Air pollution and mental health in adolescents: a cross-sectional study in Sichuan, China

Anxiety and depression are the most common mental health issues among adolescents, and the impact of air pollution on mental health is gaining increasing attention. This study aims to investigate the association between air pollutant exposure and the risks of anxiety and depression among adolescent students in Sichuan Province, China.

This study used cross-sectional data from 71,364 school students aged 10 to 19 in Sichuan Province, China, collected during two winter periods: December 2022 to March 2023 and December 2023 to March 2024. PHQ-9 and GAD-7 assessed anxiety/depression (scores ≥ 5); pollution (PM₁₀, PM_2.5, O₃, CO, SO₂, NO₂) and weather data via IP informed weighted combined pollution score for exposure. Logistic regression and mixed-effects linear models were employed to evaluate the associations, adjusting for demographic, lifestyle, family-related, and meteorological factors.

Both PM₁₀ and O₃ showed robust positive associations with mental health risks. In the fully adjusted model (Model 4), each interquartile range (IQR) increase in PM₁₀ and O₃ was associated with increased risks of anxiety (OR: 1.29, 95% CI: 1.22-1.36 for PM₁₀; OR: 1.24, 95% CI: 1.19-1.29 for O₃) and depression. Mixed-effects models confirmed that O₃ significantly increased scale scores. Quantile analysis of the weighted combined pollution score revealed a stepwise increase in risk, highlighting the significant impact of exposure to high pollution levels. Conversely, PM_2.5 and SO₂ showed inverse associations in this specific context.

Exposure to high levels of PM₁₀ and O₃ is significantly associated with increased risks of anxiety and depression in adolescents, emphasizing the need for public health measures like air quality monitoring and pollution control policies.