Shen Minxue, Gu Xiaoyu, Li Shenxin, Yu Yu, Zou Bin, Chen Xiang
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China; Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China.
Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China.
Environ Int. 2021 Dec;157:106870. doi: 10.1016/j.envint.2021.106870. Epub 2021 Sep 14.
Previous studies have revealed a significant association of fine particulate matter (PM) with emotional disorders. However, as a crucial component of PM, little is known about the potential effect of exposure to black carbon (BC) on the symptoms of depression and anxiety.
To explore the associations of long-term exposure to BC during the past six years with the current symptoms of depression and anxiety in a group of incoming college students.
This was a retrospective cohort study of incoming students in five universities of China. Symptoms of depression and anxiety during the past two weeks were measured by the Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder Scale-2 (GAD-2), respectively. Levels of BC and other environmental factors during 2013 ∼ 2018 (six years prior to the recruitment) was obtained from public repositories and linked to individual data by home addresses. Averagely daily dose of BC exposure was estimated according to the respiratory rate. Demographic and behavioral variables were collected through a questionnaire. The associations of BC with symptoms of depression and anxiety were estimated by mixed linear models adjusting for socioeconomic and behavioral characteristics, and the principal components of multiple environmental exposures. Subgroup analysis was conducted to assess the effect modification by covariates. Overall effect of environmental mixture was evaluated by weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR).
A total of 20,079 participants was included in the current study. After adjustment for covariates, long-term BC exposure was significantly associated with symptoms of depression (β = 0.17, P < 0.001) but not anxiety (β = 0.07, P = 0.125). Effect modification by sex and parental educational level: BC was correlated with depressive symptoms in women (β = 0.23, P < 0.001) but not in men (β = 0.04, P = 0.581), and higher educational level was associated with decreased effect sizes of BC. Sensitivity analysis showed that the acute and short-term effects of BC on depression was consistent with its long-term exposure (β varied from 0.18 to 0.20). WQS identified BC as the primary pollutant in association with symptoms of depression but not anxiety. BKMR identified no significant interaction between BC and other exposures.
Exposure to BC is associated with symptoms of depression but not anxiety in college students, and the relationship is modified by sex and education.
以往研究揭示了细颗粒物（PM）与情绪障碍之间存在显著关联。然而，作为PM的一个关键成分，关于接触黑碳（BC）对抑郁和焦虑症状的潜在影响却知之甚少。
探讨过去六年长期接触BC与一组即将入学的大学生当前抑郁和焦虑症状之间的关联。
这是一项针对中国五所大学即将入学学生的回顾性队列研究。分别采用患者健康问卷-2（PHQ-2）和广泛性焦虑障碍量表-2（GAD-2）测量过去两周的抑郁和焦虑症状。2013年至2018年（招募前六年）期间的BC水平和其他环境因素数据来自公共数据库，并通过家庭住址与个人数据相关联。根据呼吸速率估算BC的日均暴露剂量。通过问卷调查收集人口统计学和行为变量。采用混合线性模型，在调整社会经济和行为特征以及多种环境暴露的主要成分后，估算BC与抑郁和焦虑症状之间的关联。进行亚组分析以评估协变量的效应修正作用。通过加权分位数和（WQS）和贝叶斯核机器回归（BKMR）评估环境混合物的总体效应。
本研究共纳入20,079名参与者。在调整协变量后，长期BC暴露与抑郁症状显著相关（β = 0.17，P < 0.001）但与焦虑症状无关（β = 0.07，P = 0.125）。性别和父母教育水平的效应修正：BC与女性的抑郁症状相关（β = 0.23，P < 0.001）但与男性无关（β = 0.04，P = 0.581），且父母教育水平越高，BC的效应量越小。敏感性分析表明，BC对抑郁的急性和短期影响与其长期暴露一致（β在0.18至0.20之间）。WQS确定BC是与抑郁症状相关的主要污染物，但与焦虑症状无关。BKMR未发现BC与其他暴露之间存在显著交互作用。
接触BC与大学生的抑郁症状相关，但与焦虑症状无关，且这种关系受性别和教育程度的影响。
