Format

Send to

Choose Destination
Environ Res. 2018 Aug;165:459-472. doi: 10.1016/j.envres.2018.04.015. Epub 2018 May 1.

Ambient ozone exposure and mental health: A systematic review of epidemiological studies.

Author information

1
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.
2
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
3
Centre of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany.
4
Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany. Electronic address: Joachim.Heinrich@med.uni-muenchen.de.

Abstract

BACKGROUND:

An increasing number of studies have suggested adverse effects of air pollution on mental health. Given the potentially negative impacts of ozone exposure on the immune and nervous system driven from animal experiments, ozone might also affect mental health. However, no systematic synthesis of the relevant literature has been conducted yet. This paper reviews the studies that assessed the link between ozone exposure and mental health thus far.

METHODS:

We followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). PubMed, Web of Science, and EMBASE were systematically searched for epidemiological studies on ambient ozone exposure and mental or behavioral disorders according to the International Classification of Disease. The period was from January 1st, 1960 to December 14st, 2017. We evaluated the risk of bias by the Office of Health Assessment and Translation (OHAT) Approach and Navigation Guide for each included study.

RESULTS:

The keyword search yielded 567 results. 31 papers met the selection criteria and were included in the review. We found only inconclusive evidence that ozone affects autism spectrum disorders, impairment of cognitive functions and dementia, depression, and suicide. The large heterogeneity of study designs, outcome definitions and study quality in general prevented us from conducting meta-analyses.

CONCLUSIONS:

Current evidence for an association between ambient ozone exposure and mental health outcomes is inconclusive and further high quality studies are needed to assess any potential links given the strong biologic plausibility.

KEYWORDS:

Epidemiology; Mental disorders; Mental health; Ozone; Suicide

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center