大气臭氧长期暴露与中老年人群抑郁的关联

  目的  探究大气臭氧(ozone, O₃)长期暴露与我国中老年人群抑郁的关联，为预防和干预抑郁提供科学指导。  方法  在我国大气污染防治重点区域中选择16个省、自治区、直辖市的45个县、区作为研究现场，按照严格的调查社区选择原则和调查对象纳入标准进行随机抽样，选择8 584名40~＜90岁中老年人作为研究对象。采用统一编制的调查问卷收集调查对象的人口学特征、社会经济状况、疾病和症状信息，使用9条目患者健康问卷(Patient Health Questionnaire 9, PHQ-9)评估调查对象的抑郁患病情况。通过距离社区最近的空气质量监测国控站点数据估算调查前1年大气污染物平均浓度和调查前2年大气污染物滑动平均浓度，采用多因素Logistic回归分析模型探讨O₃暴露与罹患抑郁的关联。  结果  纳入研究的8 584名调查对象中，抑郁患病率为6.79%(583/8 584)。Logistic回归分析模型显示，未发现O₃长期暴露与抑郁患病风险有关，总体上看，调查前2年的O₃滑动平均年均浓度对应的效应值最大(OR=1.04, 95% CI: 0.96~1.13, P=0.326)，但无统计学意义；分层分析显示，与女性和不吸烟的调查对象相比，男性和现在吸烟的调查对象抑郁患病与O₃暴露的关联更强，且组间差异具有统计学意义(均有P＜0.05)；空气动力学直径＜2.5 μm的颗粒物(particulate matter smaller than 2.5 μm in aerodynamic diameter, PM_2.5)浓度和气温对抑郁患病与O₃暴露的关联存在修饰作用，低PM_2.5浓度、较高气温地区抑郁患病与O₃暴露关联更强。  结论  本研究发现男性人群、吸烟人群以及生活在PM_2.5浓度较低和年均气温较高地区的人群中，O₃暴露与抑郁患病风险存在关联。

Chronic ozone exposure and depression among middle-aged and elderly people in China

  Objective  To investigate the association between chronic ozone (O₃) exposure and depression among middle-aged and elderly people in China, in order to provide guidance for prevention and intervention of depression.  Methods  Among key areas for air pollution control in China, according to strict inclusion criteria for study sites and population, 8 584 participates aged 40~ < 90 from 45 districts/counties in 16 provinces were randomly selected and recruited using a stratified random sampling method. The demographic characteristics, socioeconomic factors, disease and symptom information were obtained through face-to-face questionnaire survey, and the depression was measured by Patient Health Questionnaire 9 (PHQ-9). One- and two-year moving average concentrations of air pollutant prior to the survey were calculated, referring to the data from the closest environmental monitoring station. The multivariate Logistic regression model was constructed to analyze the association between chronic O₃ exposure and depression.  Results  The prevalence of depression was 6.79% (n=583) among the selected 8 584 participates. Statistically significant association between chronic O₃ exposure and depression was not found from Logistic regression analysis model. The maximum OR value was 1.04 (95% CI: 0.96-1.13, P=0.326) for each 10 μg/m3 increase of two-year moving average concentrations of O₃. In subgroup analysis, the stronger associations were observed in male and current smoking participants compared with female and never smoking individuals, and these differences were statistically significant (all P < 0.05). Moreover, modification effects of particulate matter smaller than 2.5 μm in aerodynamic diameter (PM_2.5) and annual temperature were found on the O₃-depression associations. Low PM_2.5 concentrations (≤25th percentile in all districts/counties) and high temperature (≥75th percentile in all districts/counties) conditions enhanced the effects of O₃ on depression.  Conclusion  Our findings indicated statistically positive association of O₃ exposure and depression among male, current smoking individuals, population in low PM_2.5 concentration and high temperature conditions.