Long-term exposure to ambient air pollutants and mental health status: A nationwide population-based cross-sectional study

There is a suspected but unproven association between long-term exposure to ambient air pollution and mental health. The aim of this study is to investigate the association between long-term exposure to ambient air pollution and subjective stress, depressive disorders, health-related quality of life (QoL) and suicide. We selected 124,205 adults from the Korean Community Health Survey in 2013 who were at least 19 years old and who had lived in their current domiciles for > five years. Based on the computer-assisted personal interviews to measure subjective stress in daily life, EuroQoL-5 dimensions, depression diagnosis by a doctor, suicidal ideation, and suicidal attempts, we evaluated the risk of mental disorders using multiple logistic regression analysis according to the quartiles of air pollutants, such as particulate matter <10μm (PM(10)), nitrogen dioxide (NO(2)), carbon monoxide (CO), and sulfur dioxide, using yearly average concentration between August 2012 and July 2013. The prevalence of high stress, poor QoL, depressiveness, diagnosis of depression, and suicide ideation was positively associated with high concentrations of PM(10), NO(2), and CO after adjusting for confounding factors. Men were at increased risk of stress, poor QoL, and depressiveness from air pollution exposure than were women. The risk of higher stress or poor QoL in subjects < age 65 increased with air pollution more than did that in subjects ≥ age 65. Long-term exposure to ambient air pollution may be an independent risk factor for mental health disorders ranging from subjective stress to suicide ideation.