Pesticide Exposure and the Risk of Depression, Anxiety, and Suicide: A Meta-Analysis

Psychological distress, including anxiety, depression, and suicidality, may be influenced by environmental exposures such as pesticides. However, whether pesticide exposure is a significant risk factor for these mental health outcomes remains unclear.

We sought to systematically evaluate whether pesticide exposure is a risk factor for anxiety, depression, and suicide among agricultural populations.

We conducted a systematic search of PubMed, Web of Science, and Scopus through December 2024. Observational studies assessing the association between pesticide exposure and psychological distress outcomes were included. Separate meta-analyses were performed for studies with retrospective and prospective exposure assessments using random-effects models to calculate pooled odds ratios (ORs) or risk ratios (RRs). Subgroup analyses and meta-regression explored potential moderators. Publication bias and sensitivity analyses were conducted.

Twenty-one studies met the inclusion criteria. Among retrospective studies, pesticide exposure was associated with increased odds of psychological distress (pooled OR = 1.77; 95% confidence interval [CI]: 1.37-2.31). Among prospective studies, pesticide exposure was associated with increased risk (pooled RR = 1.99, 95% CI: 1.23-3.21). Subgroup analyses indicated stronger associations for depression compared to suicide. Meta-regression identified outcome type and sample size as significant moderators. Despite evidence of small-study effects, sensitivity analyses confirmed the robustness of the results.

This systematic review and meta-analysis support pesticide exposure as a potential risk factor for anxiety, depression, and suicide, underscoring the need for preventive strategies and further longitudinal research.PROSPERO Registration Number:CRD42024502004.