Associations between long term exposures to outdoor air pollution and indoor solid fuel use and depression in China

Hehua Zhang; Yang Xia; Limin Cao; Qing Chang; Yuhong Zhao

doi:10.1016/j.jenvman.2021.113982

Associations between long term exposures to outdoor air pollution and indoor solid fuel use and depression in China

J Environ Manage. 2022 Jan 15;302(Pt A):113982. doi: 10.1016/j.jenvman.2021.113982. Epub 2021 Oct 23.

Authors

Hehua Zhang¹, Yang Xia², Limin Cao³, Qing Chang¹, Yuhong Zhao⁴

Affiliations

¹ Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning Province, 110004, China.
² Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province, 110004, China.
³ The Third Central Hospital of Tianjin, Hedong District, Jintang Road, No. 83, Tianjin, 300170, China.
⁴ Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning Province, 110004, China. Electronic address: zhaoyh@sj-hospital.org.

PMID: 34700082
DOI: 10.1016/j.jenvman.2021.113982

Abstract

Depression is one of the most common mental disorders. Effects of air pollution from outdoor and indoor on depression were inconsistent. We assessed 30,139 participants from Northeast China to explore the associations between long term exposures of outdoor and indoor solid fuel use and depressive symptoms. Multiple logistic regressions models as well as multiplicative interaction and additive interaction analysis were used. Outdoor exposures to air pollutants of particulate matter (with an aerodynamic diameter <2.5 μm, [PM_2.5], odds ratio [OR] = 1.98 per standard deviation [SD], 95% confidence interval [CI]: 1.78, 2.19; with an aerodynamic diameter <10 μm, [PM₁₀], OR = 1.83, 95% CI:1.68, 2.00), sulfur dioxide (SO₂, OR = 1.42, 95% CI: 1.33, 1.52), and nitrogen dioxide (NO₂, OR = 1.62, 95% CI: 1.49, 1.76) were significantly associated with higher occurrence of depressive symptoms. A significant linear trend for increased occurrence of depressive symptoms was observed in participants using both solid fuels for cooking and heating (P = 0.04). Indoor air pollution exposures from solid fuel use for heating (OR = 1.16, 95%CI: 1.00, 1.35) and high cooking frequency (OR = 1.17, 95%CI: 1.00, 1.37) were significantly associated with increased occurrence of depressive symptoms. We observed significant interactions of indoor solid fuel use and outdoor air pollution exposures on depressive symptoms (indoor fuel use for cooking and SO₂, P value = 0.04; solid fuel use for heating and NO₂, P value = 0.02). Solid fuel use for cooking weakened the associations between SO₂(relative excess risk due to interaction [RERI] = -1.37, 95% CI: -1.88, -0.86) and depressive symptoms. Solid fuel use for heating weakened the associations between NO₂ (RERI = -1.91, 95% CI: -2.55, -1.27) and depressive symptoms. Compared with individual associations, antagonistic interactions of outdoor air pollution and indoor solid fuel use on depressive symptoms might exist. Our findings contribute to better understandings for the associations between air pollution and depressive symptoms, which might be useful for developing effective strategies for depression prevention and air pollution control.

Keywords: Air pollution; Depression; Indoor solid fuel use; Interaction analysis.

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / analysis
Air Pollution* / statistics & numerical data
Air Pollution, Indoor / analysis
Air Pollution, Indoor / statistics & numerical data
China
Cooking
Depression / epidemiology
Depression / etiology
Humans
Particulate Matter / analysis
Particulate Matter / toxicity

Substances

Air Pollutants
Particulate Matter