Background

Residential greenness has been linked to respiratory mortality, but its long-term effect on incident chronic obstructive pulmonary disease (COPD) has rarely been investigated.

Methods

This prospective cohort study was based on over 350 000 participants aged 38–70 of the UK Biobank, followed from 2006 to 2010 baseline to 2021. COPD cases were ascertained through linkages to health administrative datasets. Residential greenness was measured by satellite-derived normalized difference vegetation index (NDVI) within the 500- and 1 000-m buffer. Effects of greenness on COPD incidence were assessed using Cox proportional hazards models. We also explored mediation by physical activity, particular matter <2.5 μm in aerodynamic diameter (PM_2.5) and nitrogen oxides (NO_x). Restricted cubic spline models were fit to assess exposure–response relationships.

Results

A total of 363 212 individuals (mean [SD] age, 56.2 [8.1] years; 193 181 [53.2 %] women] were included in the analyses. 8 261 COPD cases occurred over 4 287 926 person-years of follow-up. We observed 8% lower COPD risk per IQR increase in NDVI in the 500-m buffer (95% CI: 0.89, 0.95). The association between greenness in the 500-m buffer and COPD were partially mediated by physical activity (1.0%, 95% CI: 0.2%, 1.8%), PM_2.5 (21.0%, 95% CI: 3.7%, 38.4%) and NO_x (17.0%, 95% CI: 2.8%, 31.2%). Similar results were observed for NDVI within 1 000-m buffer.

Conclusions

Long-term exposure to residential greenness was associated with lower risk of COPD incidence among UK adults. Our findings provide a rationale for greening policies as part of respiratory health promotion efforts.

中文翻译：

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住宅绿化与慢性阻塞性肺病的关联：英国生物银行的一项前瞻性队列研究

背景

住宅绿色与呼吸系统死亡率有关，但很少研究其对慢性阻塞性肺病 (COPD) 事件的长期影响。

方法

这项前瞻性队列研究基于英国生物银行 350,000 多名年龄在 38-70 岁之间的参与者，从 2006 年到 2010 年基线到 2021 年。COPD 病例是通过与卫生行政数据集的联系来确定的。在 500 米和 1000 米缓冲区内，通过卫星衍生的归一化植被指数 (NDVI) 测量住宅绿化度。使用 Cox 比例风险模型评估绿色对 COPD 发病率的影响。我们还探讨了身体活动、空气动力学直径小于 2.5 μm 的特定物质 (PM _2.5 ) 和氮氧化物 (NO _x ) 的调节作用。受限三次样条模型适合评估暴露-反应关系。

结果

共有 363 212 人（平均 [SD] 年龄，56.2 [8.1] 岁；193 181 [53.2 %] 女性] 被纳入分析。在 4 287 926 人年的随访中发生了 8 261 例 COPD 病例。我们观察到 500 米缓冲液中 NDVI 每增加 IQR，COPD 风险降低 8%（95% CI：0.89，0.95）。500 米缓冲液中的绿色与 COPD 之间的关联部分由体力活动介导（1.0%， 95% CI：0.2%，1.8%），PM _2.5（21.0%，95% CI：3.7%，38.4%）和 NOx _（ 17.0%，95% CI：2.8%，31.2%）。观察到类似的结果1 000 米缓冲区内的 NDVI。

结论

在英国成年人中，长期接触住宅绿地与较低的 COPD 发病风险相关。我们的研究结果为作为呼吸健康促进工作一部分的绿化政策提供了依据。