Associations of exposure to surrounding green, air pollution and traffic noise with mortality in a large national health survey

Abstract

PDS 70: Green space, Johan Friso Foyer, Floor 1, August 28, 2019, 1:30 PM - 3:00 PM Background/Aim: Most previous studies investigated associations of mortality with air pollution, traffic noise and surrounding green focusing on single exposures. We evaluated associations of combined long-term residential exposures to surrounding green, air pollution and traffic noise with non-accidental mortality in a large health survey. Methods: A national health survey, conducted in 2012, covering personal characteristics, lifestyle and socio-economic status (SES), was linked to the Dutch longitudinal mortality database. Subjects of the survey who were 30 years or older on 1 January 2013 (n=339,633) were followed from 1 January 2013 to 31 December 2017. Subjects with missing lifestyle data were more likely to die during follow-up. We therefore applied multiple imputation of missing values using chained equations to impute missing values for potential confounders. We used Cox proportional hazard models to evaluate associations of residential surrounding green (the average Normalized Difference Vegetation Index (NDVI) in buffers of 300m and 1000m), annual average air pollutant concentrations (including particulate matter (PM10, PM2.5), NO2) and traffic noise with mortality. Results: In the 5-year follow-up, we observed 26,886 non-accidental deaths. After adjustment for individual SES, lifestyle factors, such as physical activity and smoking status, and neighborhood SES, we found no significant associations with non-accidental mortality for any of the exposures. For example, an interquartile range (IQR, 0.13) increase in NDVI 300m was associated with a HR of 0.99 (95% CI: 0.98, 1.01) in natural mortality, an IQR (7.6 µg/m3) increase in NO2 was associated with a HR of 0.99 (95% CI: 0.97, 1.01) and an IQR (7.4 dB) increase in road-traffic noise was associated with a HR of 0.99 (95% CI: 0.97, 1.01). Conclusion: We found no evidence for effects of long-term residential exposures to surrounding green, air pollution and traffic noise with non-accidental mortality in a large population based survey in the Netherlands.