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Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort.

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posted on 2022-07-05, 07:46 authored by Ainhoa Bereziartua, Jie Chen, Kees de Hoogh, Sophia Rodopoulou, Zorana J Andersen, Tom Bellander, Jørgen Brandt, Daniela Fecht, Francesco Forastiere, John Gulliver, Ole Hertel, Barbara Hoffmann, Ulla Arthur Hvidtfeldt, WM Monique Verschuren, Karl-Heinz Jöckel, Jeanette T Jørgensen, Klea Katsouyanni, Matthias Ketzel, Norun Hjertager Krog, Boel Brynedal, Karin Leander, Shuo Liu, Petter Ljungman, Elodie Faure, Patrik KE Magnusson, Gabriele Nagel, Göran Pershagen, Annette Peters, Ole Raaschou-Nielsen, Matteo Renzi, Debora Rizzuto, Evangelia Samoli, Yvonne T van der Schouw, Sara Schramm, Gianluca Severi, Massimo Stafoggia, Maciej Strak, Mette Sørensen, Anne Tjønneland, Gudrun Weinmayr, Kathrin Wolf, Emanuel Zitt, Bert Brunekreef, Gerard Hoek

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.

History

Citation

Environment International Volume 166, August 2022, 107341

Author affiliation

School of Geography, Geology and the Environment, University of Leicester

Version

  • VoR (Version of Record)

Published in

Environment international

Volume

166

Pagination

107341

Publisher

Elsevier BV

issn

0160-4120

eissn

1873-6750

Acceptance date

2022-06-08

Copyright date

2022

Available date

2022-07-05

Spatial coverage

Netherlands

Language

eng

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