Environmental exposures and mental health: longitudinal results from the German National Cohort (NAKO)

IF 10.2 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environment International Pub Date : 2026-10-01 Epub Date: 2026-09-27 DOI:10.1016/j.envint.2026.110539

Yanding Wang, Susanne Breitner-Busch, Kathrin Wolf, Fiona Niedermayer, Nikolaos Nikolaou, Frank Padberg, Andrea Rachow, Fabian Bamberg, Stefanie Castell, Volker Harth, Antje Hebestreit, Michael Leitzmann, Wolfgang Lieb, Claudia Meinke-Franze, Dörthe Meyerdierks, Ilais Moreno Velásquez, Rajini Nagrani, Nadia Obi, Laura R. Pfrommer, Tobias Pischon, Annette Peters

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引用次数: 0

Abstract

Background

Environmental exposures such as air pollution, population density, and climate-related stressors may influence mental health, yet large-scale longitudinal evidence is limited. This study examined associations of environmental exposures with depressive and anxiety symptoms, and stress in the German National Cohort (NAKO).

Methods

We analyzed data of over 70,000 adults aged 19–74 years from the NAKO baseline (2014–2019), with repeated survey assessments in 2020 and 2022 of depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (Generalized Anxiety Disorder 7-item), and stress (Patient Health Questionnaire-stress) scores. The annual mean of environmental exposures, including nitrogen dioxide (NO₂), particulate matter (PM), black carbon, air temperature, precipitation, relative humidity, greenness (Normalized Difference Vegetation Index), and indicators of the built and social environment were assessed at the participants’ residences at baseline and standardized with their interquartile range (IQR). Longitudinal associations of exposures with mental health outcomes were assessed using covariate-adjusted linear mixed models. Subgroup analyses were conducted stratifying by urbanization level, obesity, lung disease, and cardiovascular disease status.

Findings

Higher mean air temperature (per IQR) was associated with higher depressive symptom scores (β = 0.07, 95% CI: 0.03–0.12), anxiety symptom scores (β = 0.05, 95% CI: 0.01–0.09), and stress scores (β = 0.05, 95% CI: 0.01–0.09). Exposure to NO₂ was associated with higher depressive symptom scores (β = 0.08, 95% CI: 0.03–0.14). A higher population density within 100 m was associated with higher depressive, anxiety symptoms, and stress scores. In contrast, higher levels of greenness, precipitation, and relative humidity were associated with lower depressive symptom scores. Most of the associations with depressive or anxiety symptom scores were stronger in females, younger adults, people with obesity and those living in cities.

Interpretation

Improving air quality, enhancing urban green spaces, and implementing climate-adaptation strategies could help promote mental well-being, particularly in urban and vulnerable populations.

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环境暴露与心理健康：来自德国国家队列（NAKO）的纵向结果

背景：空气污染、人口密度和气候相关压力源等环境暴露可能影响心理健康，但大规模的纵向证据有限。本研究在德国国家队列（NAKO）中调查了环境暴露与抑郁、焦虑症状和压力的关系。方法：我们分析了来自NAKO基线（2014-2019）的7万多名19-74岁成年人的数据，并在2020年和2022年重复调查评估抑郁症状（患者健康问卷-9）、焦虑症状（广泛性焦虑障碍7项）和压力（患者健康问卷-压力）得分。在基线处评估参与者住所的年平均环境暴露，包括二氧化氮（NO2）、颗粒物（PM）、黑碳、气温、降水、相对湿度、绿化率（归一化植被指数）以及建筑和社会环境指标，并采用四分位数间距（IQR）进行标准化。使用协变量调整线性混合模型评估暴露与心理健康结果的纵向关联。按城市化水平、肥胖、肺部疾病和心血管疾病状况进行亚组分析。研究结果：较高的平均气温（每IQR）与较高的抑郁症状评分（β = 0.07, 95% CI: 0.03-0.12）、焦虑症状评分（β = 0.05, 95% CI: 0.01-0.09）和压力评分（β = 0.05, 95% CI: 0.01-0.09）相关。暴露于二氧化氮与较高的抑郁症状评分相关（β = 0.08, 95% CI: 0.03-0.14）。100米范围内较高的人口密度与较高的抑郁、焦虑症状和压力评分相关。相比之下，较高水平的绿化、降水和相对湿度与较低的抑郁症状得分相关。在女性、年轻人、肥胖者和城市居民中，抑郁或焦虑症状得分的关联性更强。解读：改善空气质量、扩大城市绿地面积和实施气候适应战略有助于促进心理健康，尤其是城市和弱势群体的心理健康。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Environment International 环境科学-环境科学

CiteScore

21.90

自引率

3.40%

发文量

734

审稿时长

2.8 months

期刊介绍： Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review. It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.