Environment International (Aug 2022)
Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort
- 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,
- W.M.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 K.E. 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
Affiliations
- Ainhoa Bereziartua
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Corresponding author at: Institute for Risk Assessment Sciences (IRAS), Utrecht University, Postbus 80125, 3508 TC Utrecht, the Netherlands.
- Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
- Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Zorana J. Andersen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate – interdisciplinary Center for Climate Change, Aarhus University, Denmark
- Daniela Fecht
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy; School of Public Health, Faculty of Medicine, Imperial College London, London, UK
- John Gulliver
- Centre for Environmental Health and Sustainability & School of Geography, Geology and the Environment, University of Leicester, Leicester, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- Ole Hertel
- Department of Ecoscience, Aarhus University, Roskilde, Denmark
- Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Germany
- Ulla Arthur Hvidtfeldt
- Danish Cancer Society Research Center, Copenhagen, Denmark
- W.M.Monique Verschuren
- 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
- Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany
- Jeanette T Jørgensen
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Klea Katsouyanni
- 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
- Matthias Ketzel
- 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
- Norun Hjertager Krog
- Section of Air Pollution and Noise, Norwegian Institute of Public Health, Norway
- Boel Brynedal
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Shuo Liu
- Section of Environment and Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
- Elodie Faure
- University Paris-Saclay, UVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESP UMR1018, 94805 Villejuif, France
- Patrik K.E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Chair of Epidemiology, Ludwig Maximilians Universität München, Munich, Germany
- Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark
- Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy
- Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
- Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Yvonne T. van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Germany
- Gianluca Severi
- 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
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
- Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark; Diet, Genes and Environment (DGE), Denmark
- Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria
- Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Journal volume & issue
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Vol. 166
p. 107341
Abstract
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.
