TY - JOUR
T1 - Causal effects of air pollution on mental health among Adults——An exploration of susceptible populations and the role of physical activity based on a longitudinal nationwide cohort in China
AU - Ju, Ke
AU - Lu, Liyong
AU - Wang, Wen
AU - Chen, Ting
AU - Yang, Chenyu
AU - Zhang, En
AU - Xu, Zongyou
AU - Li, Shanshan
AU - Song, Jiangning
AU - Pan, Jay
AU - Guo, Yuming
N1 - Funding Information:
KJ was supported by China Scholarship Council [grant number 202006240087 ] ( https://www.csc.edu.cn/chuguo/s/1267 ). JP was supported by National Natural Science Foundation of China [grant number 71874116 and 72074163 ], Sichuan Science and Technology and Technology Program [grant number [ 2022YFS0052 , 2021YFQ0060 ], and Chongqing Science and Technology Bureau [grant number cstc2020jscx-cylhX0001 ]. The funding bodies did not play any role in the study design, data collection, data analyses, results interpretation, writing, and submission of this manuscript.
Funding Information:
The participants of this study were drawn from the Chinese Family Panel Study (CFPS) funded by Peking University and the National Natural Science Foundation of China. Previous studies have described the CFPS in detail (Xie and Hu, 2014). Briefly, this survey began with formal interviews in 2010 and used a stratified multistage probability strategy to draw a representative sample of the Chinese population covering 25 provinces/autonomous regions/municipalities. A 3-year-long balanced panel (N = 43,888) of participants aged between 18 and 65 years who were interviewed in 2014 and 2016 were selected for this study, and their characteristics were recorded. We compared the characteristics of the survey sample participating in this study with the characteristics of the full 2014 survey respondents in Fig. S1. The comparison showed no significant difference between the results of the two populations, and the study population of this study is a representative sample of Chinese adults. We also present the specific flowchart of the analysis in Fig. S4.KJ was supported by China Scholarship Council [grant number 202006240087] (https://www.csc.edu.cn/chuguo/s/1267). JP was supported by National Natural Science Foundation of China [grant number 71874116 and 72074163], Sichuan Science and Technology and Technology Program [grant number [2022YFS0052, 2021YFQ0060], and Chongqing Science and Technology Bureau [grant number cstc2020jscx-cylhX0001]. The funding bodies did not play any role in the study design, data collection, data analyses, results interpretation, writing, and submission of this manuscript.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/1/15
Y1 - 2023/1/15
N2 - Long-term exposure to air pollutants is likely to be associated with mental disorders, but relevant studies remain limited and inconsistent, and evidence to assess causality is particularly lacking, especially in developing countries. In addition, there are few studies on the role of physical activity in this relationship. We investigated the causal relationship between air pollutant exposure and mental health among Chinese adults and whether physical activity could play a positive role in this relationship. Using the balanced panel data for 2014 and 2016 from the China Family Panel Study, a representative Chinese national cohort study, we selected and validated appropriate instrumental variable to explore the causal relationship between air pollution and mental health and explored the moderating effect of physical activity using an instrumental variable fixed effects model (IVFE) in a counterfactual causal inference framework. PM2.5 and ground surface ozone were selected as proxies for different types of air pollutants and extended the interpretability by studying them for populations with different characteristics. A total of 21,944 participants were included in this study. In the IVFE model, we found that both PM2.5 and ground surface ozone significantly negatively affected mental health, and that habitual physical activity counteracted this negative effect regardless of different types of air pollution. We also found that the findings held for adults with different characteristics. The findings suggest that habitual physical activity may offset the deterioration of mental health in adults in developing countries due to air pollution, regardless of age, gender, income, and the presence of chronic diseases.
AB - Long-term exposure to air pollutants is likely to be associated with mental disorders, but relevant studies remain limited and inconsistent, and evidence to assess causality is particularly lacking, especially in developing countries. In addition, there are few studies on the role of physical activity in this relationship. We investigated the causal relationship between air pollutant exposure and mental health among Chinese adults and whether physical activity could play a positive role in this relationship. Using the balanced panel data for 2014 and 2016 from the China Family Panel Study, a representative Chinese national cohort study, we selected and validated appropriate instrumental variable to explore the causal relationship between air pollution and mental health and explored the moderating effect of physical activity using an instrumental variable fixed effects model (IVFE) in a counterfactual causal inference framework. PM2.5 and ground surface ozone were selected as proxies for different types of air pollutants and extended the interpretability by studying them for populations with different characteristics. A total of 21,944 participants were included in this study. In the IVFE model, we found that both PM2.5 and ground surface ozone significantly negatively affected mental health, and that habitual physical activity counteracted this negative effect regardless of different types of air pollution. We also found that the findings held for adults with different characteristics. The findings suggest that habitual physical activity may offset the deterioration of mental health in adults in developing countries due to air pollution, regardless of age, gender, income, and the presence of chronic diseases.
KW - Causal relationship
KW - China
KW - Ground surface ozone
KW - Mental health
KW - Physical activity
KW - PM
UR - http://www.scopus.com/inward/record.url?scp=85143525247&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2022.114761
DO - 10.1016/j.envres.2022.114761
M3 - Article
C2 - 36372147
AN - SCOPUS:85143525247
SN - 0013-9351
VL - 217
JO - Environmental Research
JF - Environmental Research
M1 - 114761
ER -