Meta-analysis of risk of depression and suicide associated with ambient particulate matter

【摘要】：Objectives A few recent studies reported examined the effect of ambient particulate matter(PM) pollution on depression and suicide,however,the results have been inconclusive.To our knowledge,no systematic reviews or meta-analyses have been conducted to investigate the association.We performed a systematic review and meta-analysis to quantify the overall relationship between PM exposure and depression/suicide.Methods We identified related publications by systematically searching PubMed,Medline,EMBASE,Ovid,and Web of science as of March 13,2018.Odds ratios(ORs) of eligible studies were extracted and pooled using a fix-effects or random-effects model.We pooled the various estimates across different lag patterns and specific lag times,and performed quality assessment,subgroup and sensitivity analyses according to study and participant characteristics.Results Fourteen articles(7 for depression and 7 for suicide) with data from684,859 participants(429,678 for depression studies and 255,181 for suicide) were included in the meta-analysis.For an increase of 10 μg/m~3 in PM_(2.5),we found a 19%[OR(95%CI),1.19(1.07,1.33),P for heterogeneity .001]increased risk of depression and a marginally increased risk of suicide[OR(95%CI),1.05(0.99,1.11),P for heterogeneity .001]in the general population.We didn't observe any significant associations between increasing exposure to PM10 and depression/suicide.Sensitivity and subgroup analyses suggested the robustness of results.The strongest estimated effect of depression associated with PM_(2.5) appeared in long-term lag pattern[OR(95%CI),1.25(1.07,1.45),P.01]and cumulative lag pattern[OR(95%CI),1.26(1.07,1.48),P.01].Conclusions The meta-analysis suggested that an increase in ambient PM_(2.5)concentration is strongly associated with increased depression risk in the general population,and the association appeared stronger at long-term lag and cumulative lag,suggesting a potential cumulative exposure effect over time.