RESUMO
In recent years, the increasing incidence of perinatal depression has become an important public health problem. In addition to the traditional social demographic factors, biological factors, obstetric factors, etc., the association between air pollution and perinatal depression (PND) has also attracted more and more attention. In this paper, studies on the association between air pollution and PND were reviewed, especially the associations of PND with ambient air pollutants such as PM2.5, PM10, NO2, and O3 as well as indoor air pollutants such as tobacco smoke, and the characteristics and possible biological mechanisms of the influence of different pollutants on PND were summarized. Based on the available studies, various outdoor air pollutants are associated with PND, and some pollutants may exhibit a dose-response relationship with it. As for indoor air pollution, studies only have focused on the impact of tobacco exposure on PND, and as yet, no study has explored the association between other indoor pollutants (e.g. cooking oil smoke and solid fuel) and PND. Current studies indicate that air pollution may act on PND through oxidative stress and neuroendocrine mechanisms, but the exact biological mechanism remains to be further studied. In the future, further studies should be encouraged on the epidemiological associations of other indoor air pollutants with PND and the interactions between other factors and air pollution on PND, and the underlying biological mechanisms, to provide new insights for the prevention of PND from the perspective of environmental health.
RESUMO
BACKGROUND: This study aimed to examine the environmental tobacco smoke (ETS) exposure at home and associated problem behaviors in Korean children and adolescents. METHODS: Approximately 2,167 children aged 3–18 years were included in the study after excluding 163 active smokers from the Korean Environmental Health Survey in Children and Adolescents (2012–2014). ETS data were obtained using a questionnaire; problem behaviors were measured using the Child Behavior Checklist administered to parents. The relationship between ETS exposure and problem behavior was evaluated using a survey regression model adjusted for region, age, sex, income, and father's education. The population-attributable fraction (PAF%) was calculated based on problem behaviors related to ETS exposure at home. RESULTS: The rates of ETS exposure at home were 20%, 28%, and 39% in children aged 3–5, 6–11, and 12–18 years, respectively; ETS exposure at home was associated with behavioral problems: the exposed group having higher total behavioral problem score (95% confidence interval [CI]) than the non-exposed by 2.46 (0.60–4.32) and 2.74 (0.74–4.74) in children aged 6–11 and 12–18 years, respectively, with no significant association in those aged 3–5 years. The PAF% (95% CI) of total problem behaviors for ETS exposure at home were 2.68 (−10.11–17.78), 10.66 (3.25–17.55), and 11.62 (3.03–18.96) in children aged 3–5, 6–11, and 12–18 years, respectively. Children with externalizing problems had higher PAF% than those with internalizing problems. CONCLUSION: In Korea, ETS exposure at home is associated with problem behaviors in children and adolescents with about more than 10% population attributable fraction.