Mental Health Impacts and Air Pollution in Pakistan: A Small-scale Cross-sectional Study of Awareness, Coping Strategies, and Mitigation Gaps

Pakistan, with its deteriorating air quality, is ranked as the third most polluted country globally. It has a PM₂.₅ concentration of 14.7 times the WHO annual PM₂.₅ guideline value. It threatens both the physical and mental well-being of individuals. This study evaluates the perceived psychological impacts of air pollution on Pakistani residents, such as changes in mood, anxiety, depression, sleep quality, fatigue, as well as coping mechanisms, and public awareness concerning air pollution.

A cross-sectional survey was conducted among 160 respondents (through random sampling) from urban, suburban, and rural areas of Pakistan. The survey adapted elements from validated tools, including PHQ-4 and PHQ-9. Statistical methods, i.e., the chi-square test and Spearman’s correlation, were used to assess relationships among demographics, mental health, and pollution exposure.

A considerable portion of those surveyed experienced air pollution regularly, and 70% reported worsening of air quality. Mental health impacts include anxiety, sadness, behavioral changes, fatigue, and sleep disturbances (p < 0.001) among 15–24-year-old females, undergraduates, and urban residents. Moreover, moderate positive associations were found between restlessness and irritability (ρ = 0.44, p = 0.001) and between perceived fatigue and mood changes (ρ = 0.46, p < 0.001). Although 83% of participants regarded vehicle emissions as a major source of pollution, only 11.9% engaged in protective behavioral routines, such as wearing masks or using air purifiers. The most frequent coping strategy was avoidance (37.5%), followed by exercising (19.4%).

These findings show that polluted air in Pakistan significantly affects mental health, particularly among young urban females. The study highlights the awareness, health concerns, pollution sources, and self-coping strategies of the respondents.

The outcomes of this study suggest a crucial requirement to conduct a study with a broader sample size to assess the generalized health consequences of air pollution concurrently.