美国墨西哥湾长期随访研究中的居住空气污染、绿地与不良心理健康结局。

Residential air pollution, greenspace, and adverse mental health outcomes in the U.S. Gulf Long-term Follow-up Study.

机构信息

Epidemiology Branch, NIEHS, NC, USA.

Epidemiology Branch, NIEHS, NC, USA.

出版信息

Sci Total Environ. 2024 Oct 10;946:174434. doi: 10.1016/j.scitotenv.2024.174434. Epub 2024 Jul 2.

Abstract

Air pollution and greenness are environmental determinants of mental health, though existing evidence typically considers each exposure in isolation. We evaluated relationships between co-occurring air pollution and greenspace levels and depression and anxiety. We estimated cross-sectional associations among 9015 Gulf Long-term Follow-up Study participants living in the southeastern U.S. who completed the Patient Health Questionnaire-9 (depression: score ≥ 10) and Generalized Anxiety Disorder Questionnaire-7 (anxiety: score ≥ 10). Participant residential addresses were linked to annual average concentrations of particulate matter (1 km PM) and nitrogen dioxide (1 km NO), as well as satellite-based greenness (2 km Enhanced Vegetation Index (EVI)). We used adjusted log-binomial regression to estimate prevalence ratios (PR) and 95 % confidence intervals (CI) for associations between exposures (quartiles) and depression and anxiety. In mutually adjusted models (simultaneously modeling PM, NO, and EVI), the highest quartile of PM was associated with increased prevalence of depression (PR = 1.17, 95 % CI: 1.06-1.29), whereas the highest quartile of greenness was inversely associated with depression (PR = 0.89, 95 % CI: 0.80-0.99). Joint exposure to greenness mitigated the impact of PM on depression (PR = 1.20, 95 % CI: 1.06-1.36; PR = 0.98, 95 % CI: 0.83-1.16) and anxiety (PR = 1.10, 95 % CI: 1.00-1.22; PR = 0.95, 95 % CI: 0.83-1.09) overall and in subgroup analyses. Observed associations were stronger in urbanized areas and among nonwhite participants, and varied by neighborhood deprivation. NO exposure was not independently associated with depression or anxiety in this population. Relationships between PM, greenness, and depression were strongest in the presence of characteristics that are highly correlated with lower socioeconomic status, underscoring the need to consider mental health as an environmental justice issue.

摘要

空气污染和绿化是影响心理健康的环境决定因素,尽管现有证据通常单独考虑每种暴露因素。我们评估了同时存在的空气污染和绿化水平与抑郁和焦虑之间的关系。我们对居住在美国东南部的 9015 名海湾长期随访研究参与者进行了横断面关联分析,这些参与者完成了患者健康问卷-9(抑郁:得分≥10)和广泛性焦虑症问卷-7(焦虑:得分≥10)。参与者的居住地址与每年平均浓度的颗粒物(1 公里 PM)和二氧化氮(1 公里 NO)以及基于卫星的绿化(2 公里增强植被指数(EVI))相关联。我们使用调整后的对数二项式回归来估计暴露(四分位数)与抑郁和焦虑之间的关联的患病率比(PR)和 95%置信区间(CI)。在相互调整的模型中(同时对 PM、NO 和 EVI 进行建模),PM 的最高四分位数与抑郁的患病率增加相关(PR=1.17,95%CI:1.06-1.29),而绿化的最高四分位数与抑郁呈负相关(PR=0.89,95%CI:0.80-0.99)。绿色与 PM 的联合暴露减轻了 PM 对抑郁的影响(PR=1.20,95%CI:1.06-1.36;PR=0.98,95%CI:0.83-1.16)和焦虑(PR=1.10,95%CI:1.00-1.22;PR=0.95,95%CI:0.83-1.09),并且在亚组分析中也是如此。在城市化地区和非白人参与者中观察到的关联更强,并且因邻里贫困程度而异。在该人群中,NO 暴露与抑郁或焦虑无关。在具有与较低社会经济地位高度相关的特征的情况下,PM、绿化与抑郁之间的关系最强,这凸显了需要将心理健康视为环境公正问题。

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