@article{ref1,
title="Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort",
journal="Environment international",
year="2022",
author="Bereziartua, Ainhoa and Chen, Jie and de Hoogh, Kees and Rodopoulou, Sophia and Andersen, Zorana J. and Bellander, Tom and Brandt, Jørgen and Fecht, Daniela and Forastiere, Francesco and Gulliver, John and Hertel, Ole and Hoffmann, Barbara and Arthur Hvidtfeldt, Ulla and Verschuren, W. M. Monique and Jöckel, Karl-Heinz and Jørgensen, Jeanette T. and Katsouyanni, Klea and Ketzel, Matthias and Hjertager Krog, Norun and Brynedal, Boel and Leander, Karin and Liu, Shuo and Ljungman, Petter and Faure, Elodie and Magnusson, Patrik K. E. and Nagel, Gabriele and Pershagen, Göran and Peters, Annette and Raaschou-Nielsen, Ole and Renzi, Matteo and Rizzuto, Debora and Samoli, Evangelia and van der Schouw, Yvonne T. and Schramm, Sara and Severi, Gianluca and Stafoggia, Massimo and Strak, Maciej and Sørensen, Mette and Tjønneland, Anne and Weinmayr, Gudrun and Wolf, Kathrin and Zitt, Emanuel and Brunekreef, Bert and Hoek, Gerard",
volume="166",
number="",
pages="e107341-e107341",
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. <br><br>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 (NO(2)) and road traffic noise. <br><br>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 NO(2)]. 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. <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="0160-4120",
doi="10.1016/j.envint.2022.107341",
url="http://dx.doi.org/10.1016/j.envint.2022.107341"
}