The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive Symptoms

<i>Background:</i> This study investigates the combined effects of PFAS metals (PFOA and PFOS), heavy metals (lead, cadmium, and mercury), behavioral factors (smoking and alcohol consumption), and social factors (income and education) on depressive symptoms. <i>Methods:</i> U...

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Main Authors: Olamide Ogundare, Emmanuel Obeng-Gyasi
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medical Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3271/13/2/69
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author Olamide Ogundare
Emmanuel Obeng-Gyasi
author_facet Olamide Ogundare
Emmanuel Obeng-Gyasi
author_sort Olamide Ogundare
collection DOAJ
description <i>Background:</i> This study investigates the combined effects of PFAS metals (PFOA and PFOS), heavy metals (lead, cadmium, and mercury), behavioral factors (smoking and alcohol consumption), and social factors (income and education) on depressive symptoms. <i>Methods:</i> Using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES 2017–2018), blood samples were analyzed to determine the exposure levels of PFOA, PFOS, lead, cadmium, and mercury, and self-reported behavioral and social factors were evaluated in relation to PHQ-9 scores among 181 adults. <i>Results:</i> Education was associated with lower odds of depressive symptoms (OR = 0.68, 95% CI: 0.43–1.07). Although the result was not statistically significant, the estimate suggested a potential protective effect that warranted further investigation. Bayesian Kernel Machine Regression demonstrated that heavy metals collectively had the strongest evidence for influencing depression (group PIP = 0.6508), followed by socioeconomic factors (group PIP = 0.642). Bivariate exposure–response analyses revealed complex interaction patterns whereby exposure effects varied substantially depending on co-exposure contexts. <i>Conclusions:</i> These findings highlight that depressive symptoms are shaped by complex interplays between environmental contaminants, behavior, and social determinants, underscoring the importance of mixture-based approaches in environmental mental health research and the need for integrated interventions addressing both environmental and social factors.
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spelling doaj-art-eb0fabbf98b347dd9e85cdb40b210e762025-08-20T03:16:22ZengMDPI AGMedical Sciences2076-32712025-06-011326910.3390/medsci13020069The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive SymptomsOlamide Ogundare0Emmanuel Obeng-Gyasi1Department of Built Environment, North Carolina A&T State University, Greensboro, NC 27411, USAEnvironmental Health and Disease Laboratory, North Carolina A&T State University, Greensboro, NC 27411, USA<i>Background:</i> This study investigates the combined effects of PFAS metals (PFOA and PFOS), heavy metals (lead, cadmium, and mercury), behavioral factors (smoking and alcohol consumption), and social factors (income and education) on depressive symptoms. <i>Methods:</i> Using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES 2017–2018), blood samples were analyzed to determine the exposure levels of PFOA, PFOS, lead, cadmium, and mercury, and self-reported behavioral and social factors were evaluated in relation to PHQ-9 scores among 181 adults. <i>Results:</i> Education was associated with lower odds of depressive symptoms (OR = 0.68, 95% CI: 0.43–1.07). Although the result was not statistically significant, the estimate suggested a potential protective effect that warranted further investigation. Bayesian Kernel Machine Regression demonstrated that heavy metals collectively had the strongest evidence for influencing depression (group PIP = 0.6508), followed by socioeconomic factors (group PIP = 0.642). Bivariate exposure–response analyses revealed complex interaction patterns whereby exposure effects varied substantially depending on co-exposure contexts. <i>Conclusions:</i> These findings highlight that depressive symptoms are shaped by complex interplays between environmental contaminants, behavior, and social determinants, underscoring the importance of mixture-based approaches in environmental mental health research and the need for integrated interventions addressing both environmental and social factors.https://www.mdpi.com/2076-3271/13/2/69Bayesianmixturesepidemiologyhealth
spellingShingle Olamide Ogundare
Emmanuel Obeng-Gyasi
The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive Symptoms
Medical Sciences
Bayesian
mixtures
epidemiology
health
title The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive Symptoms
title_full The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive Symptoms
title_fullStr The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive Symptoms
title_full_unstemmed The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive Symptoms
title_short The Combined Effects of Per- and Polyfluoroalkyl Substances, Metals, and Behavioral and Social Factors on Depressive Symptoms
title_sort combined effects of per and polyfluoroalkyl substances metals and behavioral and social factors on depressive symptoms
topic Bayesian
mixtures
epidemiology
health
url https://www.mdpi.com/2076-3271/13/2/69
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