Pan Chuyu, Cheng Bolun, Cheng Shiqiang, Liu Li, Yang Xuena, Meng Peilin, Qi Xin, Zhang Na, Qin Xiaoyue, He Dan, Wei Wenming, Hui Jingni, Wen Yan, Jia Yumeng, Liu Huan, Zhang Feng
Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
Precision Medicine Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Eur Psychiatry. 2024 Dec 18;68(1):e1. doi: 10.1192/j.eurpsy.2024.1809.
Despite growing awareness of the mental health damage caused by air pollution, the epidemiologic evidence on impact of air pollutants on major mental disorders (MDs) remains limited. We aim to explore the impact of various air pollutants on the risk of major MD.
This prospective study analyzed data from 170 369 participants without depression, anxiety, bipolar disorder, and schizophrenia at baseline. The concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM), particulate matter with aerodynamic diameter > 2.5 μm, and ≤ 10 μm (PM), nitrogen dioxide (NO), and nitric oxide (NO) were estimated using land-use regression models. The association between air pollutants and incident MD was investigated by Cox proportional hazard model.
During a median follow-up of 10.6 years, 9 004 participants developed MD. Exposure to air pollution in the highest quartile significantly increased the risk of MD compared with the lowest quartile: PM (hazard ratio [HR]: 1.16, 95% CI: 1.09-1.23), NO (HR: 1.12, 95% CI: 1.05-1.19), and NO (HR: 1.10, 95% CI: 1.03-1.17). Subgroup analysis showed that participants with lower income were more likely to experience MD when exposed to air pollution. We also observed joint effects of socioeconomic status or genetic risk with air pollution on the MD risk. For instance, the HR of individuals with the highest genetic risk and highest quartiles of PM was 1.63 (95% CI: 1.46-1.81) compared to those with the lowest genetic risk and lowest quartiles of PM.
Our findings highlight the importance of air pollution control in alleviating the burden of MD.
尽管人们越来越意识到空气污染对心理健康的损害，但关于空气污染物对主要精神障碍（MDs）影响的流行病学证据仍然有限。我们旨在探讨各种空气污染物对主要精神障碍风险的影响。
这项前瞻性研究分析了170369名在基线时无抑郁、焦虑、双相情感障碍和精神分裂症的参与者的数据。使用土地利用回归模型估算空气动力学直径≤2.5μm的颗粒物（PM）、空气动力学直径>2.5μm且≤10μm的颗粒物、二氧化氮（NO₂）和一氧化氮（NO）的浓度。通过Cox比例风险模型研究空气污染物与新发精神障碍之间的关联。
在中位随访10.6年期间，9004名参与者患上了精神障碍。与最低四分位数相比，暴露于最高四分位数空气污染中的参与者患精神障碍的风险显著增加：PM（风险比[HR]：1.16，95%置信区间：1.09 - 1.23）、NO₂（HR：1.12，95%置信区间：1.05 - 1.19）和NO（HR：1.10，95%置信区间：1.03 - 1.17）。亚组分析表明，收入较低的参与者在暴露于空气污染时更易患精神障碍。我们还观察到社会经济地位或遗传风险与空气污染对精神障碍风险的联合作用。例如，与遗传风险最低且PM处于最低四分位数的个体相比，遗传风险最高且PM处于最高四分位数的个体的HR为1.63（95%置信区间：1.46 - 1.81）。
我们的研究结果凸显了控制空气污染在减轻精神障碍负担方面的重要性。
