title: The Association Between Air Pollution and Onset of Depression Among Middle-Aged and Older Women.
abstract: Despite recently reported associations between air pollution and acute psychiatric outcomes, the association with depression onset has not, to our knowledge, been previously examined. We conducted a prospective cohort study among 41,844 women in the Nurses' Health Study, in the United States. The women had an average age of 66.6 (standard deviation, 7.6) years, were depression-free in 1996, and were followed through 2008. May-September ozone exposures were predicted by interpolating concentrations from the 5 nearest monitors. One-, 2-, and 5-year average concentrations of particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) were predicted at each participant's residence using a spatiotemporal model. We defined depression as report of doctor's diagnosis or use of antidepressant medication. We estimated adjusted hazard ratios with time-varying Cox models. Hazard ratios for both pollutants were elevated (per 10-parts-per-billion increase in ozone, hazard ratio (HR) = 1.06; 95% confidence interval (CI): 1.00, 1.12; per 10-μg/m3 increase in 1-year PM2.5, HR = 1.08; 95% CI: 0.97, 1.20). Associations were stronger when only antidepressant use was used to define cases (for ozone, HR = 1.08; 95% CI: 1.02, 1.14; for PM2.5, HR = 1.12; 95% CI: 1.00, 1.25). To our knowledge, these results represent the first identification of a possible association between both long-term ozone and PM2.5 exposure and depression onset. Although the stronger association specifically with antidepressant use may reflect that this endpoint better captures the onset time and milder cases, our findings should be interpreted with caution.
authors.forename: Marianthi-Anna
authors.initials: MA
authors.lastname: Kioumourtzoglou
authors.forename: Melinda C
authors.initials: MC
authors.lastname: Power
authors.forename: Jaime E
authors.initials: JE
authors.lastname: Hart
authors.forename: Olivia I
authors.initials: OI
authors.lastname: Okereke
authors.forename: Brent A
authors.initials: BA
authors.lastname: Coull
authors.forename: Francine
authors.initials: F
authors.lastname: Laden
authors.forename: Marc G
authors.initials: MG
authors.lastname: Weisskopf
mesh_terms: D017668:Age of Onset; D000368:Aged; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis*; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology*; D004032:Diet; D004781:Environmental Exposure / Q000032:analysis*; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D010126:Ozone / Q000032:analysis; D052638:Particulate Matter / Q000032:analysis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States; D016387:Women's Health
chemical_list: D000393:Air Pollutants; D000928:Antidepressive Agents; D052638:Particulate Matter; D010126:Ozone
keywords: Nurses’ Health Study; air pollution; depression onset; ozone; particulate matter