TY - JOUR
T1 - Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort
AU - Bereziartua, Ainhoa
AU - Chen, Jie
AU - de Hoogh, Kees
AU - Rodopoulou, Sophia
AU - Andersen, Zorana J.
AU - Bellander, Tom
AU - Brandt, Jorgen
AU - Fecht, Daniela
AU - Forastiere, Francesco
AU - Gulliver, John
AU - Hertel, Ole
AU - Hoffmann, Barbara
AU - Hvidtfeldt, Ulla Arthur
AU - Verschuren, W. M. Monique
AU - Joeckel, Karl-Heinz
AU - Jorgensen, Jeanette T.
AU - Katsouyanni, Klea
AU - Ketzel, Matthias
AU - Krog, Norun Hjertager
AU - Brynedal, Boel
AU - Leander, Karin
AU - Liu, Shuo
AU - Ljungman, Petter
AU - Faure, Elodie
AU - Magnusson, Patrik K. E.
AU - Nagel, Gabriele
AU - Pershagen, Goran
AU - Peters, Annette
AU - Raaschou-Nielsen, Ole
AU - Renzi, Matteo
AU - Rizzuto, Debora
AU - Samoli, Evangelia
AU - van der Schouw, Yvonne T.
AU - Schramm, Sara
AU - Severi, Gianluca
AU - Stafoggia, Massimo
AU - Strak, Maciej
AU - Sorensen, Mette
AU - Tjonneland, Anne
AU - Weinmayr, Gudrun
AU - Wolf, Kathrin
AU - Zitt, Emanuel
AU - Brunekreef, Bert
AU - Hoek, Gerard
PY - 2022
Y1 - 2022
N2 - Background: The majority of studies have shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort.Methods: Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1-km radius were assigned to participants' baseline home addresses as a measure of surrounding greenness exposure. We used Cox proportional hazards models to estimate the association of NDVI exposure with natural-cause and cause-specific mortality, adjusting for a number of potential confounders including socioeconomic status and lifestyle factors at individual and area-levels. We further assessed the associations between greenness exposure and mortality after adjusting for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and road traffic noise.Results: The pooled study population comprised 327,388 individuals who experienced 47,179 natural-cause deaths during 6,374,370 person-years of follow-up. The mean NDVI in the pooled cohort was 0.33 (SD 0.1) and 0.34 (SD 0.1) in the 300-m grid and 1-km buffer. In the main fully adjusted model, 0.1 unit increment of NDVI inside 300-m grid was associated with 5% lower risk of natural-cause mortality (Hazard Ratio (HR) 0.95 (95% CI: 0.94, 0.96)). The associations attenuated after adjustment for air pollution [HR (95% CI): 0.97 (0.96, 0.98) adjusted for PM2.5; 0.98 (0.96, 0.99) adjusted for NO2]. Additional adjustment for traffic noise hardly affected the associations. Consistent results were observed for NDVI within 1-km buffer. After adjustment for air pollution, NDVI was inversely associated with diabetes, respiratory and lung cancer mortality, yet with wider 95% confidence intervals. No association with cardiovascular mortality was found.Conclusions: We found a significant inverse association between surrounding greenness and natural-cause mortality, which remained after adjusting for spatially correlated air pollution and traffic noise.
AB - Background: The majority of studies have shown higher greenness exposure associated with reduced mortality risks, but few controlled for spatially correlated air pollution and traffic noise exposures. We aim to address this research gap in the ELAPSE pooled cohort.Methods: Mean Normalized Difference Vegetation Index (NDVI) in a 300-m grid cell and 1-km radius were assigned to participants' baseline home addresses as a measure of surrounding greenness exposure. We used Cox proportional hazards models to estimate the association of NDVI exposure with natural-cause and cause-specific mortality, adjusting for a number of potential confounders including socioeconomic status and lifestyle factors at individual and area-levels. We further assessed the associations between greenness exposure and mortality after adjusting for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and road traffic noise.Results: The pooled study population comprised 327,388 individuals who experienced 47,179 natural-cause deaths during 6,374,370 person-years of follow-up. The mean NDVI in the pooled cohort was 0.33 (SD 0.1) and 0.34 (SD 0.1) in the 300-m grid and 1-km buffer. In the main fully adjusted model, 0.1 unit increment of NDVI inside 300-m grid was associated with 5% lower risk of natural-cause mortality (Hazard Ratio (HR) 0.95 (95% CI: 0.94, 0.96)). The associations attenuated after adjustment for air pollution [HR (95% CI): 0.97 (0.96, 0.98) adjusted for PM2.5; 0.98 (0.96, 0.99) adjusted for NO2]. Additional adjustment for traffic noise hardly affected the associations. Consistent results were observed for NDVI within 1-km buffer. After adjustment for air pollution, NDVI was inversely associated with diabetes, respiratory and lung cancer mortality, yet with wider 95% confidence intervals. No association with cardiovascular mortality was found.Conclusions: We found a significant inverse association between surrounding greenness and natural-cause mortality, which remained after adjusting for spatially correlated air pollution and traffic noise.
KW - Green space
KW - Mortality
KW - Air Pollution
KW - Traffic Noise
KW - LONG-TERM EXPOSURE
KW - CORONARY-HEART-DISEASE
KW - AIR-POLLUTION
KW - URBAN GREEN
KW - RESIDENTIAL GREENNESS
KW - HEALTH-BENEFITS
KW - MENTAL-HEALTH
KW - BLUE SPACES
KW - ASSOCIATION
KW - POPULATION
U2 - 10.1016/j.envint.2022.107341
DO - 10.1016/j.envint.2022.107341
M3 - Journal article
C2 - 35717714
VL - 166
JO - Environment international
JF - Environment international
SN - 0160-4120
M1 - 107341
ER -