There is some data suggesting that residential greenspace may protect against high blood pressure in urbanized areas, but there is no evidence of effects on hypotension, in less urbanized areas, and ...in idiosyncratic geographic contexts such as mountain valleys.
The current study aimed to investigate the associations between residential greenspace and blood pressure in an alpine valley in Austria.
We conducted a cross-sectional survey of a representative sample of 555 adults living in the Lower Inn Valley, Austria. Several definitions of blood pressure were employed: continuously-measured systolic (SBP) and diastolic blood pressure (DBP), doctor-diagnosed hyper- and hypotension, and high- and low blood pressure medication use. Greenspace metrics considered were: Normalized Difference Vegetation Index (NDVI), Soil Adjusted Vegetation Index (SAVI), and tree cover as measures of surrounding greenness in circular buffers of 100 m, 300 m, 500 m, and 1000 m around the home; distance to different types of structured green space; and having a domestic garden and a balcony. Relationships were examined across different definitions of blood pressure and greenspace and evaluated for potential effect modification by demographic factors, presence of a domestic garden/balcony, adiposity, and traffic sensitivity.
Higher overall greenness was associated with 30–40% lower odds of hyper/hypotension and 2–3 mm Hg lower SBP. Similar pattern was revealed for tree cover, however, associations with hypertension were less consistent across buffers, and SBP and DBP were lower only in association with greenness in the 100-m buffer. Having a domestic garden also seemed protective of high DBP. Residing near to forests, agricultural land, or urban green spaces was not related to blood pressure. Higher NDVI500-m was stronger associated with lower SBP in those having a domestic garden, while the effect on DBP was stronger in overweight/obese participants.
These findings support the idea that greenspace should be considered as protective of both high and low blood pressure, however, underlying mechanisms remain insufficiently understood.
•We studied associations between greenspace and blood pressure.•The study area has a unique topography (an Alpine valley).•Higher greenness was inversely associated with both hyper- and hypotension.•It was also associated with lower systolic blood pressure.•Having a domestic garden seemed protective against high blood pressure.
In a rapidly urbanizing world, many people have little contact with natural environments, which may affect health and well-being. Existing reviews generally conclude that residential greenspace is ...beneficial to health. However, the processes generating these benefits and how they can be best promoted remain unclear.
During an Expert Workshop held in September 2016, the evidence linking greenspace and health was reviewed from a transdisciplinary standpoint, with a particular focus on potential underlying biopsychosocial pathways and how these can be explored and organized to support policy-relevant population health research.
Potential pathways linking greenspace to health are here presented in three domains, which emphasize three general functions of greenspace: reducing harm (e.g. reducing exposure to air pollution, noise and heat), restoring capacities (e.g. attention restoration and physiological stress recovery) and building capacities (e.g. encouraging physical activity and facilitating social cohesion). Interrelations between among the three domains are also noted. Among several recommendations, future studies should: use greenspace and behavioural measures that are relevant to hypothesized pathways; include assessment of presence, access and use of greenspace; use longitudinal, interventional and (quasi)experimental study designs to assess causation; and include low and middle income countries given their absence in the existing literature. Cultural, climatic, geographic and other contextual factors also need further consideration.
While the existing evidence affirms beneficial impacts of greenspace on health, much remains to be learned about the specific pathways and functional form of such relationships, and how these may vary by context, population groups and health outcomes. This Report provides guidance for further epidemiological research with the goal of creating new evidence upon which to develop policy recommendations.
•Although it appears that greenspace benefits health, the pathways are unclear.•We have organized pathways into three domains that emphasize greenspace functions.•Pathways likely intertwine and vary by context, populations and health outcomes.•We identify diverse challenges in measurement and analysis that require attention.•Research guided by our discussion will better efforts to enable greenspace-related health benefits.
There are a few epidemiological studies that (1) link increased ambient air pollution (AP) with an increase in lung cancer incidence rates and (2) investigate whether residing in green spaces could ...be protective against cancer. However, it is completely unclear whether other forms of cancer are also affected by AP and if residential green spaces could lower cancer incidence rates in general. Therefore, the objective was to estimate whether AP and green space are associated with several cancer types.
The analysis was based on routine health care data from around 1.9 million people from Saxony who were free of cancer in 2008 and 2009. Incident cancer cases (2010-2014) of mouth and throat, skin (non-melanoma skin cancer - NMSC), prostate, breast, and colorectum were defined as: (1) one inpatient diagnosis, or (2) two outpatient diagnoses in two different quarters within one year and a specific treatment or death within two quarters after the diagnosis. Exposures, derived from freely available 3rd party data, included particulate matter with aerodynamic diameter of less than 10 μm (PM
) and nitrogen dioxide (N0
) as well as green space (Normalized Difference Vegetation Index - NDVI). Associations between air pollutants, green space, and cancer incidence were assessed by multilevel Poisson models. Age, sex, physician contacts, short- and long-term unemployment, population density, and having an alcohol-related disorder were considered as potential confounders.
Three thousand one hundred seven people developed mouth and throat cancer, 33,178 NMSC, 9611 prostate cancer, 9577 breast cancer, and 11,975 colorectal cancer during the follow-up period (2010-2014). An increase in PM
of 10 μg/m
was associated with a 53% increase in relative risk (RR) of mouth and throat cancer and a 52% increase in RR of NMSC. Prostate and breast cancer were modestly associated with PM
with an increase in RR of 23 and 19%, respectively. The associations with N0
were in the same direction as PM
but the effect estimates were much lower (7-24%). A 10% increase in NDVI was most protective of mouth and throat cancer (- 11% RR) and of NMSC (- 16% RR). Colorectal cancer was not affected by any of the exposures.
In addition to the studies carried out so far, this study was able to provide evidence that higher ambient AP levels increase the risk of mouth and throat cancer as well as of NMSC and that a higher residential green space level might have a protective effect for NMSC in areas with low to moderate UV intensity. Nevertheless, we cannot rule out residual confounding by socioeconomic or smoking status.
•Biodiversity underpins human health as an essential life-support system.•We present an integrated biodiversity-health framework.•Biodiversity influences human health via four domains of ...pathways.•The four pathway domains are: reducing harm, restoring capacities, building capacities, and causing harm.•Understanding biodiversity-health pathways can inform public health interventions.
Biodiversity is a cornerstone of human health and well-being. However, while evidence of the contributions of nature to human health is rapidly building, research into how biodiversity relates to human health remains limited in important respects. In particular, a better mechanistic understanding of the range of pathways through which biodiversity can influence human health is needed. These pathways relate to both psychological and social processes as well as biophysical processes. Building on evidence from across the natural, social and health sciences, we present a conceptual framework organizing the pathways linking biodiversity to human health. Four domains of pathways—both beneficial as well as harmful—link biodiversity with human health: (i) reducing harm (e.g. provision of medicines, decreasing exposure to air and noise pollution); (ii) restoring capacities (e.g. attention restoration, stress reduction); (iii) building capacities (e.g. promoting physical activity, transcendent experiences); and (iv) causing harm (e.g. dangerous wildlife, zoonotic diseases, allergens). We discuss how to test components of the biodiversity-health framework with available analytical approaches and existing datasets. In a world with accelerating declines in biodiversity, profound land-use change, and an increase in non-communicable and zoonotic diseases globally, greater understanding of these pathways can reinforce biodiversity conservation as a strategy for the promotion of health for both people and nature. We conclude by identifying research avenues and recommendations for policy and practice to foster biodiversity-focused public health actions.
A growing number of epidemiological studies show associations between environmental factors and impaired cardiometabolic health. However, evidence is scarce concerning these risk factors and their ...impact on metabolic syndrome (MetS). This analysis aims to investigate associations between long-term exposure to air pollution, road traffic noise, residential greenness, and MetS.
We used data of the first (F4, 2006-2008) and second (FF4, 2013-2014) follow-up of the population-based KORA S4 survey in the region of Augsburg, Germany, to investigate associations between exposures and MetS prevalence at F4 (N = 2883) and MetS incidence at FF4 (N = 1192; average follow-up: 6.5 years). Residential long-term exposures to air pollution - including particulate matter (PM) with a diameter < 10 µm (PM
), PM < 2.5 µm (PM
), PM between 2.5 and 10 µm (PM
), absorbance of PM
(PM2.5
), particle number concentration (PNC), nitrogen dioxide (NO
), ozone (O
) - and road traffic noise were modeled by land-use regression models and noise maps. For greenness, the Normalized Difference Vegetation Index (NDVI) was obtained. We estimated Odds Ratios (OR) for single and multi-exposure models using logistic regression and generalized estimating equations adjusted for confounders. Joint Odds Ratios were calculated based on the Cumulative Risk Index. Effect modifiers were examined with interaction terms.
We found positive associations between prevalent MetS and interquartile range (IQR) increases in PM
(OR: 1.15; 95% confidence interval 95% CI: 1.02, 1.29), PM
(OR: 1.14; 95% CI: 1.02, 1.28), PM
(OR: 1.14; 95% CI: 1.02, 1.27), and PM
abs (OR: 1.17; 95% CI: 1.03, 1.32). Results further showed negative, but non-significant associations between exposure to greenness and prevalent and incident MetS. No effects were seen for exposure to road traffic noise. Joint Odds Ratios from multi-exposure models were higher than ORs from models with only one exposure.
A growing body of scientific literature indicates that urban green- and bluespace support mental health; however, little research has attempted to address the complexities in likely interrelations ...among the pathways through which benefits plausibly are realized.
The present study examines how different plausible pathways between green/bluespace and mental health can work together. Both objective and perceived measures of green- and bluespace are used in these models.
We sampled 720 students from the city of Plovdiv, Bulgaria. Residential greenspace was measured in terms of the Normalized Difference Vegetation Index (NDVI), tree cover density, percentage of green areas, and Euclidean distance to the nearest green space. Bluespace was measured in terms of its presence in the neighborhood and the Euclidean distance to the nearest bluespace. Mental health was measured with the 12-item form of the General Health Questionnaire (GHQ-12). The following mediators were considered: perceived neighborhood green/bluespace, restorative quality of the neighborhood, social cohesion, physical activity, noise and air pollution, and environmental annoyance. Structural equation modelling techniques were used to analyze the data.
Higher NDVI within a 300 m buffer around the residence was associated with better mental health through higher perceived greenspace; through higher perceived greenspace, leading to increased restorative quality, and subsequently to increased physical activity (i.e., serial mediation); through lower noise exposure, which in turn was associated with lower annoyance; and through higher perceived greenspace, which was associated with lower annoyance. Presence of bluespace within a 300 m buffer did not have a straightforward association with mental health owing to competitive indirect paths: one supporting mental health through higher perceived bluespace, restorative quality, and physical activity; and another engendering mental ill-health through higher noise exposure and annoyance.
We found evidence that having more greenspace near the residence supported mental health through several indirect pathways with serial components. Conversely, bluespace was not clearly associated with mental health.
•Green/bluespace might support mental health.•We examined pathways underlying the effect.•Increased greenspace supported mental health through indirect pathways.•Bluespace was not clearly associated with mental health.
•Our results confirm that short-term exposures are associated with lung health outcomes.•This study extends our knowledge that lifelong exposure increase the risk of poor lung health.•Lifelong ...exposure to air pollution impact asthma attacks, rhinitis and low lung function.•Lifelong exposure to greenness increased the risk of low lung function in adulthood.
To investigate if air pollution and greenness exposure from birth till adulthood affects adult asthma, rhinitis and lung function. Methods: We analysed data from 3428 participants (mean age 28) in the RHINESSA study in Norway and Sweden. Individual mean annual residential exposures to nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5), black carbon (BC), ozone (O3) and greenness (normalized difference vegetation index (NDVI)) were averaged across susceptibility windows (0–10 years, 10–18 years, lifetime, adulthood (year before study participation)) and analysed in relation to physician diagnosed asthma (ever/allergic/non-allergic), asthma attack last 12 months, current rhinitis and low lung function (lower limit of normal (LLN), z-scores of forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC below 1.64). We performed logistic regression for asthma attack, rhinitis and LLN lung function (clustered with family and study centre), and conditional logistic regression with a matched case-control design for ever/allergic/non-allergic asthma. Multivariable models were adjusted for parental asthma and education. Results: Childhood, adolescence and adult exposure to NO2, PM10 and O3 were associated with an increased risk of asthma attacks (ORs between 1.29 and 2.25), but not with physician diagnosed asthma. For rhinitis, adulthood exposures seemed to be most important. Childhood and adolescence exposures to PM2.5 and O3 were associated with lower lung function, in particular FEV1 (range ORs 2.65 to 4.21). No associations between NDVI and asthma or rhinitis were revealed, but increased NDVI was associated with lower FEV1 and FVC in all susceptibility windows (range ORs 1.39 to 1.74). Conclusions: Air pollution exposures in childhood, adolescence and adulthood were associated with increased risk of asthma attacks, rhinitis and low lung function in adulthood. Greenness was not associated with asthma or rhinitis, but was a risk factor for low lung function.
Living in greener areas has many health benefits, but evidence concerning the effects on blood pressure remains mixed. We sought to assess associations between community greenness and both blood ...pressure and hypertension in Chinese urban dwellers, and whether the associations were mediated by air pollution, body mass index, and physical activity.
We analyzed data from 24,845 adults participating in the 33 Communities Chinese Health Study, which was conducted in Northeastern China during 2009. We measured each participant's blood pressure according to a standardized protocol. We assessed community greenness using two satellite-derived vegetation indexes – the Normalized Difference Vegetation Index (NDVI) and the Soil Adjusted Vegetation Index (SAVI). Particulate matter ≤2.5 μm and nitrogen dioxide were used as proxies of ambient air pollution. We applied generalized linear mixed models to investigate the association between greenness and blood pressure. We also performed mediation analyses.
Living in greener areas was associated with lower blood pressure and hypertension prevalence; an interquartile range increase in both NDVI500-m and SAVI500-m were significantly associated with reductions in systolic blood pressure of 0.82 mm Hg (95% CI: −1.13, −0.51) and 0.89 mm Hg (95% CI: −1.21, −0.57), respectively. The same increases in greenness were also significantly associated with a 5% (95% CI: 1%, 8%) and 5% (95% CI: 1%, 9%) lower odds of having hypertension, respectively. These associations remained consistent in sensitivity analyses. The associations were stronger among women than men. Air pollutants and body mass index partly mediated the associations, but there was no evidence of mediation effects for physical activity.
Our findings indicate beneficial associations between community greenness and blood pressure in Chinese adults, especially for women. Air pollution and body mass index only partly mediated the associations.
•Evidence on greenness and blood pressure is scarce in China.•We conducted a cross-sectional study in 24,845 Chinese urban dwellers.•Associations of greenness with blood pressure metrics were examined.•Greenness levels were beneficially associated with blood pressure.•Air pollution and BMI partly mediated the greenness-blood pressure association.
People spend most of their time inside buildings and the indoor microbiome is a major part of our everyday environment. It affects humans' wellbeing and therefore its composition is important for use ...in inferring human health impacts. It is still not well understood how environmental conditions affect indoor microbial communities. Existing studies have mostly focussed on the local (e.g., building units) or continental scale and rarely on the regional scale, e.g. a specific metropolitan area. Therefore, we wanted to identify key environmental determinants for the house dust microbiome from an existing collection of spatially (area of Munich, Germany) and temporally (301 days) distributed samples and to determine changes in the community as a function of time. To that end, dust samples that had been collected once from the living room floors of 286 individual households, were profiled for fungal and bacterial community variation and diversity using microbial fingerprinting techniques. The profiles were tested for their association with occupant behaviour, building characteristics, outdoor pollution, vegetation, and urbanization. Our results showed that more environmental and particularly outdoor factors (vegetation, urbanization, airborne particulate matter) affected the community composition of indoor fungi than of bacteria. The passage of time affected fungi and, surprisingly, also strongly affected bacteria. We inferred that fungal communities in indoor dust changed semi-annually, whereas bacterial communities paralleled outdoor plant phenological periods. These differences in temporal dynamics cannot be fully explained and should be further investigated in future studies on indoor microbiomes.
Evidence on the association between long-term exposure to particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) and cardiovascular disease (CVD) is scarce in developing countries. Moreover, ...few studies assessed the role of the PM1 (≤1.0 μm) size fraction and CVD. We investigated the associations between PM1 and PM2.5 and CVD prevalence in Chinese adults.
In 2009, we randomly recruited 24,845 adults at the age of 18–74 years from 33 communities in Northeastern China. CVD status was determined by self-report of doctor-diagnosed CVD. Three-year (2006–08) average concentrations of PM1 and PM2.5 were assigned using a satellite-based exposure. We used spatial Generalized Linear Mixed Models to evaluate the associations between air pollutants and CVD prevalence, adjusting for multiple covariates. Stratified and interaction analyses and sensitivity analyses were also performed.
A 10 μg/m3 increase in long-term exposure to ambient PM1 levels was associated a 12% higher odds for having CVD (OR = 1.12; 95% CI = 1.05–1.20). Compared to PM1, association between PM2.5 and CVD was lower (OR = 1.06; 95% CI = 1.01–1.11). No significant association was observed for PM1–2.5 (1–2.5 μm) size fraction (OR = 0.98; 95% CI = 0.85–1.13). Stratified analyses showed greater effect estimates in men and the elder.
Long-term PM1 exposure was positively related to CVD, especially in men and the elder. In addition, PM1 may play a greater role than PM2.5 in associations with CVD. Further longitudinal studies are warranted to confirm our findings.
•Studies on PM1 and PM2.5 and cardiovascular disease (CVD) are scarce in China.•We conducted a cross-sectional study in 24,845 Chinese urban dwellers.•Associations of PM1 and PM2.5 with CVD were examined.•Long-term PM1 air pollution was associated with higher odds for CVD.•PM1 plays a greater role than PM2.5 in associations with CVD.
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