Childhood exposure to ambient air pollution and predicting individual risk of depression onset in UK adolescents

Knowledge about early risk factors for major depressive disorder (MDD) is critical to identify those who are at high risk. A multivariable model to predict adolescents’ individual risk of future MDD has recently been developed however its performance in a UK sample was far from perfect. Given the potential role of air pollution in the aetiology of depression, we investigate whether including childhood exposure to air pollution as an additional predictor in the risk prediction model improves the identification of UK adolescents who are at greatest risk for developing MDD. We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative UK birth cohort of 2,232 children followed to age 18 with 93% retention. Annual exposure to four pollutants – nitrogen dioxide (NO(2)), nitrogen oxides (NO(X)), particulate matter <2.5μm (PM(2.5)) and <10μm (PM(10)) – were estimated at address-level when children were aged 10. MDD was assessed via interviews at age 18. The risk of developing MDD was elevated most for participants with the highest (top quartile) level of annual exposure to NO(X) (adjusted OR=1.43, 95% CI=0.96-2.13) and PM(2.5) (adjusted OR=1.35, 95% CI=0.95-1.92). The separate inclusion of these ambient pollution estimates into the risk prediction model improved model specificity but reduced model sensitivity – resulting in minimal net improvement in model performance. Findings indicate a potential role for childhood ambient air pollution exposure in the development of adolescent MDD but suggest that inclusion of risk factors other than this may be important for improving the performance of the risk prediction model

Air quality and mental health: evidence, challenges and future directions

Background: Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course. // Aims: We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research priorities and how to address them. // Method: Through a rapid narrative review, we summarise the key scientific findings, knowledge gaps and methodological challenges. // Results: There is emerging evidence of associations between poor air quality, both indoors and outdoors, and poor mental health more generally, as well as specific mental disorders. Furthermore, pre-existing long-term conditions appear to deteriorate, requiring more healthcare. Evidence of critical periods for exposure among children and adolescents highlights the need for more longitudinal data as the basis of early preventive actions and policies. Particulate matter, including bioaerosols, are implicated, but form part of a complex exposome influenced by geography, deprivation, socioeconomic conditions and biological and individual vulnerabilities. Critical knowledge gaps need to be addressed to design interventions for mitigation and prevention, reflecting ever-changing sources of air pollution. The evidence base can inform and motivate multi-sector and interdisciplinary efforts of researchers, practitioners, policy makers, industry, community groups and campaigners to take informed action. // Conclusions: There are knowledge gaps and a need for more research, for example, around bioaerosols exposure, indoor and outdoor pollution, urban design and impact on mental health over the life course

Air quality and mental health: evidence, challenges and future directions

Background: Poor air quality is associated with poor health. Little attention is given to the complex array of environmental exposures and air pollutants that affect mental health during the life course. Aims: We gather interdisciplinary expertise and knowledge across the air pollution and mental health fields. We seek to propose future research priorities and how to address them. Method: Through a rapid narrative review, we summarise the key scientific findings, knowledge gaps and methodological challenges. Results: There is emerging evidence of associations between poor air quality, both indoors and outdoors, and poor mental health more generally, as well as specific mental disorders. Furthermore, pre-existing long-term conditions appear to deteriorate, requiring more healthcare. Evidence of critical periods for exposure among children and adolescents highlights the need for more longitudinal data as the basis of early preventive actions and policies. Particulate matter, including bioaerosols, are implicated, but form part of a complex exposome influenced by geography, deprivation, socioeconomic conditions and biological and individual vulnerabilities. Critical knowledge gaps need to be addressed to design interventions for mitigation and prevention, reflecting ever-changing sources of air pollution. The evidence base can inform and motivate multi-sector and interdisciplinary efforts of researchers, practitioners, policy makers, industry, community groups and campaigners to take informed action. Conclusions: There are knowledge gaps and a need for more research, for example, around bioaerosols exposure, indoor and outdoor pollution, urban design and impact on mental health over the life course.Natural Environment Research Council (NERC): NE/V002171/1; Engineering and Physical Sciences Research Council (EPSRC): EP/V052462/1; EP/W001411/1; EP/T003189/

Air and noise pollution exposure in early life and mental health from adolescence to young adulthood

Importance: Growing evidence associates air pollution exposure with various psychiatric disorders. However, the importance of early-life (eg, prenatal) air pollution exposure to mental health during youth is poorly understood, and few longitudinal studies have investigated the association of noise pollution with youth mental health. Objectives: To examine the longitudinal associations of air and noise pollution exposure in pregnancy, childhood, and adolescence with psychotic experiences, depression, and anxiety in youths from ages 13 to 24 years. Design, Setting, and Participants: This cohort study used data from the Avon Longitudinal Study of Parents and Children, an ongoing longitudinal birth cohort founded in 1991 through 1993 in Southwest England, United Kingdom. The cohort includes over 14000 infants with due dates between April 1, 1991, and December 31, 1992, who were subsequently followed up into adulthood. Data were analyzed October 29, 2021, to March 11, 2024. Exposures: A novel linkage (completed in 2020) was performed to link high-resolution (100 m 2) estimates of nitrogen dioxide (NO 2), fine particulate matter under 2.5 μm (PM 2.5), and noise pollution to home addresses from pregnancy to 12 years of age. Main outcomes and measures: Psychotic experiences, depression, and anxiety were measured at ages 13, 18, and 24 years. Logistic regression models controlled for key individual-, family-, and area-level confounders. Results: This cohort study included 9065 participants who had any mental health data, of whom (with sample size varying by parameter) 51.4% (4657 of 9051) were female, 19.5% (1544 of 7910) reported psychotic experiences, 11.4% (947 of 8344) reported depression, and 9.7% (811 of 8398) reported anxiety. Mean (SD) age at follow-up was 24.5 (0.8) years. After covariate adjustment, IQR increases (0.72 μg/m 3) in PM 2.5 levels during pregnancy (adjusted odds ratio [AOR], 1.11 [95% CI, 1.04-1.19]; P =.002) and during childhood (AOR, 1.09 [95% CI, 1.00-1.10]; P =.04) were associated with elevated odds for psychotic experiences. Pregnancy PM 2.5 exposure was also associated with depression (AOR, 1.10 [95% CI, 1.02-1.18]; P =.01). Higher noise pollution exposure in childhood (AOR, 1.19 [95% CI, 1.03-1.38]; P =.02) and adolescence (AOR, 1.22 [95% CI, 1.02-1.45]; P =.03) was associated with elevated odds for anxiety. Conclusions and Relevance: In this longitudinal cohort study, early-life air and noise pollution exposure were prospectively associated with 3 common mental health problems from adolescence to young adulthood. There was a degree of specificity in terms of pollutant-timing-outcome associations. Interventions to reduce air and noise pollution exposure (eg, clean air zones) could potentially improve population mental health. Replication using quasi-experimental designs is now needed to shed further light on the underlying causes of these associations.</p