Long-term exposure to green and blue space and incidence of cardiovascular disease: A Danish Nurse Cohort study

IF 4.5 2区 医学 Q1 INFECTIOUS DISEASES
{"title":"Long-term exposure to green and blue space and incidence of cardiovascular disease: A Danish Nurse Cohort study","authors":"","doi":"10.1016/j.ijheh.2024.114465","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Few cohort studies have examined the associations of natural surroundings (green and blue space) with cardiovascular disease (CVD) and show mixed findings. We aimed to investigate the associations between long-term exposure to green and blue space and incidence of CVD in the Danish Nurse Cohort.</div></div><div><h3>Methods</h3><div>We followed 19,070 female nurses living in Denmark from 1993/1999 to 2018. The shortest Euclidian distance from a residence to three types of green space (park, woodland, and heathland) and four types of blue space (lake, river, coast, and wetland), along with total count of all types of natural surroundings within a 500 meter (m), 1000 m, and 5000 m radius from a residence, were calculated using GeoDanmark data from 2005. Distance was log-transformed to correct for a right-skewed data distribution. Residential air pollution and road traffic noise data for 2005 were estimated by the Danish air pollution modeling system (‘DEHM/UBM/AirGIS’) and Nord2000 model, respectively. Cox proportional hazards models were used to estimate associations between green and blue space and the first-ever incidence of total CVD and certain CVD subtypes after adjusting for individual factors, air pollution, and noise. We examined effect modification by age, smoking status, occupational status, household income, and urbanicity level. Hazard ratio (HR) and 95% confidence interval (95% CI) were presented per <em>e</em> unit (equivalent to ∼2.72 fold) increase in distance.</div></div><div><h3>Results</h3><div>8179 new cases of CVD were observed over 344,084 person-years. Living further from woodland was associated with higher stroke incidence (HR: 1.153; 95% CI: 1.029–1.293), while living further from heathland was associated with reduced total CVD incidence (HR: 0.975; 95% CI: 0.955–0.996). No associations were found between distance to park, woodland, lake, river, coast, or wetland and total CVD incidence. Total count of all types of green and blue spaces within a 5000 m radius was linked to a reduced risk of CVD incidence. Adjusting for air pollution or road traffic noise did not alter observed associations. Younger individuals (&lt;50 years old) were observed to have lower HRs when living closer to all types of natural surroundings.</div></div><div><h3>Conclusion</h3><div>We found that proximity to woodland was associated with a reduced risk of stroke, whilst no significant or even inverse associations were observed between proximity to other types of natural surroundings and CVD incidence. Total count of all types of natural surroundings within a 5000 m radius was negatively associated with CVD incidence, suggesting cumulative benefits of these areas.</div></div>","PeriodicalId":13994,"journal":{"name":"International journal of hygiene and environmental health","volume":null,"pages":null},"PeriodicalIF":4.5000,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1438463924001469/pdfft?md5=e33cac815fcb8035a318a8e0fe7d95e3&pid=1-s2.0-S1438463924001469-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of hygiene and environmental health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1438463924001469","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Few cohort studies have examined the associations of natural surroundings (green and blue space) with cardiovascular disease (CVD) and show mixed findings. We aimed to investigate the associations between long-term exposure to green and blue space and incidence of CVD in the Danish Nurse Cohort.

Methods

We followed 19,070 female nurses living in Denmark from 1993/1999 to 2018. The shortest Euclidian distance from a residence to three types of green space (park, woodland, and heathland) and four types of blue space (lake, river, coast, and wetland), along with total count of all types of natural surroundings within a 500 meter (m), 1000 m, and 5000 m radius from a residence, were calculated using GeoDanmark data from 2005. Distance was log-transformed to correct for a right-skewed data distribution. Residential air pollution and road traffic noise data for 2005 were estimated by the Danish air pollution modeling system (‘DEHM/UBM/AirGIS’) and Nord2000 model, respectively. Cox proportional hazards models were used to estimate associations between green and blue space and the first-ever incidence of total CVD and certain CVD subtypes after adjusting for individual factors, air pollution, and noise. We examined effect modification by age, smoking status, occupational status, household income, and urbanicity level. Hazard ratio (HR) and 95% confidence interval (95% CI) were presented per e unit (equivalent to ∼2.72 fold) increase in distance.

Results

8179 new cases of CVD were observed over 344,084 person-years. Living further from woodland was associated with higher stroke incidence (HR: 1.153; 95% CI: 1.029–1.293), while living further from heathland was associated with reduced total CVD incidence (HR: 0.975; 95% CI: 0.955–0.996). No associations were found between distance to park, woodland, lake, river, coast, or wetland and total CVD incidence. Total count of all types of green and blue spaces within a 5000 m radius was linked to a reduced risk of CVD incidence. Adjusting for air pollution or road traffic noise did not alter observed associations. Younger individuals (<50 years old) were observed to have lower HRs when living closer to all types of natural surroundings.

Conclusion

We found that proximity to woodland was associated with a reduced risk of stroke, whilst no significant or even inverse associations were observed between proximity to other types of natural surroundings and CVD incidence. Total count of all types of natural surroundings within a 5000 m radius was negatively associated with CVD incidence, suggesting cumulative benefits of these areas.
长期接触绿色和蓝色空间与心血管疾病的发病率:丹麦护士队列研究。
背景:很少有队列研究探讨自然环境(绿色和蓝色空间)与心血管疾病(CVD)之间的关系,研究结果也不尽相同。我们旨在调查丹麦护士队列中长期暴露于绿色和蓝色空间与心血管疾病发病率之间的关系:我们对 1993/1999 年至 2018 年期间居住在丹麦的 19070 名女护士进行了跟踪调查。我们使用 2005 年的 GeoDanmark 数据计算了居住地到三种绿地(公园、林地和荒地)和四种蓝地(湖泊、河流、海岸和湿地)的最短欧几里得距离,以及居住地半径 500 米、1000 米和 5000 米范围内所有类型自然环境的总计数。对距离进行了对数转换,以校正数据的右斜分布。2005 年的住宅空气污染和道路交通噪声数据分别由丹麦空气污染模型系统("DEHM/UBM/AirGIS")和 Nord2000 模型估算得出。在对个体因素、空气污染和噪声进行调整后,我们使用 Cox 比例危险模型来估算绿色和蓝色空间与心血管疾病总发病率和某些心血管疾病亚型的首次发病率之间的关系。我们研究了年龄、吸烟状况、职业状况、家庭收入和城市化水平对效应的影响。结果显示了距离每增加一个 e 单位(相当于 2.72 倍)的危险比(HR)和 95% 置信区间(95% CI):在 344,084 人年中观察到 8179 例心血管疾病新发病例。居住地距离林地越远,中风发病率越高(HR:1.153;95% CI:1.029-1.293),而居住地距离沼泽地越远,心血管疾病总发病率越低(HR:0.975;95% CI:0.955-0.996)。与公园、林地、湖泊、河流、海岸或湿地的距离与心血管疾病总发病率之间没有关联。半径 5000 米范围内各类绿色和蓝色空间的总计数与心血管疾病发病风险的降低有关。调整空气污染或道路交通噪音并不会改变观察到的关联。较年轻的个体(结论:我们发现,靠近林地与降低中风风险有关,而靠近其他类型的自然环境与心血管疾病发病率之间没有观察到明显的甚至是反向的联系。半径 5000 米范围内各类自然环境的总数量与心血管疾病发病率呈负相关,这表明这些区域具有累积效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
11.50
自引率
5.00%
发文量
151
审稿时长
22 days
期刊介绍: The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信