[Association between atmospheric ozone exposure and adolescent depression in Inner Mongolia Autonomous Region]

Objective: To explore the relationship between long-term exposure to atmospheric ozone (O₃) and adolescent depressive mood, and provide baseline data for the prevention of depression in adolescents and mental health interventions in schools. Methods: Daily environmental pollutant and meteorological data were collected from Inner Mongolia Autonomous Region between 2023 and 2024. A total of 83 601 adolescents from 12 leagues (103 banners/counties/districts) in the region were selected by using stratified random cluster sampling. Depressive symptoms were measured by using the Center for Epidemiologic Studies Depression Scale. A multivariate logistic regression analysis model was used to evaluate the association between O₃ exposure and the prevalence of depression. Results: A total of 83 601 adolescents were surveyed, with a depression detection rate of 18.4% (15 356 individuals). There was a significant association between long-term O₃ exposure and the risk for depression in adolescents. The annual average concentration of O₃ one year prior to the survey showed the greatest effect, with every 10 μg/m³ increase in O₃ exposure associated with a 15% rise in depression risk (OR=1.15, 95%CI:1.10-1.21). Stratified analysis revealed that the following subgroups had significant higher risks for depression:girls (OR=1.36, 95%CI:1.25-1.49), junior high school students (OR=1.39, 95%CI:1.27-1.52), those whose mother's had educational attainment at and above university or college level (OR=1.35, 95%CI:1.15-1.58), and those whose father had educational attainment at or below the primary school level (OR=1.41, 95%CI:1.21-1.65), non-only children (OR=1.28, 95%CI:1.18-1.39), those with parents suffering from chronic diseases (OR=1.26, 95%CI:1.13-1.41), students without personal health conditions (OR=1.27, 95%CI:1.17-1.36), those who had experienced harm (OR=1.42, 95%CI:1.15-1.75), those satisfied with life (OR=1.37, 95%CI:1.20-1.57), participants reporting moderate stress (OR=1.35, 95%CI:1.21-1.50), individuals with daily internet use exceeding 4 hours (OR=1.26, 95%CI:1.06-1.49), members of large families (OR=1.47, 95%CI:1.24-1.74), and residents of the eastern region (OR=1.67, 95%CI:1.50-1.86). The results of the sensitivity analysis model remained relatively stable, indicating that O₃ has an independent effect on the risk of depression onset. Conclusion: There is a statistically significant association between long-term O₃ exposure and the risk of depression in adolescents, which warrants more attention.