Interquartile Range Increase In Normalized Difference Vegetation Index Research Articles

Association of residential air pollution and green space with all-cause and cause-specific mortality in individuals with diabetes: an 11-year prospective cohort study

To assess the long-term impact of residential air pollution and green space exposure on cause-specific mortality in individuals with type 2 diabetes mellitus (T2DM). This study includes 174,063 participants newly diagnosed with T2DM from a prospective cohort in Shanghai, China, enrolled between 2011 and 2013. Residential annual levels of air pollutants, including fine (PM2.5) and coarse (PM2.5-10) particulate matter, nitrogen dioxide (NO2), along with the normalized difference vegetation index (NDVI), were derived from satellite-based exposure models. During a median follow-up of 7.9 years (equivalent to 1,333,343 person-years), this study recorded 22,205 deaths. Higher exposure to PM2.5 was significantly associated with increased risks for all mortality outcomes, whilst PM2.5-10 showed no significant impacts. The strongest associations of PM2.5 were observed for diabetes with peripheral vascular diseases [hazard ratio (HR): 2.70; per 10μg/m3 increase] and gastrointestinal cancer (2.44). Effects of NO2 became significant at concentrations exceeding approximately 45μg/m³, with the highest associations for lung cancer (1.20) and gastrointestinal cancer (1.19). Conversely, each interquartile range increase in NDVI (0.10) was linked to reduced mortality risks across different causes, with HRs ranging from 0.76 to 1.00. The association between greenness and mortality was partly and significantly mediated by reduced PM2.5 (23.80%) and NO2 (26.60%). There was a significant and negative interaction between NO2 and greenness, but no interaction was found between PM2.5 and greenness. Our findings highlight the vulnerability of individuals with T2DM to the adverse health effects of air pollution and emphasise the potential protective effects of greenness infrastructure. The 6th Three-year Action Program of Shanghai Municipality for Strengthening the Construction of Public Health System (GWVI-11.1-22), the National Key Research and Development Program (2022YFC3702701), and the National Natural Science Foundation of China (82030103, 82373532).

Abstract PR-009: Associations between PM2.5, vegetation density and childhood brain tumors: a case-control registry-based study from Texas 1995-2011

Abstract Background: Air pollution has been reported to be associated with some childhood cancers, namely leukemias. Less is known about air pollution and childhood brain tumor risk. In adult cancers, increasing vegetation density, or greenness, has been inversely associated with cancer incidence and survival. The interplay between air pollution and greenness, which co-occur, in childhood cancer etiology is unclear. Therefore, we sought to estimate the association between prenatal and early life exposure to air pollution, greenness, and childhood cancer in Texas (1995-2011). Materials and Methods: We included 1,316 individuals with a childhood brain tumor diagnosed <17 years of age and 109,762 age- and sex-matched controls. We linked birth certificate residential address to census tract annual average particulate matter 2.5 µg/m³ (PM2.5) and Normalized Difference Vegetation Index (NDVI) to approximate prenatal and early life exposure to greenness and air pollution. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) as the measure of association between PM2.5 and NDVI interquartile range (IQR) increases and brain tumors. Models were adjusted for birth year, sex, maternal race/ethnicity, and area-level socioeconomic status (Yost index). Results: The following brain tumor types were included: ependymoma (n=136), astrocytoma (n=619), medulloblastoma (n=187), PNET (n=57), ATRT (n=54), and other gliomas (n=263). Average birth year PM2.5 and NDVI exposure levels were similar in cases and controls, 11 µg/m³ and 0.4, respectively. Each IQR increase (2.6 µg/m³) in PM2.5 was associated with ependymoma (OR: 1.27, 95% CI: 1.01-1.60) when adjusting for control-derived quartiles of NDVI. Conversely, after adjusting for PM2.5 quartiles, each IQR increase in NDVI (0.13) was inversely associated with ependymoma in those diagnosed at 0-4 years of age (OR: 0.75, 95% CI: 0.56-0.97) and with medulloblastoma in those aged 0-16 years at diagnosis (OR: 0.75, 95% CI: 0.62-0.91). There was no evidence of statistical interaction between NDVI and PM2.5 (all Likelihood Ratio Test p-values>0.05) for any brain tumors. Conclusions: Increasing residential air pollution during prenatal and early life increased the risk of childhood ependymoma in Texas independent of greenness. Conversely, increasing greenness exposure in prenatal and early life decreased the risk of ependymoma and medulloblastoma independent of PM2.5. These findings highlight the complex relationship between air pollution and greenness in childhood cancer etiology. Citation Format: Lindsay Williams, David Haynes, Jeannette Sample, Laura McGuinn, Thanh Hoang, Philip Lupo, Michael Scheurer. Associations between PM2.5, vegetation density and childhood brain tumors: a case-control registry-based study from Texas 1995-2011 [abstract]. In: Proceedings of the AACR Special Conference on Brain Cancer; 2023 Oct 19-22; Minneapolis, Minnesota. Philadelphia (PA): AACR; Cancer Res 2024;84(5 Suppl_1):Abstract nr PR-009.

EPID-29. ASSOCIATIONS BETWEEN PM2.5, VEGETATION DENSITY AND CHILDHOOD BRAIN TUMORS: A CASE-CONTROL REGISTRY-BASED STUDY FROM TEXAS 1995-2011

Abstract BACKGROUND Air pollution has been reported to be associated with childhood leukemia, and increasing vegetation density (greenness) has been inversely associated with adult cancer incidence. However, the interplay between air pollution and greenness in childhood brain tumor (CBT) etiology is unclear. We sought to estimate the association between prenatal exposure to air pollution, greenness, and CBTs in Texas (1995-2011). Materials and METHODS We included 1,316 individuals with a CBT diagnosed ≤ 16 years of age and 109,762 age- and sex-matched controls. We linked birth certificate residential address to census tract annual average particulate matter 2.5 µg/m³ (PM2.5) and Normalized Difference Vegetation Index (NDVI) to approximate prenatal exposure to air pollution and greenness. We estimated odds ratios (OR) and 95% confidence intervals (95% CI) between CBTs, PM2.5 and NDVI interquartile range (IQR) increases. Models were adjusted for birth year, sex, race/ethnicity, and area-level socioeconomic status. RESULTS Ependymoma (n=136), astrocytoma (n=619), medulloblastoma (n=187), PNET (n=57), ATRT (n=54), and other gliomas (n=263) were included. Average birth year PM2.5 and NDVI exposure levels were similar in cases and controls, 11 µg/m³ and 0.4, respectively. Each IQR increase (2.6µg/m³) in PM2.5 was associated with ependymoma (OR: 1.27, 95% CI: 1.01-1.60), adjusting for NDVI. After adjusting for PM2.5 quartiles, each IQR increase in NDVI (0.13) was inversely associated with ependymoma in those diagnosed at 0-4 years of age (OR: 0.75, 95% CI: 0.56-0.97) and medulloblastoma in those aged 0-16 years at diagnosis (OR: 0.75, 95% CI: 0.62-0.91). There was no evidence of statistical interaction for any CBT. CONCLUSIONS Increasing air pollution during the prenatal period increased risk of childhood ependymoma, independent of greenness. Conversely, increasing greenness prenatal exposure decreased the risk of ependymoma and medulloblastoma, independent of PM2.5. These findings highlight the complex relationship between air pollution and greenness in CBT etiology.

Influence of Neighborhood Social and Natural Environment on Prostate Tumor Histology in a Cohort of Male Health Professionals.

Adverse neighborhood social and natural (green space) environments may contribute to the etiology of prostate cancer (CaP), but mechanisms are unclear. We examined associations between neighborhood environment and prostate intratumoral inflammation in 967 men diagnosed with CaP with available tissue samples from 1986-2009 in the Health Professionals Follow-up Study. Exposures were linked to work or residential addresses in 1988. We estimated indices of neighborhood socioeconomic status (nSES) and segregation (Index of Concentration at the Extremes (ICE)) using US Census tract-level data. Surrounding greenness was estimated using seasonal averaged Normalized Difference Vegetation Index (NDVI) data. Surgical tissue underwent pathological review for acute and chronic inflammation, corpora amylacea, and focal atrophic lesions. Adjusted odds ratios (aORs) for inflammation (ordinal) and focal atrophy (binary) were estimated using logistic regression. No associations were observed for acute or chronic inflammation. Each interquartile-range increase in NDVI within 1,230 m of the participant's work or home address (aOR=0.74, 95% confidence interval (CI): 0.59, 0.93), in ICE-income (aOR=0.79, 95% CI: 0.61, 1.04), and in ICE-race/income (aOR=0.79, 95% CI: 0.63, 0.99) was associated with lower odds of postatrophic hyperplasia. Interquartile-range increases in nSES (aOR=0.76, 95% CI: 0.57, 1.02) and ICE-race/income (aOR=0.73, 95% CI: 0.54, 0.99) were associated with lower odds of tumor corpora amylacea. Histopathological inflammatory features of prostate tumors may be influenced by neighborhood.

Residential surrounding greenness is associated with improved lung function in adults: a cross-sectional study in eastern China

BackgroundWhile benefits of greenness exposure to health have been reported, findings specific to lung function are inconsistent. The purpose of this study is to assess the correlations of greenness exposure with multiple lung function indicators based on chronic obstructive pulmonary disease (COPD) monitoring database from multiple cities of Anhui province in China.Methods We assessed the greenness using the annual average of normalized difference vegetation index (NDVI) with a distance of 1000-meter buffer around each local community or village. Three types of lung function indicators were considered, namely indicators of obstructive ventilatory dysfunction (FVC, FEV1, FEV1/FVC, and FEV1/FEV3); an indicator of large-airway dysfunction (PEF); indicators of small-airway dysfunction (FEF25%, FEF50%, FEF75%, MMEF, FEV3, FEV6, and FEV3/FVC). Linear mixed effects model was used to analyze associations of greenness exposure with lung function through adjusting age, sex, educational level, occupation, residence, smoking status, history of tuberculosis, family history of lung disease, indoor air pollution, occupational exposure, PM2.5, and body mass index.ResultsA total of 2768 participants were recruited for the investigations. An interquartile range (IQR) increase in NDVI was associated with better FVC (153.33mL, 95%CI: 44.07mL, 262.59mL), FEV1 (109.09mL, 95%CI: 30.31mL, 187.88mL), FEV3 (138.04mL, 95%CI: 39.43mL, 236.65mL), FEV6 (145.42mL, 95%CI: 42.36mL, 248.47mL). However, there were no significant associations with PEF, FEF25%, FEF50%, FEF75%, MMEF, FEV1/FVC, FEV1/FEV6, FEV3/FVC. The stratified analysis displayed that an IQR increase in NDVI was related with improved lung function in less than 60 years, females, urban populations, nonsmokers, areas with medium concentrations of PM2.5 and individuals with BMI of less than 28 kg/m2. Sensitivity analyses based on another greenness indice (enhanced vegetation index, EVI) and annual maximum of NDVI remained consistent with the main analysis.ConclusionsOur findings supported that exposure to greenness was strongly related with improved lung function.

Residential greenness and kidney function: A cohort study of Thai employees.

Higher residential greenness is associated with a lower risk of chronic kidney disease, but evidence on the association between greenness exposure and kidney function has not been conducted. Using cohort data from Electricity Generating Authority of Thailand (EGAT) employees, we investigated the association between long-term exposure to greenness and kidney function using estimated glomerular filtration rate (eGFR) in Bangkok Metropolitan Region (BMR), Thailand. We analyzed data from 2022 EGAT workers (aged 25-55 years at baseline) from 2009 to 2019. The level of greenness was calculated using the satellite-derived Enhanced Vegetation Index (EVI) and Normalized Difference Vegetation Index (NDVI). From 2008 to 2019, the average concentration of each air pollutant (PM10, O3, NO2, SO2, and CO) at the sub-district level in BMR was generated using the Kriging method. Long-term exposure for each participant was defined as the 1-year average concentrations before the date of the physical examination in 2009, 2014, and 2019. We employed linear mixed effects models to evaluate associations of NDVI and EVI with eGFR. The robustness of the results was also tested by including air pollutants in the models. After relevant confounders were controlled, the interquartile range increase in NDVI was associated with higher eGFR [1.03% (95%CI: 0.33, 1.74)]. After PM10 and SO2 were included in the models, the associations between NDVI and eGFR became weaker. The additions of O3, NO2, and CO strengthened the associations between them. In contrast, we did not find any association between EVI and eGFR. In conclusion, there was a positive association between NDVI and eGFR, but not for EVI. Air pollutants had a significant impact on the relationship between NDVI and eGFR. Additional research is needed to duplicate this result in various settings and populations to confirm our findings.

Association between greenness and cardiovascular risk factors: Results from a large cohort study in Thailand

BackgroundThe risk of cardiovascular diseases may be reduced by residing in green environments. However, there are relatively few longitudinal cohort studies, especially in Southeast Asia, that focused on the health benefits of long-term greenness exposure in young adults. The present study examined the association between long-term exposure to residential greenness and self-reported morbidities in participants of the Thai Cohort Study (TCS) in Thailand from 2005 to 2013. MethodsThe self-reported outcomes, including high blood pressure, high blood cholesterol, and diabetes, were reported in 2005, 2009, and 2013, where the study participants provided the exact year of disease occurrence. Greenness was assessed by the satellite-based Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), with a spatial resolution of 250 m. Long-term exposure to NDVI and EVI of each participant's sub-district was averaged over the period of person-time. We used Cox proportional hazards models to examine the association between greenness and health outcomes. Associations with self-reported morbidity were measured using hazard ratios (HRs) per interquartile range (IQR) increase in NDVI and EVI. ResultsAfter adjusting for potential confounders, we observed that an IQR increase in NDVI was associated with lower incidence of high blood pressure (HR = 0.92, 95% CI: 0.89, 0.97) and high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.92), but not significantly associated with diabetes (HR = 0.93, 95%CI: 0.85, 1.01). EVI was also inversely associated with self-reported high blood pressure (HR = 0.92, 95%CI: 0.88, 0.96), high blood cholesterol (HR = 0.89, 95%CI: 0.87, 0.91), and diabetes (HR = 0.92, 95%CI: 0.85, 0.99). ConclusionsLong-term exposure to residential greenness was inversely associated with self-reported high blood pressure, high blood cholesterol, and diabetes in participants of TCS. Our study provides evidence that greenness exposure may reduce cardiovascular disease risk factors in adult population.

821Surrounding greenness is associated with slower biological ageing based on epigenetics

Abstract Background High surrounding greenness has many health benefits, but few studies have evaluated these from the perspective of epigenetics. Methods We derived Horvath’s DNA methylation age (DNAmAge), Hannum’s DNAmAge, PhenoAge, and GrimAge from DNA methylation data measured from peripheral blood samples of 479 Australian women in 130 families. The DNA methylation age acceleration (DNAmAgeAC) was calculated as the residuals after regressing DNAmAge on chronological age. Greenness was represented by the satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) within 300m, 500m, 1000m and 2000m surrounding participants’ home addresses. The greenness-DNAmAgeAC association was evaluated using a within-sibship design fitted by linear mixed effect models, adjusting for familial clustering and important covariates. Results Our analyses based on the whole sample suggested that the greenness-DNAmAgeAC association was only statistically significant for GrimAge acceleration. Each inter-quartile range (IQR) increase in NDVI within 1000m was associated with 0.59 (95% CI: 0.18, 1.01) year decrease in GrimAge acceleration. Greenness was also inversely associated with GrimAge’s three DNA methylation based components (cystatin-C, growth differentiation factor 15, and smoking pack-years). For participants at higher 50% area-level socioeconomic status (SES), each IQR increase in NDVI within 1000m was associated with 1.24 (95%CI: 0.39, 2.09) year and 0.79 (95%CI: 0.29, 1.30) year decrease in Hannum’s DNAmAgeAC and GrimAge acceleration, respectively. Conclusions Higher surrounding greenness was associated with slower biological aging measured by GrimAge acceleration and Hannun’s DNAmAgeAC in Australian women, particularly among those who lived in areas at higher SES. Key messages Epigenetics provides a potential mechanism for why surrounding greenness is an important health issue for community construction.

Surrounding Greenness and Biological Aging Based on DNA Methylation: A Twin and Family Study in Australia

Background:High surrounding greenness has many health benefits and might contribute to slower biological aging. However, very few studies have evaluated this from the perspective of epigenetics.Objectives:We aimed to evaluate the association between surrounding greenness and biological aging based on DNA methylation.Methods:We derived Horvath’s DNA methylation age (DNAmAge), Hannum’s DNAmAge, PhenoAge, and GrimAge based on DNA methylation measured in peripheral blood samples from 479 Australian women in 130 families. Measures of DNAmAge acceleration (DNAmAgeAC) were derived from the residuals after regressing each DNAmAge metric on chronological age. Greenness was represented by satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) metrics within 300-, 500-, 1,000-, and buffers surrounding participant addresses. Greenness-DNAmAgeAC associations were estimated using a within-sibship design fitted by linear mixed effect models, adjusting for familial clustering and important covariates.Results:Greenness metrics were associated with significantly lower DNAmAgeAC based on GrimAge acceleration, suggesting slower biological aging with higher greenness based on both NDVI and EVI in buffer areas. For example, each interquartile range increase in NDVI within was associated with a 0.59 (95% CI: 0.18, 1.01)–year decrease in GrimAge acceleration. Greenness was also inversely associated with three of the eight components of GrimAge, specifically, DNA methylation-based surrogates of serum cystatin-C, serum growth differentiation factor 15, and smoking pack years. Associations between greenness and biological aging measured by Horvath’s and Hannum’s DNAmAgeAC were less consistent, and depended on neighborhood socioeconomic status. No significant associations were estimated for PhenoAge acceleration.Discussion:Higher surrounding greenness was associated with slower biological aging, as indicated by GrimAge age acceleration, in Australian women. Associations were also evident for three individual components of GrimAge, but were inconsistent for other measures of biological aging. Additional studies are needed to confirm our results. https://doi.org/10.1289/EHP8793

Association of Greenness with Blood Pressure among Individuals with Type 2 Diabetes across Rural to Urban Community Types in Pennsylvania, USA.

Greenness may impact blood pressure (BP), though evidence is limited among individuals with type 2 diabetes (T2D), for whom BP management is critical. We evaluated associations of residential greenness with BP among individuals with T2D in geographically diverse communities in Pennsylvania. To address variation in greenness type, we evaluated modification of associations by percent forest. We obtained systolic (SBP) and diastolic (DBP) BP measurements from medical records of 9593 individuals following diabetes diagnosis. Proximate greenness was estimated within 1250-m buffers surrounding individuals’ residences using the normalized difference vegetation index (NDVI) prior to blood pressure measurement. Percent forest was calculated using the U.S. National Land Cover Database. Linear mixed models with robust standard errors accounted for spatial clustering; models were stratified by community type (townships/boroughs/cities). In townships, the greenest communities, an interquartile range increase in NDVI was associated with reductions in SBP of 0.87 mmHg (95% CI: −1.43, −0.30) and in DBP of 0.41 mmHg (95% CI: −0.78, −0.05). No significant associations were observed in boroughs or cities. Evidence for modification by percent forest was weak. Findings suggest a threshold effect whereby high greenness may be necessary to influence BP in this population and support a slight beneficial impact of greenness on cardiovascular disease risk.

Associations of Residential Greenness with Depression and Anxiety in Rural Chinese Adults

SummaryBackgroundDepression and anxiety are top contributors to non-fatal health loss globally. Several studies have indicated the association between residential greenness and mental health.MethodThe participants (n = 27,366) were recruited from four counties in Henan Province, China during 2015–2017. Symptoms of depression and anxiety were evaluated using the Patient Health Questionnaire-2 (PHQ-2) and the Generalized Anxiety Disorder-2 (GAD-2) in the baseline survey. The level of residential greenness during the 3-year period before the baseline survey was assessed using the Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI). The mixed-effect linear regression model was applied to examine the associations of residential greenness with depression and anxiety.ResultsThe results of adjusted models showed that the score of PHQ-2 (Δscore and 95% confidence interval [CI]) decreased by −0.024 (−0.041, −0.006) and −0.022 (−0.038, −0.004) with an interquartile range (IQR) increase in NDVI and EVI within a 1,000-m buffer radius, respectively. The score of GAD-2 (Δscore and 95% CI) decreased by −0.024 (−0.040, −0.006) and −0.028 (−0.044, −0.011), in relation to an IQR increase in NDVI and EVI within a 1,000-m buffer radius, respectively.ConclusionsA higher level of residential greenness was significantly associated with lower risk of depression and anxiety in rural areas of Henan Province. Improving residential greenness accessibility may help to promote the mental health of rural populations.

Neighborhood greenness associated with chronic obstructive pulmonary disease: A nationwide cross-sectional study in China

Differential findings have been reported on the association between neighborhood greenness and chronic obstructive pulmonary disease (COPD). The underlying reasons might be the different types of vegetation and the diagnosis methods used in different studies. In this nationwide cross-sectional study in China, we examined the linkage between neighborhood greenness and COPD prevalence among 66,752 adults aged 40 years and above. Neighborhood greenness was estimated using the normalized difference vegetation index (NDVI) based on satellite imagery within buffers of 100, 300, 500, 1000, 2000, 3000 and 5000 m of residential community of the participants. COPD was defined according to the 2017 Global Initiative for Chronic Obstructive Lung Disease lung function criteria. A two-level logistic regression model was applied to estimate the associations. Finally, 9134 adults were classified as COPD. We observed significant positive associations between neighborhood greenness and COPD prevalence. The odds ratio for each interquartile range increase in NDVI within 100 m buffer was 1.08 (95% CI: 1.01, 1.15) after adjustment for potential confounders. Consistent associations were observed across all other NDVI buffer sizes. Stratified analyses revealed that younger adults (40–65 years) and urban residents might be the vulnerable subpopulations. Further regional analyses found that residents from the Northeastern and Northern China were more likely to have this association. Our results indicated that neighborhood greenness might be one risk factor of COPD prevalence. Our study have important public health implications for allocating the surrounding green spaces among living areas, especially for those with respiratory illness; however, the findings and the underlying mechanisms warrant further examinations in longitudinal settings.

Associations between green space and preterm birth: Windows of susceptibility and interaction with air pollution

BackgroundRecent studies have reported inconsistent associations between maternal residential green space and preterm birth (PTB, born < 37 completed gestational weeks). In addition, windows of susceptibility during pregnancy have not been explored and potential interactions of green space with air pollution exposures during pregnancy are still unclear. ObjectivesTo evaluate the relationships between green space and PTB, identify windows of susceptibility, and explore potential interactions between green space and air pollution. MethodsBirth certificate records for all births in California (2001–2008) were obtained. The Normalized Difference Vegetation Index (NDVI) was used to characterized green space exposure. Gestational age was treated as a time-to-event outcome; Cox proportional hazard models were applied to estimate the association between green space exposure and PTB, moderately PTB (MPTB, gestational age < 35 weeks), and very PTB (VPTB, gestational age < 30 weeks), after controlling for maternal age, race/ethnicity, education, and median household income. Month-specific green space exposure was used to identify potential windows of susceptibility. Potential interactions between green space and air pollution [fine particulate matter < 2.5 µm (PM2.5), nitrogen dioxide (NO2), and ozone (O3)] were examined on both additive and multiplicative scales. ResultsIn total, 3,753,799 eligible births were identified, including 341,123 (9.09%) PTBs, 124,631 (3.32%) MPTBs, and 22,313 (0.59%) VPTBs. A reduced risk of PTB was associated with increases in residential NDVI exposure in 250 m, 500 m, 1000 m, and 2000 m buffers. In the 2000 m buffer, the association was strongest for VPTB [adjusted hazard ratio (HR) per interquartile range increase in NDVI: 0.959, 95% confidence interval (CI): 0.942–0.976)], followed by MPTB (HR = 0.970, 95% CI: 0.962–0.978) and overall PTB (HR = 0.972, 95% CI: 0.966–0.978). For PTB, green space during the 3rd − 5th gestational months had stronger associations than those in the other time periods, especially during the 4th gestational month (NDVI 2000 m: HR = 0.970, 95% CI: 0.965–0.975). We identified consistent positive additive and multiplicative interactions between decreasing green space and higher air pollution. ConclusionThis large study found that maternal exposure to residential green space was associated with decreased risk of PTB, MPTB, and VPTB, especially in the second trimester. There is a synergistic effect between low green space and high air pollution levels on PTB, indicating that increasing exposure to green space may be more beneficial for women with higher air pollution exposures during pregnancy.

The contribution of residential greenness to mortality among men with prostate cancer: a registry-based cohort study of Black and White men.

Background:Black men with prostate cancer (CaP) experience excess mortality compared with White men. Residential greenness, a health promoting contextual factor, could explain racial disparities in mortality among men with CaP.Methods:We identified Pennsylvania Cancer Registry cases diagnosed between January 2000 and December 2015. Totally, 128,568 participants were followed until death or 1 January 2018, whichever occurred first. Residential exposure at diagnosis was characterized using the Normalized Difference Vegetation Index (NDVI) with 250 m resolution. We estimated hazard ratios (HRs) using Cox models, adjusting for area-level socioeconomic status, geographic healthcare access, and segregation. To determine whether increasing residential greenness could reduce racial disparities, we compared standardized 10-year mortality Black-White risk differences under a hypothetical intervention fixing NDVI to the 75th percentile of NDVI experienced by White men.Results:We observed 29,978 deaths over 916,590 person-years. Comparing men in the highest to lowest NDVI quintile, all-cause (adjusted HR [aHR]: 0.88, 95% confidence interval [CI]: 0.84, 0.92, Ptrend < 0.0001), prostate-specific (aHR: 0.88, 95% CI: 0.80, 0.99, Ptrend= 0.0021), and cardiovascular-specific (aHR: 0.82, 95% CI: 0.74, 0.90, Ptrend < 0.0001) mortality were lower. Inverse associations between an interquartile range increase in NDVI and cardiovascular-specific mortality were observed in White (aHR: 0.90, 95% CI: 0.86, 0.93) but not Black men (aHR: 0.97, 95% CI: 0.89, 1.06; Phet = 0.067). Hypothetical interventions to increase NDVI led to nonsignificant reductions in all-cause (−5.3%) and prostate-specific (−23.2%), but not cardiovascular-specific mortality disparities (+50.5%).Discussion:Residential greenness was associated with lower mortality among men with CaP, but findings suggest that increasing residential greenness would have limited impact on racial disparities in mortality.

The association between neighborhood greenness and incidence of lethal prostate cancer: A prospective cohort study.

Growing evidence suggests that neighborhood contextual environment could influence risk factors and, therefore, incidence of lethal prostate cancer. We studied the association between neighborhood greenness and lethal prostate cancer incidence and assessed mediation by vigorous physical activity. A total of 47,958 participants were followed in the Health Professionals Follow-up Study from 1986 to 2014. Neighborhood greenness exposure was estimated using normalized difference vegetation index (NDVI) with 1 km resolution, assigned to home or work addresses at start of follow-up. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using sequentially adjusted Cox models with individual and contextual prostate cancer risk factors as covariates. Analyses were compared among those whose addresses were constant over follow-up and stratified by population density and address type. We observed 898 cases over 1,054,743 person-years. An interquartile range increase in NDVI was associated with 5% lower rate of lethal prostate cancer (aHR = 0.95, 95% CI = 0.88, 1.03), with stronger associations in nonmovers (aHR = 0.92, 95% CI = 0.85, 1.01). Inverse associations were observed among men in high (aHR = 0.90, 95% CI = 0.82, 0.99) but not low (aHR = 1.11, 95% CI = 0.95, 1.29, P het = 0.086) population density areas, and those reporting from work (aHR = 0.87, 95% CI = 0.75, 1.01) but not home (aHR = 1.04, 95% CI = 0.91, 1.17, P het = 0.10) addresses. There was no evidence of mediation by vigorous physical activity. We report inverse associations between neighborhood greenness and lethal prostate cancer when restricting to nonmovers and in high population density areas. Replication could confirm findings and clarify mechanisms.

Long-term exposure to greenspace and metabolic syndrome: A Whitehall II study

BackgroundMetabolic syndrome is an important risk factor for non-communicable diseases, particularly type 2 diabetes, coronary heart disease, and stroke. Long-term exposure to greenspace could be protective of metabolic syndrome, but evidence for such an association is lacking. Accordingly, we investigated the association between long-term exposure to greenspace and risk of metabolic syndrome. MethodsThe present longitudinal study was based on data from four clinical examinations between 1997 and 2013 in 6076 participants of the Whitehall II study, UK (aged 45–69 years at baseline). Long-term exposure to greenspace was assessed by satellite-based indices of greenspace including Normalized Difference Vegetation Index (NDVI) and Vegetation Continuous Field (VCF) averaged across buffers of 500 and 1000 m surrounding the participants’ residential location at each follow-up. The ascertainment of metabolic syndrome was based on the World Health Organization (WHO) definition. Hazard ratios for metabolic syndrome were estimated using Cox proportional hazards regression models, controlling for age, sex, ethnicity, lifestyle factors, and socioeconomic status. ResultsHigher residential surrounding greenspace was associated with lower risk of metabolic syndrome. An interquartile range increase in NDVI and VCF in the 500 m buffer was associated with 13% (95% confidence interval (CI): 1%, 23%) and 14% (95% CI: 5%, 22%) lower risk of metabolic syndrome, respectively. Greater exposure to greenspace was also associated with each individual component of metabolic syndrome, including a lower risk of high levels of fasting glucose, large waist circumference, high triglyceride levels, low HDL cholesterol, and hypertension. The association between residential surrounding greenspace and metabolic syndrome may have been mediated by physical activity and exposure to air pollution. ConclusionsThe findings of the present study suggest that middle-aged and older adults living in greener neighbourhoods are at lower risk of metabolic syndrome than those living in neighbourhoods with less greenspace.

The influence of green space on the short-term effects of particulate matter on hospitalization in the U.S. for 2000–2013

Although a few studies have identified positive association between green space and reduced mortality rate, the effect modification of green space for the impact of air pollution on health outcomes is under studied. We quantified whether green space modifies associations between short-term exposure to particulate matter (PM10, PM2.5) and hospitalization across 364 urban U.S. counties for 2000–2013. Green space was measured by normalized difference vegetation index (NDVI). Daily number of hospital admissions for cardiovascular or respiratory diseases from Medicare enrollees (≥65yrs) and air quality monitoring data for each county were used to assess risks, as percent change in hospitalization related to 10μg/m3 increase in particulate matter. We computed an absolute change in county-specific relative risks explained by difference in county-level NDVI. The study results found that the association between air pollution and health was less in areas with more green space. We estimated that an interquartile range increase in NDVI corresponds to a 1.68% (95% CI: 0.43, 2.91) decrease in the association between PM10 and cardiovascular hospitalization and 10.40% (95% CI: 7.34, 13.34) decrease in the PM10-hospitalization association of acute myocardial infarction. For hospitalization associated with PM2.5, a 0.18% (95% CI: −0.39, 0.73) absolute decrease in relative risk was found for cardiovascular hospitalizations. In results stratified by age, younger age groups (65–74, 75–84yrs) had larger reductions for the PM10-hospitalization association with increase in NDVI than older populations (≥85yrs) but not for the PM2.5-hospitalization association. These findings add evidence for health benefits of green space in diminishing the health impacts of particulate matters on hospitalizations for older populations in the U.S.

Urban residential greenness and adiposity: A cohort study in Stockholm County

BackgroundIncreasing evidence suggests that exposure to residential greenness is associated with positive health outcomes among urban populations. However, few studies have considered effects on adiposity development in a longitudinal setting. ObjectivesThis study aimed to explore the association between long-term exposure to urban residential greenness and markers of adiposity. MethodsA cohort of 5126 adults from five municipalities in Stockholm County was examined clinically at baseline (1992–1998) and follow-up (2002–2006) after on average nine years. Time-weighted average exposure to urban greenness was estimated by Normalized Difference Vegetation Index (NDVI) within 100 m, 250 m, and 500 m buffers around the residential addresses of each participant. Multiple linear and Poisson regression models were used to estimate associations between greenness and change in weight and waist circumference as well as risk of overweight, obesity and central obesity. Co-exposures to air pollution, traffic noise and distance to water were also examined. ResultsIn women, higher levels of residential greenness were associated with a reduced increase in waist circumference during follow-up (β = −0.11 cm/year, 95% CI −0.14; −0.08 per one interquartile range increase in NDVI) and decreased risk for central obesity (IRR = 0.88: 95% CI 0.79; 0.99) in the 500 m buffer. No associations were observed for men or with regard to weight development or the risk of developing overweight or obesity. Exposure to low NDVI levels in combination with high NOx from road traffic and transportation noise as well as long distance to water rendered statistically significant increases in waist circumference in both sexes. ConclusionHigher long-term exposure to greenness was associated with a reduced increase in waist circumference and lower risk of central adiposity in women but not in men. In both sexes, low NDVI exposure in combination with other environmental risk factors appeared particularly harmful.

Maternal Exposure to Greenness during Pregnancy and Birth Weight

Background/Aim: Exposure to greenness in the residential neighbourhood, measured through the normalized difference vegetation index (NDVI), has been shown to affect human health. In this study, we study the association between maternal exposure to NDVI during pregnancy and birth weight with adjustment for air pollution as well as other individual and neighbourhood confounders. Methods: For 684,266 births between 2001 and 2012 in Massachusetts, each birth was assigned an average NDVI during pregnancy using the 250 * 250 m grid cell for which the mother lived in. We regress birth weight against NDVI, particulate air pollution (PM2.5 at 1 * 1 km), and other covariates in generalized linear models. We adjust for nonlinearity in effect using splines. The full list of covariates are as follows: marital status, maternal education, government-supported prenatal care, maternal/paternal age and race, maternal cigarette smoking before/during pregnancy, parity, Kotelchuck Index for prenatal care, gestational/other diabetes and hypertension, mode of delivery, infant sex, clinical gestational age, and census-tract percent black population and median income. Results: In the linear model with NDVI and covariates, an interquartile range (IQR) increase in NDVI (0.225) was associated with a 13.87 (95% CI: 11.98, 15.75) gram increase in birth weight. After adjusting for PM2.5, an IQR increase in NDVI was associated with a 14.90 (12.91, 16.90) gram increase in birth weight. Including interactive terms between NDVI and each of government-supported prenatal care, maternal education, and infant sex did not significantly change the NDVI effect estimates. Conclusions: Maternal exposure to greenness measured through NDVI appears beneficial to newborn health as it is positively associated with birth weight, even after adjusting for highly-resolved particulate air pollution predictions and many individual / neighbourhood health and socioeconomic variables.