Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort,Environment International

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Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort
Environment International ( IF 10.3 ) Pub Date : 2022-06-11 , DOI: 10.1016/j.envint.2022.107341
Ainhoa Bereziartua ₁ , Jie Chen ₁ , Kees de Hoogh ₂ , Sophia Rodopoulou ₃ , Zorana J Andersen ₄ , Tom Bellander ₅ , Jørgen Brandt ₆ , Daniela Fecht ₇ , Francesco Forastiere ₈ , John Gulliver ₉ , Ole Hertel ₁₀ , Barbara Hoffmann ₁₁ , Ulla Arthur Hvidtfeldt ₁₂ , W M Monique Verschuren ₁₃ , Karl-Heinz Jöckel ₁₄ , Jeanette T Jørgensen ₄ , Klea Katsouyanni ₁₅ , Matthias Ketzel ₁₆ , Norun Hjertager Krog ₁₇ , Boel Brynedal ₁₈ , Karin Leander ₁₉ , Shuo Liu ₄ , Petter Ljungman ₂₀ , Elodie Faure ₂₁ , Patrik K E Magnusson ₂₂ , Gabriele Nagel ₂₃ , Göran Pershagen ₅ , Annette Peters ₂₄ , Ole Raaschou-Nielsen ₂₅ , Matteo Renzi ₂₆ , Debora Rizzuto ₂₇ , Evangelia Samoli ₃ , Yvonne T van der Schouw ₂₈ , Sara Schramm ₂₉ , Gianluca Severi ₃₀ , Massimo Stafoggia ₃₁ , Maciej Strak ₃₂ , Mette Sørensen ₃₃ , Anne Tjønneland ₃₄ , Gudrun Weinmayr ₂₃ , Kathrin Wolf ₃₅ , Emanuel Zitt ₃₆ , Bert Brunekreef ₁ , Gerard Hoek ₁

Affiliation

Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - interdisciplinary Center for Climate Change, Aarhus University, Denmark.
MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK.
Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy; School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, UK.
Department of Ecoscience, Aarhus University, Roskilde, Denmark.
Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany.
Danish Cancer Society Research Center, Copenhagen, Denmark.
National Institute for Public Health and the Environment, Bilthoven, the Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; Environmental Research Group, School of Public Health, Imperial College London, London, UK.
Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford GU2 7XH, United Kingdom.
Section of Air Pollution and Noise, Norwegian Institute of Public Health, Norway.
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden.
University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP UMR1018, 94805 Villejuif, France.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany.
Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark.
Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy.
Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Germany.
University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" team, CESP UMR1018, 94805 Villejuif, France; Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy.
Institute for Risk Assessment Sciences, Utrecht University, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.
Danish Cancer Society Research Center, Copenhagen, Denmark; Diet, Genes and Environment (DGE), Denmark.
Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria.

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 (PM_2.5), 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 PM_2.5; 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.

中文翻译：

ELAPSE 汇总队列中暴露于周围绿化以及自然原因和特定原因死亡率的情况

背景

大多数研究表明，较高的绿色暴露与死亡风险降低相关，但很少有研究对空间相关的空气污染和交通噪音暴露进行控制。我们的目标是解决 ELAPSE 汇总队列中的这一研究空白。

方法

将 300 米网格单元和 1 公里半径内的平均归一化植被指数 (NDVI) 分配给参与者的基线家庭地址，作为周围绿化暴露的衡量标准。我们使用 Cox 比例风险模型来估计 NDVI 暴露与自然原因和特定原因死亡率的关联，并调整了一些潜在的混杂因素，包括个人和地区层面的社会经济地位和生活方式因素。在调整细颗粒物 (PM _2.5 )、二氧化氮 (NO ₂ ) 和道路交通噪音后，我们进一步评估了绿色暴露与死亡率之间的关联。

结果

汇总研究人群包括 327,388 人，在 6,374,370 人年的随访期间，有 47,179 人自然死亡。在 300 米网格和 1 公里缓冲区中，合并队列中的平均 NDVI 分别为 0.33 (SD 0.1) 和 0.34 (SD 0.1)。在主要的完全调整模型中，300 米网格内 NDVI 增量 0.1 单位与自然原因死亡风险降低 5% 相关（风险比 (HR) 0.95 (95% CI: 0.94, 0.96)）。空气污染调整后，相关性减弱 [HR (95% CI)：0.97 (0.96, 0.98)，针对 PM _2.5进行调整；0.98 (0.96, 0.99) 针对 NO ₂进行调整]。对交通噪音的额外调整几乎不会影响协会。在 1 公里缓冲区内观察到 NDVI 的结果一致。调整空气污染后，NDVI 与糖尿病、呼吸道疾病和肺癌死亡率呈负相关，但 95% 置信区间更宽。未发现与心血管死亡率相关。