{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T16:56:18Z","timestamp":1777913778273,"version":"3.51.4"},"reference-count":47,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:00:00Z","timestamp":1760659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["West J Nurs Res"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Psychological distress, including anxiety, depression, and suicidality, may be influenced by environmental exposures such as pesticides. However, whether pesticide exposure is a significant risk factor for these mental health outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We sought to systematically evaluate whether pesticide exposure is a risk factor for anxiety, depression, and suicide among agricultural populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a systematic search of PubMed, Web of Science, and Scopus through December 2024. Observational studies assessing the association between pesticide exposure and psychological distress outcomes were included. Separate meta-analyses were performed for studies with retrospective and prospective exposure assessments using random-effects models to calculate pooled odds ratios (ORs) or risk ratios (RRs). Subgroup analyses and meta-regression explored potential moderators. Publication bias and sensitivity analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-one studies met the inclusion criteria. Among retrospective studies, pesticide exposure was associated with increased odds of psychological distress (pooled OR\u2009=\u20091.77; 95% confidence interval [CI]: 1.37-2.31). Among prospective studies, pesticide exposure was associated with increased risk (pooled RR\u2009=\u20091.99, 95% CI: 1.23-3.21). Subgroup analyses indicated stronger associations for depression compared to suicide. Meta-regression identified outcome type and sample size as significant moderators. Despite evidence of small-study effects, sensitivity analyses confirmed the robustness of the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis support pesticide exposure as a potential risk factor for anxiety, depression, and suicide, underscoring the need for preventive strategies and further longitudinal research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO Registration Number:<\/jats:title>\n                    <jats:p>CRD42024502004.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01939459251383089","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T09:12:52Z","timestamp":1760692372000},"page":"102-113","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Pesticide Exposure and the Risk of Depression, Anxiety, and Suicide: A Meta-Analysis"],"prefix":"10.1177","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-1376","authenticated-orcid":false,"given":"Prasert","family":"Kham-ai","sequence":"first","affiliation":[{"name":"Princess Agrarajakumari Faculty of Nursing, Chulabhorn Royal Academy, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattika","family":"Chaichan","sequence":"additional","affiliation":[{"name":"Princess Agrarajakumari Faculty of Nursing, Chulabhorn Royal Academy, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Narisara","family":"Sripo","sequence":"additional","affiliation":[{"name":"Princess Agrarajakumari Faculty of Nursing, Chulabhorn Royal Academy, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanyaphat","family":"Pongchangyou","sequence":"additional","affiliation":[{"name":"Princess Agrarajakumari Faculty of Nursing, Chulabhorn Royal Academy, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dao","family":"Weiangkham","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Phayao, Phayao, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9532-1573","authenticated-orcid":false,"given":"Karen","family":"Heaton","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"International Labour Organization. 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