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, Jørgen
AU - Fecht, Daniela
AU - Forastiere, Francesco
AU - Gulliver, John
AU - Hertel, Ole
AU - Hoffmann, Barbara
AU - Arthur Hvidtfeldt, Ulla
AU - Verschuren, W. M.Monique
AU - Jöckel, Karl Heinz
AU - Jørgensen, Jeanette T.
AU - Katsouyanni, Klea
AU - Ketzel, Matthias
AU - Hjertager Krog, Norun
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, Göran
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 - Sørensen, Mette
AU - Tjønneland, Anne
AU - Weinmayr, Gudrun
AU - Wolf, Kathrin
AU - Zitt, Emanuel
AU - Brunekreef, Bert
AU - Hoek, Gerard
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2022/8/1
Y1 - 2022/8/1
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 - Air Pollution
KW - Green space
KW - Mortality
KW - Traffic Noise
UR - http://www.scopus.com/inward/record.url?scp=85132333563&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2022.107341
DO - 10.1016/j.envint.2022.107341
M3 - Article
C2 - 35717714
AN - SCOPUS:85132333563
SN - 0160-4120
VL - 166
JO - Environment International
JF - Environment International
M1 - 107341
ER -