Prospective Study of Air Pollution and Psychiatric Disorders

描述（由申请人提供）：我们的主要目标是评估长期暴露于空气污染与老年妇女精神疾病（特别是抑郁和焦虑）之间的关系。抑郁症和焦虑症等精神疾病给公共卫生造成了巨大的负担。据估计，四分之一的人在一生中会经历焦虑症，使这种疾病成为美国最常见的精神疾病。2000年，抑郁症在导致残疾生活年数的原因中排名第一，在导致残疾调整生命年数损失的所有原因中排名第四。因此，更好地了解这些疾病中可改变的风险因素的作用可能会带来巨大的健康和相关的经济效益。一些证据表明，空气污染和精神疾病之间可能存在关联。特别是，空气污染对心血管的影响已经得到充分证实，而且有证据表明，老年人的抑郁症可能有很强的心血管病因。我们建议在护士健康研究（NHS）中进行一项研究，这是一项大型前瞻性女性队列研究（自1976年以来跟踪了121,700名女性注册护士）。在这个队列中，我们使用完善的、有效的量表（心理健康指数5项量表[MHI-5]和Crown-Crisp指数[CCI]）来评估抑郁和焦虑。此外，我们还估算了暴露于胸部（PM10）和细颗粒物（PM2.5）空气污染、交通相关的空气污染（主要是超细颗粒物或纳米颗粒）以及空气污染的气态成分，如SO2、NO2、CO和臭氧（O3）。因此，我们在一个非常大的，美国范围的老年妇女队列中有相关数据，可以解决长期暴露于空气污染与精神疾病有关的新假设。

DESCRIPTION (provided by applicant): Our principle objective is to assess the association between long-term exposures to air pollution and psychiatric disorders-specifically depression and anxiety-in older women. The public health burden of psychiatric disorders like depression and anxiety is tremendous. An estimated 1 in 4 individuals will experience an anxiety disorder during the lifetime making such disorders the most common psychiatric disorders in the United States. In 2000, depression ranked number one in terms of causes of Years Lived with Disability and ranked fourth among all causes of disability adjusted life years (DALYs) lost. Thus, improved understanding of the role of a modifiable risk factor for these conditions could have great health, and associated financial, benefits. Several lines of evidence suggest the likelihood of an association between air pollution and psychiatric disorders. In particular, there are well established cardiovascular effects of air pollution, and there is evidence that depression in the elderly may have a strong cardiovascular etiology. We propose a study within the Nurses' Health Study (NHS), a large prospective cohort of women (121,700 female registered nurses followed since 1976). In this cohort, we have assessed depression and anxiety using well- established, validated scales (the Mental Health Index 5-item scale [MHI-5] and the Crown-Crisp index [CCI]). In addition, we have estimates of exposures to thoracic (PM10) and fine (PM2.5) particulate air pollution, traffic-related air pollution (largely ultrafine particulates-or nanoparticles), as well as gaseous components of air pollution such as SO2, NO2, CO, and ozone (O3). Thus, we have relevant data within a very large, US-wide cohort of elderly women with which to address the novel hypothesis that long-term exposure to air pollution is related to psychiatric disorders. PUBLIC HEALTH RELEVANCE: The principal goal of this proposal is to determine whether long-term exposure to different aspects of air pollution are risk factors for depression and anxiety among elderly women throughout the US-a possible association suggested by several lines of evidence, but heretofore unexplored. We will take advantage of validated psychiatric health questionnaire data collected as part of the Nurses Health Study and state of the art Geographic Information Systems (GIS)-based spatio-temporal models of individual exposures to particulate matter, traffic related particles, and gaseous air contaminants to explore this question. This work could open new avenues of research into a generally under-explored field-the possibility that environmental contaminants may contribute to psychiatric disturbances-and suggest possible modifiable risk factors for these conditions that have tremendous public health impact.