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 -