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Associations of combined exposures to surrounding green, air pollution and traffic noise on mental health

Environment international, 2019-08, Vol.129, p.525-537 [Peer Reviewed Journal]

2019 The Authors ;Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved. ;ISSN: 0160-4120 ;EISSN: 1873-6750 ;DOI: 10.1016/j.envint.2019.05.040 ;PMID: 31158598

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  • Title:
    Associations of combined exposures to surrounding green, air pollution and traffic noise on mental health
  • Author: Klompmaker, Jochem O. ; Hoek, Gerard ; Bloemsma, Lizan D. ; Wijga, Alet H. ; van den Brink, Carolien ; Brunekreef, Bert ; Lebret, Erik ; Gehring, Ulrike ; Janssen, Nicole A.H.
  • Subjects: Antidepressants ; Anxiolytics ; Hypnotics & sedatives ; Joint odds ratio ; NDVI ; NO2 ; PM2.5
  • Is Part Of: Environment international, 2019-08, Vol.129, p.525-537
  • Description: Evidence is emerging that poor mental health is associated with the environmental exposures of surrounding green, air pollution and traffic noise. Most studies have evaluated only associations of single exposures with poor mental health. To evaluate associations of combined exposure to surrounding green, air pollution and traffic noise with poor mental health. In this cross-sectional study, we linked data from a Dutch national health survey among 387,195 adults including questions about psychological distress, based on the Kessler 10 scale, to an external database on registered prescriptions of anxiolytics, hypnotics & sedatives and antidepressants. We added data on residential surrounding green in a 300 m and a 1000 m buffer based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), modeled annual average air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and modeled road- and rail-traffic noise (Lden and Lnight) to the survey. We used logistic regression to analyze associations of surrounding green, air pollution and traffic noise exposure with poor mental health. In single exposure models, surrounding green was inversely associated with poor mental health. Air pollution was positively associated with poor mental health. Road-traffic noise was only positively associated with prescription of anxiolytics, while rail-traffic noise was only positively associated with psychological distress. For prescription of anxiolytics, we found an odds ratio [OR] of 0.88 (95% CI: 0.85, 0.92) per interquartile range [IQR] increase in NDVI within 300 m, an OR of 1.14 (95% CI: 1.10, 1.19) per IQR increase in NO2 and an OR of 1.07 (95% CI: 1.03, 1.11) per IQR increase in road-traffic noise. In multi exposure analyses, associations with surrounding green and air pollution generally remained but attenuated. Joint odds ratios [JOR], based on the Cumulative Risk Index (CRI) method, of combined exposure to air pollution, traffic noise and decreased surrounding green were higher than the ORs of single exposure models. Associations of environmental exposures with poor mental health differed somewhat by age. Studies including only one of these three correlated exposures may overestimate the influence of poor mental health attributed to the studied exposure, while underestimating the influence of combined environmental exposures. •Surrounding green was inversely associated with poor mental health.•Air pollution and to a limited extent traffic noise were positively associated with poor mental health.•In multi exposure models, associations with surrounding green and air pollution attenuated, but remained significant.•The most consistent associations were observed with prescription of anxiolytics and prescription of hypnotics & sedatives.•Joint odds ratios of combined exposure were higher than the ORs of single exposure models.
  • Publisher: Netherlands: Elsevier Ltd
  • Language: English
  • Identifier: ISSN: 0160-4120
    EISSN: 1873-6750
    DOI: 10.1016/j.envint.2019.05.040
    PMID: 31158598
  • Source: Open Access: DOAJ Directory of Open Access Journals
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