Mental health consequences of urban air pollution: prospective population-based longitudinal survey

• DOI: 10.1007/s00127-020-01966-x
• Publication Date: 2020-10-23T21:02:41Z
• Authors: Ioannis Bakolis; Ryan Hammoud; Robert Stewart; Sean Beevers; David Dajnak; Shirlee MacCrimmon; Matthew Broadbent; Megan Pritchard; Narushige Shiode; Daniela Fecht; John Gulliver; Matthew Hotopf; Stephani L. Hatch; Ian S. Mudway
• Keywords: DISORDER; Adult; SHORT-TERM EXPOSURE; 1702 Cognitive Sciences; BIOMARKERS; 610; Common mental disorders; 03 medical and health sciences; 0302 clinical medicine; INFLAMMATION; PARTICULATE MATTER; Air Pollution; SCHIZOPHRENIA; 11. Sustainability; NANOPARTICLES; Psychotic experiences; Humans; Longitudinal Studies; Prospective Studies; Mixed models; Psychiatry; Original Paper; Air Pollutants; Science & Technology; 1103 Clinical Sciences; ASSOCIATION; Environmental Exposure; ROAD TRAFFIC NOISE; 3. Good health; COMMUNITY; Mental Health; 1701 Psychology; 13. Climate action; Air quality; Urban health; Life Sciences & Biomedicine

Abstract Purpose The World Health Organisation (WHO) recently ranked air pollution as the major environmental cause of premature death. However, the significant potential health and societal costs of poor mental health in relation to air quality are not represented in the WHO report due to limited evidence. We aimed to test the hypothesis that long-term exposure to air pollution is associated with poor mental health.

Methods A prospective longitudinal population-based mental health survey was conducted of 1698 adults living in 1075 households in South East London, from 2008 to 2013. High-resolution quarterly average air pollution concentrations of nitrogen dioxide (NO2) and oxides (NOx), ozone (O3), particulate matter with an aerodynamic diameter < 10 μm (PM10) and < 2.5 μm (PM2.5) were linked to the home addresses of the study participants. Associations with mental health were analysed with the use of multilevel generalised linear models, after adjusting for large number of confounders, including the individuals’ socioeconomic position and exposure to road-traffic noise.

Results We found robust evidence for interquartile range increases in PM2.5, NOx and NO2 to be associated with 18–39% increased odds of common mental disorders, 19–30% increased odds of poor physical symptoms and 33% of psychotic experiences only for PM10. These longitudinal associations were more pronounced in the subset of non-movers for NO2 and NOx.

Conclusions The findings suggest that traffic-related air pollution is adversely affecting mental health. Whilst causation cannot be proved, this work suggests substantial morbidity from mental disorders could be avoided with improved air quality.