Wang Qing, Yang Zhiming
1School of Business, Dalian University of Technology, Panjin, 124221 Liaoning China.
2Donlinks School of Economics and Management, University of Science and Technology Beijing, Beijing, 100083 China.
Int J Ment Health Syst. 2018 Jun 18;12:33. doi: 10.1186/s13033-018-0212-4. eCollection 2018.
Exogenous stressors resulting from air pollution can lead to depression and chronic disease. Chinese levels of air pollution are among the highest in the world, and although associated adverse health effects are gradually emerging, research determining individual vulnerability is limited. This study estimated the association between air pollution and depressive symptoms and identified whether chronic disease influences an individual's susceptibility to depressive symptoms relating to air pollution.
Individual sample data from the China Health and Retirement Longitudinal Study and a group of city-level variables in 2011 and 2013 were used with the random effects model and Tobit model. Adjustments were made for demographic, socioeconomic status, health behavior, and city-level climate variables with respect to living areas. Analysis was also stratified using chronic disease characteristics.
The total Center for Epidemiological Studies Depression scale evaluating depressive symptoms ranged between 7 and 28 [average 11.623 (SD = 4.664)]. An 1% increase in sulfur dioxide and total suspended particulate emission intensities was associated with depressive symptoms scores that were 1.266 (SE = 0.107, P < 0.001, 95% CI 1.057-1.475) and 1.318 (SE = 0.082, P < 0.001, 95% CI 1.157-1.480) higher, respectively. Compared to respondents without chronic disease, those with chronic diseases such as hypertension, dyslipidemia, diabetes or high blood sugar, cardiovascular diseases, cancer or malignant tumor, liver disease, chronic lung diseases, kidney disease, stomach or other digestive disease, arthritis or rheumatism, and asthma had scores that were higher for depressive symptoms.
Results confirm that the adverse health effects of air pollution should be considered when developing air pollution policies. Findings also provide justification for mental health interventions targeting air pollution exposure, especially for people with chronic diseases.
空气污染产生的外部应激源可导致抑郁和慢性疾病。中国的空气污染水平位居世界前列，尽管相关的不良健康影响正逐渐显现，但确定个体易感性的研究有限。本研究估计了空气污染与抑郁症状之间的关联，并确定慢性病是否会影响个体对与空气污染相关的抑郁症状的易感性。
使用来自中国健康与养老追踪调查的个体样本数据以及2011年和2013年的一组城市层面变量，采用随机效应模型和托比特模型。针对居住地区的人口统计学、社会经济地位、健康行为和城市层面的气候变量进行了调整。分析还根据慢性病特征进行了分层。
评估抑郁症状的总流行病学研究中心抑郁量表得分在7至28分之间[平均11.623（标准差=4.664）]。二氧化硫和总悬浮颗粒物排放强度每增加1%，抑郁症状得分分别高出1.266（标准误=0.107，P<0.001，95%置信区间1.057-1.475）和1.318（标准误=0.082，P<0.001，95%置信区间1.157-1.480）。与无慢性病的受访者相比，患有高血压、血脂异常、糖尿病或高血糖、心血管疾病、癌症或恶性肿瘤、肝病、慢性肺病、肾病、胃或其他消化系统疾病、关节炎或风湿病以及哮喘等慢性病的受访者抑郁症状得分更高。
结果证实，在制定空气污染政策时应考虑空气污染对健康的不良影响。研究结果还为针对空气污染暴露的心理健康干预提供了依据，特别是针对患有慢性病的人群。
