Associations between air pollution and perceived stress: the Veterans Administration Normative Aging Study

Environ Health. 2015 Jan 27;14:10. doi: 10.1186/1476-069X-14-10.


Background: There is mixed evidence suggesting that air pollution may be associated with increased risk of developing psychiatric disorders. We aimed to investigate the association between air pollution and non-specific perceived stress, often a precursor to development of affective psychiatric disorders.

Methods: This longitudinal analysis consisted of 987 older men participating in at least one visit for the Veterans Administration Normative Aging Study between 1995 and 2007 (n = 2,244 visits). At each visit, participants were administered the 14-item Perceived Stress Scale (PSS), which quantifies stress experienced in the previous week. Scores ranged from 0-56 with higher scores indicating increased stress. Differences in PSS score per interquartile range increase in moving average (1, 2, and 4-weeks) of air pollution exposures were estimated using linear mixed-effects regression after adjustment for age, race, education, physical activity, anti-depressant medication use, seasonality, meteorology, and day of week. We also evaluated effect modification by season (April-September and March-October for warm and cold season, respectively).

Results: Fine particles (PM2.5), black carbon (BC), nitrogen dioxide, and particle number counts (PNC) at moving averages of 1, 2, and 4-weeks were associated with higher perceived stress ratings. The strongest associations were observed for PNC; for example, a 15,997 counts/cm(3) interquartile range increase in 1-week average PNC was associated with a 3.2 point (95%CI: 2.1-4.3) increase in PSS score. Season modified the associations for specific pollutants; higher PSS scores in association with PM2.5, BC, and sulfate were observed mainly in colder months.

Conclusions: Air pollution was associated with higher levels of perceived stress in this sample of older men, particularly in colder months for specific pollutants.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging
  • Air Pollutants / analysis*
  • Air Pollution / adverse effects*
  • Boston
  • Environmental Exposure / adverse effects*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Nitrogen Dioxide / analysis
  • Particulate Matter / analysis*
  • Psychotic Disorders / etiology*
  • Seasons
  • Soot / analysis
  • Stress, Psychological / chemically induced*
  • Time Factors
  • United States
  • United States Department of Veterans Affairs
  • Young Adult


  • Air Pollutants
  • Particulate Matter
  • Soot
  • Nitrogen Dioxide