Although a significant association between air pollution and mental health has been identified, few studies have addressed this relationship based on cancer diagnosis. This study investigated whether associations between long-term air pollution and mental health conditions differ based on whether the individual has been diagnosed with cancer. | Kim et al. BMC Cancer 2021 21 1298 https s12885-021-09013-x RESEARCH ARTICLE Open Access Relationship between chronic exposure to ambient air pollution and mental health in Korean adult cancer survivors and the general population Hyun Jin Kim1 Jin young Min2 Yong Seok Seo3 and Kyoung bok Min4 Abstract Background Although a significant association between air pollution and mental health has been identified few studies have addressed this relationship based on cancer diagnosis. This study investigated whether associations between long-term air pollution and mental health conditions differ based on whether the individual has been diag nosed with cancer. Methods Nationally representative data were used and a total of 38 101 adults were included in the analyses. We assessed mental health factors such as perceived stress depressive symptoms and suicidal ideation and analyzed the associations between these factors and individuals annual average exposure to air pollutants including particulate matter with an aerodynamic diameter 10 μm PM10 nitrogen dioxide sulfur dioxide and carbon monoxide. Results Compared with the general population P M10 exposure in cancer survivors predicted a higher risk of depres sive symptoms odds ratio OR 95 confidence interval CI and suicidal ideation OR 95 CI . Notably the statistically significant relationship between P M10 exposure and suicidal ideation in cancer survivors disappeared after further adjustment for depressive symptoms p . This pattern was also observed in the result of propensity score-matched analysis for comparison between cancer survivors and the gen eral population. Conclusions This study provides the first evidence that cancer survivors with depressive symptoms may be more susceptible to suicidal ideation in the context of persistent PM10 exposure. Keywords Ambient air pollution Chronic exposure cancer Depressive symptoms Perceived stress Suicidal ideation Background .
