Article

Relation of Cumulative Low-Level Lead Exposure to Depressive and Phobic Anxiety Symptom Scores in Middle-Age and Elderly Women

Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA.
Environmental Health Perspectives (Impact Factor: 7.98). 02/2012; 120(6):817-23. DOI: 10.1289/ehp.1104395
Source: PubMed

ABSTRACT Different lines of evidence suggest that low-level lead exposure could be a modifiable risk factor for adverse psychological symptoms, but little work has explored this relation.
We assessed whether bone lead--a biomarker of cumulative lead exposure--is associated with depression and anxiety symptoms among middle-age and elderly women.
Participants were 617 Nurses' Health Study participants with K-shell X-ray fluorescence bone lead measures and who had completed at last one Mental Health Index 5-item scale (MHI-5) and the phobic anxiety scale of the Crown-Crisp Index (CCI) assessment at mean ± SD age of 59 ± 9 years (range, 41-83 years). With exposure expressed as tertiles of bone lead, we analyzed MHI-5 scores as a continuous variable using linear regression and estimated the odds ratio (OR) of a CCI score ≥ 4 using generalized estimating equations.
There were no significant associations between lead and either outcome in the full sample, but associations were found among premenopausal women and women who consistently took hormone replacement therapy (HRT) between menopause and bone lead measurement (n = 142). Compared with women in the lowest tertile of tibia lead, those in the highest scored 7.78 points worse [95% confidence interval (CI): -11.73, -3.83] on the MHI-5 (p-trend = 0.0001). The corresponding OR for CCI ≥ 4 was 2.79 (95% CI: 1.02, 7.59; p-trend = 0.05). No consistent associations were found with patella lead.
These results provide support for an association of low-level cumulative lead exposure with increased depressive and phobic anxiety symptoms among older women who are premenopausal or who consistently take postmenopausal HRT.

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    • "Among urban dwellers in Japan, for example, optimism is directly and independently associated with good mental health [95]. On the other hand, rates of anxiety and depression are especially high among those residing in proximity to industrial areas that contain higher levels of air pollution [91], while various environmental contaminants have been linked to anxiety, depression, and behavioral problems in human and experimental research [96] [97] [98]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper summarizes the discussions from the Natural Environments Initiative meeting hosted by the Harvard School of Public Health’s Center for Global Health and the Environment and the Harvard Radcliffe Institute for Advanced Studies in October 2013. It presents ongoing worldwide research on health benefits stemming from exposure to natural environments and design cues with particular attention applications in urban environments. This meeting generated a Workshop statement forged by the participants that affirms the health benefits of nature and presents the need for additional collaborative, transdisciplinary to refine salutogenic planning and design practices. Workshop participants represented disciplinary and professional perspectives from medicine, landscape architecture, public heath, and forestry science rooted in the cultural, ecological and political realities of a dozen countries and five continents. When framing the benefits of nature, they considered health outcomes including mental health disorders, obesity, Type 2 diabetes, metabolic disorders, allergies, cardiovascular disease, and more. Many environmental factors (including those related to physical activity, residential planning, environmental contamination and severe weather attributed to climate change) mediate these health outcomes at local, regional and global levels. This paper provides an illustrative review that captures many relevant studies discussed during the workshop. Although not exhaustive, our review indicates that the available evidence is applicable to various populations and ecological settings, and broadly supports the association of improved health outcomes with exposure to natural environments. Full report available at: http://www.chgeharvard.org/sites/default/files/resources/Paper-NaturalEnvironmentsInitiative_0.pdf
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