Chronic environmental contamination: A systematic review of psychological health consequences

Abstract

We sought to undertake a systematic review to assess the current research and to provide a platform for future research on the psychological health impact of chronic environmental contamination (CEC). CEC is the experience of living in an area where hazardous substances are known or perceived to be present in air, water, or soil at elevated levels for a prolonged and unknown period of time. We employed a systematic review approach to assess the psychological health impact of CEC in literature from 1995 to 2019, and conducted a meta-analysis of available findings (k = 60, N = 25,858) on the impact of CEC on anxiety, general stress, depression, and PTSD. We also present a narrative synthesis of findings that suggest risk factors for the experience of psychological health impacts in the wake of CEC. Likely factors increasing risk for elevated psychological health impact from CEC experience are institutional delegitimization of community concerns and the real or perceived presence of health effects from CEC. The meta-analyses observed small-to-medium effects of experiencing CEC on anxiety, general stress, depression, and PTSD. However, there was also evident risk of bias in the data. Our review suggests that psychological health in the context of CEC is an important potential public health burden and a key area for future improved research.

Keywords: Chronic environmental contamination; Mental health; Stress.

Fig. 1.

Screening and selection process for the systematic review.

Fig. 2.

Effect size forest plot for meta-analysis of the effect of contamination-related health concerns on all psychological health dependent variables. Note. Each individual Fisher’s z effect size is presented as a black square with 95% CI error bars. Size of the square for each individual effect size represents relative weight based on sample size. The large black rhombus represents the aggregated Fisher’s z effect size. The width of the rhombus represents the 95% CI around the effect size.

Fig. 3.

Effect size forest plot for meta-analyses, separated by psychological health outcome. Note. Each individual Fisher’s z effect size is presented as a black square with 95% CI error bars. Size of the square for each individual effect size represents relative weight based on sample size. Large black rhombuses represent the aggregated Fisher’s z effect sizes for Anxiety, General Stress, Depression, PTSD, and all outcomes combined. The width of each rhombus represents the 95% CI around the effect size.