A Community-Based Cross-Sectional Study of Indoor Air Pollution and Its Mental Health Implications Among Rural Households

Sreedhara Aditya Sarma; Pradeep TS

doi:10.55489/njcm.160820255498

Authors

Sreedhara Aditya Sarma Department of Community Medicine, Sri Devaraj Urs Medical college, SDUAHER, Kolar, Karnataka, India
Pradeep TS Department of Community Medicine, Sri Devaraj Urs Medical college, SDUAHER, Kolar, Karnataka, India

DOI:

https://doi.org/10.55489/njcm.160820255498

Keywords:

Mental health, Anxiety , Depression , Rural households, Indoor Air quality

Abstract

Introduction: Emerging research indicates that air pollution can affect the central nervous system through various pathways, leading to inflammation and oxidative stress. This process leads to neurotoxicity and raises the risk of neurodevelopmental and neurodegenerative disorders, as well as anxiety and depression.

Materials and methods: The present study is a cross-sectional study conducted over two years, involving rural households that use solid fuels. Air quality was measured using high-quality instruments. Mental health statuses such as anxiety and depression among residents of these households were assessed using standardized tools. The chi-square test was applied to examine associations, with a p-value less than 0.05 considered statistically significant.

Results: Out of 812 residents, the majority belonged to the 31 to 40 years age group, male gender, a nuclear family, and the upper middle class of Modified BG Prasad Classification 2023. 25.6% had marked to severe anxiety, and 23.2% had mild depression. The AQI of rural households revealed that 192 (23.6%) were of poor standards as per the National guidelines. Anxiety and depression mental health status had a statistically significant association with AQI.

Conclusion: The present study adds to the small but growing evidence indicating that exposure to indoor air pollution can be associated with mental health issues like Anxiety and Depression.

References

Leung DY. Outdoor-indoor air pollution in urban environment: challenges and opportunities. Frontiers in Environmental Science. 2015 Jan 15;2:69. DOI: https://doi.org/10.3389/fenvs.2014.00069

Rosário Filho NA, Urrutia-Pereira M, D'Amato G, Cecchi L, Ansotegui IJ, Galán C, Pomés A, Murrieta-Aguttes M, Caraballo L, Rouadi P, Chong-Neto HJ, Peden DB. Air pollution and indoor settings. World Allergy Organ J. 2021 Jan 7;14(1):100499. DOI: https://doi.org/10.1016/j.waojou.2020.100499 PMid:33510831 PMCid:PMC7806792

Kankaria A, Nongkynrih B, Gupta SK. Indoor air pollution in India: implications on health and its control. Indian J Community Med. 2014 Oct;39(4):203-7. DOI: https://doi.org/10.4103/0970-0218.143019 PMid:25364142 PMCid:PMC4215499

Mushtaq B, Bandh SA, Shafi S. Air pollution and its abatement. Environmental Management: Environmental Issues, Awareness and Abatement. Singapore: Springer; 2020:47-93. DOI: https://doi.org/10.1007/978-981-15-3813-1_2

Amegah AK, Jaakkola JJ. Household air pollution and the sustainable development goals. Bull World Health Organ. 2016 Mar 1;94(3):215-21. DOI: https://doi.org/10.2471/BLT.15.155812 PMid:26966333 PMCid:PMC4773927

Antonsen S, Mok PLH, Webb RT, Mortensen PB, McGrath JJ, Agerbo E, Brandt J, Geels C, Christensen JH, Pedersen CB. Exposure to air pollution during childhood and risk of developing schizophrenia: a national cohort study. Lancet Planet Health. 2020 Feb;4(2):e64-e73. DOI: https://doi.org/10.1016/S2542-5196(20)30004-8 PMid:32112749

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5™. 5th ed. Arlington (VA): American Psychiatric Publishing; 2013. Available from: https://doi.org/10.1176/appi.books.9780890425596

Borroni E, Pesatori AC, Bollati V, Buoli M, Carugno M. Air pollution exposure and depression: A comprehensive updated systematic review and meta-analysis. Environ Pollut. 2022 Jan 1;292(Pt A):118245. DOI: https://doi.org/10.1016/j.envpol.2021.118245 PMid:34600062

Wang KC, Lo YC, Liao CC, Jou YY, Huang HB. Associations Between Symptoms of Depression and Air Pollutant Exposure Among Older Adults: Results From the Taiwan Longitudinal Study on Aging (TLSA). Front Public Health. 2022 Jan 12;9:779192. DOI: https://doi.org/10.3389/fpubh.2021.779192 PMid:35096739 PMCid:PMC8790292

Emetere ME, Olaniyan IE, Fadiji JO, Olaogun KA, Adeniji NO, Deji-Jinadu BB, Olapade OT. Indoor Air Pollution: A Review on the Challenges in Third World Countries. Air, Soil and Water Research. 2024 Mar;17:11786221241239891. DOI: https://doi.org/10.1177/11786221241239891

Maharana SP, Paul B, Garg S, DasguptaA, Bandyopadhyay L. Exposure to indoor air pollution and its perceived impact on health of women and their children: A household survey in a slum of Kolkata, India. Indian J Public Health 2018;62(3):182-187. DOI: https://doi.org/10.4103/ijph.IJPH_259_18 PMid:30232966

Zung WWK. Zung self-rating depression scale and depression status inventory. In Assessment of depression 1986 (pp. 221-231). Springer, Berlin, Heidelberg. DOI: https://doi.org/10.1007/978-3-642-70486-4_21

Dunstan DA, Scott N. Norms for Zung's self-rating anxiety scale. BMC Psychiatry. 2020 Dec;20(1):90. DOI: https://doi.org/10.1186/s12888-019-2427-6 PMid:32111187 PMCid:PMC7048044

Mahantshetti S, Singh J, Dhandapani S. Updated Modified BG Prasad Classification for October 2023. Natl J Community Med. 2024 Jan 1;15(01):89-90. DOI: https://doi.org/10.55489/njcm.150120243515

Central Pollution Control Board [Internet]. [cited 2024 May 10]. Available from: https://cpcb.nic.in/National-Air-Quality-Index/

Barron H, Hafizi S, Andreazza AC, Mizrahi R. Neuroinflammation and Oxidative Stress in Psychosis and Psychosis Risk. Int J Mol Sci. 2017 Mar 17;18(3):651. DOI: https://doi.org/10.3390/ijms18030651 PMid:28304340 PMCid:PMC5372663

Thomson EM. Air Pollution, Stress, and Allostatic Load: Linking Systemic and Central Nervous System Impacts. J Alzheimers Dis. 2019;69(3):597-614. DOI: https://doi.org/10.3233/JAD-190015 PMid:31127781 PMCid:PMC6598002

Zorn JV, Schür RR, Boks MP, Kahn RS, Joëls M, Vinkers CH. Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis. Psychoneuroendocrinology. 2017;77:25-36. DOI: https://doi.org/10.1016/j.psyneuen.2016.11.036 PMid:28012291

Di Domenico M, Benevenuto SGM, Tomasini PP, Yariwake VY, de Oliveira Alves N, Rahmeier FL, da Cruz Fernandes M, Moura DJ, Nascimento Saldiva PH, Veras MM. Concentrated ambient fine particulate matter (PM2.5) exposure induce brain damage in pre and postnatal exposed mice. Neurotoxicology. 2020 Jul;79:127-141. DOI: https://doi.org/10.1016/j.neuro.2020.05.004 PMid:32450181

Li H, Cai J, Chen R, Zhao Z, Ying Z, Wang L, Chen J, Hao K, Kinney PL, Chen H, Kan H. Particulate Matter Exposure and Stress Hormone Levels: A Randomized, Double-Blind, Crossover Trial of Air Purification. Circulation. 2017 Aug 15;136(7):618-627. DOI: https://doi.org/10.1161/CIRCULATIONAHA.116.026796. Erratum in: Circulation. 2017 Sep 12;136(11):e199. DOI: https://doi.org/10.1161/CIR.0000000000000533. PMID: 28808144.

Vert C, Sánchez-Benavides G, Martínez D, Gotsens X, Gramunt N, Cirach M, Molinuevo JL, Sunyer J, Nieuwenhuijsen MJ, Crous-Bou M, Gascon M. Effect of long-term exposure to air pollution on anxiety and depression in adults: A cross-sectional study. Int J Hyg Environ Health. 2017 Aug;220(6):1074-1080. DOI: https://doi.org/10.1016/j.ijheh.2017.06.009 PMid:28705430

Riva A, Rebecchi A, Capolongo S, Gola M. Can Homes Affect Well-Being? A Scoping Review among Housing Conditions, Indoor Environmental Quality, and Mental Health Outcomes. Int J Environ Res Public Health. 2022 Nov 30;19(23):15975. DOI: https://doi.org/10.3390/ijerph192315975 PMid:36498051 PMCid:PMC9736414

Braithwaite I, Zhang S, Kirkbride JB, Osborn DPJ, Hayes JF. Air Pollution (Particulate Matter) Exposure and Associations with Depression, Anxiety, Bipolar, Psychosis and Suicide Risk: A Systematic Review and Meta-Analysis. Environ Health Perspect. 2019 Dec;127(12):126002. DOI: https://doi.org/10.1289/EHP4595 PMid:31850801 PMCid:PMC6957283

Xie T, Yuan Y, Zhang H. Information, awareness, and mental health: Evidence from air pollution disclosure in China. Journal of Environmental Economics and Management. 2023 Jul 1;120:102827. DOI: https://doi.org/10.1016/j.jeem.2023.102827

Fan SJ, Heinrich J, Bloom MS, Zhao TY, Shi TX, Feng WR, Sun Y, Shen JC, Yang ZC, Yang BY, Dong GH. Ambient air pollution and depression: A systematic review with meta-analysis up to 2019. Sci Total Environ. 2020 Jan 20;701:134721. DOI: https://doi.org/10.1016/j.scitotenv.2019.134721 PMid:31715478

Buoli M, Grassi S, Caldiroli A, Carnevali GS, Mucci F, Iodice S, Cantone L, Pergoli L, Bollati V. Is there a link between air pollution and mental disorders? Environ Int. 2018 Sep;118:154-168. DOI: https://doi.org/10.1016/j.envint.2018.05.044 PMid:29883762

Ao, C., Dong, Y., & Kuo, P. F. Industrialization, indoor and ambient air quality, and elderly mental health. China Economic Review. 2021;69:101676. DOI: https://doi.org/10.1016/j.chieco.2021.101676

Khan A, Plana-Ripoll O, Antonsen S, Brandt J, Geels C, Landecker H, Sullivan PF, Pedersen CB, Rzhetsky A. Environmental pollution is associated with increased risk of psychiatric disorders in the US and Denmark. PLoS Biol. 2019 Aug 20;17(8):e3000353. DOI: https://doi.org/10.1371/journal.pbio.3000353. Erratum in: PLoS Biol. 2019 Oct 2;17(10):e3000513. DOI: https://doi.org/10.1371/journal.pbio.3000513. PMid:31430271 PMCid:PMC6701746

Laurent JGC, MacNaughton P, Jones E, Young AS, Bliss M, Flanigan S, Vallarino J, Chen LJ, Cao X, Allen JG. Associations between Acute Exposures to PM2.5 and Carbon Dioxide Indoors and Cognitive Function in Office Workers: A Multicountry Longitudinal Prospective Observational Study. Environ Res Lett. 2021 Sep;16(9):094047. DOI: https://doi.org/10.1088/1748-9326/ac1bd8 PMid:35330988 PMCid:PMC8942432

Radua J, De Prisco M, Oliva V, Fico G, Vieta E, Fusar-Poli P. Impact of air pollution and climate change on mental health outcomes: an umbrella review of global evidence. World Psychiatry. 2024 Jun;23(2):244-256. DOI: https://doi.org/10.1002/wps.21219 PMid:38727076 PMCid:PMC11083864

Lin LZ, Zhan XL, Jin CY, Liang JH, Jing J, Dong GH. The epidemiological evidence linking exposure to ambient particulate matter with neurodevelopmental disorders: A systematic review and meta-analysis. Environ Res. 2022 Jun;209:112876. DOI: https://doi.org/10.1016/j.envres.2022.112876 PMid:35134379

Wang R, Ye C, Huang X, Halimulati M, Sun M, Ma Y, Fan R, Zhang Z. cMIND Diet, Indoor Air Pollution, and Depression: A Cohort Study Based on the CLHLS from 2011 to 2018. Nutrients. 2023 Feb 27;15(5):1203. DOI: https://doi.org/10.3390/nu15051203 PMid:36904202 PMCid:PMC10005708

Lian X, Wan X, Si F, Guo J, Tang Z, Wang Y, Xie S, Li J. The association between air pollutants and depression in children and adolescents: a systematic review. Environ. Res. Commun. 2023;5:102002. DOI: https://doi.org/10.1088/2515-7620/ad00a6

Manczak EM, Miller JG, Gotlib IH. Census tract ambient ozone predicts trajectories of depressive symptoms in adolescents. Dev Psychol. 2022 Mar;58(3):485-492. DOI: https://doi.org/10.1037/dev0001310 PMid:35286107