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Cerkauskaite S, Kubilius R, Dedele A, Vencloviene J. Association between greenery and health indicators in urban patients with symptomatic heart failure: a retrospective cohort study in Lithuania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2801-2812. [PMID: 37883741 DOI: 10.1080/09603123.2023.2274381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
Urban green spaces benefit physical, mental health, and reduses the risk of cardiovascular disease. A study in Kaunas, Lithuania collected health data from 100 patients with symptomatic heart failure (HF) during 2006-2009. Residential greenness was measured by the normalized difference vegetation index (NDVI). We assessed the impact of greenness on health indicators and on changes in health markers after 6 months. Higher greenness levels based on the NDVI 1-km radius were related to higher mean values of heart rate (HR) and ejection fraction and lower left ventricular (LV) end-diastolic diameter index (LV EDDI), LV end-systolic volume (ESV), left atrium size (LAS), and right atrium size (RAS) at baseline. After 6 months, a decrease in DBP and HR and an improvement in spiroergometric parameters were associated with exposure to high levels of greenness. The long-term rehabilitation group experienced significant changes in spiroergometric indicators. The results confirm that the greenness of the residential environment can improve health indicators in patients with HF.
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Affiliation(s)
- Sonata Cerkauskaite
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Raimondas Kubilius
- Department of Rehabilitation, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Audrius Dedele
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Jone Vencloviene
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Williams LA, Haynes D, Sample JM, Lu Z, Hossaini A, McGuinn LA, Hoang TT, Lupo PJ, Scheurer ME. PM2.5, vegetation density, and childhood cancer: a case-control registry-based study from Texas 1995-2011. J Natl Cancer Inst 2024; 116:876-884. [PMID: 38366656 DOI: 10.1093/jnci/djae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/05/2024] [Accepted: 02/09/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Air pollution is positively associated with some childhood cancers, whereas greenness is inversely associated with some adult cancers. The interplay between air pollution and greenness in childhood cancer etiology is unclear. We estimated the association between early-life air pollution and greenness exposure and childhood cancer in Texas (1995 to 2011). METHODS We included 6101 cancer cases and 109 762 controls (aged 0 to 16 years). We linked residential birth address to census tract annual average fine particulate matter <2.5 µg/m³ (PM2.5) and Normalized Difference Vegetation Index (NDVI). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) between PM2.5/NDVI interquartile range increases and cancer. We assessed statistical interaction between PM2.5 and NDVI (likelihood ratio tests). RESULTS Increasing residential early-life PM2.5 exposure was associated with all childhood cancers (OR = 1.10, 95% CI = 1.06 to 1.15), lymphoid leukemias (OR = 1.15, 95% CI = 1.07 to 1.23), Hodgkin lymphomas (OR = 1.27, 95% CI = 1.02 to 1.58), non-Hodgkin lymphomas (OR = 1.24, 95% CI = 1.02 to 1.51), ependymoma (OR = 1.27, 95% CI = 1.01 to 1.60), and others. Increasing NDVI exposure was inversely associated with ependymoma (0- to 4-year-old OR = 0.75, 95% CI = 0.58 to 0.97) and medulloblastoma (OR = 0.75, 95% CI = 0.62 to 0.91) but positively associated with malignant melanoma (OR = 1.75, 95% CI = 1.23 to 2.47) and Langerhans cell histiocytosis (OR = 1.56, 95% CI = 1.07 to 2.28). There was evidence of statistical interaction between NDVI and PM2.5 (P < .04) for all cancers. CONCLUSION Increasing early-life exposure to PM2.5 increased the risk of childhood cancers. NDVI decreased the risk of 2 cancers yet increased the risk of others. These findings highlight the complexity between PM2.5 and NDVI in cancer etiology.
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Affiliation(s)
- Lindsay A Williams
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
- Brain Tumor Program, University of Minnesota, Minneapolis, MN, USA
| | - David Haynes
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Jeannette M Sample
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Zhanni Lu
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Ali Hossaini
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Laura A McGuinn
- Department of Family Medicine, University of Chicago, Chicago, IL, USA
| | - Thanh T Hoang
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- Cancer and Hematology Center, Texas Children's Hospital, Houston, TX, USA
| | - Philip J Lupo
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- Cancer and Hematology Center, Texas Children's Hospital, Houston, TX, USA
| | - Michael E Scheurer
- Department of Pediatrics, Division of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
- Cancer and Hematology Center, Texas Children's Hospital, Houston, TX, USA
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Han W, Zhang J, Xu Z, Yang T, Huang J, Beevers S, Kelly F, Li G. Could the association between ozone and arterial stiffness be modified by fish oil supplementation? ENVIRONMENTAL RESEARCH 2024; 249:118354. [PMID: 38325778 DOI: 10.1016/j.envres.2024.118354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/10/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Arterial stiffness (AS) is an important predicting factor for cardiovascular disease. However, no epidemiological studies have ever explored the mediating role of biomarkers in the association between ozone and AS, nor weather fish oil modified such association. METHODS Study participants were drawn from the UK biobank, and a total of 95,699 middle-aged and older adults were included in this study. Ozone was obtained from Community Multiscale Air Quality (CMAQ) model matched to residential addresses, fish oil from self-reported intake, and arterial stiffness was based on device measurements. First, we applied a double robust approach to explore the association between ozone or fish oil intake and arterial stiffness, adjusting for potential confounders at the individual and regional levels. Then, how triglycerides, apolipoprotein B (Apo B)/apolipoprotein A (ApoA) and non-high-density lipoprotein cholesterol (Non-HDL-C) mediate the relationship between ozone and AS. Last, the modifying role of fish oil was further explored by stratified analysis. RESULTS The mean age of participants was 55 years; annual average ozone exposure was associated with ASI (beta:0.189 [95%CI: 0.146 to 0.233], P < 0.001), and compared to participants who did not consume fish oil, fish oil users had a lower ASI (beta: 0.061 [95%CI: -0.111 to -0.010], P = 0.016). The relationship between ozone exposure and AS was mediated by triglycerides, ApoB/ApoA, and Non-HDL-C with mediation proportions ranging from 10.90% to 18.30%. Stratified analysis showed lower estimates on the ozone-AS relationship in fish oil users (P = 0.011). CONCLUSION Ozone exposure was associated with higher levels of arterial stiffness, in contrast to fish oil consumption, which showed a protective association. The association between ozone exposure and arterial stiffness was partially mediated by some biomarkers. In the general population, fish oil consumption might provide protection against ozone-related AS.
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Affiliation(s)
- Wenxing Han
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Jin Zhang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Zhihu Xu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Teng Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China.
| | - Sean Beevers
- Environmental Research group, school of public health, Imperial college London, London, UK.
| | - Frank Kelly
- Environmental Research group, school of public health, Imperial college London, London, UK.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China; Environmental Research group, school of public health, Imperial college London, London, UK.
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Mendili M, Sellami Z, Somai R, Khadhri A. Assessing Tunisia's urban air quality using combined lichens and Sentinel-5 satellite integration. ENVIRONMENTAL MONITORING AND ASSESSMENT 2024; 196:545. [PMID: 38740605 DOI: 10.1007/s10661-024-12705-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/04/2024] [Indexed: 05/16/2024]
Abstract
In Tunisia, urban air pollution is becoming a bigger problem. This study used a combined strategy of biomonitoring with lichens and satellite mapping with Sentinel-5 satellite data processed in Google Earth Engine (GEE) to assess the air quality over metropolitan Tunis. Lichen diversity was surveyed across the green spaces of the Faculty of Science of Tunisia sites, revealing 15 species with a predominance of pollution-tolerant genera. The Index of Atmospheric Purity (IAP) calculated from the lichen data indicated poor air quality. Spatial patterns of pollutants sulfur dioxide (SO2), ozone (O3), nitrogen dioxide (NO2), carbon monoxide (CO), and aerosol index across Greater Tunis were analyzed from Sentinel-5 datasets on the GEE platform. The higher values of these indices in the research area indicate that it may be impacted by industrial activity and highlight the considerable role that vehicle traffic plays in air pollution. The results of the IAP, IBL, and the combined ground-based biomonitoring and satellite mapping techniques confirm poor air quality and an environment affected by atmospheric pollutants which will enable proactive air quality management strategies to be put in place in Tunisia's rapidly expanding cities.
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Affiliation(s)
- Mohamed Mendili
- Faculty of Sciences, Plant, Soil, Environment Interactions Laboratory, The University of Tunis El Manar, Campus Academia, 2092, Tunis, Tunisia.
| | - Zahra Sellami
- Faculty of Sciences, Plant, Soil, Environment Interactions Laboratory, The University of Tunis El Manar, Campus Academia, 2092, Tunis, Tunisia
| | - Rania Somai
- Faculty of Sciences, Plant, Soil, Environment Interactions Laboratory, The University of Tunis El Manar, Campus Academia, 2092, Tunis, Tunisia
| | - Ayda Khadhri
- Faculty of Sciences, Plant, Soil, Environment Interactions Laboratory, The University of Tunis El Manar, Campus Academia, 2092, Tunis, Tunisia
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Abstract
Accumulating evidence suggests that living in areas of high surrounding greenness or even brief exposures to areas of high greenery is conducive to cardiovascular health, which may be related to the environmental, social, psychological, and physiological benefits of greenspaces. Recent data from multiple cross-sectional, longitudinal, and cohort studies suggest that living in areas of high surrounding greenness is associated with a lower risk of all-cause and cardiovascular mortality. High levels of neighborhood greenery have been linked also to a decrease in the burden of cardiovascular disease risk factors as reflected by lower rates of hypertension, dyslipidemia, and diabetes. Those who live in greener environments report better mental health and more frequent social interactions, which can benefit cardiovascular health as well. In this narrative review, we discuss evidence linking greenspaces to cardiovascular health as well as the potential mechanisms underlying the beneficial effects of greenspaces, including the impact of vegetation on air, noise and light pollution, ambient temperature, physical activity, mental health, and biodiversity. We review literature on the beneficial effects of acute and chronic exposure to nature on cardiovascular disease risk factors, inflammation and immune function, and we highlight the potential cardiovascular effects of biogenic volatile organic compounds that are emitted by trees and shrubs. We identify current knowledge gaps in this area and underscore the need for additional population studies to understand more clearly and precisely the link between greenness and health. Such understanding is urgently needed to fully redeem the promise of greenspaces in preventing adverse environmental exposures, mitigating the effects of climate change, and creating healthier living environments.
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Affiliation(s)
- Rachel J Keith
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Medicine (R.J.K., A.B.), University of Louisville
| | - Joy L Hart
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Communication (J.L.H.), University of Louisville
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute (R.J.K., J.L.H., A.B.)
- Department of Medicine (R.J.K., A.B.), University of Louisville
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Rajagopalan S, Ramaswami A, Bhatnagar A, Brook RD, Fenton M, Gardner C, Neff R, Russell AG, Seto KC, Whitsel LP. Toward Heart-Healthy and Sustainable Cities: A Policy Statement From the American Heart Association. Circulation 2024; 149:e1067-e1089. [PMID: 38436070 DOI: 10.1161/cir.0000000000001217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Nearly 56% of the global population lives in cities, with this number expected to increase to 6.6 billion or >70% of the world's population by 2050. Given that cardiometabolic diseases are the leading causes of morbidity and mortality in people living in urban areas, transforming cities and urban provisioning systems (or urban systems) toward health, equity, and economic productivity can enable the dual attainment of climate and health goals. Seven urban provisioning systems that provide food, energy, mobility-connectivity, housing, green infrastructure, water management, and waste management lie at the core of human health, well-being, and sustainability. These provisioning systems transcend city boundaries (eg, demand for food, water, or energy is met by transboundary supply); thus, transforming the entire system is a larger construct than local urban environments. Poorly designed urban provisioning systems are starkly evident worldwide, resulting in unprecedented exposures to adverse cardiometabolic risk factors, including limited physical activity, lack of access to heart-healthy diets, and reduced access to greenery and beneficial social interactions. Transforming urban systems with a cardiometabolic health-first approach could be accomplished through integrated spatial planning, along with addressing current gaps in key urban provisioning systems. Such an approach will help mitigate undesirable environmental exposures and improve cardiovascular and metabolic health while improving planetary health. The purposes of this American Heart Association policy statement are to present a conceptual framework, summarize the evidence base, and outline policy principles for transforming key urban provisioning systems to heart-health and sustainability outcomes.
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Sharifi Y, Sobhani S, Ramezanghorbani N, Payab M, Ghoreshi B, Djalalinia S, Nouri Ghonbalani Z, Ebrahimpur M, Eslami M, Qorbani M. Association of greenspaces exposure with cardiometabolic risk factors: a systematic review and meta-analysis. BMC Cardiovasc Disord 2024; 24:170. [PMID: 38509487 PMCID: PMC10953288 DOI: 10.1186/s12872-024-03830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Cardiometabolic conditions are major contributors to the global burden of disease. An emerging body of evidence has associated access to and surrounding public open spaces (POS) and greenspace with cardiometabolic risk factors, including obesity, body mass index (BMI), hypertension (HTN), blood glucose (BG), and lipid profiles. This systematic review aimed to synthesize this evidence. METHODS This systematic review was conducted based on the PRISMA guidelines. Four electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for eligible articles published until July 2023. All observational studies which assessed the association of greenspace and POS with cardiometabolic risk factors including obesity, BMI, HTN, BG, and lipid profiles were included and reviewed by two authors independently. Heterogeneity between studies was assessed using the I2 index and Cochrane's Q test. Random/fixed effect meta-analyses were used to combine the association between greenspace exposure with cardiometabolic risk factors. RESULTS Overall, 118 relevant articles were included in our review. The majority of the articles were conducted in North America or Europe. In qualitative synthesis, access or proximity to greenspaces or POS impacts BMI and blood pressure or HTN, BG, and lipid profiles via various mechanisms. According to the random effect meta-analysis, more access to greenspace was significantly associated with lower odds of HTN (odds ratio (OR): 0.81, 95% confidence intervals (CIs): 0.61-0.99), obesity (OR: 0.83, 95% CIs: 0.77-0.90), and diabetes (OR:0.79, 95% CI: 0.67,0.90). CONCLUSIONS Findings of this systematic review and meta-analysis suggested that greenspace accessibility is associated with some cardiometabolic risk factors. Improving greenspace accessibility could be considered as one of the main strategies to reduce cardiometabolic risk factors at population level.
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Affiliation(s)
- Yasaman Sharifi
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Sobhani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Nahid Ramezanghorbani
- Department of Development and Coordination Scientific Information and Publications, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Moloud Payab
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnaz Ghoreshi
- Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Shirin Djalalinia
- Development of Research & Technology Center, Ministry of Health and Medical Education, Tehran, Iran
| | - Zahra Nouri Ghonbalani
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maysa Eslami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
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Riggs DW, Baumgartner KB, Baumgartner R, Boone S, Judd SE, Bhatnagar A. Long-term exposure to air pollution and risk of stroke by ecoregions: The REGARDS study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123367. [PMID: 38280465 PMCID: PMC10996890 DOI: 10.1016/j.envpol.2024.123367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
Several cohort studies have found associations between long-term exposure to air pollution and stroke risk. However, it is unclear whether the surrounding ecology may modify these associations. This study evaluates associations of air pollution with stroke risk by ecoregions, which are areas of similar type, quality, and quantity of environmental resources in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. We assessed the incidence of stroke in 26,792 participants (45+ yrs) from the REGARDS study, a prospective cohort recruited across the contiguous United States. One-yr and 3-yr means of PM2.5, PM10, O3, NO2, SO2, and CO were estimated at baseline using data from the Center for Air, Climate, & Energy Solution, and assigned to participants at the census block group level. Incident stroke was ascertained through September 30, 2020. Relations of air pollutants with the risk of incident stroke were estimated using Cox proportional hazards models, adjusting for relevant demographics, behavioral risk factors, and neighborhood urbanicity. Models were stratified by EPA designated ecoregions. A 5.4 μg/m3 (interquartile range) increase in 1-yr PM10 was associated with a hazard ratio (95 %CI) for incident stroke of 1.07 (1.003, 1.15) in the overall study population. We did not find evidence of positive associations for PM2.5, O3, NO2, SO2, and CO in the fully adjusted models. In our ecoregion-specific analysis, associations of PM2.5 with stroke were stronger in the Great Plains ecoregion (HR = 1.44) than other ecoregions, while associations for PM10 were strongest in the Eastern Temperate Forests region (HR = 1.15). The associations between long-term exposure to air pollution and risk of stroke varied by ecoregion. Our results suggests that the type, quality, and quantity of the surrounding ecology can modify the effects of air pollution on risk of stroke.
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Affiliation(s)
- Daniel W Riggs
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States; Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States.
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Richard Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Stephanie Boone
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States
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Riggs DW, Bhatnagar A. Invited Perspective: A Natural Prescription for Hypertension? ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:31301. [PMID: 38427032 PMCID: PMC10906658 DOI: 10.1289/ehp14482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024]
Affiliation(s)
- Daniel W. Riggs
- Department of Medicine, University of Louisville, Louisville, Kentucky, USA
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, USA
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10
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Poulsen AH, Sørensen M, Hvidtfeldt UA, Ketzel M, Christensen JH, Brandt J, Frohn LM, Massling A, Khan J, Münzel T, Raaschou-Nielsen O. Concomitant exposure to air pollution, green space and noise, and risk of myocardial infarction: a cohort study from Denmark. Eur J Prev Cardiol 2024; 31:131-141. [PMID: 37738461 DOI: 10.1093/eurjpc/zwad306] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 08/28/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
AIMS The three correlated environmental exposures (air pollution, road traffic noise, and green space) have all been associated with the risk of myocardial infarction (MI). The present study aimed to analyse their independent and cumulative association with MI. METHODS AND RESULTS In a cohort of all Danes aged 50 or older in the period 2005-17, 5-year time-weighted average exposure to fine particles (PM2.5), ultrafine particles, elemental carbon, nitrogen dioxide (NO2), and road traffic noise at the most and least exposed façades of residence was estimated. Green space around residences was estimated from land use maps. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence interval (CI), and cumulative risk indices (CRIs) were calculated. All expressed per interquartile range. Models were adjusted for both individual and neighbourhood-level socio-demographic covariates. The cohort included 1 964 702 persons. During follow-up, 71 285 developed MI. In single-exposure models, all exposures were associated with an increased risk of MI. In multi-pollutant analyses, an independent association with risk of MI was observed for PM2.5 (HR: 1.026; 95% CI: 1.002-1.050), noise at most exposed façade (HR: 1.024; 95% CI: 1.012-1.035), and lack of green space within 150 m of residence (HR: 1.018; 95% CI: 1.010-1.027). All three factors contributed significantly to the CRI (1.089; 95% CI: 1.076-1.101). CONCLUSION In a nationwide cohort study, air pollution, noise, and lack of green space were all independently associated with an increased risk of MI. The air pollutant PM2.5 was closest associated with MI risk.
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Affiliation(s)
- Aslak Harbo Poulsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - Mette Sørensen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Ulla A Hvidtfeldt
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Department of Civil and Environmental Engineering, Global Centre for Clean Air Research (GCARE), Surrey ,UK
| | - Jesper H Christensen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate-Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate-Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Lise M Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate-Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Andreas Massling
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jibran Khan
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Thomas Münzel
- Center for Cardiology, Cardiology I, University Medical Center Mainz of the Johannes Gutenberg University, Mainz, Germany
| | - Ole Raaschou-Nielsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen 2100, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Sadeh M, Fulman N, Agay N, Levy I, Ziv A, Chudnovsky A, Brauer M, Dankner R. Residential Greenness and Long-term Mortality Among Patients Who Underwent Coronary Artery Bypass Graft Surgery. Epidemiology 2024; 35:41-50. [PMID: 37820249 DOI: 10.1097/ede.0000000000001687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND Studies have reported inverse associations between exposure to residential greenness and mortality. Greenness has also been associated with better surgical recovery. However, studies have had small sample sizes and have been restricted to clinical settings. We investigated the association between exposure to residential greenness and all-cause mortality among a cohort of cardiac patients who underwent coronary artery bypass graft (CABG) surgery. METHODS We studied this cohort of 3,128 CABG patients between 2004 and 2009 at seven cardiothoracic departments in Israel and followed patients until death or 1st May 2021. We collected covariate information at the time of surgery and calculated the patient-level average normalized difference vegetation index (NDVI) over the entire follow-up in a 300 m buffer from the home address. We used Cox proportional hazards regression models to estimate associations between greenness and death, adjusting for age, sex, origin, socioeconomic status, type of hospital admission, peripherality, air pollution, and distance from the sea. RESULTS Mean age at surgery was 63.8 ± 10.6 for men and 69.5 ± 10.0 for women. During an average of 12.1 years of follow-up (37,912 person-years), 1,442 (46%) patients died. A fully adjusted Cox proportional hazards model estimated a 7% lower risk of mortality (HR: 0.93, 95% CI = [0.85, 1.00]) per 1 interquartile range width increase (0.04) in NDVI. Results were robust to the use of different buffer sizes (100 m-1,250 m from the home) and to the use of average NDVI exposure during the first versus the last 2 years of follow-up. CONCLUSIONS Residential greenness was associated with lower risk of mortality in CABG patients.
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Affiliation(s)
- Maya Sadeh
- From the Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Fulman
- GIScience Research Group, Institute of Geography, Heidelberg University, Heidelberg, Germany
| | - Nirit Agay
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Ilan Levy
- Air Quality Division, Israel Ministry of Environmental Protection
| | - Arnona Ziv
- Unit for Data Management and Computerization, the Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Alexandra Chudnovsky
- AIR-O Lab, Porter School of Environment and Geosciences, Faculty of Exact Sciences, Department of Geography and Human Environment, Tel Aviv University, Israel
| | - Michael Brauer
- School of Population & Public Health, University of British Columbia, Canada
| | - Rachel Dankner
- From the Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
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12
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Bhatnagar A, Keith R, Yeager R, Riggs D, Sears C, Bucknum B, Smith T, Fleischer D, Chandler C, Walker KL, Hart JL, Srivastava S, Turner J, Rai S. The Green Heart Project: Objectives, Design, and Methods. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.05.23299461. [PMID: 38105951 PMCID: PMC10723507 DOI: 10.1101/2023.12.05.23299461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The Green Heart Project is a community-based trial to evaluate the effects of increasing greenery on urban environment and community health. The study was initiated in 2018 in a low-to-middle-income mixed-race residential area of nearly 28,000 residents in Louisville, KY. The 4 square mile area was surveyed for land use, population characteristics, and greenness, and assigned to 8 paired clusters of demographically- and environmentally matched "target" (T) and adjacent "control" (C), clusters. Ambient levels of ultrafine particles, ozone, oxides of nitrogen, and environmental noise were measured in each cluster. Individual-level data were acquired during in-person exams of 735 participants in Wave 1 (2018-2019) and 545 participants in Wave 2 (2021) to evaluate sociodemographic and psychosocial factors. Blood, urine, nail, and hair samples were collected to evaluate standard cardiovascular risk factors, inflammation, stress, and pollutant exposure. Cardiovascular function was assessed by measuring arterial stiffness and flow-mediated dilation. After completion of Wave 2, more than 8,000 mature, mostly evergreen, trees and shrubs were planted in the T clusters in 2022. Post planting environmental and individual-level data were collected during Wave 3 (2022) from 561 participants. We plan to continue following changes in area characteristics and participant health to evaluate the long-term impact of increasing urban greenery.
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Affiliation(s)
- Aruni Bhatnagar
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Rachel Keith
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Ray Yeager
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Daniel Riggs
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Clara Sears
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | | | - Ted Smith
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | | | | | - Kandi L Walker
- Christina Lee Brown Envirome Institute
- Department of Communications, University of Louisville, Louisville, KY
| | - Joy L Hart
- Christina Lee Brown Envirome Institute
- Department of Communications, University of Louisville, Louisville, KY
| | - Sanjay Srivastava
- Christina Lee Brown Envirome Institute
- Department of Medicine, University of Louisville, Louisville, KY
| | - Jay Turner
- Department of Chemical Engineering, Washington University, St. Louis, MO
| | - Shesh Rai
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH
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13
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Jin L, Xie Z, Lorkiewicz P, Srivastava S, Bhatnagar A, Conklin DJ. Endothelial-dependent relaxation of α-pinene and two metabolites, myrtenol and verbenol, in isolated murine blood vessels. Am J Physiol Heart Circ Physiol 2023; 325:H1446-H1460. [PMID: 37889254 DOI: 10.1152/ajpheart.00380.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/11/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023]
Abstract
Epidemiological evidence shows that residential proximity to greenspaces is associated with lower risk of all-cause and cardiovascular mortality; however, the mechanism(s) underlying this link remains unclear. Plants emit biogenic volatile organic compounds such as α-pinene that could elicit beneficial cardiovascular effects. To explore the role of α-pinene more directly, we studied the metabolism and the vascular effects of α-pinene. We found that exposure of mice to α-pinene (1 ppm, 6 h) generated two phase I oxidation metabolites, cis- and trans-verbenol [(1R,2R,5R)-verbenol and (1 R,2S,5R)-verbenol)] and myrtenol [(1S,5R)-(+)-myrtenol] that were identified in urine by GC-MS. Precontracted naïve murine male and female aorta and superior mesenteric artery (SMA) were relaxed robustly (60% tension reduction) by increasing concentrations of α-pinene, myrtenol, and verbenol to 0.3 mM, whereas 1 mM α-pinene was vasotoxic. The SMA was six times more sensitive than the aorta to α-pinene. Both myrtenol and verbenol were equally potent and efficacious as parent α-pinene in male and female SMA. The sensitive portion of the α-pinene-, myrtenol-, and verbenol-induced relaxations in male SMA was mediated by 1) endothelium, 2) eNOS-derived NO, and 3) guanylyl cyclase (GC) activity. Moreover, α-pinene activated the transient receptor potential ankyrin-1 (TRPA1) channel whereas the metabolites did not. Endothelial-derived NO regulates blood flow, blood pressure, and thrombosis, and it is plausible that inhaled (and ingested) α-pinene (or its metabolites) augments NO release to mediate the cardiovascular benefits of exposure to greenness.NEW & NOTEWORTHY A common plant-derived biogenic volatile organic compound, α-pinene, and two of its metabolites, myrtenol and verbenol, stimulate vasorelaxation in murine superior mesenteric artery. Both α-pinene- and its metabolites induce vasorelaxation by activation of the endothelium, nitric oxide, and guanylyl cyclase. α-Pinene also activates the transient receptor potential ankyrin-1. Positive associations between greenness exposure and human cardiovascular health may be a result of the vascular action of α-pinene and its metabolites, a novel consideration.
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Affiliation(s)
- L Jin
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
| | - Z Xie
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - P Lorkiewicz
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - S Srivastava
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - A Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
| | - D J Conklin
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, Kentucky, United States
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, Kentucky, United States
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14
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Baheti B, Chen G, Ding Z, Wu R, Zhang C, Zhou L, Liu X, Song X, Wang C. Residential greenness alleviated the adverse associations of long-term exposure to ambient PM 1 with cardiac conduction abnormalities in rural adults. ENVIRONMENTAL RESEARCH 2023; 237:116862. [PMID: 37574100 DOI: 10.1016/j.envres.2023.116862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Ambient air pollution was linked to elevated risks of adverse cardiovascular events, and alterations in electrophysiological properties of the heart might be potential pathways. However, there is still lacking research exploring the associations between PM1 exposure and cardiac conduction parameters. Additionally, the interactive effects of PM1 and residential greenness on cardiac conduction parameters in resource-limited areas remain unknown. METHODS A total of 27483 individuals were enrolled from the Henan Rural Cohort study. Cardiac conduction parameters were tested by 12-lead electrocardiograms. Concentrations of PM1 were evaluated by satellite-based spatiotemporal models. Levels of residential greenness were assessed using Enhanced Vegetation Index (EVI) and Normalized difference vegetation index (NDVI). Logistic regression models and restricted cubic splines were fitted to explore the associations of PM1 and residential greenness exposure with cardiac conduction abnormalities risk, and the interaction plot method was performed to visualize their interaction effects. RESULTS The 3-year median concentration of PM1 was 56.47 (2.55) μg/m3, the adjusted odds rate (ORs) and 95% confidence intervals (CIs) for abnormal HR, PR, QRS, and QTc interval risk in response to 1 μg/m3 increase in PM1 were 1.064 (1.044, 1.085), 1.037 (1.002, 1.074), 1.061 (1.044, 1.077) and 1.046 (1.028, 1.065), respectively. Participants exposure to higher levels of PM1 had increased risks of abnormal HR (OR = 1.221, 95%CI: 1.144, 1.303), PR (OR = 1.061, 95%CI: 0.940, 1.196), QRS (OR = 1.225, 95%CI: 1.161, 1.294) and QTc interval (OR = 1.193, 95%CI: 1.121, 1.271) compared with lower levels of PM1. Negative interactive effects of exposure to PM1 and residential greenness on abnormal HR, QRS, and QTc intervals were observed (Pfor interaction < 0.05). CONCLUSION Long-term PM1 exposure was associated with elevated cardiac conduction abnormalities risks, and this adverse association might be mitigated by residential greenness to some extent. These findings emphasize that controlling PM1 pollution and increasing greenness levels might be effective strategies to reduce cardiovascular disease burdens in resource-limited areas.
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Affiliation(s)
- Bota Baheti
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Zhongao Ding
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiyu Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lue Zhou
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoqin Song
- Physical Examination Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China; NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, PR China.
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15
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Lai KY, Webster C, Gallacher JE, Sarkar C. Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review. J Urban Health 2023; 100:745-787. [PMID: 37580546 PMCID: PMC10447831 DOI: 10.1007/s11524-023-00764-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/16/2023]
Abstract
With rapid urbanization, built environment has emerged as a set of modifiable factors of cardiovascular disease (CVD) risks. We conducted a systematic review to synthesize evidence on the associations of attributes of urban built environment (e.g. residential density, land use mix, greenness and walkability) with cardiovascular risk factors (e.g. hypertension and arterial stiffness) and major CVD events including mortality. A total of 63 studies, including 31 of cross-sectional design and 32 of longitudinal design conducted across 21 geographical locations and published between 2012 and 2023 were extracted for review. Overall, we report moderately consistent evidence of protective associations of greenness with cardiovascular risks and major CVD events (cross-sectional studies: 12 of 15 on hypertension/blood pressure (BP) and 2 of 3 on arterial stiffness; and longitudinal studies: 6 of 8 on hypertension/BP, 7 of 8 on CVD mortality, 3 of 3 on ischemic heart disease mortality and 5 of 8 studies on stroke hospitalization or mortality reporting significant inverse associations). Consistently, walkability was associated with lower risks of hypertension, arterial stiffness and major CVD events (cross-sectional studies: 11 of 12 on hypertension/BP and 1 of 1 on arterial stiffness; and longitudinal studies: 3 of 6 on hypertension/BP and 1 of 2 studies on CVD events being protective). Sixty-seven percent of the studies were rated as "probably high" risk of confounding bias because of inability to adjust for underlying comorbidities/family history of diseases in their statistical models. Forty-six percent and 14% of the studies were rated as "probably high" risk of bias for exposure and outcome measurements, respectively. Future studies with robust design will further help elucidate the linkages between urban built environment and cardiovascular health, thereby informing planning policies for creating healthy cities.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Ej Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
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16
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Lv S, Shi Y, Xue Y, Hu Y, Hu M, Li S, Xie W, Li Y, Ouyang Y, Li Z, Liu M, Wei J, Guo X, Liu X. Long-term effects of particulate matter on incident cardiovascular diseases in middle-aged and elder adults: The CHARLS cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115181. [PMID: 37393817 DOI: 10.1016/j.ecoenv.2023.115181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/07/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Although there is evidence of long-term effects of particulate matter (PM) on cardiovascular diseases (CVD), researches about long-term effects of PM1 on CVD are limited. We aimed to examine the long-term effects and magnitude of PM, especially PM1, on incident CVD in China. METHODS We included 6016 participants aged ≥ 45 years without CVD at baseline in 2011 from the China Health and Retirement Longitudinal Study. Personal PM (PM1, PM2.5, and PM10) concentrations were estimated using geocoded residential address. Generalized linear mixed models and SHapley Additive exPlanation were utilized to calculate the impacts and contributions of PM on CVD. Sensitivity analyses were used to check the robustness. RESULTS After a follow up of 4-year, 481 (7.99 %) participants developed CVD. Per 10 μg/m3 uptick in 1-year average concentrations of PM1, PM2.5 and PM10 was associated with a 1.20 [95 % confidence interval (CI): 1.05-1.37], 1.13 (95 % CI: 1.11-1.15), and 1.10 (95 % CI: 1.06-1.13) fold risk of incident CVD, respectively. The 2-year average concentrations of PM1, PM2.5 and PM10 were associated with incident CVD, corresponding to a 1.03 (95 % CI: 0.96-1.10), 1.11 (95 % CI: 1.02-1.21), and 1.09 (95 % CI: 1.03-1.15) fold risk, respectively. The SHapley Additive exPlanation values of PM1, PM2.5, and PM10 were 0.170, 0.153, and 0.053, respectively, corresponding to the first, second, and fifth among all air pollutants. Effects of PM1, PM2.5 and PM10 on CVD remained statistically significant in two-pollutant models. The elderly, males, smokers and alcohol drinkers tended to have slightly higher effects, while the differences were not statistically significant (all P-values > 0.05) between subgroups. CONCLUSION Long-term exposure to PM1, PM2.5, and PM10 was associated with an increased incidence of CVD. The smaller the particle size, the more important it was for incident CVD indicating that emphasis should be placed on small size of PM.
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Affiliation(s)
- Shiyun Lv
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Yadi Shi
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yongxi Xue
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yaoyu Hu
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Meiling Hu
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Shuting Li
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Wenhan Xie
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yuan Li
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yixin Ouyang
- School of Public Health, Capital Medical University, Beijing 100069, China
| | - Zhiwei Li
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Mengmeng Liu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20742, USA
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China; National Institute for Data Science in Health and Medicine, Capital Medical University, Beijing 100069, China.
| | - Xiangtong Liu
- School of Public Health, Capital Medical University, Beijing 100069, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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17
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Paoin K, Pharino C, Vathesatogkit P, Phosri A, Buya S, Saranburut K, Ueda K, Seposo XT, Ingviya T, Kitiyakara C, Thongmung N, Sritara P. Residential greenness and kidney function: A cohort study of Thai employees. Health Place 2023; 80:102993. [PMID: 36791509 DOI: 10.1016/j.healthplace.2023.102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/26/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
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.
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Affiliation(s)
- Kanawat Paoin
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
| | - Chanathip Pharino
- Department of Environmental Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
| | - Prin Vathesatogkit
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Arthit Phosri
- Department of Environmental Health Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Suhaimee Buya
- School of Information, Computer and Communication Technology, Sirindhorn International Institute of Technology, Thammasat University, Pathum Thani, Thailand; School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Ishikawa, Japan
| | - Krittika Saranburut
- Cardiovascular and Metabolic Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kayo Ueda
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan; Graduate School of Global Environmental Sciences, Kyoto University, Kyoto, Japan
| | - Xerxes Tesoro Seposo
- Department of Hygiene, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Thammasin Ingviya
- Air Pollution and Health Effect Research Center, Prince of Songkla University, Songkhla, Thailand; Medical Data Center for Research and Innovation, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chagriya Kitiyakara
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nisakron Thongmung
- Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Piyamitr Sritara
- Department of Internal Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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18
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Li J, Liu F, Liang F, Yang Y, Lu X, Gu D. Air pollution exposure and vascular endothelial function: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:28525-28549. [PMID: 36702984 DOI: 10.1007/s11356-023-25156-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 01/02/2023] [Indexed: 06/18/2023]
Abstract
Vascular endothelial dysfunction is an early stage to cardiovascular diseases (CVDs), but whether air pollution exposure has an effect on it remains unknown. We conducted a systematic review and meta-analysis to summarize epidemiological evidence between air pollution and endothelial dysfunction. We searched the database of PubMed, EMBASE, the Cochrane Library, and Web of Science up to November 10, 2022. Fixed and random effect models were used to pool the effect change or percent change (% change) and 95% confidence interval (95% CI) of vascular function associated with particulate matter (PM) and gaseous pollutants. I2 statistics, funnel plot, and Egger's test were used to evaluate heterogeneity and publication bias. There were 34 articles included in systematic review, and 25 studies included in meta-analysis. For each 10 µg/m3 increment in short-term PM2.5 exposure, augmentation index (AIx) and pulse wave velocity (PWV) increased by 2.73% (95% CI: 1.89%, 3.57%) and 0.56% (95% CI: 0.22%, 0.89%), and flow-mediated dilation (FMD) decreased by 0.17% (95% CI: - 0.33%, - 0.00%). For each 10 µg/m3 increment in long-term PM2.5 exposure, FMD decreased by 0.99% (95% CI: - 1.41%, - 0.57%). The associations between remaining pollutants and outcomes were not statistically significant. The effect of short-term PM2.5 exposure on FMD change was stronger in population with younger age, lower female proportion, higher mean body mass index and higher PM2.5 exposure. Cardiac or vasoactive medication might attenuate this effect. Our study provides evidence that PM2.5 exposure had adverse impact on vascular endothelial function, indicating the importance of air quality improvement for early CVD prevention.
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Affiliation(s)
- Jinyue Li
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, China
| | - Fangchao Liu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, China
| | - Fengchao Liang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, China
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Yuxin Yang
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, China
| | - Xiangfeng Lu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, China
| | - Dongfeng Gu
- Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 10037, China.
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, China.
- School of Medicine, Southern University of Science and Technology, Shenzhen, 518055, China.
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19
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Wu J, Luo M, Lin N, Huang Z, Wang T, Xu T, Zhang L, You Z, Lin M, Lin K, Xie X, Guo Y. Association of greenness exposure with coronary artery stenosis and biomarkers of myocardial injury in patients with myocardial infarction. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 856:159036. [PMID: 36167129 DOI: 10.1016/j.scitotenv.2022.159036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Greenness has been linked to cardiovascular health; however, limited evidence is available regarding its association with coronary artery stenosis and biomarkers of myocardial injury. We aimed to assess these associations and examine their modification and mediation effects in patients with myocardial infarction (MI). METHODS This study included 2030 patients with MI. The normalized difference vegetation index (NDVI) was used to characterize greenness exposure. We used a logistic regression model to explore the relationship between coronary artery stenosis and residential greenness, and applied linear regression models to assess the association of greenness with biomarkers of myocardial injury. The bootstrap method was used to explore whether potential variables mediated the associations. To further investigate the exposure-response curve describing these relationships, we developed restricted cubic spline models. RESULT Compared to the lowest quartile of NDVI, the odds ratio (OR) (95 % confidence interval [CI]) for severe stenosis (≥75 % stenosis) was 0.68 (95 % CI: 0.47 to 0.98) for the third quartile. Participants in the highest greenness exposure quartile had lower levels of cardiac troponin I (cTnI), creatine kinase (CK), and creatine kinase isoenzyme (CKMB) than those in the lowest quartile (β = -0.22, 95 % CI: -0.40 to -0.05; β = -0.13, 95 % CI: -0.22 to -0.04; β = -0.07, 95 % CI: -0.14 to -0.003). The association between residential greenness and myocardial injury biomarkers was stronger in men and older participants. Mediation analyses revealed that the effects of greenness on coronary stenosis, cTnI, CK, and CKMB were mediated by systolic blood pressure (SBP) and diastolic blood pressure (DBP). CONCLUSION Higher greenness exposure was associated with coronary artery stenosis and reduced levels of myocardial injury biomarkers, including cTnI, CK, and CKMB. These associations may be partially mediated by SBP and DBP levels.
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Affiliation(s)
- Jieyu Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Manqing Luo
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China; Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Na Lin
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China; Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Zelin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Tinggui Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Tingting Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Liwei Zhang
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China; Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Zhebin You
- Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China; Fujian Heart Failure Center Alliance, Fuzhou, China; Fujian Key Laboratory of Geriatrics, Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Maoqing Lin
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China; Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Kaiyang Lin
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China; Fujian Heart Failure Center Alliance, Fuzhou, China
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China; Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China.
| | - Yansong Guo
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, China; Fujian Provincial Key Laboratory of Cardiovascular Disease, Fujian Provincial Center for Geriatrics, Fujian Provincial Clinical Research Center for Severe Acute Cardiovascular Diseases, Fuzhou, China; Fujian Heart Failure Center Alliance, Fuzhou, China.
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20
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Bikomeye JC, Balza JS, Kwarteng JL, Beyer AM, Beyer KMM. The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies. PLoS One 2022; 17:e0276517. [PMID: 36417344 PMCID: PMC9683573 DOI: 10.1371/journal.pone.0276517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
SIGNIFICANCE Globally, cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. While having different etiologies, CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with either disease. For both pathologies, factors such as poverty, lack of physical activity (PA), poor dietary intake, and climate change increase risk of adverse outcomes. Prior research has shown that greenspaces and other nature-based interventions (NBIs) contribute to improved health outcomes and climate change resilience. OBJECTIVE To summarize evidence on the impact of greenspaces or NBIs on cardiovascular health and/or cancer-related outcomes and identify knowledge gaps to inform future research. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Peer Review of Electronic Search Strategies (PRESS) guidelines, we searched five databases: Web of Science, Scopus, Medline, PsycINFO and GreenFile. Two blinded reviewers used Rayyan AI and a predefined criteria for article inclusion and exclusion. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale (NOS). This review is registered with PROSPERO, ID # CRD42021231619. RESULTS & DISCUSSION Of 2565 articles retrieved, 31 articles met the inclusion criteria, and overall had a low risk of bias. 26 articles studied cardiovascular related outcomes and 5 studied cancer-related outcomes. Interventions were coded into 4 categories: forest bathing, green exercise, gardening, and nature viewing. Outcomes included blood pressure (BP), cancer-related quality of life (QoL) and (more infrequently) biomarkers of CVD risk. Descriptions of findings are presented as well as visual presentations of trends across the findings using RAW graphs. Overall studies included have a low risk of bias; and alluvial chart trends indicated that NBIs may have beneficial effects on CVD and cancer-related outcomes. CONCLUSIONS & IMPLICATIONS (1) Clinical implication: Healthcare providers should consider the promotion of nature-based programs to improve health outcomes. (2) Policy implication: There is a need for investment in equitable greenspaces to improve health outcomes and build climate resilient neighborhoods. (3) Research or academic implication: Research partnerships with community-based organizations for a comprehensive study of benefits associated with NBIs should be encouraged to reduce health disparities and ensure intergenerational health equity. There is a need for investigation of the mechanisms by which NBIs impact CVD and exploration of the role of CVD biological markers of inflammation among cancer survivors.
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Affiliation(s)
- Jean C. Bikomeye
- Division of Epidemiology & Social Sciences, PhD Program in Public and Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Joanna S. Balza
- Division of Epidemiology & Social Sciences, PhD Program in Public and Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Jamila L. Kwarteng
- Division of Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
- MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Andreas M. Beyer
- MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
- Division of Cardiology, Department of Medicine, Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Kirsten M. M. Beyer
- Division of Epidemiology & Social Sciences, PhD Program in Public and Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
- MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
- * E-mail:
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21
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Xu Y, Yi L, Cabison J, Rosales M, O'Sharkey K, Chavez TA, Johnson M, Lurmann F, Pavlovic N, Bastain TM, Breton CV, Wilson JP, Habre R. The impact of GPS-derived activity spaces on personal PM 2.5 exposures in the MADRES cohort. ENVIRONMENTAL RESEARCH 2022; 214:114029. [PMID: 35932832 DOI: 10.1016/j.envres.2022.114029] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/22/2022] [Accepted: 07/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In-utero exposure to particulate matter with aerodynamic diameter less than 2.5 μm (PM2.5) is associated with low birth weight and health risks later in life. Pregnant women are mobile and locations they spend time in contribute to their personal PM2.5 exposures. Therefore, it is important to understand how mobility and exposures encountered within activity spaces contribute to personal PM2.5 exposures during pregnancy. METHODS We collected 48-h integrated personal PM2.5 samples and continuous geolocation (GPS) data for 213 predominantly Hispanic/Latina pregnant women in their 3rd trimester in Los Angeles, CA. We also collected questionnaires and modeled outdoor air pollution and meteorology in their residential neighborhood. We calculated three GPS-derived activity space measures of exposure to road networks, greenness (NDVI), parks, traffic volume, walkability, and outdoor PM2.5 and temperature. We used bivariate analyses to screen variables (GPS-extracted exposures in activity spaces, individual characteristics, and residential neighborhood exposures) based on their relationship with personal, 48-h integrated PM2.5 concentrations. We then built a generalized linear model to explain the variability in personal PM2.5 exposure and identify key contributing factors. RESULTS Indoor PM2.5 sources, parity, and home ventilation were significantly associated with personal exposure. Activity-space based exposure to roads was associated with significantly higher personal PM2.5 exposure, while greenness was associated with lower personal PM2.5 exposure (β = -3.09 μg/m3 per SD increase in NDVI, p-value = 0.018). The contribution of outdoor PM2.5 to personal exposure was positive but relatively lower (β = 2.05 μg/m3 per SD increase, p-value = 0.016) than exposures in activity spaces and the indoor environment. The final model explained 34% of the variability in personal PM2.5 concentrations. CONCLUSIONS Our findings highlight the importance of activity spaces and the indoor environment on personal PM2.5 exposures of pregnant women living in Los Angeles, CA. This work also showcases the multiple, complex factors that contribute to total personal PM2.5 exposure.
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Affiliation(s)
- Yan Xu
- Spatial Sciences Institute, University of Southern California, USA.
| | - Li Yi
- Spatial Sciences Institute, University of Southern California, USA.
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Karl O'Sharkey
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Thomas A Chavez
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | | | | | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, USA.
| | - John P Wilson
- Spatial Sciences Institute, University of Southern California, USA; Department of Population and Public Health Sciences, University of Southern California, USA; Department of Civil & Environmental Engineering, Computer Science, and Sociology, University of Southern California, USA.
| | - Rima Habre
- Spatial Sciences Institute, University of Southern California, USA; Department of Population and Public Health Sciences, University of Southern California, USA.
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22
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Chen Z, Liu P, Xia X, Wang L, Li X. The underlying mechanism of PM2.5-induced ischemic stroke. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 310:119827. [PMID: 35917837 DOI: 10.1016/j.envpol.2022.119827] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/04/2022] [Accepted: 07/19/2022] [Indexed: 06/15/2023]
Abstract
Under the background of global industrialization, PM2.5 has become the fourth-leading risk factor for ischemic stroke worldwide, according to the 2019 GBD estimates. This highlights the hazards of PM2.5 for ischemic stroke, but unfortunately, PM2.5 has not received the attention that matches its harmfulness. This article is the first to systematically describe the molecular biological mechanism of PM2.5-induced ischemic stroke, and also propose potential therapeutic and intervention strategies. We highlight the effect of PM2.5 on traditional cerebrovascular risk factors (hypertension, hyperglycemia, dyslipidemia, atrial fibrillation), which were easily overlooked in previous studies. Additionally, the effects of PM2.5 on platelet parameters, megakaryocytes activation, platelet methylation, and PM2.5-induced oxidative stress, local RAS activation, and miRNA alterations in endothelial cells have also been described. Finally, PM2.5-induced ischemic brain pathological injury and microglia-dominated neuroinflammation are discussed. Our ultimate goal is to raise the public awareness of the harm of PM2.5 to ischemic stroke, and to provide a certain level of health guidance for stroke-susceptible populations, as well as point out some interesting ideas and directions for future clinical and basic research.
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Affiliation(s)
- Zhuangzhuang Chen
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Peilin Liu
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xiaoshuang Xia
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Lin Wang
- Department of Geriatrics, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China
| | - Xin Li
- Department of Neurology, The Second Hospital of Tianjin Medical University, Tianjin, China; Tianjin Interdisciplinary Innovation Centre for Health and Meteorology, Tianjin, China.
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23
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Greenspace and mortality in the U.K. Biobank: Longitudinal cohort analysis of socio-economic, environmental, and biomarker pathways. SSM Popul Health 2022; 19:101194. [PMID: 36059376 PMCID: PMC9429791 DOI: 10.1016/j.ssmph.2022.101194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/06/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022] Open
Abstract
Exposure to natural greenspace benefits health through direct and indirect pathways: increasing physical activity, improving mental health, relieving social isolation, reducing exposure to extreme temperature, noise, and air pollution. Understanding the etiologic pathway of greenspace and health is needed. Here, we used a large cohort follow-up data from the U.K. Biobank to quantify the magnitude of behavioural factors, psychological factors, biomarkers/physiological measurements, co-morbid diseases, and environmental exposure as potential mediators in the relationship between greenspace and mortality. We estimated hazard ratios (HR) with Cox proportional hazards models, and undertook exploratory mediation analyses to quantify the relative contribution of five types of mediators. Our results indicate greenspace was strongly associated with lower mortality risks [per IQR of public greenspace (HR = 0.90 (95% CI 0.86-0.84)) and domestic gardens (HR = 0.91, (95% CI 0.88-0.94))]. The protective associations were especially pronounced among those with lower individual-level socioeconomic status or living in places with area-level deprivation. Exploratory mediation analysis detected benefits in pathways through reducing air pollution, relieving social isolation and depression, increased physical activity and time spent outdoor, better lung function (FEV1/FVC), and having higher serum vitamin D levels.
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24
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Wang L, Chen G, Hou J, Wei D, Liu P, Nie L, Fan K, Wang J, Xu Q, Song Y, Wang M, Huo W, Jing T, Li W, Guo Y, Wang C, Mao Z. Ambient ozone exposure combined with residential greenness in relation to serum sex hormone levels in Chinese rural adults. ENVIRONMENTAL RESEARCH 2022; 210:112845. [PMID: 35134378 DOI: 10.1016/j.envres.2022.112845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/18/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Long-term exposure to ambient ozone (O3) and residential greenness independently relate to altered hormones levels in urban settings and developed countries. However, independent and their joint associations with progestogen and androgen were sparsely studied in rural regions. MATERIALS AND METHODS A total of 6211 individuals were recruited in this study. Random forest model was applied to predict the daily average concentrations of O3 using the satellites data. Residential greenness was reflected by the normalized difference vegetation index (NDVI). Liquid chromatography-tandem mass spectrometry was used to measure serum progestogen and androgen concentrations. Gender and menopausal status modified associations of long-term exposure to O3 and residential greenness with hormones levels were analyzed by generalized linear models. RESULTS Long-term exposure to O3 was negatively related to 17-hydroxyprogesterone, testosterone, and androstenedione in both men and women (premenopausal and postmenopausal); the estimated β and 95% CI of ln-progesterone in response to per 10 μg/m3 increment in O3 concentration was -0.560 (-0.965, -0.155) in postmenopausal women. Association of long-term exposure to O3 with serum androgen levels in premenopausal and postmenopausal women were alleviated by residing in places with higher greenness. Additionally, a prominent effect of long-term exposure to O3 related to decreased serum progestogen and androgen levels was found in participants with middle- or high-level of physical activity or lower education level. CONCLUSIONS The results suggested that long-term exposure to high levels of O3 related to decreased serum androgen levels was attenuated by living in high greenness places in women regardless of menopause status. Future studies are needed to confirm the positive health effects of residential greenness on the potential detrimental effects due to exposure to O3.
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Affiliation(s)
- Lulu Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Gongbo Chen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, PR China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Dandan Wei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Pengling Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Luting Nie
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Keliang Fan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Juan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Qingqing Xu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yu Song
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Mian Wang
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Occupational and Environmental Health Sciences, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Tao Jing
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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25
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Chen W, Han Y, Wang Y, Chen X, Qiu X, Li W, Xu Y, Zhu T. Glucose Metabolic Disorders Enhance Vascular Dysfunction Triggered by Particulate Air Pollution: a Panel Study. Hypertension 2022; 79:1079-1090. [PMID: 35193365 DOI: 10.1161/hypertensionaha.121.18889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Vascular dysfunction is a biological pathway whereby particulate matter (PM) exerts deleterious cardiovascular effects. The effects of ambient PM on vascular function in prediabetic individuals are unclear. METHODS A panel study recruited 112 Beijing residents with and without prediabetes. Multiple vascular function indices were measured up to 7 times. The associations between vascular function indices and short-term exposure to ambient PM, including fine particulate matter (PM2.5), ultrafine particles, accumulation mode particles, and black carbon, and the modification of these associations by glucose metabolic status were examined using linear mixed-effects models. RESULTS Increases in brachial artery pulse pressure, central aortic pulse pressure, and ejection duration, and decreases in subendocardial viability ratio and reactive hyperemia index were significantly associated with at least one PM pollutant in all participants, indicating increased vascular dysfunction. For example, for an interquartile range increment in 5-day moving average ultrafine particles, brachial artery pulse pressure, and central aortic pulse pressure increased 5.4% (0.8%-10.4%) and 6.2% (1.2%-11.5%), respectively. Additionally, PM-associated changes in vascular function differed according to glucose metabolic status. Among participants with high fasting blood glucose levels (≥6.1 mmol/L), PM exposure was significantly associated with increased brachial artery systolic blood pressure, central aortic systolic blood pressure, brachial artery pulse pressure, central aortic pulse pressure, and augmentation pressure normalized to a heart rate of 75 bpm and decreased subendocardial viability ratio and reactive hyperemia index. Weaker or null associations were observed in the low-fasting blood glucose group. CONCLUSIONS Glucose metabolic disorders may exacerbate vascular dysfunction associated with short-term ambient PM exposure.
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Affiliation(s)
- Wu Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health (W.C., Y.H., Y.W., X.C., X.Q., Y.X., T.Z.), Peking University, Beijing, China
| | - Yiqun Han
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health (W.C., Y.H., Y.W., X.C., X.Q., Y.X., T.Z.), Peking University, Beijing, China.,Environmental Research Group, MRC Centre for Environment and Health, Imperial College London, United Kingdom (Y.H.)
| | - Yanwen Wang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health (W.C., Y.H., Y.W., X.C., X.Q., Y.X., T.Z.), Peking University, Beijing, China.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China (Y.W.)
| | - Xi Chen
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health (W.C., Y.H., Y.W., X.C., X.Q., Y.X., T.Z.), Peking University, Beijing, China.,Hebei Technology Innovation Center of Human Settlement in Green Building (TCHS), Shenzhen Institute of Building Research Co, Ltd, Xiongan, China (X.C.)
| | - Xinghua Qiu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health (W.C., Y.H., Y.W., X.C., X.Q., Y.X., T.Z.), Peking University, Beijing, China
| | - Weiju Li
- Peking University Hospital (W.L.), Peking University, Beijing, China
| | - Yifan Xu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health (W.C., Y.H., Y.W., X.C., X.Q., Y.X., T.Z.), Peking University, Beijing, China
| | - Tong Zhu
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Center for Environment and Health (W.C., Y.H., Y.W., X.C., X.Q., Y.X., T.Z.), Peking University, Beijing, China
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26
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Zhao Y, Bao WW, Yang BY, Liang JH, Gui ZH, Huang S, Chen YC, Dong GH, Chen YJ. Association between greenspace and blood pressure: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 817:152513. [PMID: 35016929 DOI: 10.1016/j.scitotenv.2021.152513] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Many studies have investigated the association between greenspaces and blood pressure (BP), but the results remain mixed. We conducted a systematic review and meta-analysis to comprehensively evaluate the evidence concerning greenspaces with BP levels and prevalent hypertension. Systematic literature searches were performed in Web of Science, PubMed, and Embase up to 25 April 2021. Combined effect estimates were calculated using random-effect models for each greenspace exposure assessment method that had been examined in ≥3 studies. Sensitivity analysis, subgroup analysis, and publication bias were also conducted. Of 38 articles (including 52 analyses, 5.2 million participants in total) examining the effects of normalized difference vegetation index (NDVI) (n = 23), proportion of greenspace (n = 11), distance to greenspace (n = 9), and others (n = 9) were identified. Most studies (65%) reported beneficial associations between greenspaces and BP levels/hypertension. Our results of meta-analyses showed that higher NDVI500m was significantly associated with lower levels of systolic blood pressure (SBP = -0.77 mmHg, 95%CI: -1.23 to -0.32) and diastolic blood pressure (DBP = -0.32 mmHg, 95%CI: -0.57 to -0.07). We also found that NDVI in different buffers and the proportion of greenspaces were significantly associated with lower odds (1-9%) of hypertension. However, no significant effect was found for distance to greenspaces. In summary, our results indicate the beneficial effects of greenspace exposure on BP and hypertension. However, future better-designed studies, preferably longitudinal, are needed to confirm and better quantify the observed benefits in BP and/or hypertension.
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Affiliation(s)
- Yu Zhao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhao-Huan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yi-Can Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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Liang Z, Wang W, Yang C, Wang Y, Shen J, Li P, Ma L, Wei F, Chen R, Liang C, Li S, Zhang L. Residential greenness and prevalence of chronic kidney disease: Findings from the China National Survey of Chronic Kidney Disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150628. [PMID: 34592294 DOI: 10.1016/j.scitotenv.2021.150628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
Green space is associated with many health benefits, but evidence concerning the effects on chronic kidney disease (CKD) has not been investigated. Using the nationwide cross-sectional study of 47,204 adults from the China National Survey of Chronic Kidney Disease dataset and residential greenness assessed by the normalized difference vegetation index (NDVI), this study evaluated the association between residential greenness and CKD prevalence. An interquartile range increase in NDVI1000m (0.26) was associated with decreased odds of CKD for all participants with an odds ratio (OR) of 0.79 (95% confidence interval [CI]: 0.73-0.86). Subgroup analyses demonstrated more apparent inverse associations in younger adults <65 years, male participants, people in higher socio-economic status, as well as people with smoking and alcohol drinking habit. In addition, more apparent inverse associations were found in regions with higher fine particulate matter (PM2.5) concentration levels, with OR of 0.56 (95% CI: 0.49, 0.65) for higher pollution regions, and OR of 0.95 (95% CI: 0.83, 1.09) for lower pollution regions (P for interaction <0.001). The exposure-response curves captured more apparent declines in OR of CKD when in lower NDVI1000m exposure ranges (<0.6), even controlling for the PM2.5 concentration. Our results indicated that residential greenness might be beneficial for the prevention and control of CKD at the population level, suggesting the positive significance of strengthening green space construction, particularly in regions with low greenness.
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Affiliation(s)
- Ze Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Wanzhou Wang
- School of Public Health, Peking University, Beijing 100191, China
| | - Chao Yang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Research Units of Diagnosis and Treatment of Immune-Mediated Kidney Diseases, Chinese Academy of Medical Sciences, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Yueyao Wang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Jiashu Shen
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Pengfei Li
- Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China
| | - Lin Ma
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Feili Wei
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Rui Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China
| | - Chenyu Liang
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Shuangcheng Li
- Key Laboratory for Earth Surface Processes of the Ministry of Education, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China.
| | - Luxia Zhang
- Renal Division, Department of Medicine, Peking University First Hospital, Peking University Institute of Nephrology, Beijing 100034, China; Advanced Institute of Information Technology, Peking University, Hangzhou 311215, China; National Institute of Health Data Science at Peking University, Beijing 100191, China.
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28
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Lai KY, Kumari S, Gallacher J, Webster C, Sarkar C. Associations of residential walkability and greenness with arterial stiffness in the UK Biobank. ENVIRONMENT INTERNATIONAL 2022; 158:106960. [PMID: 34735956 DOI: 10.1016/j.envint.2021.106960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/25/2021] [Accepted: 10/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Arterial stiffness is a key non-invasive marker of early vascular ageing, however, little is known of its associations with urban built environment. We examined the associations of objectively-measured residential walkability and greenness with arterial stiffness in a large UK-wide population cohort. METHODS We employed data from the baseline UK Biobank cohort comprising adult participants recruited over the period of 2006 to 2010. Residential walkability index, defined as a function of density (residential, retail and public transit), street-level design, and destination accessibility was measured using a 1-Km dwelling catchment, while greenness was modelled as the mean Normalized Difference Vegetation Index (NDVI) of 0.5-metre resolution assessed within a 0.5-Km catchment. Arterial stiffness index (ASI) was measured non-invasively from the pulse waveform. Linear regression models were developed to examine associations of walkability and greenness with arterial stiffness. Restricted cubic spline (RCS) models were developed to examine dose-response relationships. We also examined effect modifications by sex and age, as well as the interaction effect of greenness and walkability. RESULTS This cross-sectional study used a target sample of 169,704 UK Biobank participants aged ≥ 39 years. After full adjustments, in reference to the lowest walkability exposure quartile, those in the highest were associated with lower ASI (β = -0.083 m/s, 95% CI: -0.14 to -0.03, p = 0.005). Participants in the third and fourth NDVI greenness exposure quartiles were also associated with lower ASI (β = -0.074 m/s, -0.14 to -0.01, p < 0.020 for the third and β = -0.293 m/s, -0.36 to -0.23, p < 0.001 for the fourth quartiles in reference to the first). The inverse association between NDVI greenness and ASI was more pronounced among women (p < 0.001), older adults (p = 0.011) and among participants in the highest walkability quartile (p < 0.001). CONCLUSION Designing more walkable and greener residential environments can be a preventive intervention aimed at lowering the population distribution of vascular ageing and associated cardiovascular risks.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - Sarika Kumari
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - John Gallacher
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, United Kingdom
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Pokfulam, Hong Kong, China; School of Public Health, The University of Hong Kong, Patrick Manson Building, Sassoon Road, Pokfulam, Hong Kong, China.
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Hernandez-Garcia E, Chrysikou E, Kalea AZ. The Interplay between Housing Environmental Attributes and Design Exposures and Psychoneuroimmunology Profile-An Exploratory Review and Analysis Paper in the Cancer Survivors' Mental Health Morbidity Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10891. [PMID: 34682637 PMCID: PMC8536084 DOI: 10.3390/ijerph182010891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 12/11/2022]
Abstract
Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate the constructs of cancer survivorship care and health care delivery through physiological supportive domestic spaces. Building on the concept of therapeutic architecture, psychoneuroimmunology (PNI) indicators-with the central role in low-grade systemic inflammation-are associated with major psychiatric disorders and late effects of post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on behaviour and mental disorders. Whilst attention is paid to the non-objective measurements for examining the home environmental domains and mental health outcomes, little is gathered about the multidimensional effects on physiological responses. This exploratory review presents a first analysis of how addressing the PNI outcomes serves as a catalyst for therapeutic housing research. We argue the crucial component of housing in supporting the sustainable primary care and public health-based cancer survivorship care model, particularly in the psychopathology context. Ultimately, we illustrate a series of interventions aiming at how housing environmental attributes can trigger PNI profile changes and discuss the potential implications in the non-pharmacological treatment of cancer survivors and patients with mental morbidities.
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Affiliation(s)
- Eva Hernandez-Garcia
- The Bartlett Real Estate Institute, The Bartlett School of Sustainable Construction, University College London, London WC1E 6BT, UK;
| | - Evangelia Chrysikou
- The Bartlett Real Estate Institute, The Bartlett School of Sustainable Construction, University College London, London WC1E 6BT, UK;
- Clinic of Social and Family Medicine, Department of Social Medicine, University of Crete, 700 13 Heraklion, Greece
| | - Anastasia Z. Kalea
- Division of Medicine, University College London, London WC1E 6JF, UK;
- Institute of Cardiovascular Science, University College London, London WC1E 6HX, UK
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30
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Abstract
Inhalation of fine particulate matter (PM2.5), produced by the combustion of fossil fuels, is an important risk factor for cardiovascular disease. Exposure to PM2.5 has been linked to increases in blood pressure, thrombosis, and insulin resistance. It also induces vascular injury and accelerates atherogenesis. Results from animal models corroborate epidemiological evidence and suggest that the cardiovascular effects of PM2.5 may be attributable, in part, to oxidative stress, inflammation, and the activation of the autonomic nervous system. Although the underlying mechanisms remain unclear, there is robust evidence that long-term exposure to PM2.5 is associated with premature mortality due to heart failure, stoke, and ischemic heart disease. Expected final online publication date for the Annual Review of Medicine, Volume 73 is January 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Aruni Bhatnagar
- Department of Medicine, University of Louisville, Louisville, Kentucky 40202, USA;
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31
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Bikomeye JC, Namin S, Anyanwu C, Rublee CS, Ferschinger J, Leinbach K, Lindquist P, Hoppe A, Hoffman L, Hegarty J, Sperber D, Beyer KMM. Resilience and Equity in a Time of Crises: Investing in Public Urban Greenspace Is Now More Essential Than Ever in the US and Beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8420. [PMID: 34444169 PMCID: PMC8392137 DOI: 10.3390/ijerph18168420] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 01/14/2023]
Abstract
The intersecting negative effects of structural racism, COVID-19, climate change, and chronic diseases disproportionately affect racial and ethnic minorities in the US and around the world. Urban populations of color are concentrated in historically redlined, segregated, disinvested, and marginalized neighborhoods with inadequate quality housing and limited access to resources, including quality greenspaces designed to support natural ecosystems and healthy outdoor activities while mitigating urban environmental challenges such as air pollution, heat island effects, combined sewer overflows and poor water quality. Disinvested urban environments thus contribute to health inequity via physical and social environmental exposures, resulting in disparities across numerous health outcomes, including COVID-19 and chronic diseases such as cancer and cardiovascular diseases (CVD). In this paper, we build off an existing conceptual framework and propose another conceptual framework for the role of greenspace in contributing to resilience and health equity in the US and beyond. We argue that strategic investments in public greenspaces in urban neighborhoods impacted by long term economic disinvestment are critically needed to adapt and build resilience in communities of color, with urgency due to immediate health threats of climate change, COVID-19, and endemic disparities in chronic diseases. We suggest that equity-focused investments in public urban greenspaces are needed to reduce social inequalities, expand economic opportunities with diversity in workforce initiatives, build resilient urban ecosystems, and improve health equity. We recommend key strategies and considerations to guide this investment, drawing upon a robust compilation of scientific literature along with decades of community-based work, using strategic partnerships from multiple efforts in Milwaukee Wisconsin as examples of success.
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Affiliation(s)
- Jean C. Bikomeye
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
| | - Sima Namin
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
| | - Chima Anyanwu
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
| | - Caitlin S. Rublee
- Department of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Jamie Ferschinger
- Sixteenth Street Community Health Centers, Environmental Health & Community Wellness, 1337 S Cesar Chavez Drive, Milwaukee, WI 53204, USA;
| | - Ken Leinbach
- The Urban Ecology Center, 1500 E. Park Place, Milwaukee, WI 53211, USA;
| | - Patricia Lindquist
- Wisconsin Department of Natural Resources, Division of Forestry, 101 S. Webster Street, P.O. Box 7921, Madison, WI 53707, USA;
| | - August Hoppe
- The Urban Wood Lab, Hoppe Tree Service, 1813 S. 73rd Street, West Allis, WI 53214, USA;
| | - Lawrence Hoffman
- Department of GIS, Groundwork Milwaukee, 227 West Pleasant Street, Milwaukee, WI 53212, USA;
| | - Justin Hegarty
- Reflo—Sustainable Water Solutions, 1100 S 5th Street, Milwaukee, WI 53204, USA;
| | - Dwayne Sperber
- Wudeward Urban Forest Products, N11W31868 Phyllis Parkway, Delafield, WI 53018, USA;
| | - Kirsten M. M. Beyer
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
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32
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Silva JP, Singh A, Oldenburg B, Gunathunga W, Alagiyawanna AMAAP, Mavoa S. Associations between residential greenness and self-reported heart disease in Sri Lankan men: A cross-sectional study. PLoS One 2021; 16:e0252382. [PMID: 34048455 PMCID: PMC8162690 DOI: 10.1371/journal.pone.0252382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/15/2021] [Indexed: 11/28/2022] Open
Abstract
Cardiovascular diseases (CVDs) are major contributors to morbidity and mortality in lower-middle-income countries (LMICs). Features of the natural environment, such as greenness, are a potential, modifiable determinant of CVD, yet there is a lack of evidence, particularly in LMICs. Our study investigated associations between residential greenness, measured using the Normalized Difference Vegetation Index (NDVI), and self-reported heart disease in 5268 Sri Lankan men aged 34 to 55 years. Multivariable logistic regression models were fitted to examine associations between mean NDVI within 100 m, 400 m, 800 m, 1600 m, and 2000 m of the residential address, adjusting for age, marital status, income, education, alcohol consumption, smoking and road length. Fully adjusted models showed that a 0.1 increase in mean NDVI was associated with lower odds of heart disease when using the 400 m (OR: 0.80; 95% CI: 0.64, 1.00), 800 m (OR: 0.85; 95% CI: 0.63, 1.14), and 2000 m (OR: 0.74; 95% CI: 0.48, 1.13) buffers. Further research in different contexts, and with improved outcome measures, is needed to confirm relationships between residential greenness and heart disease in rural areas and in LMICs.
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Affiliation(s)
- J. Padmaka Silva
- Office of the Regional Director of Health Services, Monaragala, Sri Lanka
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - Ankur Singh
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - Brian Oldenburg
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
| | - Wasantha Gunathunga
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Suzanne Mavoa
- Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, Australia
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