Department of Epidemiology and Biostatistics at School of Public Health and the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
Department of Epidemiology and Biostatistics at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Sci Total Environ. 2022 Jan 15;804:149986. doi: 10.1016/j.scitotenv.2021.149986. Epub 2021 Sep 4.
Long-term exposure to ambient air pollution was linked to depression incidence, although the results were limited and inconsistent.
To investigate the effects of long-term air pollution exposure on depression risk prospectively in China.
The present study used data from Yinzhou Cohort on adults without depression at baseline, and followed up until April 2020. Two-year moving average concentrations of particulate matter with a diameter ≤ 2.5 μm (PM), ≤10 μm (PM) and nitrogen dioxide (NO) were measured using land-use regression (LUR) models for each participant. Depression cases were ascertained using the Health Information System (HIS) of the local health administration by linking the unique identifiers. We conducted Cox regression models with time-varying exposures to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of depression with each pollutant, after adjusting for a sequence of individual covariates as demographic characteristics, lifestyles, and comorbidity. Besides, physical activity, baseline potential depressive symptoms, cancer status, COVID-19 pandemic, different outcome definitions and air pollution exposure windows were considered in sensitivity analyses.
Among the 30,712 adults with a mean age of 62.22 ± 11.25, 1024 incident depression cases were identified over totaling 98,619 person-years of observation. Interquartile range increments of the air pollutants were associated with increased risks of depression, and the corresponding HRs were 1.59 (95%CI: 1.46, 1.72) for PM, 1.49 (95%CI: 1.35, 1.64) for PM and 1.58 (95%CI: 1.42, 1.77) for NO. Subgroup analyses suggested that participants without taking any protective measures towards air pollution were more susceptible. The results remained robust in all sensitivity analyses.
Long-term exposure to ambient air pollution was identified as a risk factor for depression onset. Strategies to reduce air pollution are necessary to decrease the disease burden of depression.
长期暴露于环境空气污染与抑郁症发病有关，尽管结果有限且不一致。
在中国前瞻性研究长期空气污染暴露对抑郁症发病风险的影响。
本研究使用了基线时无抑郁症的鄞州区成年人的队列数据，并随访至 2020 年 4 月。使用土地利用回归（LUR）模型为每个参与者测量了直径≤2.5μm（PM）、≤10μm（PM）和二氧化氮（NO）的两年移动平均浓度。通过连接当地卫生管理局的健康信息系统（HIS），使用独特的标识符确定抑郁症病例。我们使用时变暴露的 Cox 回归模型来估计每种污染物与抑郁症的风险比（HR）和 95%置信区间（95%CI），并在调整一系列个体协变量（如人口统计学特征、生活方式和合并症）后进行分析。此外，在敏感性分析中还考虑了体育活动、基线潜在抑郁症状、癌症状况、COVID-19 大流行、不同的结局定义和空气污染暴露窗口。
在 30712 名平均年龄为 62.22±11.25 岁的成年人中，共有 1024 例抑郁症发病，总计观察了 98619 人年。空气污染物的四分位间距增加与抑郁症发病风险增加相关，相应的 HR 分别为 PM 为 1.59（95%CI：1.46，1.72），PM 为 1.49（95%CI：1.35，1.64），NO 为 1.58（95%CI：1.42，1.77）。亚组分析表明，没有采取任何针对空气污染保护措施的参与者更容易患病。所有敏感性分析的结果均保持稳健。
长期暴露于环境空气污染被确定为抑郁症发病的一个危险因素。需要采取减少空气污染的策略来降低抑郁症的疾病负担。
