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Radua J, De Prisco M, Oliva V, Fico G, Vieta E, Fusar-Poli P. Impact of air pollution and climate change on mental health outcomes: an umbrella review of global evidence. World Psychiatry 2024; 23:244-256. [PMID: 38727076 PMCID: PMC11083864 DOI: 10.1002/wps.21219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
The impact of air pollution and climate change on mental health has recently raised strong concerns. However, a comprehensive overview analyzing the existing evidence while addressing relevant biases is lacking. This umbrella review systematically searched the PubMed/Medline, Scopus and PsycINFO databases (up to June 26, 2023) for any systematic review with meta-analysis investigating the association of air pollution or climate change with mental health outcomes. We used the R metaumbrella package to calculate and stratify the credibility of the evidence according to criteria (i.e., convincing, highly suggestive, suggestive, or weak) that address several biases, complemented by sensitivity analyses. We included 32 systematic reviews with meta-analysis that examined 284 individual studies and 237 associations of exposures to air pollution or climate change hazards and mental health outcomes. Most associations (n=195, 82.3%) involved air pollution, while the rest (n=42, 17.7%) regarded climate change hazards (mostly focusing on temperature: n=35, 14.8%). Mental health outcomes in most associations (n=185, 78.1%) involved mental disorders, followed by suicidal behavior (n=29, 12.4%), access to mental health care services (n=9, 3.7%), mental disorders-related symptomatology (n=8, 3.3%), and multiple categories together (n=6, 2.5%). Twelve associations (5.0%) achieved convincing (class I) or highly suggestive (class II) evidence. Regarding exposures to air pollution, there was convincing (class I) evidence for the association between long-term exposure to solvents and a higher incidence of dementia or cognitive impairment (odds ratio, OR=1.139), and highly suggestive (class II) evidence for the association between long-term exposure to some pollutants and higher risk for cognitive disorders (higher incidence of dementia with high vs. low levels of carbon monoxide, CO: OR=1.587; higher incidence of vascular dementia per 1 μg/m3 increase of nitrogen oxides, NOx: hazard ratio, HR=1.004). There was also highly suggestive (class II) evidence for the association between exposure to airborne particulate matter with diameter ≤10 μm (PM10) during the second trimester of pregnancy and the incidence of post-partum depression (OR=1.023 per 1 μg/m3 increase); and for the association between short-term exposure to sulfur dioxide (SO2) and schizophrenia relapse (risk ratio, RR=1.005 and 1.004 per 1 μg/m3 increase, respectively 5 and 7 days after exposure). Regarding climate change hazards, there was highly suggestive (class II) evidence for the association between short-term exposure to increased temperature and suicide- or mental disorders-related mortality (RR=1.024), suicidal behavior (RR=1.012), and hospital access (i.e., hospitalization or emergency department visits) due to suicidal behavior or mental disorders (RR=1.011) or mental disorders only (RR=1.009) (RR values per 1°C increase). There was also highly suggestive (class II) evidence for the association between short-term exposure to increased apparent temperature (i.e., the temperature equivalent perceived by humans) and suicidal behavior (RR=1.01 per 1°C increase). Finally, there was highly suggestive (class II) evidence for the association between the temporal proximity of cyclone exposure and severity of symptoms of post-traumatic stress disorder (r=0.275). Although most of the above associations were small in magnitude, they extend to the entire world population, and are therefore likely to have a substantial impact. This umbrella review classifies and quantifies for the first time the global negative impacts that air pollution and climate change can exert on mental health, identifying evidence-based targets that can inform future research and population health actions.
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Affiliation(s)
- Joaquim Radua
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Michele De Prisco
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Vincenzo Oliva
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Giovanna Fico
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Eduard Vieta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudlsey NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
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Liem DG, Woo YC. Encouraging online consumers into making better food choices: The power of nature exposure on healthy food choices. Appetite 2024; 199:107382. [PMID: 38723667 DOI: 10.1016/j.appet.2024.107382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND online environments can influence food desire and choices. We tested if online calming nature and stressful street environments can affect desire for healthy and unhealthy foods. METHOD we asked 238 participants (40 ± 14 yrs) to rate their desire (100 mm VAS) for 7 low calorie nutrient rich foods (Healthy) and 7 high calorie nutrient poor foods (Unhealthy), and perceived stress (state anxiety in STAI), before and after imagining themselves in a control, nature park, or busy street condition. RESULTS participants who imagined themselves being in a nature park had a significant higher desire for Healthy foods, than participants in the busy street condition (p < 0.05). Participants in the busy street condition decreased their desire for Healthy foods after they imagined themselves in a busy street (p < 0.05)). However, perceived stress did not impact the association between condition and desire for low calorie foods nor high calorie foods. CONCLUSION this study suggests that online environments can have an impact on healthy food desires, which could be of importance for the increased number of food choices which are made in online environments.
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Affiliation(s)
- Djin Gie Liem
- Deakin University, CASS Food Research Centre, Australia.
| | - Yu Chu Woo
- Deakin University, CASS Food Research Centre, Australia.
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Wang X, Wu Y, Chen Y, Xu J, Gao Q, Zang S. Traffic-related pollution and symptoms of depression and anxiety among Chinese adults: A population-based study. J Affect Disord 2024; 352:101-109. [PMID: 38360369 DOI: 10.1016/j.jad.2024.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Limited understanding exists regarding the associations of traffic-related pollution with depression and anxiety symptoms in individuals residing within low- and middle-income countries. METHODS Data for this study were extracted from the Psychology and Behavior Investigation of Chinese Residents (PBICR) survey, implemented between June 20 and August 31, 2023. We determined residential proximity to major roadways through self-reports and evaluated depression symptoms using the Patient Health Questionnaire-9 (PHQ-9), along with anxiety symptoms assessed through the Generalized Anxiety Disorder-7 (GAD-7). We examined the associations between residential proximity to major roadways and depression and anxiety symptoms using logistic regressions and generalized linear models, while controlling for potential confounding variables. RESULTS This study comprised a total of 22,723 participants. The adjusted odds ratios (OR) for depression symptoms were 1.34 (95 % confidence interval (CI) 1.20, 1.51), 1.29 (95 % CI 1.17, 1.43), 1.34 (95 % CI 1.20, 1.49), and 1.32 (95 % CI 1.17, 1.49) among individuals residing within <50 m, 50-100 m, 101-200 m, and 201-300 m, respectively, in comparison to those residing >300 m from a major roadway. Individuals residing <50 m, 50-100 m, 101-200 m, and 201-300 m from a major roadway exhibited adjusted OR for anxiety symptoms of 1.49 (95 % CI 1.30, 1.69), 1.21 (95 % CI 1.07, 1.37), 1.38 (95 % CI 1.21, 1.56), and 1.38 (95 % CI 1.20, 1.59), respectively, in contrast to those residing >300 m. CONCLUSIONS This study provides valuable insights into the associations between environmental factors and mental health. The findings underscore the importance of integrating environmental considerations into comprehensive mental health frameworks, especially for individuals residing near high-traffic areas.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yifei Chen
- Department of Interventional Radiology, The First Hospital of China Medical University, No.155 Nanjing North Street, Heping District Area, Shenyang, Liaoning Province 110002, China
| | - Jiayi Xu
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Qian Gao
- Department of Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province 110122, China.
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Freymueller J, Schmid HL, Senkler B, Lopez Lumbi S, Zerbe S, Hornberg C, McCall T. Current methodologies of greenspace exposure and mental health research-a scoping review. Front Public Health 2024; 12:1360134. [PMID: 38510363 PMCID: PMC10951718 DOI: 10.3389/fpubh.2024.1360134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Greenspaces can provide an important resource for human mental health. A growing body of literature investigates the interaction and the influence of diverse greenspace exposures. In order to gain a comprehensive understanding of the complex connection between greenspace and mental health, a variety of perspectives and methodological combinations are needed. The aim of this review is to assess the current methodologies researching greenspace and mental health. Methods A scoping review was conducted. Four electronic databases (Pubmed, Embase, PsycInfo, Web of Science) were searched for relevant studies. A wide range of greenspace and mental health keywords were included to provide a comprehensive representation of the body of research. Relevant information on publication characteristics, types of greenspaces, mental health outcomes, and measurements of greenspace exposure and mental health was extracted and assessed. Results 338 studies were included. The included studies encompassed a multitude of methods, as well as outcomes for both greenspace and mental health. 28 combinations were found between seven categories each for greenspace and mental health assessment. Some pairings such as geoinformation systems for greenspace assessment and questionnaires investigating mental health were used much more frequently than others, implying possible research gaps. Furthermore, we identified problems and inconsistences in reporting of greenspace types and mental health outcomes. Discussion The identified methodological variety is a potential for researching the complex connections between greenspace and mental health. Commonly used combinations can provide important insights. However, future research needs to emphasize other perspectives in order to understand how to create living environments with mental health benefits. For this purpose, interdisciplinary research is necessary.
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Affiliation(s)
- Julius Freymueller
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Hannah-Lea Schmid
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Ben Senkler
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Susanne Lopez Lumbi
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Stefan Zerbe
- Faculty of Agricultural, Environmental and Food Sciences, Free University of Bozen-Bolzano, Bolzano, Italy
- Institute of Geography, University of Hildesheim, Hildesheim, Germany
| | - Claudia Hornberg
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
| | - Timothy McCall
- Medical School OWL, Department of Sustainable Environmental Health Sciences, Bielefeld University, Bielefeld, Germany
- School of Public Health, Department of Environment and Health, Bielefeld University, Bielefeld, Germany
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Zhang Y, Wu T, Yu H, Fu J, Xu J, Liu L, Tang C, Li Z. Green spaces exposure and the risk of common psychiatric disorders: A meta-analysis. SSM Popul Health 2024; 25:101630. [PMID: 38405164 PMCID: PMC10885792 DOI: 10.1016/j.ssmph.2024.101630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Objective To explore the effects of green spaces exposure on common psychiatric disorders. Methods PubMed, Embase, Web of Science and MEDLINE were screened and articles published prior to November 15, 2023 were included. Analyses were performed on common psychiatric disorders, categorized into depression, anxiety, dementia, schizophrenia, and attention deficit hyperactivity disorder (ADHD). And the subgroup analyses were conducted for depression, anxiety, dementia, and schizophrenia. Results In total, 2,0064 studies were retrieved, 59 of which were included in our study; 37 for depression, 14 for anxiety, 8 for dementia, 7 for schizophrenia and 5 for ADHD. Green spaces were found to benefit the moderation of psychiatric disorders (OR = 0.91, 95% CI: 0.89 to 0.92). Green spaces positively influence depression (OR = 0.89, 95% CI: 0.86 to 0.93), regardless of the cross-sectional or cohort studies. Green spaces can also help mitigate the risk of anxiety (OR = 0.94, 95%CI:0.92 to 0.96). As an important index for measuring green spaces, a higher normalized difference vegetation index (NDVI) level related to a lower level of depression (OR = 0.95, 95%CI:0.91 to 0.98) and anxiety (OR = 0.95, 95%:0.92 to 0.98). The protection was also found in dementia (OR = 0.95, 95% CI: 0.93 to 0.96), schizophrenia (OR = 0.74, 95% CI: 0.67 to 0.82), and ADHD (OR = 0.89, 95% CI: 0.86 to 0.92) results. Conclusion Green spaces decrease the risk of psychiatric disorders, including depression, anxiety, dementia, schizophrenia, and ADHD. Further studies on green spaces and psychiatric disorders are needed, and more green spaces should be considered in city planning.
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Affiliation(s)
- Yimin Zhang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Tongyan Wu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Hao Yu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, The Second Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Jianfei Fu
- Department of Medical Records and Statistics, Ningbo First Hospital, Ningbo, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Chunlan Tang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Zhen Li
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
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Pan R, Song J, Yi W, Liu J, Song R, Li X, Liu L, Yuan J, Wei N, Cheng J, Huang Y, Zhang X, Su H. Heatwave characteristics complicate the association between PM 2.5 components and schizophrenia hospitalizations in a changing climate: Leveraging of the individual residential environment. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 271:115973. [PMID: 38219619 DOI: 10.1016/j.ecoenv.2024.115973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/16/2024]
Abstract
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.
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Affiliation(s)
- Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Yuee Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, 241002 Wuhu, Anhui, China
| | - Xulai Zhang
- Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
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Sun Z, Han Z, Zhu D. How does air pollution threaten mental health? Protocol for a machine-learning enhanced systematic map. BMJ Open 2024; 14:e071209. [PMID: 38245011 PMCID: PMC10806688 DOI: 10.1136/bmjopen-2022-071209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 11/28/2023] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION Air pollution exposure has influenced a broad range of mental health conditions. It has attracted research from multiple disciplines such as biomedical sciences, epidemiology, neurological science, and social science due to its importance for public health, with implications for environmental policies. Establishing and identifying the causal and moderator effects is challenging and is particularly concerning considering the different mental health measurements, study designs and data collection strategies (eg, surveys, interviews) in different disciplines. This has created a fragmented research landscape which hinders efforts to integrate key insights from different niches, and makes it difficult to identify current research trends and gaps. METHOD AND ANALYSIS This systematic map will follow the Collaboration for Environmental Evidence's guidelines and standards and Reporting Standards for Systematic Evidence Syntheses guidelines. Different databases and relevant web-based search engines will be used to collect the relevant literature. The time period of search strategies is conducted from the inception of the database until November 2022. Citation tracing and backward references snowballing will be used to identify additional studies. Data will be extracted by combining of literature mining and manual correction. Data coding for each article will be completed by two independent reviewers and conflicts will be reconciled between them. Machine learning technology will be applied throughout the systematic mapping process. Literature mining will rapidly screen and code the numerous available articles, enabling the breadth and diversity of the expanding literature base to be considered. The systematic map output will be provided as a publicly available database. ETHICS AND DISSEMINATION Primary data will not be collected and ethical approval is not required in this study. The findings of this study will be disseminated through a peer-reviewed scientific journal and academic conference presentations.
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Affiliation(s)
- Zhuanlan Sun
- High-Quality Development Evaluation Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Zhe Han
- School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Demi Zhu
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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Mitiku KW, Tegegne E, Amsalu M, Habtegiorgis SD, Melaku B. Mental illness in children and its determinants in Ethiopia: A systematic review and meta-analysis, 2023. Clin Child Psychol Psychiatry 2024; 29:168-186. [PMID: 37864448 DOI: 10.1177/13591045231209078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
INTRODUCTION Young people are at risk of developing mental health disorders. Depression, anxiety, and behavioral problems are among the primary causes of illness and impairment among teenagers. Suicide is the fourth highest cause of mortality in those aged 15 to 29. This study aimed to assess the determinants of mental health among children in Ethiopia. METHODS Online databases were searched from inception until March 2023. Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 was used in this review. Subgroup analysis, I2 test, funnel plot, and Egger's test were performed. Pooled odds ratios (OR) were calculated. RESULT Fourteen studies were included in the meta-analysis. The pooled prevalence of mental illnesses among Ethiopian children was 24.68% (95% CI: 19.99%-32.38%). Having previous child abuse history (OR: 5.65; 95% CI: 4.32-7.39), poor socio-economic status (OR: 1.94; 95% CI: 1.24-3.04), urban residence (OR: 1.93; 95% CI:1.39-2.67), and being male (OR: 1.65; 95% CI: 1.15-2.38) were determinants of childhood mental illness in Ethiopia. CONCLUSION and Recommendations: Mental disorders are highly prevalent in children with a history of child abuse, and a strong legislative body must be established to prosecute child abusers. Interventions that focus on gender equality in education and the creation of a safe environment for poor urban children are suggested.
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Affiliation(s)
- Kalkidan Worku Mitiku
- Department of Public Health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Eniyew Tegegne
- Department of Environmental health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Menichil Amsalu
- Department of Public Health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Samuel Derbie Habtegiorgis
- Department of Public Health, College of health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Birhanu Melaku
- School of Medicine and Health Science, Department of Public Health, GAMBY Medical and Business College, Bahirdar, Ethiopia
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Quang N, Van Truong L, Chung E, Van Quang B, Long LQ, Ngoc NT, Minh NT, Anh DM, Thanh ND, Nam NT. Predicting Anxiety and Depression Among Erectile Dysfunction Patients: A Cross-Sectional Study. Am J Mens Health 2024; 18:15579883231223502. [PMID: 38288597 PMCID: PMC10826397 DOI: 10.1177/15579883231223502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024] Open
Abstract
In Vietnam, erectile dysfunction (ED) is prevalent and recognized to be associated with mental disorders; however, societal taboos impede a comprehensive understanding of this connection. Our study aims to investigate the factors related to higher levels of anxiety and/or depression (HAD) in individuals with ED. Between November 2022 and March 2023, a face-to-face survey was conducted at the Center for Andrology of Viet Duc University Hospital, involving 390 patients diagnosed with ED. The survey included 51 questions covering general patient information, the International Index of Erectile Function-15 (IIEF-15), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7). The stepwise Akaike Information Criterion (AIC) method was used to identify factors associated with HAD. The study revealed an average age of 37.63 (11.84) years among participants, with a HAD prevalence of 17.69%. Several factors were associated with a higher likelihood of belonging to the HAD group in ED patients. These factors included non-office workers (OR: 1.11; 95% CI: [1.01, 1.21], p = .025), medium and high levels of work-related stress (OR: 1.23; [1.06, 1.44], p = .008; OR: 1.22; [1.04, 1.45], p = .018), multiple shameful experiences related to ED (OR: 1.16; [1.08, 1.25], p < .001), moderate and severe ED (OR: 1.17; [1.03, 1.32], p = .013; OR: 1.31; [1.14, 1.51], p < .001), and dissatisfaction with intercourse skills (OR: 1.09; [1.01, 1.17], p = .028). Our findings suggest a 16% higher likelihood of HAD status in individuals with multiple shameful experiences related to ED, while moderate and severe ED are associated with respective increases of 17% and 31% in the likelihood. These findings emphasize the importance of considering mental health in the care of individuals with ED.
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Affiliation(s)
- Nguyen Quang
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
- University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Le Van Truong
- Traditional Medicine Hospital, Ministry of Public Security, Hanoi, Vietnam
| | - Eric Chung
- Department of Urology, University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Bui Van Quang
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
- University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Luu Quang Long
- Center for Andrology, Viet Duc University Hospital, Hanoi, Vietnam
| | | | | | - Do Mai Anh
- Vietnam University of Traditional Medicine, Hanoi, Vietnam
| | | | - Nguyen Truong Nam
- Faculty of Traditional Medicine at Phenikaa University, Hanoi, Vietnam
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10
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Xu C, Miao L, Turner D, DeRubeis R. Urbanicity and depression: A global meta-analysis. J Affect Disord 2023; 340:299-311. [PMID: 37557989 DOI: 10.1016/j.jad.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/29/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Previous meta-analyses have revealed that in adult and older adult populations of developed countries, depression is more prevalent in urban than rural areas. No meta-analyses have identified the effects of urbanicity on the general age demographic for developing countries. We conducted a meta-analysis of urban-rural differences in depression across all age demographics for developed and developing countries. METHODS PubMed and PsycINFO databases were searched for studies published between 1980 and 2020. Studies were included if they reported prevalences of urban and rural depression, or odds ratios comparing urban-rural depression prevalence. Studies were excluded for: nonrepresentative samples, non-standard measures of depression, and reporting continuous outcomes only. Meta-analytic models of urban-rural differences in the odds of depression were conducted across country development levels and age demographics. RESULTS From 1597 records screened and 302 full texts assessed for eligibility, 80 studies (N = 539,557) were included for meta-analysis. Urban residence was significantly associated with a higher prevalence of depression in developed countries (OR = 1.30, 95 % CI [1.17, 1.46], z = 4.75, p < .001), which was primarily driven by urban-rural differences in the general population age demographic (OR = 1.37, 95 % CI [1.22, 1.54], z = 5.38, p < .001). LIMITATIONS Studies reporting urban-rural differences in depression in terms of continuous symptom severity scores were not included. CONCLUSIONS Urbanicity appears to uniquely be associated with a higher prevalence of depression in developed countries, but not in developing countries.
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Affiliation(s)
- Colin Xu
- Department of Psychology, University of Pennsylvania, United States of America.
| | - Lucille Miao
- Department of Psychology, University of Pennsylvania, United States of America
| | - Devon Turner
- Department of Psychology, University of Pennsylvania, United States of America
| | - Robert DeRubeis
- Department of Psychology, University of Pennsylvania, United States of America
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11
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Lan Y, Helbich M. Short-term exposure sequences and anxiety symptoms: a time series clustering of smartphone-based mobility trajectories. Int J Health Geogr 2023; 22:27. [PMID: 37817189 PMCID: PMC10563352 DOI: 10.1186/s12942-023-00348-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Short-term environmental exposures, including green space, air pollution, and noise, have been suggested to affect health. However, the evidence is limited to aggregated exposure estimates which do not allow the capture of daily spatiotemporal exposure sequences. We aimed to (1) determine individuals' sequential exposure patterns along their daily mobility paths and (2) examine whether and to what extent these exposure patterns were associated with anxiety symptoms. METHODS We cross-sectionally tracked 141 participants aged 18-65 using their global positioning system (GPS) enabled smartphones for up to 7 days in the Netherlands. We estimated their location-dependent exposures for green space, fine particulate matter, and noise along their moving trajectories at 10-min intervals. The resulting time-resolved exposure sequences were then partitioned using multivariate time series clustering with dynamic time warping as the similarity measure. Respondents' anxiety symptoms were assessed with the Generalized Anxiety Disorders-7 questionnaire. We fitted linear regressions to assess the associations between sequential exposure patterns and anxiety symptoms. RESULTS We found four distinctive daily sequential exposure patterns across the participants. Exposure patterns differed in terms of exposure levels and daily variations. Regression results revealed that participants with a "moderately health-threatening" exposure pattern were significantly associated with fewer anxiety symptoms than participants with a "strongly health-threatening" exposure pattern. CONCLUSIONS Our findings support that environmental exposures' daily sequence and short-term magnitudes may be associated with mental health. We urge more time-resolved mobility-based assessments in future analyses of environmental health effects in daily life.
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Affiliation(s)
- Yuliang Lan
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 BC, Utrecht, The Netherlands.
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 BC, Utrecht, The Netherlands
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12
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Wallace DA, Gallagher JP, Peterson SR, Ndiaye-Gueye S, Fox K, Redline S, Johnson DA. Is exposure to chemical pollutants associated with sleep outcomes? A systematic review. Sleep Med Rev 2023; 70:101805. [PMID: 37392613 PMCID: PMC10528206 DOI: 10.1016/j.smrv.2023.101805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/25/2023] [Accepted: 06/08/2023] [Indexed: 07/03/2023]
Abstract
Environmental exposures may influence sleep; however, the contributions of environmental chemical pollutants to sleep health have not been systematically investigated. We conducted a systematic review to identify, evaluate, summarize, and synthesize the existing evidence between chemical pollutants (air pollution, exposures related to the Gulf War and other conflicts, endocrine disruptors, metals, pesticides, solvents) and dimensions of sleep health (architecture, duration, quality, timing) and disorders (sleeping pill use, insomnia, sleep-disordered breathing)). Of the 204 included studies, results were mixed; however, the synthesized evidence suggested associations between particulate matter, exposures related to the Gulf War, dioxin and dioxin-like compounds, and pesticide exposure with worse sleep quality; exposures related to the Gulf War, aluminum, and mercury with insomnia and impaired sleep maintenance; and associations between tobacco smoke exposure with insomnia and sleep-disordered breathing, particularly in pediatric populations. Possible mechanisms relate to cholinergic signaling, neurotransmission, and inflammation. Chemical pollutants are likely key determinants of sleep health and disorders. Future studies should aim to evaluate environmental exposures on sleep across the lifespan, with a particular focus on developmental windows and biological mechanisms, as well as in historically marginalized or excluded populations.
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Affiliation(s)
- Danielle A Wallace
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Jayden Pace Gallagher
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shenita R Peterson
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | - Seyni Ndiaye-Gueye
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kathleen Fox
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Dayna A Johnson
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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13
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Guyot M, Pelgrims I, Aerts R, Keune H, Remmen R, De Clercq EM, Thomas I, Vanwambeke SO. Non-response bias in the analysis of the association between mental health and the urban environment: a cross-sectional study in Brussels, Belgium. Arch Public Health 2023; 81:129. [PMID: 37420293 DOI: 10.1186/s13690-023-01118-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/23/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND This paper aims at analysing the impact of partial non-response in the association between urban environment and mental health in Brussels. The potential threats of the partial non-response are biases in survey estimates and statistics. The effect of non-response on statistical associations is often overlooked and evidence in the research literature is lacking. METHODS Data from the Belgian Health Interview Survey 2008 and 2013 were used. The association between non-response and potential determinants was explored through logistic regressions. RESULTS Participants with low income, low educational levels, lower or higher age or in households with children were less likely to respond. When adjusting for socio-economic variables, non-response was higher in areas which are less vegetated, more polluted or more urbanised. Because the determinants of non-response and depressive disorders were similar, it is reasonable to assume that there will be more people with mental health problems among the non-respondents. And because more non-responses were found in low vegetation areas, the protective association between green spaces and mental health may be underestimated. CONCLUSION Our capacity to measure the association between the urban environment and health is affected by non-response in surveys. The non-random spatial and socio-economic distribution of this bias affects the research findings.
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Affiliation(s)
- Madeleine Guyot
- Earth & Life Institute, Université catholique de Louvain, Louvain-La-Neuve, Belgium
- Louvain Institute of Data Analysis and Modeling in Economics and Statistics, Université catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Ingrid Pelgrims
- Chemical and Physical Health Risks, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Epidemiology and Public Health, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium
| | - Raf Aerts
- Chemical and Physical Health Risks, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Division Ecology, Evolution and Biodiversity Conservation, KU Leuven, Louvain, Belgium
| | - Hans Keune
- Faculty of Medicine and Health Sciences Department of Primary and Interdisciplinary Care, University of Antwerp, Wilrijk, Belgium
| | - Roy Remmen
- Faculty of Medicine and Health Sciences Department of Primary and Interdisciplinary Care, University of Antwerp, Wilrijk, Belgium
| | - Eva M De Clercq
- Chemical and Physical Health Risks, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Isabelle Thomas
- Louvain Institute of Data Analysis and Modeling in Economics and Statistics, Université catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Sophie O Vanwambeke
- Earth & Life Institute, Université catholique de Louvain, Louvain-La-Neuve, Belgium.
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14
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Tan J, Chen N, Bai J, Yan P, Ma X, Ren M, Maitland E, Nicholas S, Cheng W, Leng X, Chen C, Wang J. Ambient air pollution and the health-related quality of life of older adults: Evidence from Shandong China. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 336:117619. [PMID: 36924708 DOI: 10.1016/j.jenvman.2023.117619] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/03/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
Ambient air pollution is a major public health concern impacting all aspects of human health. There is a lack of studies on the impact of ambient air pollution on health-related quality of life (HRQoL) of older Chinese adults. Our study answers two questions: How concentrations of ambient air pollutants are associated with HRQoL among older adults in China and, second, what are the possible mechanisms through which ambient air pollution affects HRQoL. From the 2018 National Health Service Survey, we sampled 5717 aged 65 years or older residents for the eastern province of Shandong, China. Data on individual exposures to PM2.5 and PM10 (particulate matter with diameter less than or equal to 2.5 μm and 10 μm) and sulfur dioxide (SO2) were collected from the ChinaHighAirPollutants (CHAP) datasets. Mixed-effects Tobit regression models and mixed-effects ordered Probit regression models were employed to examine the associations of long-term exposure to ambient air pollution with the European Quality of Life 5 Dimensions 3 Level Version (EQ-5D-3L) scale comprising mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Socioeconomic, demographic and behavioral factors relating to HRQoL were also examined. The results show that for each 1 μg/m3 increase, EQ-5D-3L scores fell 0.002 for PM2.5; 0.001 for PM10 and 0.002 for SO2. Long term exposure to PM2.5, PM10 and SO2 were also associated with increased prevalence of pain/discomfort and anxiety/depression. The reduced HRQoL effects of ambient air pollution were exacerbated by higher socioeconomic status (affluent, urban and higher level of education). Our findings suggested that HRQoL of older Chinese adults was not only associated with demographic, socioeconomic, and health-related factors, but also negatively correlated with air pollution, especially through increased pain/discomfort and anxiety/depression. The paper proposes policy recommendations.
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Affiliation(s)
- Jialong Tan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Nuo Chen
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Jing Bai
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Peizhe Yan
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Xinyu Ma
- Economics and Management School, Wuhan University, Wuhan, China
| | - Meiling Ren
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, England, United Kingdom
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Australian Technology Park, Sydney, New South Wales, Australia; Newcastle Business School, University of Newcastle, Newcastle, New South Wales, Australia
| | - Wenjing Cheng
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Xue Leng
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China
| | - Chen Chen
- School of Public Health, Wuhan University, Wuhan, China.
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Wuhan, China; Center for Health Economics and Management at the School of Economics and Management, Wuhan University, Wuhan, China.
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15
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Molot J, Sears M, Anisman H. Multiple Chemical Sensitivity: It's time to catch up to the science. Neurosci Biobehav Rev 2023; 151:105227. [PMID: 37172924 DOI: 10.1016/j.neubiorev.2023.105227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
Multiple chemical sensitivity (MCS) is a complex medical condition associated with low dose chemical exposures. MCS is characterized by diverse features and common comorbidities, including fibromyalgia, cough hypersensitivity, asthma, and migraine, and stress/anxiety, with which the syndrome shares numerous neurobiological processes and altered functioning within diverse brain regions. Predictive factors linked to MCS comprise genetic influences, gene-environment interactions, oxidative stress, systemic inflammation, cell dysfunction, and psychosocial influences. The development of MCS may be attributed to the sensitization of transient receptor potential (TRP) receptors, notably TRPV1 and TRPA1. Capsaicin inhalation challenge studies demonstrated that TRPV1 sensitization is manifested in MCS, and functional brain imaging studies revealed that TRPV1 and TRPA1 agonists promote brain-region specific neuronal variations. Unfortunately, MCS has often been inappropriately viewed as stemming exclusively from psychological disturbances, which has fostered patients being stigmatized and ostracized, and often being denied accommodation for their disability. Evidence-based education is essential to provide appropriate support and advocacy. Greater recognition of receptor-mediated biological mechanisms should be incorporated in laws, and regulation of environmental exposures.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Margaret Sears
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Hymie Anisman
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
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16
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Yuan Y, Wang K, Wang Z, Zheng H, Ma Z, Liu R, Hu K, Yang Z, Zhang Y. Ambient ozone exposure and depression among middle-aged and older adults: Nationwide longitudinal evidence in China. Int J Hyg Environ Health 2023; 251:114185. [PMID: 37167761 DOI: 10.1016/j.ijheh.2023.114185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND Epidemiological studies have linked long-term ozone (O3) exposure with depression in developed countries. However, available literature is sparse and exists great heterogeneities. We aimed to investigate the association of long-term O3 exposure with depression among Chinese middle-aged and older adults. METHODS We designed a repeated measurement study based on longitudinal data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (CHARLS). Annual mean O3 concentrations assessed through machine learning-based spatiotemporal models were assigned to each participant at city level. Depression score was measured using the 10-item Center for Epidemiologic Studies Depression scale (CES-D-10), with scores above the cut-off point of ten defined as depressive symptom. Mixed-effects models were used to evaluate the impact of O3 on depression score and depressive symptom, and quantify the concentration-response (C-R) relationships. Subgroup analyses were performed to examine the potential effect modifications. RESULTS A total of 19,582 participants with 60,125 visits were included in our analysis, with mean depression score of 8.1 (standard deviation: 6.3). Multivariable-adjusted mixed-effects model estimated a 6.34% (95% confidence interval [CI]: 3.34%, 9.43%) increase in depression score and an odds ratio (OR) of 1.29 (95% CI: 1.16, 1.45) for depressive symptom associated with per 10-μg/m3 rise in annual mean O3 exposure. Significantly elevated risks were identified only at high concentrations (approximately ≥90 μg/m3). Participants who suffered from chronic diseases had a significant increased risk of depression (% Change in depression score: 8.42% [95% CI: 4.79%, 12.17%], and OR: 1.42 [95% CI: 1.24, 1.62]), and an evident effect modification was identified for depressive symptom (P = 0.01). FINDINGS Our study provided novel evidence that long-term O3 exposure could be a risk factor for depression among Chinese middle-aged and older adults. Our findings may have significant implications for formulating policies in reducing disease burden of depression by controlling air pollution.
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Affiliation(s)
- Yang Yuan
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Kai Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Zhen Wang
- Department of Pediatrics, Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan, 442000, Hubei, China.
| | - Hao Zheng
- Department of Environmental Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, Jiangsu, China
| | - Zongwei Ma
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210093, Jiangsu, China
| | - Riyang Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210093, Jiangsu, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China.
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17
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Wen Q, Liu H, Chen J, Ye H, Pan Z. Evaluation of Satisfaction with the Built Environment of University Buildings under the Epidemic and Its Impact on Student Anxiety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4183. [PMID: 36901195 PMCID: PMC10001516 DOI: 10.3390/ijerph20054183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/22/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Anxiety on college campuses has increased due to the COVID-19 epidemic's profound effects on society. Much research has been conducted on how the built environment influences mental health; however, little has been undertaken on how it affects student mental health in the context of the epidemic from the architectural scale perspective of academic buildings. Based on online survey data, this study develops multiple linear regression and binary logistic regression models to investigate students' satisfaction ratings of the academic buildings' physical environments during the epidemic and how these satisfaction ratings affect students' anxiety tendencies. According to the study's findings regarding the natural exposure perspective, students who perceived the academic building's poor semi-open space view (p = 0.004, OR = 3.22) as unsatisfactory factors were more likely to show anxiety tendencies. In terms of the physical conditions, students who were dissatisfied with the noise level in the classroom (p = 0.038, OR = 0.616) and the summer heat in semi-open spaces (p = 0.031, OR = 2.38) were more likely to exhibit anxiety tendencies. Additionally, even after controlling for confusing distractions, the general satisfaction rating of the academic building's physical environments (p = 0.047, OR = 0.572) was still able to significantly and negatively affect students' anxiety tendencies. The study's findings can be used in the architectural and environmental planning of academic buildings focusing on mental health.
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Affiliation(s)
- Qiang Wen
- School of Civil Engineering and Architecture, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Haiqiang Liu
- School of Civil Engineering and Architecture, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Jinyuan Chen
- School of Civil Engineering and Architecture, Zhejiang Sci-Tech University, Hangzhou 310018, China
| | - Huiyao Ye
- Department of Architecture, Zhejiang University, Hangzhou 310018, China
| | - Zeyu Pan
- School of Civil Engineering and Architecture, Zhejiang Sci-Tech University, Hangzhou 310018, China
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18
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Fang D, Bing W, Yao-Hui H, Chun-Xia J, Ying Z, Xing-Li L, Hua-Wei T, Ying-Jun X, Wan-Wei L, Xiu-Juan L, Dong-Yong F, Wei-Ting Y, Rong Z, Jian-Ping L, Yin-Qin Z. The association of air pollutants with hospital outpatient visits for child and adolescence psychiatry in Shenzhen, China. ENVIRONMENTAL RESEARCH 2023; 216:114598. [PMID: 36257448 DOI: 10.1016/j.envres.2022.114598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/11/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Although exposure to ambient air pollution has been associated with mental disorder, little is known about its potential effects on children and adolescents, especially in Chinese population. We aimed to reveal the relationship of air pollutants with hospital outpatient visits for child and adolescence psychiatry (HOVCAP) in Shenzhen. METHODS A case-crossover study based on time-series data was applied, and a distributed lag non-linear model (DLNM) was used to evaluate the non-linear and delayed effects of 4 major air pollutants (NO2, PM2.5, SO2 and O3) on HOVCAP. Least absolute shrinkage and selection operator (LASSO) regression was used to control the multicollinearity between covariates and to filter variables. RESULT A total of 94,660 cases aged 3-18 were collected from 2014 to 2019 in the Mental Health Center of Shenzhen. Results of pollutants at mode value (M0) showed that in the single lag effect result, when the average daily concentration of NO2 at 24 μg/m3, there was a significant effect on HOVCAP over lag 1, lag 4 and lag 5, respectively. The cumulative RR of NO2 M0 value to the outpatient visits were 1.438 (1.137-1.818) over lag 0-2, 1.454 (1.120-1.887) over lag 0-3, 1.466 (1.084-1.982) over lag 0-4, 1.680 (1.199-2.354) over lag 0-5, 1.993 (1.369-2.903) over lag 0-6, and 2.069 (1.372-3.119) over lag 0-7. However, PM2.5, SO2, O3 were not associated with HOVCAP over neither single lag effects nor cumulative effects. The RR values both shown an increase either when NO2 increases by 10 units or when the maximum concentration of NO2 is reached. CONCLUSION Our study suggests that exposure to the normal air quality of NO2 in Shenzhen may associated with the risk of HOVCAP. However, PM2.5, SO2, O3 were not associated with HOVCAP.
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Affiliation(s)
- Dong Fang
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, 518034, China.
| | - Wang Bing
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China.
| | - Han Yao-Hui
- Chronic Disease Prevention and Treatment Center of Shenzhen Futian District, Shenzhen, 518034, China.
| | - Jing Chun-Xia
- Department of Epidemiology, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, 510632, Guangdong, China.
| | - Zhang Ying
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China.
| | - Liu Xing-Li
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, 518034, China.
| | - Tian Hua-Wei
- Chronic Disease Prevention and Treatment Center of Shenzhen Futian District, Shenzhen, 518034, China.
| | - Xiang Ying-Jun
- Chronic Disease Prevention and Treatment Center of Shenzhen Futian District, Shenzhen, 518034, China.
| | - Liao Wan-Wei
- Chronic Disease Prevention and Treatment Center of Shenzhen Futian District, Shenzhen, 518034, China.
| | - Li Xiu-Juan
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China.
| | - Fan Dong-Yong
- Chronic Disease Prevention and Treatment Center of Shenzhen Futian District, Shenzhen, 518034, China.
| | - Yang Wei-Ting
- Chronic Disease Prevention and Treatment Center of Shenzhen Futian District, Shenzhen, 518034, China.
| | - Zhao Rong
- Chronic Disease Prevention and Treatment Center of Shenzhen Futian District, Shenzhen, 518034, China
| | - Lu Jian-Ping
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen, 518003, China
| | - Zhong Yin-Qin
- Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, 518034, China.
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19
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Qiu X, Wei Y, Weisskopf M, Spiro A, Shi L, Castro E, Coull B, Koutrakis P, Schwartz J. Air pollution, climate conditions and risk of hospital admissions for psychotic disorders in U.S. residents. ENVIRONMENTAL RESEARCH 2023; 216:114636. [PMID: 36283440 PMCID: PMC9712244 DOI: 10.1016/j.envres.2022.114636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/04/2022] [Accepted: 10/20/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND The physical environmental risk factors for psychotic disorders are poorly understood. This study aimed to examine the associations between exposure to ambient air pollution, climate measures and risk of hospitalization for psychotic disorders and uncover potential disparities by demographic, community factors. METHODS Using Health Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs), we applied zero-inflated negative binomial regression to obtain relative risks of hospitalization due to psychotic disorders associated with increases in residential exposure to ambient air pollution (fine particulate matter, PM2.5; nitrogen dioxide, NO2), temperature and cumulative precipitation. The analysis covered all-age residents in eight U.S. states over the period of 2002-2016. We additionally investigated modification by age, sex and area-level poverty, percent of blacks and Hispanics. RESULTS Over the study period and among the covered areas, we identified 1,211,100 admissions due to psychotic disorders. For each interquartile (IQR) increase in exposure to PM2.5 and NO2, we observed a relative risk (RR) of 1.11 (95% confidence interval (CI) = 1.09, 1.13) and 1.27 (95% CI = 1.24, 1.31), respectively. For each 1 °C increase of temperature, the RR was 1.03 (95% CI = 1.03, 1.04). Males were more affected by NO2. Older age residents (≥30 yrs) were more sensitive to PM2.5 and temperature. Population living in economically disadvantaged areas were more affected by air pollution. CONCLUSIONS The study suggests that living in areas with higher levels of air pollutants and ambient temperature could contribute to additional risk of inpatient care for individuals with psychotic disorders.
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Affiliation(s)
- Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marc Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Avron Spiro
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Massachusetts Veterans Epidemiology Research and Information Center, Veterans Affairs Boston Healthcare System, Boston, MA, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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20
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Zundel CG, Ryan P, Brokamp C, Heeter A, Huang Y, Strawn JR, Marusak HA. Air pollution, depressive and anxiety disorders, and brain effects: A systematic review. Neurotoxicology 2022; 93:272-300. [PMID: 36280190 PMCID: PMC10015654 DOI: 10.1016/j.neuro.2022.10.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022]
Abstract
Accumulating data suggest that air pollution increases the risk of internalizing psychopathology, including anxiety and depressive disorders. Moreover, the link between air pollution and poor mental health may relate to neurostructural and neurofunctional changes. We systematically reviewed the MEDLINE database in September 2021 for original articles reporting effects of air pollution on 1) internalizing symptoms and behaviors (anxiety or depression) and 2) frontolimbic brain regions (i.e., hippocampus, amygdala, prefrontal cortex). One hundred and eleven articles on mental health (76% human, 24% animals) and 92 on brain structure and function (11% human, 86% animals) were identified. For literature search 1, the most common pollutants examined were PM2.5 (64.9%), NO2 (37.8%), and PM10 (33.3%). For literature search 2, the most common pollutants examined were PM2.5 (32.6%), O3 (26.1%) and Diesel Exhaust Particles (DEP) (26.1%). The majority of studies (73%) reported higher internalizing symptoms and behaviors with higher air pollution exposure. Air pollution was consistently associated (95% of articles reported significant findings) with neurostructural and neurofunctional effects (e.g., increased inflammation and oxidative stress, changes to neurotransmitters and neuromodulators and their metabolites) within multiple brain regions (24% of articles), or within the hippocampus (66%), PFC (7%), and amygdala (1%). For both literature searches, the most studied exposure time frames were adulthood (48% and 59% for literature searches 1 and 2, respectively) and the prenatal period (26% and 27% for literature searches 1 and 2, respectively). Forty-three percent and 29% of studies assessed more than one exposure window in literature search 1 and 2, respectively. The extant literature suggests that air pollution is associated with increased depressive and anxiety symptoms and behaviors, and alterations in brain regions implicated in risk of psychopathology. However, there are several gaps in the literature, including: limited studies examining the neural consequences of air pollution in humans. Further, a comprehensive developmental approach is needed to examine windows of susceptibility to exposure and track the emergence of psychopathology following air pollution exposure.
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Affiliation(s)
- Clara G Zundel
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
| | - Patrick Ryan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Cole Brokamp
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
| | - Autumm Heeter
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA.
| | - Yaoxian Huang
- Department of Civil and Environmental Engineering, Wayne State University, 5050 Anthony Wayne Drive, Detroit, MI, USA.
| | - Jeffrey R Strawn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Anxiety Disorders Research Program, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA.
| | - Hilary A Marusak
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, USA; Translational Neuroscience Program, Wayne State University, Detroit, MI, USA.
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21
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Zhang Z, Amegbor PM, Sigsgaard T, Sabel CE. Assessing the association between urban features and human physiological stress response using wearable sensors in different urban contexts. Health Place 2022; 78:102924. [DOI: 10.1016/j.healthplace.2022.102924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022]
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22
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Tortorella A, Menculini G, Moretti P, Attademo L, Balducci PM, Bernardini F, Cirimbilli F, Chieppa AG, Ghiandai N, Erfurth A. New determinants of mental health: the role of noise pollution. A narrative review. Int Rev Psychiatry 2022; 34:783-796. [PMID: 36786115 DOI: 10.1080/09540261.2022.2095200] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Urbanisation processes and anthropogenic actions led to a significant increase in pollution levels, with relevant consequences on global health. In particular, noise pollution demonstrated an association with cardiovascular, metabolic, and respiratory diseases. Furthermore, increasing evidence underlined the possible role of air and noise pollution in the development of psychiatric disorders. In this narrative review, evidence concerning the relationship between noise pollution and the emergence of psychiatric symptoms or psychiatric disorders is summarised. After the literature search process was completed, 40 papers were included in the present review. The exposure to road-, rail-, and air- traffic represented a risk factor for the emergence of affective disorders. This could also be mediated by the occurrence of circadian rhythms disturbances or by noise annoyance and noise sensitivity, both influencing psychological well-being and health-related quality of life. Fewer studies concentrated on special populations, particularly pregnant women and children, for whom noise pollution was confirmed as a risk factor for psychopathology. The better clarification of the complex interaction between noise pollution and mental health may help to identify subjects at risk and targeting specific prevention and intervention strategies in the urban environment.
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Affiliation(s)
| | | | | | - Luigi Attademo
- SPDC Potenza, Department of Mental Health, ASP Basilicata, Italian National Health Service, Potenza, Italy.,Planetary Health Lab, Old Medical School, University of Edinburgh, Edinburgh, UK
| | - Pierfrancesco Maria Balducci
- Department of Psychiatry, University of Perugia, Perugia, Italy.,Department of Mental Health, CSM Terni, Terni, Italy
| | - Francesco Bernardini
- Planetary Health Lab, Old Medical School, University of Edinburgh, Edinburgh, UK.,SPDC Pordenone, Department of Mental Health, AsFO Friuli Occidentale, Italian National Health Service, Pordenone, Italy
| | | | | | - Nicola Ghiandai
- Department of Psychiatry, University of Perugia, Perugia, Italy
| | - Andreas Erfurth
- 1st Department of Psychiatry and Psychotherapeutic Medicine, Wiener Gesundheitsverbund Klinik Hietzing, Vienna, Austria
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23
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Sztuka IM, Örken A, Sudimac S, Kühn S. The other blue: Role of sky in the perception of nature. Front Psychol 2022; 13:932507. [PMID: 36389494 PMCID: PMC9651055 DOI: 10.3389/fpsyg.2022.932507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 08/31/2022] [Indexed: 12/05/2022] Open
Abstract
Nature is frequently operationalized as greenery or water to estimate the restorativeness of the environment. Pursuing a deeper understanding of the connection between representation of naturalness and its relationship with restoration, we conducted an experiment aimed to investigate if the sky is perceived as an element of nature. The main goal of this study was to understand how the composition of the environment guides people’s selection of sky as nature in an explicit task. Moreover, we investigated how the amount of visible sky determines this relationship. One hundred five participants participated in a novel explicit judgment task conducted online. In this task, we prepared a set of images trimmed out of 360-degree high dynamic range images. The images were classified according to two primary independent variables representing type of environment (four levels: Nature, Some Nature, Some Urban and Urban) and horizon level (three levels: Low, Medium and High). Each participant was asked to select, by clicking on the image, what they consider as “nature.” In addition, they were asked to judge images on five visual analogue scales: emotional response, aesthetic preference, feeling of familiarity, the openness of the space and naturalness. For analysis, images were segmented into 11 semantic categories (e.g., trees, sky, and water) with each pixel being assigned one semantic label. Our results show that, sky is associated with selections of nature in a specific pattern. The relationship is dependent on the particular set of conditions that are present in the environment (i.e., weather, season of the year) rather than the type of the environment (urban, nature). The availability of sky on the image affects the selection of other nature labels with selections more likely when only a small amount of sky was available. Furthermore, we found that the amount of sky had a significant positive association with the naturalness rating of the whole image, but the effect was small. Our results also indicate that subjective selections of sky predict the naturalness better than trees and water. On the other hand, objective presence of trees and water has a stronger positive association with naturalness while objective presence of sky is positively associated with naturalness. The results show that, relative to its availability sky is considered as nature.
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Affiliation(s)
- Izabela Maria Sztuka
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
- Max Planck Dahlem Campus of Cognition (MPDCC), Max Planck Institute for Human Development, Berlin, Germany
- *Correspondence: Izabela Maria Sztuka, ; Simone Kühn,
| | - Ada Örken
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Sonja Sudimac
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
- Max Planck Dahlem Campus of Cognition (MPDCC), Max Planck Institute for Human Development, Berlin, Germany
- Max Planck Institute for Human Development, International Max Planck Research School on the Life Course (LIFE), Berlin, Germany
| | - Simone Kühn
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
- Max Planck Dahlem Campus of Cognition (MPDCC), Max Planck Institute for Human Development, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research Berlin, Germany and London, UK, Berlin, Germany
- *Correspondence: Izabela Maria Sztuka, ; Simone Kühn,
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24
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Yue Y, Yang D, Owen N, Van Dyck D. The built environment and mental health among older adults in Dalian: The mediating role of perceived environmental attributes. Soc Sci Med 2022; 311:115333. [PMID: 36084518 DOI: 10.1016/j.socscimed.2022.115333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 07/11/2022] [Accepted: 08/26/2022] [Indexed: 11/21/2022]
Abstract
The basic attributes of the urban built environment are an important factor affecting mental health. However, research has rarely distinguished objective and perceived built environment characteristics to explore the associations with older adults' mental health. Based on data of 879 respondents aged 60 or older in Dalian, China, we explored the mediating roles of perceived built environmental attributes in the relationship between objective built environmental characteristics and mental wellbeing by structural equation modelling. Furthermore, to control for residential self-selection, the model was further tested by excluding the participants who self-selected their residences. The results showed that accessibility to daily living service facilities was positively associated with older adults' mental wellbeing through an indirect role of perceived built environmental attributes. The positive direct effect of aggregation of daily living service facilities on mental wellbeing was offset by the negative indirect effects of perceived built environmental attributes. In addition, the street interface density was negatively related to mental wellbeing through indirect effects. The diverse leisure, exercise and landscape facilities, underground parking and presence of elevators within neighborhoods were all positively associated with older adults' mental wellbeing through direct and/or indirect effects. The results were verified after excluding residential self-selection samples. These findings are helpful for evidence-based planning strategies and can provide guidelines on designing neighborhood landscapes and facilities which can further contribute to aging in place policies.
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Affiliation(s)
- Yafei Yue
- Department of Urban Planning, School of Architecture and Fine Art, Dalian University of Technology, Dalian, China; Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium; State Key Laboratory of Green Building in Western China, Xian University of Architecture & Technology, Xian, China.
| | - Dongfeng Yang
- Department of Urban Planning, School of Architecture and Fine Art, Dalian University of Technology, Dalian, China; State Key Laboratory of Green Building in Western China, Xian University of Architecture & Technology, Xian, China
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia; Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Delfien Van Dyck
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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25
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Lan Y, Roberts H, Kwan MP, Helbich M. Daily space-time activities, multiple environmental exposures, and anxiety symptoms: A cross-sectional mobile phone-based sensing study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 834:155276. [PMID: 35439503 DOI: 10.1016/j.scitotenv.2022.155276] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/16/2022] [Accepted: 04/10/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Few mobility-based studies have investigated the associations between multiple environmental exposures, including social exposures, and mental health. OBJECTIVE To assess how exposure to green space, blue space, noise, air pollution, and crowdedness along people's daily mobility paths are associated with anxiety symptoms. METHODS 358 participants were cross-sectionally tracked with Global Positioning System (GPS)-enabled mobile phones. Anxiety symptoms were measured at baseline using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. Green space, blue space, noise, and air pollution were assessed based on concentric buffers of 50 m and 100 m around each GPS point. Crowdedness was measured by the number of nearby Bluetooth-enabled devices detected along the mobility paths. Multiple linear regressions with full covariate adjustment were fitted to examine anxiety-environmental exposures associations. Random forest models were applied to explore possible nonlinear associations and exposure interactions. RESULTS Regression results showed null linear associations between GAD-7 scores and environmental exposures. Random forest models indicated that GAD-7-environment associations varied nonlinearly with exposure levels. We found a negative association between green space and GAD-7 scores only for participants with moderate green space exposure. We observed a positive association between GAD-7 scores and noise levels above 60 dB and air pollution concentrations above 17.2 μg m-3. Crowdedness was positively associated with GAD-7 scores, but exposure-response functions flattened out with pronounced crowdedness of >7.5. Blue space tended to be positively associated with GAD-7 scores. Random forest models ranked environmental exposures as more important to explain GAD-7 scores than linear models. CONCLUSIONS Our findings indicate possible nonlinear associations between mobility-based environmental exposures and anxiety symptoms. More studies are needed to obtain an in-depth understanding of underlying anxiety-environment mechanisms during daily life.
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Affiliation(s)
- Yuliang Lan
- Department of Human Geography and Spatial Planning, Utrecht University, the Netherlands.
| | - Hannah Roberts
- Department of Human Geography and Spatial Planning, Utrecht University, the Netherlands
| | - Mei-Po Kwan
- Department of Human Geography and Spatial Planning, Utrecht University, the Netherlands; Department of Geography and Resource Management and Institute of Space and Earth Information Science, Chinese University of Hong Kong, Hong Kong, China
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Utrecht University, the Netherlands
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26
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Pan Q, Zha S, Li J, Guan H, Xia J, Yu J, Cui C, Liu Y, Xu J, Liu J, Chen G, Jiang M, Zhang J, Ding X, Zhao X. Identification of the susceptible subpopulations for wide pulse pressure under long-term exposure to ambient particulate matters. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 834:155311. [PMID: 35439510 DOI: 10.1016/j.scitotenv.2022.155311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
Wide pulse pressure (WPP) is a preclinical indicator for arterial stiffness and cardiovascular diseases. Long-term exposure to ambient particulate matters (PMs) would increase the risk of WPP. Although reducing pollutants emissions and avoiding outdoor activity during a polluted period are effective ways to blunt the adverse effects. Identifying and protecting the susceptible subpopulation is another crucial way to reduce the disease burdens. Therefore, we aimed to identify the susceptible subpopulations of WPP under long-term exposure to PMs. The WPP was defined as pulse pressure over 60 mmHg. Three-year averages of PMs were estimated using random forest approaches. Associations between WPP and PMs exposure were estimated using generalized propensity score weighted logistic regressions. Demographic, socioeconomic characteristics, health-related behaviors, and hematological biomarkers were collected to detect the modification effects on the WPP-PMs associations. Susceptible subpopulations were defined as those with significantly higher risks of WPP under PMs exposures. The PMs-WPP associations were significant with ORs (95%CI) of 1.126 (1.094, 1.159) for PM1, 1.174 (1.140, 1.210) for PM2.5, and 1.111 (1.088, 1.135) for PM10. There were 17 subpopulations more sensitive to WPP under long-term exposure to PMs. The susceptibility was higher in subpopulations with high BMI (Q3-Q4 quartiles), high-intensive physical activity (Q3 or Q4 quartile), insufficient or excessive fruit intake (Q1 or Q5 quartile), insufficient or too long sleep length (<7 or >8 h). Subpopulations with elevated inflammation markers (WBC, LYM, BAS, EOS: Q3-Q4 quartiles) and glucose metabolism indicators (HbA1c, GLU: Q3-Q4 quartiles) were more susceptible. Besides, elder, urban living, low socioeconomic level, and excessive red meat and sodium salt intake were also related to higher susceptibility. Our findings on the susceptibility characteristics would help to develop more targeted disease prevention and therapy strategies. Health resources can be allocated more effectively by putting more consideration to subpopulations with higher susceptibility.
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Affiliation(s)
- Qing Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shun Zha
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Jingzhong Li
- Tibet Center for Disease Control and Prevention, Tibet, China
| | - Han Guan
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jingjie Xia
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Jianhong Yu
- Pidu District Center for Disease Control and Prevention, Chengdu, China
| | | | - Yuanyuan Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiayue Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jin Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangdong, China
| | - Min Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Juying Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Xianbin Ding
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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27
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Recent Techniques in Determining the Effects of Climate Change on Depressive Patients: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:1803401. [PMID: 35978588 PMCID: PMC9377838 DOI: 10.1155/2022/1803401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/03/2022] [Accepted: 07/11/2022] [Indexed: 11/18/2022]
Abstract
Climate change is amongst the most serious issues nowadays. Climate change has become a concern for the scientific community as it could affect human health. Researchers have found that climate change potentially impacts human mental health, especially among depressive patients. However, the relationship is still unclear and needs further investigation. The purpose of this systematic review is to systematically evaluate the evidence of the association between climate change effects on depressive patients, investigate the effects of environmental exposure related to climate change on mental health outcomes for depressive patients, analyze the current technique used to determine the relationship, and provide the guidance for future research. Articles were identified by searching specified keywords in six electronic databases (Google Scholar, PubMed, Scopus, Springer, ScienceDirect, and IEEE Digital Library) from 2012 until 2021. Initially, 1823 articles were assessed based on inclusion criteria. After being analyzed, only 15 studies fit the eligibility criteria. The result from included studies showed that there appears to be strong evidence of the association of environmental exposure related to climate change in depressive patients. Temperature and air pollution are consistently associated with increased hospital admission of depressive patients; age and gender became the most frequently considered vulnerability factors. However, the current evidence is limited, and the output finding between each study is still varied and does not achieve a reasonable and mature conclusion regarding the relationship between the variables. Therefore, more evidence is needed in this domain study. Some variables might have complex patterns, and hard to identify the relationship. Thus, technique used to analyze the relationship should be strengthened to identify the relevant relationship.
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28
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An Evaluation of Risk Ratios on Physical and Mental Health Correlations due to Increases in Ambient Nitrogen Oxide (NOx) Concentrations. ATMOSPHERE 2022. [DOI: 10.3390/atmos13060967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Nitrogen oxides (NOx) are gaseous pollutants contributing to pollution in their primary form and are also involved in reactions forming ground-level ozone and fine particulate matter. Thus, NOx is of great interest for targeted pollution reduction because of this cascade effect. Primary emissions originate from fossil fuel combustion making NOx a common outdoor and indoor air pollutant. Numerous studies documenting the observed physical health impacts of NOx were reviewed and, where available, were summarized using risk ratios. More recently, the literature has shifted to focus on the mental health implications of NOx exposure, and a review of the current literature found five main categories of mental health-related conditions with respect to NOx exposure: common mental health disorders, sleep, anxiety, depression, and suicide. All the physical and mental health effects with available risk ratios were organized in order of increasing risk. Mental health concerns emerged as those most influenced by NOx exposure, with physical health impacts, such as asthma, only beginning to surface as the fourth highest risk. Mental health conditions occupied seven of the top ten highest risk health ailments. The results summarized in this narrative review show that there are clear positive correlations between NOx and negative physical and mental health manifestations, thus strengthening the argument in support of the reduction in ambient NOx levels.
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29
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Marchionatti LE, Caye A, Kieling C. The mental health of children and young people living in big cities in a revolving postpandemic world. Curr Opin Psychiatry 2022; 35:200-206. [PMID: 35579874 DOI: 10.1097/yco.0000000000000769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The world's population is increasingly urban, with most children and young people growing up and living in cities. Evidence suggests that urbanicity is linked to an increased risk for the development of mental health disorders. Rather than an accumulation of risk factors, urbanization is a complex process that profoundly structures living conditions. In this sense, it is timely to discuss what are the social and structural determinants of mental health of children and young people in such settings. RECENT FINDINGS Three domains of determinants of mental health were selected for discussion: economics and living conditions, crime and violence, and urban layouts. For each, we debated realities faced by urban children and young people, providing an overview of recent evidence on implications for mental disorders and well being. We also discuss the potential impacts of the covid-19 pandemic on each domain, as well as recommendations for future action. SUMMARY Structural factors are of major relevance for the mental health of children and young people living in cities. The agenda of mental health promotion and prevention must include whole-of-society interventions aimed at improving living conditions, including economic and social capital, violence prevention and urbanistic planning.
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Affiliation(s)
| | - Arthur Caye
- Department of Psychiatry
- Child and Adolescent Psychiatry Division, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Christian Kieling
- Department of Psychiatry
- Child and Adolescent Psychiatry Division, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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30
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Chi D, Aerts R, Van Nieuwenhuyse A, Bauwelinck M, Demoury C, Plusquin M, Nawrot TS, Casas L, Somers B. Residential Exposure to Urban Trees and Medication Sales for Mood Disorders and Cardiovascular Disease in Brussels, Belgium: An Ecological Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:57003. [PMID: 35543508 PMCID: PMC9093162 DOI: 10.1289/ehp9924] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 03/31/2022] [Accepted: 04/04/2022] [Indexed: 05/21/2023]
Abstract
BACKGROUND The available evidence for positive associations between urban trees and human health is mixed, partly because the assessment of exposure to trees is often imprecise because of, for instance, exclusion of trees in private areas and the lack of three-dimensional (3D) exposure indicators (e.g., crown volume). OBJECTIVES We aimed to quantify all trees and relevant 3D structural traits in Brussels (Belgium) and to investigate associations between the number of trees, tree traits, and sales of medication commonly prescribed for mood disorders and cardiovascular disease. METHODS We developed a workflow to automatically isolate all individual trees from airborne light detection and ranging (LiDAR) data collected in 2012. Trait data were subsequently extracted for 309,757 trees in 604 census tracts. We used the average annual age-standardized rate of medication sales in Brussels for the period 2006 to 2014, calculated from reimbursement information on medication prescribed to adults (19-64 years of age). The medication sales data were provided by sex at the census tract level. Generalized log-linear models were used to investigate associations between the number of trees, the crown volume, tree structural variation, and medication sales. Models were run separately for mood disorder and cardiovascular medication and for men and women. All models were adjusted for indicators of area-level socioeconomic status. RESULTS Single-factor models showed that higher stem densities and higher crown volumes are both associated with lower medication sales, but opposing associations emerged in multifactor models. Higher crown volume [an increase by one interquartile range (IQR) of 1.4×104 m³/ha] was associated with 34% lower mood disorder medication sales [women, β=-0.341 (95% CI: -0.379, -0.303); men, β=-0.340 (95% CI: -0.378, -0.303)] and with 21-25% lower cardiovascular medication sales [women, β=-0.214 (95% CI: -0.246, -0.182); men, β=-0.252 (95% CI: -0.285, -0.219)]. Conversely, a higher stem density (an increase by one IQR of 21.8 trees/ha) was associated with 28-32% higher mood disorder medication sales [women, β=0.322 (95% CI: 0.284, 0.361); men, β=0.281 (95% CI: 0.243, 0.319)] and with 20-24% higher cardiovascular medication sales [women, β=0.202 (95% CI: 0.169, 0.236); men, β=0.240 (95% CI: 0.206, 0.273)]. DISCUSSION We found a trade-off between the number of trees and the crown volumes of those trees for human health benefits in an urban environment. Our results demonstrate that conserving large trees in urban environments may not only support conservation of biodiversity but also human health. https://doi.org/10.1289/EHP9924.
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Affiliation(s)
- Dengkai Chi
- Division of Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- KU Leuven Urban Studies Institute, KU Leuven, Leuven, Belgium
| | - Raf Aerts
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Division of Ecology, Evolution and Biodiversity Conservation, KU Leuven, Leuven, Belgium
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - An Van Nieuwenhuyse
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
- Center for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Claire Demoury
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Michelle Plusquin
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - Tim S. Nawrot
- Center for Environmental Sciences, University of Hasselt, Hasselt, Belgium
- Center for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Lidia Casas
- Social Epidemiology and Health Policy, Department Family Medicine and Population Health, University of Antwerp, Wilrijk, Belgium
| | - Ben Somers
- Division of Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium
- KU Leuven Plant Institute, KU Leuven, Leuven, Belgium
- KU Leuven Urban Studies Institute, KU Leuven, Leuven, Belgium
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31
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Borroni E, Pesatori AC, Bollati V, Buoli M, Carugno M. Air pollution exposure and depression: A comprehensive updated systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118245. [PMID: 34600062 DOI: 10.1016/j.envpol.2021.118245] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/21/2021] [Accepted: 09/25/2021] [Indexed: 06/13/2023]
Abstract
We provide a comprehensive and updated systematic review and meta-analysis of the association between air pollution exposure and depression, searching PubMed, Embase, and Web of Sciences for relevant articles published up to May 2021, and eventually including 39 studies. Meta-analyses were performed separately according to pollutant type [particulate matter with diameter ≤10 μm (PM10) and ≤2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO)] and exposure duration [short- (<30 days) and long-term (≥30 days)]. Test for homogeneity based on Cochran's Q and I2 statistics were calculated and the restricted maximum likelihood (REML) random effect model was applied. We assessed overall quality of pooled estimates, influence of single studies on the meta-analytic estimates, sources of between-study heterogeneity, and publication bias. We observed an increased risk of depression associated with long-term exposure to PM2.5 (relative risk: 1.074, 95% confidence interval: 1.021-1.129) and NO2 (1.037, 1.011-1.064), and with short-term exposure to PM10 (1.009, 1.006-1.012), PM2.5 (1.009, 1.007-1.011), NO2 (1.022, 1.012-1.033), SO2 (1.024, 1.010-1.037), O3 (1.011, 0.997-1.026), and CO (1.062, 1.020-1.105). The publication bias affecting half of the investigated associations and the high heterogeneity characterizing most of the meta-analytic estimates partly prevent to draw very firm conclusions. On the other hand, the coherence of all the estimates after excluding single studies in the sensitivity analysis supports the soundness of our results. This especially applies to the association between PM2.5 and depression, strengthened by the absence of heterogeneity and of relevant publication bias in both long- and short-term exposure studies. Should further investigations be designed, they should involve large sample sizes, well-defined diagnostic criteria for depression, and thorough control of potential confounding factors. Finally, studies dedicated to the comprehension of the mechanisms underlying the association between air pollution and depression remain necessary.
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Affiliation(s)
- Elisa Borroni
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy
| | - Angela Cecilia Pesatori
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy; Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via san Barnaba 8, 20122, Milan, Italy.
| | - Valentina Bollati
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy; Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via san Barnaba 8, 20122, Milan, Italy
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