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Toxic Tuesdays

Particulate Matter and Mental Health

Toxic Tuesdays

CHEJ highlights several toxic chemicals and the communities fighting to keep their citizens safe from harm.

Particulate Matter and Mental Health

Outdoor air pollution is one of the biggest environmental threats to public health, causing an estimated 4 million premature deaths worldwide each year. One common component of air pollution is particulate matter (PM), which is a mixture of dust, chemicals, and liquid droplets. PM is primarily released into the air by industrial facilities that perform mixing and combustion. When people inhale PM in the air, it gets into their lungs and bloodstream, worsening existing lung diseases and even causing lung disease, heart disease, and lung cancer. Very fine particulate matter less then 2.5 micrometers in diameter – called PM2.5 – is especially dangerous. It can penetrate deep into the lungs and bloodstream, eventually reaching many other organs. PM2.5 exposure can cause lung and heart diseases and is also associated with diabetes, cognitive impairment, and dementia. PM2.5 exposure also increases the chance of dying from COVID-19 infection.

While the effects of long-term PM2.5 exposure on physical health are well established, less is known about how it affects psychological and mental health. A recent study in the journal Environmental Health used mental health data from The Irish Longitudinal Study on Ageing (TILDA), a nationally-representative study of 8,504 adults age 50 and over in Ireland. Data on TILDA participants has been collected every 2 years since 2009 and includes many health and wellness factors. It also includes information about participants’ residential addresses throughout their lives. The study in Environmental Health matched TILDA participants’ reported residential addresses from 1998 to 2014 with the average annual PM2.5 concentration at those addresses. It then assessed how that average annual PM2.5 exposure was related to participants’ 2014 self-reported mental health indicators in the TILDA: depression, anxiety, worry, stress, and overall quality of life. The study controlled for demographic and socioeconomic factors like age, sex, marital status, employment status, education, and health status to better attribute differences in mental health to PM2.5 exposure.

The study found that higher PM2.5 exposure was strongly associated with higher risk of depression and anxiety. PM2.5 exposure was not associated with differences in worry, stress, or overall quality of life. The authors speculate that different aspects of mental health may be differentially impacted by factors such as length of exposure, age at exposure, and exposure to other pollutants. While the association between PM2.5 exposure and depression and anxiety is striking, it is important to note that the study is not designed to determine if PM2.5 exposure directly caused depression and anxiety.

Several studies in the past few years have suggested that short-term PM2.5 exposure is associated with mental health changes such as depression, anxiety, bipolar disorder, schizophrenia, and suicidality. However, this study is one of the few that has assessed the effects of long-term PM2.5 exposure, which is particularly relevant because most real-life exposure to PM2.5 tends to persist for long periods of time. It adds to a growing body of scientific evidence that environmental hazards are associated with decreased mental health and wellbeing.

This study is also an important advance because it demonstrates that exposure to low PM2.5 levels can still have harmful effects on health. The average annual PM2.5 exposure in this study was 7.67 μg/m3. In contrast, the national average PM2.5 level in the US is 8.4 μg/m3, and 90% of the world population live in areas with average annual PM2.5 levels above 10 μg/m3. (The EPA’s interactive air quality map that shows current PM pollution can be found here.)

The National Ambient Air Quality Standards has determined that the maximum safe concentration of PM2.5 in outdoor air to be 9 μg/m3. The results from this study suggest that this is not a health protective standard, and adverse mental health effects can occur at PM2.5 levels below this value. The World Health Organization’s global air quality guidelines recommend a maximum annual PM2.5 level of 5 μg/m3. This standard is more health protective, but this study demonstrates that long-term exposure to low levels of PM2.5 can still significantly impact health.

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Backyard Talk

Depression, A New Side Effect of Fracking — Pennsylvanians who live near fracking are more likely to be depressed

By: Sharon Franklin

July 29, 2018

Stress and depression are higher among those living closest to more and bigger wells.

People who live near unconventional natural gas operations such as fracking are more likely to experience depression, according to a new study, by Joan A. Casey, Holly C. Wilcox, Annemarie G. Hirsch, Jonathan Pollak and  Brian S. Schwartz  “Associations of unconventional natural gas development with depression symptoms and disordered sleep in Pennsylvania.”

Background:  The study is the first of its kind published in Scientific Reports.  The University of California at Berkeley and Johns Hopkins University Researched reviewed the rates of depression in nearly 5,000 adults living in southwestern Pennsylvania’s Marcellus shale region in 2015.

They found that people living near fracking-related operations are more likely to be depressed than the general population, and that stress and depression went up among people living closest to more and bigger natural gas wells. One of the study’s co-authors, Joan Casey stated “Previously we’ve looked at the links between unconventional natural gas development and things like asthma exacerbations, migraine headaches and fatigue. The next step was thinking about mental health, because we had a lot of anecdotal reports of sleep disturbances and psychosocial stress related to unconventional natural gas development.”

At the end of 2015, 9,669 wells had been drilled in Pennsylvania’s Marcellus shale.  By 2016, the region led the nation in shale gas production. There have been other small sample studies on the links between fracking and depression, however, this is the first to investigate a link between the two using a validated survey among a larger population. The researchers in this study compared data on the number of wells, the phase of extraction, and the volume of production in order to group residents into categories of “very low,” “low,” “medium,” and “high” levels of exposure to fracking operations.  To assess the severity of depression symptoms, the researchers utilized a patient health questionnaire that included questions such as, “How often have you been bothered by feeling down, depressed, hopeless?

The study’s results: Dr. Casey noted that the greatest increases in rates of depression occurred among people with mild to moderate symptoms living near high-volume fracking operations.  She states “People in the highest group of exposure were 1.5 times more likely to have mild depression symptoms than those in very low exposure group.

Casey added, “Based on our observations, it seems like living near unconventional natural gas development may not cause an increase in diagnoses of severe major depressive disorders but might exacerbate symptoms in those with mild or moderate depression and create some depression and stress in otherwise healthy people.”

The researchers minimized over reporting by not informing the subjects that the study was related to fracking.

While that strengthened the study’s results, Casey pointed out that it also limited their ability to examine the causes of depression in those living near fracking operations.“Some people in these communities might have positive associations with natural gas extraction… Maybe they’re leasing their land and getting economic benefits, so it’s actually lessening their symptoms, while others may only be getting exposures and have concerns about its health impacts, which could be worsening their symptoms.”

Additionally, the researchers reviewed electronic health records to determine whether there was an increase in physician-diagnosed sleep disorders or prescriptions for sleep aids in the region but did not observe an increase in those instances associated with proximity to fracking operations.

Unanswered Questions
The study addressed whether exposure to the chemicals being released into the environment could play a role in the increase of depression symptoms among those living near unconventional natural gas operations.

Casey said “I think we’ve probably now done enough epidemiological studies showing the links between unconventional natural gas extraction and health.”

  1.  “The next step will be to tease apart what our exposure pathways are.”
  2.  “Is this being caused by air pollution and volatile organic compounds?”
  3.  “Is it more about perception and psychosocial stressors than actual exposure?”

Casey concluded that they don’t know the answers to these questions, and to be able to move forward, they will have to start unraveling those mysteries.

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