TY  - JOUR
PY  - 2022//
TI  - Exposure to surrounding greenness and natural-cause and cause-specific mortality in the ELAPSE pooled cohort
JO  - Environment international
A1  - Bereziartua, Ainhoa
A1  - Chen, Jie
A1  - de Hoogh, Kees
A1  - Rodopoulou, Sophia
A1  - Andersen, Zorana J.
A1  - Bellander, Tom
A1  - Brandt, Jørgen
A1  - Fecht, Daniela
A1  - Forastiere, Francesco
A1  - Gulliver, John
A1  - Hertel, Ole
A1  - Hoffmann, Barbara
A1  - Arthur Hvidtfeldt, Ulla
A1  - Verschuren, W. M. Monique
A1  - Jöckel, Karl-Heinz
A1  - Jørgensen, Jeanette T.
A1  - Katsouyanni, Klea
A1  - Ketzel, Matthias
A1  - Hjertager Krog, Norun
A1  - Brynedal, Boel
A1  - Leander, Karin
A1  - Liu, Shuo
A1  - Ljungman, Petter
A1  - Faure, Elodie
A1  - Magnusson, Patrik K. E.
A1  - Nagel, Gabriele
A1  - Pershagen, Göran
A1  - Peters, Annette
A1  - Raaschou-Nielsen, Ole
A1  - Renzi, Matteo
A1  - Rizzuto, Debora
A1  - Samoli, Evangelia
A1  - van der Schouw, Yvonne T.
A1  - Schramm, Sara
A1  - Severi, Gianluca
A1  - Stafoggia, Massimo
A1  - Strak, Maciej
A1  - Sørensen, Mette
A1  - Tjønneland, Anne
A1  - Weinmayr, Gudrun
A1  - Wolf, Kathrin
A1  - Zitt, Emanuel
A1  - Brunekreef, Bert
A1  - Hoek, Gerard
SP  - e107341
EP  - e107341
VL  - 166
IS  - 
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. <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>
LA  - en
SN  - 0160-4120
UR  - http://dx.doi.org/10.1016/j.envint.2022.107341
ID  - ref1
ER  -