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

Association of ambient air pollution exposure with psychological distress in mid and later adulthood: A 26-year prospective cohort study

BACKGROUND

Existing evidence on associations between exposure to air pollution and psychological distress from middle to older age is limited by consideration of short exposure periods, poor historical covariates, exposures and outcomes, and cross-sectional study designs. We aimed to examine this association over a 26-year period between ages 43 and 69.

METHODS

We utilised data from the Medical Research Council National Survey of Health and Development Study (the 1946 British birth cohort). Land-use regression models estimated exposure to specific air pollutants using household addresses for 1991 (NO2), 2001 (PM10, NO2), and 2010 (NO2, NOx, PM10, PM2.5, PMcoarse, PM2.5abs). These were linked to the closest data collection wave at ages 43, 53 and 60-64, respectively. Psychological distress was assessed through the 28-item version of the General Health Questionnaire (GHQ-28), at ages 53, 60-64 and 69. Associations between each of the pollutants with psychological distress were analysed using generalised linear mixed models, adjusted for pollution exposure before age 43, assigned sex, social class, smoking status, neighbourhood deprivation, and previous mental health problems. We also examined effect modification by social class.

RESULTS

At age 69, 2125 participants completed the GHQ-28. In fully adjusted models, higher NO2 exposure was associated with higher GHQ-28 scores across a 26-year period (β=0.023, 95%CI:0.005, 0.040 per interquartile range increase in exposure), whereas higher exposure to PM10 was associated with lower GHQ-28 scores across a 16-year period (β=-0.021, 95%CI:-0.037, -0.006). There was no evidence of associations between exposure to other pollutants at age 60-64 and GHQ-28 at age 69. We found no effect modification by social class.

CONCLUSIONS

In this cohort there was some evidence of an association between higher cumulative exposure to NO2 and higher psychological distress, but mixed associations with other exposures. Policies to reduce pollutant exposure may help improve psychological symptoms in middle to late adulthood.

Effects of ambient fine particulate matter on the exacerbation of psychiatric disorders in southern Taiwan: a case-crossover study

This study investigated the impact of short-term exposures to ambient fine particulate matter 2.5 (PM2.5) on the exacerbation of psychiatric disorders (PDs) in southern Taiwan between 2014 and 2020. Data on emergency room visits (ERVs) for PDs and air pollutant levels were obtained from the Chang Gung Research Database and the Environmental Protection Administration, respectively. A time-stratified case-crossover design was adopted to estimate the risks of ERVs for PDs. At lag4 days, a 10-μg/m3 increase in PM2.5 was associated with significant increases in ERVs in both single- and multi-pollutant models, with odds ratio (OR) of 1.18 [95% confidence interval (95% CI): 1.00, 1.38] (PM2.5), 1.20 (95% CI: 1.00, 1.43) (PM2.5 + SO2), 1.23 (95% CI: 1.03, 1.46) (PM2.5 + O3), and 1.25 (95% CI: 1.03, 1.52) (PM2.5 + SO2 + O3). For cumulative lags (lag0-6), a 10-μg/m3 increase in PM2.5 was associated with significant increases in ERVs only for multi-pollutant model (PM2.5 + SO2), with OR of 1.41 (95% CI: 1.03, 1.93). Among males, significant increases in ERVs were observed at lag4 and lag0-6 days; however, no significant associations were observed in females. In conclusion, short-term exposure to PM2.5 increased the risk of PDs exacerbation, exhibiting both delayed and cumulative effects, with male patients found to be more sensitive.

Housing Insecurity and Older Adults' Health and Well-Being in a Gentrifying City: Results from the EPIPorto Cohort Study

Using 2022 data from 600 adults (≥ 60 years) in Porto, Portugal, we explored the association between housing insecurity and various health outcomes. We examined housing conditions, affordability, and stability in relation to loneliness, quality of life, cognitive function, perception of healthy ageing, and sleep using regression models. Older adults without house heating (β = 2.293; 95%CI = 0.753, 3.833), with leaks/dampness/rot (β = 3.741; 1.818, 5.664), insufficient daylight (β = 2.787; 0.095, 5.479), living in neighborhoods with noise (β = 1.793, 0.280 to 3.305), pollution/grime (β = 2.580; 0.746, 4.414), and violence/crime/vandalism (β = 3.940; 1.723, 6.157), who faced housing cost overburden (β = 2.001; 0.426, 3.577), eviction (β = 12.651; 0.852, 24.450), and moved frequently (β = 4.129; 1.542, 6.716) exhibited higher levels of loneliness. Similarly, lack of house heating (β = - 1.942; - 3.438, - 0.445), leaks/dampness/rot (β = - 4.157; - 5.999, - 2.316), insufficient daylight (β = - 3.124; - 5.714, - 0.534), noise (β = - 2.143; - 3.600, - 0.686), pollution/grime (β = - 2.093; - 3.860, - 0.325), violence/crime/vandalism (β = - 2.819; - 4.948, - 0.691), and those with housing cost overburden (β = - 2.435; - 3.930, - 0.940) reported lower quality of life. Those with no toilet (β =  - 1.891; - 3.760, - 0.021) or shower (β =  - 1.891; - 3.760, - 0.021) and who faced forced displacement (β =  - 2.179; - 3.516, - 0.842) presented lower cognitive function. Furthermore, those living in neighborhoods with pollution/grime (OR = 0.494; 0.322, 0.756) and violence/crime/vandalism (OR = 0.477; 0.284, 0.801), those in social housing (OR = 0.728; 0.575, 0.922), and those who moved frequently (OR = 0.475; 0.257, 0.879) reported lower levels of perceived healthy ageing. Insufficient sleep was more common among residents in social housing (OR = 2.155; 1.102, 4.213), while poor sleep quality was least likely both among those living in social housing (OR = 0.445; 0.220, 0.900) and affordable housing (OR = 0.381; 0.162, 0.896). Good quality, stable, and affordable housing seems crucial for healthy ageing.

Long term exposure to ambient air pollution and hospital admission burden in Scotland: 16 year prospective population cohort study

OBJECTIVES

Air pollution is considered a major threat for global health and is associated with various health outcomes. Previous research on long term exposure to ambient air pollution and health placed more emphasis on mortality rather than hospital admission outcomes and was characterised by heterogeneities in the size of effect estimates between studies, with less focus on mental/behavioural or infectious diseases outcomes. In this study, we investigated the association between long term exposure to ambient air pollution and all cause and cause specific hospital admissions.

DESIGN

This was a prospective cohort study.

SETTING

Individual level data from the Scottish Longitudinal Study (SLS) were linked to yearly concentrations of four pollutants (nitrogen dioxide (NO2), sulphur dioxide (SO2), particulate matter diameter ≤10 µm (PM10) and particulate matter diameter ≤2.5 µm (PM2.5)) at 1 km2 spatial resolution using the individual's residential postcode for each year between 2002 and 2017.

PARTICIPANTS

The study included 202 237 adult individuals aged ≥17 years.

OUTCOME MEASURES

The associations between air pollution and all cause, cardiovascular, respiratory, infectious, mental/behavioural disorders and other cause hospital admissions were examined using multi-level, mixed effects, negative binomial regression.

RESULTS

Higher exposure to NO2, PM10 and PM2.5 was associated with a higher incidence of all cause, cardiovascular, respiratory and infectious hospital admissions before adjusting for the area of residence, and in fully adjusted models when considering cumulative exposure across time. In fully adjusted models, the incidence rate for respiratory hospital admissions increased by 4.2% (95% CI 2.1% to 6.3%) and 1.2% (95% CI 0.8% to 1.7%) per 1 µg/m3 increase in PM2.5 and NO2 pollutants, respectively. SO2 was mainly associated with respiratory hospital admissions (incidence rate ratio (IRR)=1.016; 95% CI 1.004 to 1.027) and NO2 was related to a higher incidence of hospital admissions for mental/behavioural disorders (IRR=1.021; 95% CI 1.011 to 1.031). Average cumulative exposure to air pollution showed stronger positive associations with higher rates of hospital admissions.

CONCLUSIONS

The results of this study support an association between long term (16 years) exposure to ambient air pollution and increased all cause and cause specific hospital admissions for both physical and mental/behavioural illnesses. The results suggest that interventions on air pollution through stricter environmental regulations could help ease the hospital care burden in Scotland in the long term.

Perception matters: How air pollution influences life satisfaction in China

Academic studies on environmental pollution have convincingly acknowledged the salient relevance of ambient pollutant emissions on individual life satisfaction. However, an understanding of how the different dimensions of air pollution influence public self-assessment of their living condition is required. This research investigates whether objective pollutant emissions and subjective evaluation influence individual life satisfaction. The findings were based on data from the China Environment Yearbook and China Social Survey in 2019. The multi-level linear regression model found that air pollutants emissions, including particulate matter (PM) and sulfur dioxide (SO2), failed to explain the variations in public life satisfaction because of the lag effect of public perception. A significant nexus between perceived air pollution and public life satisfaction was observed at a significance level of 0.01. Specially, as the perceived air pollution by the public increased by one-point, life satisfaction decreased by 0.22 on a scale of 1-10, on average. Heterogeneous analysis based on income further suggested the salient negative effect of PM emissions on life satisfaction only occurred in the high-income group. The findings were robust after various methodological analyses. This study has theoretical implications for understanding the effects of air pollution on public subjective perception and provides guidance for how the government can manage the relationship between environmental governance and life satisfaction.

The Climate Crisis and Breastfeeding: Opportunities for Resilience

The climate crisis is an emerging global challenge that poses potential risks to breastfeeding practices and outcomes. There are multifaceted effects of climate change affecting the breastfeeding dyad across environmental, societal, and human health dimensions. Breastfeeding support in the face of climate change will require solutions at the structural level-healthcare, community, and workplace settings-and at the mother-infant dyad level. Breastfeeding can additionally be an adaptive response to crisis situations and can mitigate some of the environmental challenges associated with climate change. Despite the undeniable significance of climate change on breastfeeding (and vice versa), our perspective as experts in the field is that this topic has not been systematically addressed. Although we highlight some of the challenges, potential solutions, and co-benefits of breastfeeding in the context of climate change, there are numerous issues that could be further explored and necessitate additional preparedness planning.

The association of long-term exposure to outdoor air pollution with all-cause GP visits and hospital admissions by ethnicity and country of birth in the United Kingdom

BACKGROUND

Air pollution is associated with poor health. Yet, more research is needed to reveal the association of long-term exposure to outdoor air pollution with less studied health outcomes like hospital admissions and general-practitioner (GP) visits and whether this association is stronger for ethnic minorities compared to the rest of population. This study investigates the association between air pollution and all-cause GP visits and hospital admissions by ethnicity in the United-Kingdom (UK).

METHODS

We used individual-level longitudinal data from the "UK Household Longitudinal Study" including 46,442 adult individuals who provided 140,466 responses across five years (2015-2019). This data was linked to yearly concentrations of NO2, SO2, and particulate-matter (PM10, PM2.5) outdoor pollution using the Lower Super Output Area (LSOA) of residence for each individual. Multilevel mixed-effects ordered logistic models were used to assess the association between air pollution and all-cause GP visits and hospital admissions.

RESULTS

We found higher odds of hospital admissions per 1 μg/m3 increase in annual concentrations of NO2 (OR = 1.008; 95%CI = 1.004-1.012), SO2 (OR = 1.048; 95%CI = 1.014-1.083), PM10 (OR = 1.011; 95%CI = 1.003-1.018), and PM2.5 (OR = 1.018; 95%CI = 1.007-1.029) pollutants. Higher odds of GP visits were also observed with increased exposure to NO2 (OR = 1.010; 95%CI = 1.006-1.014) and SO2 (OR = 1.114; 95%CI = 1.077-1.152) pollutants. The observed associations did not differ across ethnic groups, but by country of birth, they were more pronounced in individuals born outside UK than those born in UK.

CONCLUSION

This study supports an association between higher exposure to outdoor air pollution and increased all-cause hospital admissions and GP visits. Further longitudinal studies with longer follow-up time periods may be able to reveal more definite conclusions on the influence of ethnicity on the association between long-term outdoor air pollution and both hospital admissions and GP visits.

The spatial-temporal effect of air pollution on individuals' reported health and its variation by ethnic groups in the United Kingdom: a multilevel longitudinal analysis

BACKGROUND

Air pollution is associated with poor health; though it is unclear whether this association is stronger for ethnic minorities compared to the rest of the population. This study uses longitudinal data to investigate the spatial-temporal effect of air pollution on individuals' reported health and its variation by ethnicity in the United-Kingdom (UK).

METHODS

Longitudinal individual-level data from Understanding Society: the UK Household Longitudinal Study including 67,982 adult individuals with 404,264 repeated responses over 11 years (2009-2019) were utilized and were linked to yearly concentrations of NO₂, SO₂, and particulate-matter (PM10, PM2.5) pollution once at the local authority and once at the census Lower Super Output Area (LSOA) of residence for each individual. This allows for analysis at two geographical scales over time. The association between air pollution and individuals' health (Likert scale: 1-5, Excellent to poor) and its variation by ethnicity was assessed using three-level mixed-effects ordered logistic models. Analysis distinguished between spatial (between areas) and temporal (across time within each area) effects of air pollution on health.

RESULTS

Higher concentrations of NO₂, SO₂, PM10, and PM2.5 pollution were associated with poorer health. Decomposing air pollution into between (spatial: across local authorities or LSOAs) and within (temporal: across years within each local authority or LSOA) effects showed a significant between effect for NO₂ and SO₂ pollutants at both geographical scales, while a significant between effect for PM10 and PM2.5 was shown only at the LSOAs level. No significant within effects were detected at an either geographical level. Indian, Pakistani/Bangladeshi, Black/African/Caribbean and other ethnic groups and non-UK-born individuals reported poorer health with increasing concentrations of NO₂, SO₂, PM10, and PM2.5 pollutants in comparison to the British-white and UK-born individuals.

CONCLUSION

Using longitudinal data on individuals' health linked with air pollution data at two geographical scales (local authorities and LSOAs), this study supports the presence of a spatial-temporal association between air pollution and poor self-reported health, which is stronger for ethnic minorities and foreign-born individuals in the UK, partly explained by location-specific differences. Air pollution mitigation is necessary to improve individuals' health, especially for ethnic minorities who are affected the most.