Are mental health problems in children and adolescents associated with outdoor air pollution?
: A systematic review

  • Nils Schnitzler

Student thesis: Master's Thesis


Mental health issues can gravely impair people’s functioning in everyday life. In the general population and in adults, these issues have been linked to air pollution. Currently, little is known about the association between exposure to air pollution and mental health in children and adolescents. This study addresses the possible association between airborne, outdoor particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5) and mental health problems in children and adolescents (ages 0 up to and including 18 years) – a crucial period for psychological development.
A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Several search terms related to air pollution and mental health were used. As per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach, the quality of the body of evidence was assessed by evaluating risk of bias, inconsistency, indirectness, imprecision, and publication bias, as well as magnitude of effect, dose-response relationships, and residual confounding. Results were summarized in a table of summary, and in a PRISMA flowchart.
The systematic review yielded more than 2200 papers, 10 of which were included for further analysis. Our results indicate a possible association of PM2.5 with mental health problems in children and adolescents – specifically: anxiety, depression, mood disorders, schizophrenia, and suicidality. However, the current quality of evidence was assessed to be very low. Further research into the association is warranted. Future research should especially try to address the role of possible confounders and multiple exposures to PM2.5 and other air pollutants. Governments should (continue to) heed the precautionary principle, and implement (additional) measures that address air pollution.
Date of Award27 Oct 2022
Original languageEnglish
SupervisorFrank Van Belleghem (Examiner), Michelle Plusquin (Supervisor), Rossella Alfano (Supervisor) & Esmée Bijnens (Co-assessor)

Master's Degree

  • Master Environmental Sciences

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