The Link Between PM2.5 Exposure and Depression: A Systematic Review

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Prayuth Poowaruttanawiwit
Chanida Chantim
Fasinee Arunrodpanya
Kanphitcha Dedmad
Junjilar Soputaon


Objective: This study aimed to investigate the association between exposure to fine particulate matter (PM2.5) and depression by conducting a systematic review.

Methods: A comprehensive search of electronic databases was performed to identify relevant studies. The inclusion criteria were limited to original epidemiological studies that examined the association between PM2.5 exposure and depression in human populations. Seven studies met the eligibility criteria and were included in the final analysis. The included studies were conducted in different countries and utilized varying study designs and sample sizes. Systematic review was conducted to synthesize the findings from the individual studies.

Results: The results of the systematic review indicated a consistent association between exposure to PM2.5 and depression. Moreover, the studies suggested that this association might be bidirectional, with exposure to PM2.5 leading to depression and depression increasing the risk of PM2.5 exposure. However, the strength of the association varied among studies, indicating that the effect of PM2.5 exposure on depression might be influenced by contextual factors such as population characteristics, geographic location, and exposure duration. More research is needed to establish a causal relationship between PM2.5 exposure and depression.

Conclusion: This systematic review highlights the significant impact of PM2.5 air pollution on mental health, particularly its association with depression. Elevated levels of PM2.5 are linked to an increased risk of depression, and long-term exposure to this pollutant raises the risk of depression and anxiety, especially in males. Addressing PM2.5 pollution is crucial for promoting mental well-being.


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Pope CA, Dockery DW. Health effects of fine particulate air pollution: lines that connect. J Air Waste Manag Assoc. 2006;56:709-742.

Liu C, Chen R, Sera F, Vicedo-Cabrera AM, Guo Y, Tong S, et al. Ambient particulate air pollution and daily mortality in 652 cities. N Engl J Med. 2019;381:705-715.

Brook RD, Cakmak S, Turner MC, Brook JR. Ischemic heart disease and ambient particle air pollution. Circulation. 2013;127:704-711.

Cai Y, Zhang B, Ke W, Feng B, Lin H, Xiao J, et al. Associations of short-term and long-term exposure to ambient air pollutants with hypertension: a systematic review and meta-analysis. Hypertension. 2018;71:1073-1081.

Kim SH, Kim YK, Park SY, Hong YC. Long-term fine particulate matter exposure and major depressive disorder in a community-based urban cohort. Environ Health Perspect. 2019;127:107008.

Kim YJ, Hong YC, Lee BE, Park H. PM2.5 exposure and the risks of stroke mortality in the elderly. Environ Health Prev Med. 2019;24:1-9.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA. 2000;283:2008-2012.

Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Ottawa Hospital Research Institute [Internet]. [cited 2023 Mar 30]. Available from:

Pieper D, Mathes T, Eikermann M. The assessment of multiple systematic reviews (AMSTAR) 2: five years of experience in its application. Res Synth Methods. 2021;12:193-202.

Kioumourtzoglou MA, Power MC, Hart JE, Okereke OI, Coull BA, Laden F, et al. The association between air pollution and onset of depression among middle-aged and older women. Am J Epidemiol. 2017;185:801-809.

Newbury JB, Stewart R, Fisher HL, Beevers S, Dajnak D, Broadbent M, et al. Association between air pollution exposure and mental health service use among individuals with first presentations of psychotic and mood disorders: retrospective cohort study. Br J Psychiatry. 2021;219:678-685.

Reuben A, Arseneault L, Beddows A, Beevers SD, Moffitt TE, Ambler A, et al. Association of air pollution exposure in childhood and adolescence with psycho-pathology at the transition to adulthood. JAMA Netw Open. 2021;4:e217508.

Qiu X, Shi L, Kubzansky LD, Wei Y, Castro E, Li H, Weisskopf MG, et al. Association of long-term exposure to air pollution with late-life depression in older adults in the US. JAMA Netw Open. 2023;6:e2253668.

Yang T, Wang J, Huang J, Kelly FJ, Li G. Long-term exposure to multiple ambient air pollutants and association with incident depression and anxiety. JAMA Psychiatry. 2023;80:305-313.

Liu Q, Wang W, Gu X, Deng F, Wang X, Lin H, et al. Association between particulate matter air pollution and risk of depression and suicide: a systematic review and meta-analysis. Environ Sci Pollut Res Int. 2021;28:9029-9049.

Braithwaite I, Zhang S, Kirkbride JB, Osborn DPJ, Hayes JF. Air pollution (particulate matter) exposure and associations with depression, anxiety, bipolar, psychosis and suicide risk: A systematic review and meta-analysis. Environ Health Perspect. 2019;127:126002.

Li J, Li X, Liu Y, Wang Y, Yan H, Zhang M, et al. The association between exposure to ambient particulate matter and depression: A systematic review and meta-analysis. J Affect Disord. 2020;275:930-939.

Li N, Sioutas C, Cho A, Schmitz D, Misra C, Sempf J, et al. Ultrafine particulate pollutants induce oxidative stress and mitochondrial damage. EHP. 2003;111:455-460.

Zhang Y, Crouch MJ, Yamamoto T. The impact of fine particulate matter (PM2.5) on psychiatric disorders: A review. Environ Health Prev Med. 2019;24:1-10.

Liang D, Shi L, Zhao J, Liu P, Schwartz J. Association between short-term exposure to air pollution and mental health outcomes in China: A systematic review with meta-analysis. Environ Res. 2019;176:108517.

Liu X, Chen H, Bo Q. Association between fine particulate matter (PM2.5) and depression risk: An updated systematic review and meta-analysis. ESPR. 2021;28:2466-2478.

Yao Y, Sang N, Zhou M, Shi X. Association between exposure to PM2.5 and depressive symptoms among middle-aged and elderly Chinese women. IJERPH. 2020;17:2026.

Kongtip P, Nankongnab N, Phaneuf D. Environmental pollution in Thailand: Current and future research directions. Chemosphere. 2021;262:127754.

Horsley J, Tan ET. Air pollution and public health: A guidance note for environmental health practitioners. World Health Organization; 2019.

American Lung Association [Internet]. How to protect yourself from air pollution. [cited 2023 Sep 5]. Available from: from-air-pollution

Reynolds KJ, Day TA, Hughson RL. The effects of air pollution on cardiovascular and respiratory health and implications for the workplace. OEM. 2018;75:87-95.

National Institute for Health and Care Excellence. Depression in adults: recognition and management. Clinical guideline [CG90]. [Internet]. 2018 [cited 2023 Mar 29]. Available from:

World Health Organization. Depression and other common mental disorders: global health estimates. [Internet]. 2017 [cited 2023 Mar 29]. Available from:

American Psychological Association. Exercise fuels the brain's stress buffers. [Internet]. 2019 [cited 2023 Mar 29]. Available from: monitor/2019/01/cover-exercise-brain

National Institute of Mental Health. Depression. [Internet]. 2021 [cited 2023 Mar 29]. Available from:

Lin CH, Nicol CJB, Wan C, Chen SJ, Huang RN, Chiang MC. Exposure to PM2.5 induces neurotoxicity, mitochondrial dysfunction, oxidative stress and inflammation in human SH-SY5Y neuronal cells. Neurotoxicology. 2022;88:25-35.

Li Z, Tian F, Ban H, Xia S, Cheng L, Ren X, et al. Energy metabolism disorders and oxidative stress in the SH-SY5Y cells following PM2.5 air pollution exposure. Toxicol Lett. 2022;369:25-33.

Thangavel P, Park D, Lee YC. Recent insights into particulate matter (PM2.5)-mediated toxicity in humans: an overview. Int J Environ Res Public Health. 2022;19:7511.

Bhui K, Newbury JB, Latham RM, Ucci M, Nasir ZA, Turner B, et al. Air quality and mental health: evidence, challenges and future directions. BJPsych Open. 2023;9:e120.