Self-rated stress, distress, mental health, and health as modifiers of the association between long-term exposure to ambient pollutants and mortality

Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved..

BACKGROUND: Individual and neighbourhood-scale socioeconomic characteristics modify associations between exposure to air pollution and mortality. The role of stress, which may integrate effects of social and environmental exposures on health, is unknown. We examined whether an individual's perspective on their own well-being, as assessed using self-rated measures of stress and health, modifies the pollutant-mortality relationship.

METHODS: The Canadian Community Health Survey (CCHS)-mortality cohort includes respondents from surveys administered between 2001 and 2012 linked to vital statistics and postal codes from 1981 until 2016. Annual fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) exposure estimates were attached to a sample of cohort members aged 30-89 years (n = 398,300 respondents/3,848,400 person-years). We examined whether self-rated stress, distress, mental health, and general health modified associations between long-term exposure to each pollutant (three-year moving average with one-year lag) and non-accidental mortality using Cox survival models, adjusted for individual- (i.e. socioeconomic and behavioural) and neighbourhood-scale covariates.

RESULTS: In fully-adjusted models, the relationship between exposure to pollutants and mortality was stronger among those with poor self-rated mental health, including a significant difference for NO2 (hazard ratio (HR) = 1.15, 95% CI 1.06-1.25 per IQR) compared to those with very good/excellent mental health (HR = 1.05, 95% CI 1.01-1.08; Cochran's Q = 4.01; p < 0.05). Poor self-rated health was similarly associated with higher pollutant-associated HRs, but only in unadjusted models. Stress and distress did not modify pollutant-mortality associations.

CONCLUSIONS: Poor self-rated mental and general health were associated with increased mortality attributed to exposure to ambient pollutants.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:191

Enthalten in:

Environmental research - 191(2020) vom: 05. Dez., Seite 109973

Sprache:

Englisch

Beteiligte Personen:

Thomson, Errol M [VerfasserIn]
Christidis, Tanya [VerfasserIn]
Pinault, Lauren [VerfasserIn]
Tjepkema, Michael [VerfasserIn]
Colman, Ian [VerfasserIn]
Crouse, Daniel L [VerfasserIn]
van Donkelaar, Aaron [VerfasserIn]
Martin, Randall V [VerfasserIn]
Hystad, Perry [VerfasserIn]
Robichaud, Alain [VerfasserIn]
Ménard, Richard [VerfasserIn]
Brook, Jeffrey R [VerfasserIn]
Burnett, Richard T [VerfasserIn]

Links:

Volltext

Themen:

66H7ZZK23N
Air Pollutants
Air pollution
Distress
Environmental Pollutants
Health
Journal Article
Mortality
Nitrogen Dioxide
Ozone
Particulate Matter
Research Support, Non-U.S. Gov't
S7G510RUBH
Stress

Anmerkungen:

Date Completed 11.01.2021

Date Revised 11.01.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.envres.2020.109973

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM313845212