Keywords
dióxido de carbono
material particulado
epidemiology of mental problems
nitrogen dioxide
particulate matter
How to Cite
Abstract
Introduction: Various studies have identified exposure to nitrogen dioxide (NO2), particulate matter (PM10) and other pollutants as a risk factor for the incidence of mental disorders. However, these associations have not been previously explored in Costa Rica. Methods: An ecological-geographic study was designed at the district level in the Greater Metropolitan Area (GAM) of Costa Rica. Data on suicide events, suicide attempts, and depression were obtained from 154 districts of the GAM of Costa Rica; along with data on two pollutants: NO2 and PM10 for a period of four years (2016 to 2019). Data were correlated using a robust negative binomial regression model and a geographically weighted regression. Results: The association between pollutants and suicide was positive, but not significant, the same happened with the relationship between NO2 and suicide attempt. The model shows a negative but non-significant relationship between PM10 and suicide attempt, while an increase of one unit of NO2 (> 40μg/m3) was linked to a higher incidence rate of depression (percentage change: 9.50%, CI:5.00% to 14.00%). Conclusions: Higher levels of pollution were associated with an increase in the incidence rate of depression in the GAM districts of Costa Rica. The association between pollutants and suicide and suicide attempt and the independent variables cannot be affirmed or rejected. It is necessary to indicate other possible ways of configuring the relationship with more explanatory variables.
References
Arrieta-Fuentes, A. (2016). Dispersión de material particulado (pm10), con interrelación de factores meteorológicos y topográficos. Revista Ingeniería, Investigación y Desarrollo, 16 (2), 43-54. https://doi.org/10.19053/1900771X.v16.n2.2016.5445
Balakrishnan, U., & Tsaneva, M. (2023). Impact of Air Pollution on Mental Health in India. 59(1). https://doi.org/10.1080/00220388.2022.2120804
Bakian, A., Huber, R., Coon, H., Gray, D., Wilson, P., McMahon, W., y Renshaw, P. (2015). Acute Air Pollution Exposure and Risk of Suicide Completion. American Journal of Epidemiology, 181(5), 295-303. https://doi.org/10.1093/aje/kwu341
Bakolis, I., Hammoud, R., Stewart, R., Beevers, S., Dajnak, D., MacCrimmon, S., Broadbent, M., Pritchard, M., Shiode, N., Fecht, D., Gulliver, J., Hotopf, M., Hatch, S. L., & Mudway, I. S. (2021). Mental health consequences of urban air pollution: Prospective population-based longitudinal survey. Social Psychiatry and Psychiatric Epidemiology, 56(9), 1587-1599. https://doi.org/10.1007/s00127-020-01966-x
Bhui, K., Newbury, J. B., Latham, R. M., Ucci, M., Nasir, Z. A., Turner, B., O’Leary, C., Fisher, H. L., Marczylo, E., Douglas, P., Stansfeld, S., Jackson, S. K., Tyrrel, S., Rzhetsky, A., Kinnersley, R., Kumar, P., Duchaine, C., & Coulon, F. (2023). Air quality and mental health: Evidence, challenges and future directions. BJPsych Open, 9(4), e120. https://doi.org/10.1192/bjo.2023.507
Braithwaite, I., Zhang, S., Kirkbride, J., Osborn, P., y Hayes, J. (2019). Exposure to air pollution (particulate matter) and associations with depression, anxiety, bipolar, psychosis, and suicide risk: a systematic review and meta-analysis. Environmental Health Perspectives, 127(12), 1-23. https://doi.org/10.1289/EHP4595
Calderón, L., Mora, A., Ontiveros, E., Gomez, G., Barragán, G., Broadway, J., Chapman, S., Valencia, G., Jewells, V., Maronpot, R., Heríquez, C., Pérez, B., Torres, R., Herrit, L., Brooks, D., Osnaya, N., Monroy, M., González, A., Reynoso, Villareal-Calderón, R. (2008a). Air pollution, cognitive deficits, and brain abnormalities: a pilot study with children. Brain and cognition, 68(2), 117–127. https://doi.org/10.1016/j.bandc.2008.04.008
Calderón, L., Solt, A, Henríquez, C., Torres, R., Nuse, B., Herritt, L., Villarreal, R., Osnaya, N., Stone, I., García, R., Brooks, D., González, A., Reynoso, R., Delgado, R. y Reed, W. (2008b). Long-term Air Pollution Exposure Is Associated with Neuroinflammation, an Altered Innate Immune Response, Disruption of the Blood-Brain Barrier, Ultrafine Particulate Deposition, and Accumulation of Amyloid β-42 and α-Synuclein in Children and Young Adults. Patología toxicológica, 36(2), 296–300. https://doi.org/10.1177/0192623307313011
Cheng, Y., Meng, Y., Li, X., & Yin, J. (2024). Effects of ambient air pollution on the hospitalization risk and economic burden of mental disorders in Qingdao, China. International Archives of Occupational and Environmental Health, 97(2), 109-120. https://doi.org/10.1007/s00420-023-02030-2
Dagnino, J. Riesgo relativo y odds ratio (razón de ventajas). Revista Chilena de Anestesia. 2014; 43 (4), 317-321. https://revistachilenadeanestesia.cl/riesgo-relativo-y-razon-de-ventajas/
Du, J., Cui, Y., Yang, L., Duan, Y., Qi, Q., & Liu, H. (2024). Associations of Indoor Ventilation Frequency with Depression and Anxiety in Chinese Older Adults. Indoor Air, 2024(1), 9943687. https://doi.org/10.1155/2024/9943687
ESRI. (2016). Distancia inversa ponderada (IDW). https://desktop.arcgis.com/es/arcmap/10.3/tools/geostatistical-analyst-toolbox/idw.htm#S_GUID-BAA893F9-208D-4D7D-807A-18F8BD5CFDAA
ESRI. (2021). Cómo funciona Autocorrelación espacial (I de Moran global), https://desktop.arcgis.com/es/arcmap/latest/tools/spatial-statistics-toolbox/h-how-spatial-autocorrelation-moran-s-i-spatial-st.htm
ESRI. (2018). Regresión ponderada geográficamente (GWR), https://desktop.arcgis.com/es/arcmap/10.3/tools/spatial-statistics-toolbox/geographically-weighted-regression.htm
Fernández, J., Astudillo, C., Rodríguez, L., y Florez, V. (2018). Association between air pollution and suicide: A time series analysis in four Colombian cities. Environmental Health, 17(1), 47, 1-8. https://doi.org/10.1186/s12940-018-0390-1
Figueruelo, J. y Marino, M. (2012). Química Física del Ambiente y de los Procesos Medioambientales. Editorial Reverté. S.A.
Furczyk, K., Schutová, B., Tanja, M., Tome, J. y Büttner, A. (2013). La neurobiología del suicidio: una revisión de los estudios post mortem. Revista de psiquiatría molecular, 1(2),2-22. https://doi.org/10.1186/2049-9256-1-2
García, C., Rodríguez, L., Cortez, M., De la Cruz, J., y Fernández-Niño, J. (2019). Air Pollution and Suicide in Mexico City: A Time Series Analysis, 2000-2016. International Journal of Environmental Research and Public Health, 16(16), 2971.https://doi.org/10.3390/ijerph16162971
Gerlofs, ME., Van D., Cassée, R., Schins, P., Wang, K., y Campbell, A. (2010). Effect of prolonged exposure to diesel engine exhaust on proinflammatory markers in different regions of the rat brain. Part Fibre Toxicol, 12(7) 1-10. https://doi.org/10.1186/1743-8977-7-12
Gładka, A., Rymaszewska, J., y Zatoński, T. (2018). Impact of air pollution on depression and suicide. International Journal of Occupational Medicine and Environmental Health, 31(6), 711-721. https://doi.org/10.13075/ijomeh.1896.01277
Gładka, A., Zatoński, T., y Rymaszewska, J. (2022). Association between the long-term exposure to air pollution and depression. Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University, 31(10), 2- 14. https://doi.org/10.17219/acem/149988
GIZ. (2021). Atlas de Servicios Ecosistémicos de la Gran Área Metropolitana, Costa Rica. https://atlasverde.net/isla-de-calor/
Guxens, M., y Sunyer, J (2012). A review of epidemiological studies on neuropsychological effects of air pollution. Swiss Med Wkly, 141, 1-7. https://doi.org/10.57187/smw.2012.13322
Hamui, Liz. (2019). La noción de “trastorno”: entre la enfermedad y el padecimiento. Una mirada desde las ciencias sociales. Revista de la Facultad de Medicina, 62(5), 39-47. https://doi.org/10.22201/fm.24484865e.2019.62.5.08
He, G., Chen, Y., Wang, S., Dong, Y., Ju, G., & Chen, B. (2020). The Association Between PM2.5 and Depression in China. Dose-Response, 18(3), 1559325820942699. https://doi.org/10.1177/1559325820942699
Hong, Y., Lee, J., Kim, H. y Kwon, H. (2002). Air pollution: a new risk factor in ischemic stroke mortality. Stroke: Journal of the American Heart Association, 33 (9), 2165-2169. https://doi.org/10.1161/01.str.0000026865.52610.5b
Instituto Meteorológico Nacional. (2008). El clima, su variabilidad y cambio climático en Costa Rica. http://cglobal.imn.ac.cr/index.php/publications/el-clima-su-variabilidad-y-cambio-climatico-en-costa-rica/
Jayaraj, R.L., Rodríguez, E.A., Wang, Y., y Block, M. (2017). Outdoor Ambient Air Pollution and Neurodegenerative Diseases: The Neuroinflammation Hypothesis. Curr Envir Health Rpt, 4, 166–179. https://doi.org/10.1007/s40572-017-0142-3
Kioumourtzoglou, M., Power, M., Hart, J., Okereke, O., Coull, B., Laden F. y Weisskopf, M. (2017). The association between air pollution and onset of depression among middle-aged and older women. Am J Epidemiol, 185 (9), 801–809. https://doi.org/10.1093/aje/kww163.
Kuo, P.-F., & Putra, I. G. B. (2021). Analyzing the relationship between air pollution and various types of crime. PLOS ONE, 16(8), e0255653. https://doi.org/10.1371/journal.pone.0255653
Lin, S., Zhao, J., Li, J., Liu, X., Zhang, Y., Wang, S., Mei, Q., Chen, Z., & Gao, Y. (2022). A Spatial–Temporal Causal Convolution Network Framework for Accurate and Fine-Grained PM2.5 Concentration Prediction. Entropy, 24(8), 1125. https://doi.org/10.3390/e24081125
Levesque, S., Taetzsch, T., Lull, ME., Kodavanti, U., Stadler, K., Wagner, A., Johnson, J., Duke, L., Kodavanti., Surace, M. y Block, M. (2011). Diesel Exhaust Activates & Primes Microglia: Air Pollution, Neuroinflammation, & Regulation of Dopaminergic Neurotoxicity. Environmental Health Perspectives, 119(8):1149–1155. https://doi.org/10.1289/ehp.1002986
Łopuszańska, U., y Studzińska, M. (2017). The correlations between air pollution and depression. Curr Probl Psychiatry, 18 (2), 100-109. http://dx.doi.org/10.1515/cpp-2017-0009
Martínez, R., Estrada, F., Hernández, A., Barajas, A., Islas, S., Navarro, L., y Chavarria, A. (2018). Neuroinflamación: el ying-yang de la neuroinmunología. Revista de la Facultad de Medicina (México), 61(5), 44-53. http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0026 17422018000500044&lng=es&tlng=es.
Mebarak, M., De Castro, A., Salamanca, M. y Quintero, M. (2009). Salud mental: un abordaje desde la perspectiva actual de la psicología de la salud. Psicología desde el Caribe, (23), 83-112. http://www.scielo.org.co/pdf/psdc/n23/n23a06.pdf
Miller, K., Siscovick, D., Shepard, L., Pastor, K., Sullivan, J., Anderson, G. y Kaufman, J. (2007). Long-Term Exposure to Air Pollution and Incidence of Cardiovascular Events in Women. [Exposición a largo plazo a la contaminación del aire e incidencia de eventos cardiovasculares en mujeres] N. ingl. J. Med, 356(5), 447–458. https://doi.org/10.1056/nejmoa054409
Ministerio de Salud (2016). Sexto Informe de la Calidad del Aire: GAM 2013-2015. https://www.ministeriodesalud.go.cr/index.php/centro-de-prensa/noticias/727-noticias-2016/938-vi-informe-de-calidad-del-aire-de-la-gam-2013-2015
Ministerio de Salud (2021). Informe de Calidad del Aire Área Metropolitana de Costa Rica 2017-2018. Autor.
Miranda, K., y Ortiz, L. (2008). Evaluación de la concentración de material particulado suspendido pm10 y su relación con la morbilidad asociados a ERA´S en niños menores a catorce años por enfermedad respiratoria aguda en el municipio de Toluviejo (Sucre). [Tesis de grado]. Universidad de La Salle. https://ciencia.lasalle.edu.co/ing_ambiental_sanitaria/586/
Morales, I., Farías, G., y Maccioni, B. (2010). La neuroinflamación como factor detonante del desarrollo de la enfermedad de Alzheimer. Rev chil neuro-psiquiat, 48(1), 49 57. https://scielo.conicyt.cl/pdf/rchnp/v48n1/art07.pdf
Morris, J., Tan, J., y Bestwick. (2018). Evaluation of stability of directly standardized rates for sparse data using simulation methods. Population Health Metrics 19(16), 2-9. https://doi.org/10.1186/s12963-018-0177-1
Nguyen, A.-M., Malig, B. J., & Basu, R. (2021). The association between ozone and fine particles and mental health-related emergency department visits in California, 2005–2013. PLOS ONE, 16(4), e0249675. https://doi.org/10.1371/journal.pone.0249675
Ng, C., Stickley, A., Konishi, S., y Watanabe, C. (2016). Ambient air pollution and suicide in Tokyo, 2001–2011. Journal Of Affective Disorders, 201, 194-202. https://doi.org/10.1016/j.jad.2016.05.006
Organización de las Naciones Unidas. (s.f.). Objetivo 11: Lograr que las ciudades sean más inclusivas, seguras, resilientes y sostenibles. Objetivos de Desarrollo Sostenible. https://www.un.org/sustainabledevelopment/es/cities/
Organización Mundial de la Salud. (2022a). Trastornos mentales. World Health Organization. https://www.who.int/es/news-room/fact-sheets/detail/depression
Organización Mundial de la Salud. (2022b). Salud mental: fortalecer nuestra respuesta. World Health Organization. https://www.who.int/es/news-room/fact-sheets/detail/mental-health-strengthening-our-response
Petrowski, K., Bührer, S., Strauß, B., Decker, O., & Brähler, E. (2021). Examining air pollution (PM10), mental health and well-being in a representative German sample. Scientific Reports, 11(1), 18436. https://doi.org/10.1038/s41598-021-93773-w
Pun, VC., Manjourides, J. y Suh, H. (2017). Association of ambient air pollution with depressive and anxiety symptoms in older adults: results from the NSHAP study. Environ Health Perspect, 125(3), 342–348. https://doi.org/10.1289/EHP494
Raison, C., Capuron, L., y Miller, A. (2006). Cytokines is the blues: inflammation and the pathogenesis of depression. Trends in Immunology, 27(1), 24-31. https://doi.org/10.1016/j.it.2005.11.006
Shen, Z., Sun, Y., Li, Y., Zhang, Q., Liu, Y., Han, J., Yang, J., Li, J., Ha, Z., Yang, Y., Liu, Z., Guan, S., & Sun, J. (2025). Association of dust exposure with anxiety and depression in the occupational population: The important role of sleep duration. BMC Public Health, 25(1), 358. https://doi.org/10.1186/s12889-025-21520-1
Szyszkowicz, M., Willey, J., Grafstein, E., Rowe, B., y Colman, I. (2020). Air Pollution and Emergency Department Visits for Suicide Attempts in Vancouver, Canada. Environmental Health Insights, 4(1), 79-86. https://primo-tc-na01.hosted.exlibrisgroup.com/permalink/f/1n8vhrc/TN_cdi_bioone_primary_10_1177_EHI_S5662
The Lancet. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The lancet, 392, 1789–858. https://doi.org/10.1016/S0140-6736(20)30925-9
Vert, C., Sánchez, G., Martínez, D., Gotsens, X., Gramunt, N., Cirach, M. y Gascon, M. (2017). Effect of long-term exposure to air pollution on anxiety and depression in adults: A cross-sectional study. International Journal of Hygiene and Environmental Health, 220(6), 1074-1080. https://primo-tc-na01.hosted.exlibrisgroup.com/permalink/f/1n8vhrc/TN_cdi_gale_infotracacademiconefile_A512914191
Wang, Y., Eliot, M., Koutrakis, P., Gryparis, A., Schwartz, J., Coull, B., Wellenius, G. (2014). Ambient air pollution and depressive symptoms in older adults: Results from the MOBILIZE Boston study. Environmental Health Perspectives, 122(6), 553-558. https://doi.org/10.1289/ehp.1205909
Xiong, J., Ye, C., Zhou, T. y Cheng, W. (2019) Health Risk and Resilience Assessment with Respect to the Main Air Pollutants in Sichuan. En t. J. Environ. Res. Salud Pública, 16(15), 2-9. https://doi.org/10.3390/ijerph16152796
Zijlema, W., Wolf, K., Emeny, R., Ladwig, K., Peters, A., Kongsgård, H., Rosmalen, J. (2016). The association of air pollution and depressed mood in 70,928 individuals from four European cohorts. International Journal of Hygiene and Environmental Health, 219(2), 212-219. https://doi.org/10.1016/j.ijheh.2015.11.006
##plugins.facebook.comentarios##
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Copyright (c) 2025 Mónica Jiménez Seas, Horacio Alejandro Chamizo García, Nicole Villegas Gonzáles , José Pablo Sibaja Brenes