The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greenness

Recent increases in nitrogen dioxide (NO2) and ozone (O3), two highly reactive and oxidative pollutants, have raised concerns about their potential impact on adolescent mental health. This study leveraged data from the Chinese National Survey on Students’ Constitution and Health (CNSSCH) in 2019, a...

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Main Authors: Jiajia Dang, Yaqi Wang, Ning Ma, Shan Cai, Jianhui Guo, Yunfei Liu, Haoyu Zhou, Xinyao Lian, Di Shi, Ziyue Chen, Yihang Zhang, Jiaxin Li, Tianyu Huang, Guangrong Zhu, Jing Li, Jun Ma, Yi Song
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Environment International
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Online Access:http://www.sciencedirect.com/science/article/pii/S0160412024007992
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author Jiajia Dang
Yaqi Wang
Ning Ma
Shan Cai
Jianhui Guo
Yunfei Liu
Haoyu Zhou
Xinyao Lian
Di Shi
Ziyue Chen
Yihang Zhang
Jiaxin Li
Tianyu Huang
Guangrong Zhu
Jing Li
Jun Ma
Yi Song
author_facet Jiajia Dang
Yaqi Wang
Ning Ma
Shan Cai
Jianhui Guo
Yunfei Liu
Haoyu Zhou
Xinyao Lian
Di Shi
Ziyue Chen
Yihang Zhang
Jiaxin Li
Tianyu Huang
Guangrong Zhu
Jing Li
Jun Ma
Yi Song
author_sort Jiajia Dang
collection DOAJ
description Recent increases in nitrogen dioxide (NO2) and ozone (O3), two highly reactive and oxidative pollutants, have raised concerns about their potential impact on adolescent mental health. This study leveraged data from the Chinese National Survey on Students’ Constitution and Health (CNSSCH) in 2019, a nationally representative cross-sectional survey of Chinese adolescents. A total of 149,697 adolescents aged 10–18 years were included in this study. NO2 and O3 were sourced from the ChinaHighAirPollutants dataset, and the combined oxidative potential (OX) was subsequently calculated using the concentrations of NO2 and O3. The study quantitively examined the association of NO2, O3, and OX with adolescent mental health using the Dual Factor Model of Mental Health (DFM), which was derived from a questionnaire. According to the DFM, mental health status was divided into four groups: complete mental health, vulnerable, symptomatic but content, and troubled. Greenness around schools, measured by the Normalized Difference Vegetation Index (NDVI), was examined for its potential effect modification on the association between NO2, O3, OX, and mental health. Each IQR (Interquartile Range) increase in OX was related to adverse mental health outcomes, with ORs of 1.17 (95 % CI: 1.06, 1.29) for being vulnerable, 1.20 (95 % CI: 1.12, 1.28) for being more symptomatic but content, and 1.15 (95 % CI: 1.07, 1.23) for being troubled. Similar findings emerged in relation to O3 exposure. A positive association was observed between NO2 exposure and being vulnerable (OR = 1.07; 95 % CI: 1.01, 1.16). Additionally, the impact of exposure to NO2, O3, and OX on mental health outcomes was significantly stronger in the low-level NDVI group compared to the high-level NDVI group (P for interaction < 0.05). The joint effects analysis revealed that adolescents exposed to high levels of air pollutants and low NDVI had the highest odds of adverse mental health outcomes. These results highlight the complex relationship between NO2, O3, OX, and mental health, with particular emphasis on the underexplored role of OX. Notably, the findings suggest that reducing pollution and increasing greenery could offer significant benefits for improving adolescent mental health.
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spelling doaj-art-f414c69e2d9e42819f88d1a2188209402025-01-24T04:44:04ZengElsevierEnvironment International0160-41202025-01-01195109212The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greennessJiajia Dang0Yaqi Wang1Ning Ma2Shan Cai3Jianhui Guo4Yunfei Liu5Haoyu Zhou6Xinyao Lian7Di Shi8Ziyue Chen9Yihang Zhang10Jiaxin Li11Tianyu Huang12Guangrong Zhu13Jing Li14Jun Ma15Yi Song16Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaVanke School of Public Health, Tsinghua University, Beijing 100084, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; Corresponding authors.Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, ChinaInstitute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China; National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing 100191, China; Corresponding authors.Recent increases in nitrogen dioxide (NO2) and ozone (O3), two highly reactive and oxidative pollutants, have raised concerns about their potential impact on adolescent mental health. This study leveraged data from the Chinese National Survey on Students’ Constitution and Health (CNSSCH) in 2019, a nationally representative cross-sectional survey of Chinese adolescents. A total of 149,697 adolescents aged 10–18 years were included in this study. NO2 and O3 were sourced from the ChinaHighAirPollutants dataset, and the combined oxidative potential (OX) was subsequently calculated using the concentrations of NO2 and O3. The study quantitively examined the association of NO2, O3, and OX with adolescent mental health using the Dual Factor Model of Mental Health (DFM), which was derived from a questionnaire. According to the DFM, mental health status was divided into four groups: complete mental health, vulnerable, symptomatic but content, and troubled. Greenness around schools, measured by the Normalized Difference Vegetation Index (NDVI), was examined for its potential effect modification on the association between NO2, O3, OX, and mental health. Each IQR (Interquartile Range) increase in OX was related to adverse mental health outcomes, with ORs of 1.17 (95 % CI: 1.06, 1.29) for being vulnerable, 1.20 (95 % CI: 1.12, 1.28) for being more symptomatic but content, and 1.15 (95 % CI: 1.07, 1.23) for being troubled. Similar findings emerged in relation to O3 exposure. A positive association was observed between NO2 exposure and being vulnerable (OR = 1.07; 95 % CI: 1.01, 1.16). Additionally, the impact of exposure to NO2, O3, and OX on mental health outcomes was significantly stronger in the low-level NDVI group compared to the high-level NDVI group (P for interaction < 0.05). The joint effects analysis revealed that adolescents exposed to high levels of air pollutants and low NDVI had the highest odds of adverse mental health outcomes. These results highlight the complex relationship between NO2, O3, OX, and mental health, with particular emphasis on the underexplored role of OX. Notably, the findings suggest that reducing pollution and increasing greenery could offer significant benefits for improving adolescent mental health.http://www.sciencedirect.com/science/article/pii/S0160412024007992Mental healthNitrogen dioxideOzoneOxidative potentialGreenness
spellingShingle Jiajia Dang
Yaqi Wang
Ning Ma
Shan Cai
Jianhui Guo
Yunfei Liu
Haoyu Zhou
Xinyao Lian
Di Shi
Ziyue Chen
Yihang Zhang
Jiaxin Li
Tianyu Huang
Guangrong Zhu
Jing Li
Jun Ma
Yi Song
The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greenness
Environment International
Mental health
Nitrogen dioxide
Ozone
Oxidative potential
Greenness
title The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greenness
title_full The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greenness
title_fullStr The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greenness
title_full_unstemmed The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greenness
title_short The impact of long-term exposure to NO2, O3, and their oxidative potential on adolescents’ mental health, and the protective role of school-based greenness
title_sort impact of long term exposure to no2 o3 and their oxidative potential on adolescents mental health and the protective role of school based greenness
topic Mental health
Nitrogen dioxide
Ozone
Oxidative potential
Greenness
url http://www.sciencedirect.com/science/article/pii/S0160412024007992
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