The health effects of a forest environment on subclinical cardiovascular disease and heath-related quality of life.

Tsung-Ming Tsao,Ming-Jer Tsai,Ta-Chen Su,Heng-Lun Lin,Chang-Fu Wu,Kai-Jen Chuang,Hsing Chao,Sandy-H.J Hsu,Charles- Ck Chou,Ya-Nan Wang,Jing-Shiang Hwang,Una Macleod

doi:10.1371/journal.pone.0103231

Abstract

BackgroundAssessment of health effects of a forest environment is an important emerging area of public health and environmental sciences.PurposeTo demonstrate the long-term health effects of living in a forest environment on subclinical cardiovascular diseases (CVDs) and health-related quality of life (HRQOL) compared with that in an urban environment.Materials and MethodsThis study included the detailed health examination and questionnaire assessment of 107 forest staff members (FSM) and 114 urban staff members (USM) to investigate the long-term health effects of a forest environment. Air quality monitoring between the forest and urban environments was compared. In addition, work-related factors and HRQOL were evaluated.ResultsLevels of total cholesterol, low-density lipoprotein cholesterol, and fasting glucose in the USM group were significantly higher than those in the FSM group. Furthermore, a significantly higher intima-media thickness of the internal carotid artery was found in the USM group compared with that in the FSM group. Concentrations of air pollutants, such as NO, NO2, NOx, SO2, CO, PM2.5, and PM10 in the forest environment were significantly lower compared with those in the outdoor urban environment. Working hours were longer in the FSM group; however, the work stress evaluation as assessed by the job content questionnaire revealed no significant differences between FSM and USM. HRQOL evaluated by the World Health Organization Quality of Life-BREF questionnaire showed FSM had better HRQOL scores in the physical health domain.ConclusionsThis study provides evidence of the potential beneficial effects of forest environments on CVDs and HRQOL.

Highlights

Cardiovascular diseases (CVDs), including coronary heart disease, strokes, heart failure, hypertension, rheumatic heart disease, myocardial infarction, cardiomyopathy, and other heart diseases, are the leading causes of morbidity and mortality worldwide [1]
A significantly higher intima-media thickness of the internal carotid artery was found in the urban staff members (USM) group compared with that in the forest staff members (FSM) group
Working hours were longer in the FSM group; the work stress evaluation as assessed by the job content questionnaire revealed no significant differences between FSM and USM

Summary

Introduction

Cardiovascular diseases (CVDs), including coronary heart disease, strokes, heart failure, hypertension, rheumatic heart disease, myocardial infarction, cardiomyopathy, and other heart diseases, are the leading causes of morbidity and mortality worldwide [1]. The increasing rate of CVDs morbidity and mortality has globally become a major focus of public health policies and epidemiological studies. The causes of CVDs are very complex; consistent evidence from both epidemiological and experimental studies have demonstrated that environmental pollution, genetics, dietary habits, diabetes, hypertension, smoking habits, and psychosocial factors increase the risk of developing CVDs [2,3,4,5,6,7,8]. Environmental pollution is a major factor affecting CVDs; a large number of studies have confirmed the association of air pollution with human diseases, which is not confined to illness and involves a higher impact on CVDs morbidity and mortality [4]. Purpose: To demonstrate the long-term health effects of living in a forest environment on subclinical cardiovascular diseases (CVDs) and health-related quality of life (HRQOL) compared with that in an urban environment

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