Association of mold exposure and solid household fuel use with depression and anxiety among older adults in China

Abstract Background Exposure to mold and solid cooking fuels represents a significant environmental health concern, contributing substantially to indoor air pollution among elderly populations. However, the association between mold exposure, household fuel use, and mental health remains poorly under...

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Main Authors: Xinyan Ma, Hanqing Zhao, Yan Wang, Mengdi Hou, Wei Liu, Minghui Sun
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Environmental Health
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Online Access:https://doi.org/10.1186/s12940-025-01193-4
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author Xinyan Ma
Hanqing Zhao
Yan Wang
Mengdi Hou
Wei Liu
Minghui Sun
author_facet Xinyan Ma
Hanqing Zhao
Yan Wang
Mengdi Hou
Wei Liu
Minghui Sun
author_sort Xinyan Ma
collection DOAJ
description Abstract Background Exposure to mold and solid cooking fuels represents a significant environmental health concern, contributing substantially to indoor air pollution among elderly populations. However, the association between mold exposure, household fuel use, and mental health remains poorly understood. Here we examine individual and joint associations of these exposures on depression, anxiety, and their co-occurrence in older adults. Methods We evaluated 9,243 elderly participants from the eighth survey wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to explore the associations between mold exposure, solid fuel use, and depression, anxiety, and their co-occurrence. Multivariable logistic regression models were employed to quantify these relationships, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) reported. Results The study identified a depression prevalence of 13.61% and an anxiety prevalence of 11.79%. Participants exposed to mold demonstrated significantly higher odds of depression (OR = 2.26, 95% CI = 1.93–2.63), anxiety (OR = 2.11, 95% CI = 1.80–2.48), and their co-occurrence (OR = 2.58, 95% CI = 2.10–3.16), compared to participants without mold exposure. Moreover, the use of solid fuels for cooking, as opposed to clean fuels, was correlated with higher occurrence of depression (OR = 1.27, 95% CI = 1.10–1.47), anxiety (OR = 1.31, 95% CI = 1.12–1.52), and their co-occurrence (OR = 1.36, 95% CI = 1.10–1.67). Notably, solid fuel use appeared to attenuate the association between mold exposure and anxiety (Relative excess risk due to interaction [RERI] = -0.22, 95% CI = -0.44, -0.01). Conclusions The study found that exposure to mold and use of solid fuels may be associated with higher prevalence of depression, anxiety, and their co-occurrence. Further prospective studies are warranted to validate our findings.
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spelling doaj-art-2d64b75dc1724a2fa9b3fbcbe2e1c9612025-08-20T03:05:57ZengBMCEnvironmental Health1476-069X2025-07-0124111110.1186/s12940-025-01193-4Association of mold exposure and solid household fuel use with depression and anxiety among older adults in ChinaXinyan Ma0Hanqing Zhao1Yan Wang2Mengdi Hou3Wei Liu4Minghui Sun5The Third Affiliated Hospital of Jinzhou Medical UniversityHunan Provincial Center for Disease Control and PreventionThe Fourth Affiliated Hospital of Harbin Medical UniversityShengjing Hospital of China Medical UniversityThe Third Affiliated Hospital of Jinzhou Medical UniversityThe Third Affiliated Hospital of Jinzhou Medical UniversityAbstract Background Exposure to mold and solid cooking fuels represents a significant environmental health concern, contributing substantially to indoor air pollution among elderly populations. However, the association between mold exposure, household fuel use, and mental health remains poorly understood. Here we examine individual and joint associations of these exposures on depression, anxiety, and their co-occurrence in older adults. Methods We evaluated 9,243 elderly participants from the eighth survey wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to explore the associations between mold exposure, solid fuel use, and depression, anxiety, and their co-occurrence. Multivariable logistic regression models were employed to quantify these relationships, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) reported. Results The study identified a depression prevalence of 13.61% and an anxiety prevalence of 11.79%. Participants exposed to mold demonstrated significantly higher odds of depression (OR = 2.26, 95% CI = 1.93–2.63), anxiety (OR = 2.11, 95% CI = 1.80–2.48), and their co-occurrence (OR = 2.58, 95% CI = 2.10–3.16), compared to participants without mold exposure. Moreover, the use of solid fuels for cooking, as opposed to clean fuels, was correlated with higher occurrence of depression (OR = 1.27, 95% CI = 1.10–1.47), anxiety (OR = 1.31, 95% CI = 1.12–1.52), and their co-occurrence (OR = 1.36, 95% CI = 1.10–1.67). Notably, solid fuel use appeared to attenuate the association between mold exposure and anxiety (Relative excess risk due to interaction [RERI] = -0.22, 95% CI = -0.44, -0.01). Conclusions The study found that exposure to mold and use of solid fuels may be associated with higher prevalence of depression, anxiety, and their co-occurrence. Further prospective studies are warranted to validate our findings.https://doi.org/10.1186/s12940-025-01193-4AnxietyDepressionIndoor air pollutionMold exposureSolid fuels use
spellingShingle Xinyan Ma
Hanqing Zhao
Yan Wang
Mengdi Hou
Wei Liu
Minghui Sun
Association of mold exposure and solid household fuel use with depression and anxiety among older adults in China
Environmental Health
Anxiety
Depression
Indoor air pollution
Mold exposure
Solid fuels use
title Association of mold exposure and solid household fuel use with depression and anxiety among older adults in China
title_full Association of mold exposure and solid household fuel use with depression and anxiety among older adults in China
title_fullStr Association of mold exposure and solid household fuel use with depression and anxiety among older adults in China
title_full_unstemmed Association of mold exposure and solid household fuel use with depression and anxiety among older adults in China
title_short Association of mold exposure and solid household fuel use with depression and anxiety among older adults in China
title_sort association of mold exposure and solid household fuel use with depression and anxiety among older adults in china
topic Anxiety
Depression
Indoor air pollution
Mold exposure
Solid fuels use
url https://doi.org/10.1186/s12940-025-01193-4
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