP code per year as dependent variable. We used Nonnegative Matrix Factorization (NMF) to identify particle source factors and obtained the source-specific estimates. Generalized Weighted Quantile Sum (gWQS) Regression was applied to obtain an overall mixture effect. Separate but similar models were fitted for different age groups (<30 yrs. vs. ≥ 30 yrs) and psychiatric illness sub-categories to assess effect heterogeneity.

RESULTS

Sulfate, Fe, Pb and Zn were associated with the largest risk increases in single-component models. The biggest harmful associations were observed for metal industry source (high loadings of Pb and sulfate). For one quartile increase in components mixture score, we observed an adjusted RR of 1.24 (95 % CI, 1.21-1.26). Older population were more affected. We also observed higher increase in bipolar and psychotic admission risk for increased components source and mixture level.

CONCLUSION

Living in areas with higher levels of particle components was associated with increased risk of psychiatric hospitalization among the residents in eight U.S. states. Certain components (i.e. Pb, sulfate) and sources (metal industry) were the most related.

Exploring the role of exposure to green and blue spaces in preventing anxiety and depression among young people aged 14-24 years living in urban settings: A systematic review and conceptual framework

Despite the growing problem of anxiety and depression amongst young people aged 14-24 years living in urban settings, reviews about the role of exposure to green and blue spaces or nature in preventing anxiety and depression tend to focus on children, adults or sometimes adolescents. This review aims to explore whether exposure to green and blue spaces reduces the risk of anxiety and depression among young people aged 14-24 years living in urban settings and provide a conceptual framework. The academic databases CINAHL plus, Global Health, MEDLINE, ProQuest: Dissertations and Theses, PsycINFO, Scopus and OpenGrey were searched for research published in English between January 2000 and June 2020. All study designs were eligible. All included studies were assessed for quality. Searches identified 9208 sources with 48 meeting the inclusion criteria for the review. Experimental studies provided evidence that walking or being in a green space improves mood and state anxiety immediately following the intervention. Non-randomised evaluations and observational studies suggest that social interaction, physical activity, and mindfulness mediate the relationship between exposure to green space and mental health. We propose that the absence of noise and restorative qualities of green spaces promotes mindfulness and interrupt rumination, which in turn reduce the risk of anxiety disorders and depression. This review and the resulting conceptual framework provide evidence to healthcare professionals about the value of contact with nature and green social prescribing. For policymakers, it provides evidence about the value of bringing the benefits of forests, vegetation and nature into cities, and ensuring that these spaces are accessible and safe for young people to use.

The Causes and Role of Antinatalism in Poland in the Context of Climate Change, Obstetric Care, and Mental Health

Antinatalism is an umbrella term for numerous moral dilemmas associated with procreation. In the past few years, the deterioration of environmental conditions, social difficulties, global worsening of people's mental health, and pandemics have induced discussion about antinatalism. Therefore, we aimed to characterize antinatalists in the Polish population in terms of the frequency and description of the main reasons behind this phenomenon. The cross-sectional study was performed in the Polish population. An online, four-part survey was performed between 19 and 25 January 2022. The study group comprised 1240 respondents. Antinatalists (n = 472, 38%) were defined as people who do not have children and want to be childless in the future, whereas pronatalists (n = 768, 62%) consisted of people who want to have offspring in the future and/or already have children. The opinion that climate change is a significant reason not to have a child appeared twice as often among antinatalists. Additionally, the performed binary logistic regression model highlighted the importance of the fear of climate change as an independent factor facilitating an antinatalistic attitude. Regarding females, the following factors discouraging them from having a child were observed: fear of child's congenital diseases, pregnancy complications, dissatisfaction with medical services, and fear of exacerbation of maternal chronic diseases. Anxiety, depression, and stress were not found to be statistically different between pro- and antinatalist groups. However, further analysis revealed that female antinatalists were significantly more depressive and anxious. Our study helps us to understand why, as mentioned beforehand, around 38% of respondents prefer to stay childless. In conclusion, antinatalism views have become relatively prevalent in society, and its reasons include environmental antinatalism and medical factors, including depression and anxiety. However, better access to medical services and changes in climate politics were not found to be significant factors in encouraging society to decide to have offspring.

Green Space for Mental Health in the COVID-19 Era: A Pathway Analysis in Residential Green Space Users

Residential green space is among the most accessible types of urban green spaces and may help maintain mental health during the COVID-19 pandemic. However, it is insufficiently understood how residents use residential green space for exercise during the epidemic. The pathways between residential green space and mental health also merit further exploration. Therefore, we conducted an online study among Chinese residents in December 2021 to capture data on engagement with urban green space for green exercise, the frequency of green exercise, perceived pollution in green space, perceptions of residential green space, social cohesion, depression, and anxiety. Among the 1208 respondents who engaged in green exercise last month, 967 (80%) reported that green exercise primarily occurred in residential neighborhoods. The rest (20%) reported that green exercise occurred in more distant urban green spaces. The most common reasons that respondents sought green exercise in urban green spaces were better air and environmental qualities. Structural equation modeling (SEM) was then employed to explore the pathways between the perceived greenness of residential neighborhoods and mental health among respondents who used residential green space for exercise. The final model suggested that residential green space was negatively associated with anxiety (β = −0.30, p = 0.001) and depression (β = −0.33, p < 0.001), mainly through indirect pathways. Perceived pollution and social cohesion were the two mediators that contributed to most of the indirect effects. Perceived pollution was also indirectly associated with green exercise through less social cohesion (β = −0.04, p = 0.010). These findings suggest a potential framework to understand the mental health benefits of residential green space and its accompanying pathways during the COVID-19 era.

Impact of Environmental Pollutants on Gut Microbiome and Mental Health via the Gut–Brain Axis

Over the last few years, the microbiome has emerged as a high-priority research area to discover missing links between brain health and gut dysbiosis. Emerging evidence suggests that the commensal gut microbiome is an important regulator of the gut–brain axis and plays a critical role in brain physiology. Engaging microbiome-generated metabolites such as short-chain fatty acids, the immune system, the enteric nervous system, the endocrine system (including the HPA axis), tryptophan metabolism or the vagus nerve plays a crucial role in communication between the gut microbes and the brain. Humans are exposed to a wide range of pollutants in everyday life that impact our intestinal microbiota and manipulate the bidirectional communication between the gut and the brain, resulting in predisposition to psychiatric or neurological disorders. However, the interaction between xenobiotics, microbiota and neurotoxicity has yet to be completely investigated. Although research into the precise processes of the microbiota–gut–brain axis is growing rapidly, comprehending the implications of environmental contaminants remains challenging. In these milieus, we herein discuss how various environmental pollutants such as phthalates, heavy metals, Bisphenol A and particulate matter may alter the intricate microbiota–gut–brain axis thereby impacting our neurological and overall mental health.

Air pollution and individuals' mental well-being in the adult population in United Kingdom: A spatial-temporal longitudinal study and the moderating effect of ethnicity

BACKGROUND

Recent studies suggest an association between ambient air pollution and mental well-being, though evidence is mostly fragmented and inconclusive. Research also suffers from methodological limitations related to study design and moderating effect of key demographics (e.g., ethnicity). This study examines the effect of air pollution on reported mental well-being in United Kingdom (UK) using spatial-temporal (between-within) longitudinal design and assesses the moderating effect of ethnicity.

METHODS

Data for 60,146 adult individuals (age:16+) with 349,748 repeated responses across 10-data collection waves (2009-2019) from "Understanding-Society: The-UK-Household-Longitudinal-Study" were linked to annual concentrations of NO2, SO2, PM10, and PM2.5 pollutants using the individuals' place of residence, given at the local-authority and at the finer Lower-Super-Output-Areas (LSOAs) levels; allowing for analysis at two geographical scales across time. The association between air pollution and mental well-being (assessed through general-health-questionnaire-GHQ12) and its modification by ethnicity and being non-UK born was assessed using multilevel mixed-effect logit models.

RESULTS

Higher odds of poor mental well-being was observed with every 10μg/m3 increase in NO2, SO2, PM10 and PM2.5 pollutants at both LSOAs and local-authority levels. Decomposing air pollution into spatial-temporal (between-within) effects showed significant between, but not within effects; thus, residing in more polluted local-authorities/LSOAs have higher impact on poor mental well-being than the air pollution variation across time within each geographical area. Analysis by ethnicity revealed higher odds of poor mental well-being with increasing concentrations of SO2, PM10, and PM2.5 only for Pakistani/Bangladeshi, other-ethnicities and non-UK born individuals compared to British-white and natives, but not for other ethnic groups.

CONCLUSION

Using longitudinal individual-level and contextual-linked data, this study highlights the negative effect of air pollution on individuals' mental well-being. Environmental policies to reduce air pollution emissions can eventually improve the mental well-being of people in UK. However, there is inconclusive evidence on the moderating effect of ethnicity.

Associations between Air Pollution and Psychiatric Symptoms in The Normative Aging Study

BACKGROUND

Environmental risk factors for psychiatric health are poorly identified. We examined the association between air pollution and psychiatric symptoms, which are often precursors to the development of psychiatric disorders.

METHODS

This study included 570 participants in the US Veterans Administration (VA) Normative Aging Study and 1,114 visits (defined as an onsite follow-up at the VA with physical examination and questionnaires) from 2000-2014 with information on the Brief Symptom Inventory (BSI) to assess their psychiatric symptom levels. Differences in the three BSI global measures (Global Severity Index - GSI, Positive Symptom Distress Index - PSDI and Positive Symptom Total - PST) were reported per interquartile (IQR) increase of residential address-specific air pollutants levels (fine particulate matter - PM_2.5, ozone - O₃, nitrogen dioxide - NO₂) at averages of 1 week, 4 weeks, 8 weeks and 1 year prior to the visit using generalized additive mixed effects models. We also evaluated modification by neighborhood factors.

RESULTS

On average, among the NAS sample (average age, 72.4 yrs. (standard deviation: 6.7 yrs.)), an IQR increase in 1- and 4- week averages of NO₂ before visit was associated with a PSDI T score (indicator for psychiatric symptom intensity) increase of 1.60 (95% Confidence Interval (CI): 0.31, 2.89), 1.71 (95% CI: 0.18, 3.23), respectively. Similarly, for each IQR increase in 1- and 4-week averages of ozone before visit, PSDI T-score increased by 1.66 (95% CI: 0.68, 2.65), and 1.36 (95% CI: 0.23, 2.49), respectively. Stronger associations were observed for ozone and PSDI in low house value and low household income areas. No associations were found for PM_2.5.

CONCLUSIONS

Exposure to gaseous air pollutants was associated with higher intensity of psychiatric symptoms among a cohort of older men, particularly in communities with lower socio-economic or housing conditions.

A systematic review of the mental health risks and resilience among pollution-exposed adolescents

Pollution is harmful to human physical health and wellbeing. What is less well established is the relationship between adolescent mental health - a growing public health concern - and pollution. In response, we systematically reviewed studies documenting associations between pollution and mental health in adolescents. We searched Africa Wide, Medline, PsycArticles, PsycInfo, PubMed, CINAHL, ERIC, SciELO, Scopus, and Web of Science Core Collection for studies published up to 10 April 2020 that investigated exposure to any pollutant and symptoms of anxiety; depression; disruptive, impulse-control, and conduct disorders; neurodevelopmental disorders; psychosis; or substance abuse in 10-24-year-olds (i.e., adolescents as per expanded and more inclusive definition of adolescence). This identified 2291 records and we assessed 128 papers for inclusion. We used a narrative synthesis to coalesce the studies' findings. This review is registered on PROSPERO, CRD42020176664. Seventeen studies from Asia, Europe, the Middle East, and North America were included. Air and water pollution exposure was associated with elevated symptoms of depression, generalised anxiety, psychosis, and/or disruptive, impulse control and conduct disorder. Exposure to lead and solvents was associated with neurodevelopmental impairments. Most studies neglected factors that could have supported the mental health resilience of adolescents exposed to pollution. Notwithstanding the limited quality of most reviewed studies, results suggest that pollution exposure is a risk to adolescent mental health. High-quality research is urgently required, including the factors and processes that protect the mental health of pollution-exposed adolescents. Studies with adolescents living in low- and lower middle-income countries and the southern hemisphere must be prioritized.

Exploring multiple pathways and mediation effects of urban environmental factors for suicide prevention

Public health is threatened by air pollution and high temperature, especially in urban areas and areas impacted by climate change. Well-designed urban forms have co-benefits on promoting human health and mediating atmospheric environment-related threats (e.g., high temperature and air pollution). Previous studies overlooked these mediating effects of urban form on suicide mortality. This study used partial least squares modeling and countywide data in Taiwan to identify the crucial influences and pathways of urban environment, socioeconomic status, and diseases on suicide mortality. The model considered the impact of the characteristics of urban form (i.e., urban development intensity, land mix, and urban sprawl), urban industrial status (i.e., industrial level), urban greening (i.e., green coverage), disease (i.e., important diseases morbidity of human immunodeficiency virus [HIV], cerebrovascular disease [CVD], chronic liver disease and cirrhosis [CLDC], nephritis, nephrotic syndrome and nephrosis [NNSN], malignant tumor [MT]), socioeconomic status (i.e., income level and aging population rate), and the atmospheric environment (i.e., air pollution and high temperature) on suicide mortality. Optimizing land mix and minimizing urban development intensity and urban sprawl have been found to reduce suicide mortality. The mediating effect of urban form on suicide mortality originated from air pollution and high temperature, and mediating air pollution was greater than high temperature. Furthermore, industrial level, important diseases (HIV, CVD, CLDC, NNSN, and MT) morbidity, an aging population rate, air pollution, and high temperature were associated with an increase in suicide mortality, whereas green coverage and income level were associated with a reduction in suicide rates. The findings demonstrate that appropriate urban policy and urban planning may lower suicide mortality, be useful strategies for suicide prevention, and be a foundation for building a healthy city. Moreover, this study provides clarity on the complex relationship of suicide and the urban environment while identifying crucial factors.

The Need for Collective Awareness of Attempted Suicide Rates in a Warming Climate

Background: Climate factors may offer a stronger explanation of the variations in suicide rates compared with economic variables, even in the case of patients admitted involuntarily. Aims: We assessed the role of temperature as a determinant of the increased prevalence of suicide attempts (SA). Method: The sample comprised all cases of hospitalization for SA at the Psychiatric Clinic of the IRCCS Ospedale Policlinico San Martino between August 2013 and July 2018. For ambient temperature, data were provided by the Meteorological Observatory of the University of Genoa. Results: We noted a peak in suicides that was typically found in late spring and early summer due to global warming. Limitations: Other environmental/psychological factors contributing to the onset of an acute clinical event were not considered. The cross-sectional design of the study is another limitation. Conclusion: Further studies are needed to clarify the impact of climatic factors on suicide behavior and implement early intervention and preventive strategies for mental health.