The joint impact of greenspace and air pollution on mortality: a nationwide study in Finland.

IF 5.9 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Matti Koivuranta, Marko Korhonen, Ina Rissanen
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引用次数: 0

Abstract

Background: Greenspace has been linked to reduced mortality while air pollution has been associated with increased mortality. We examined whether the joint association of greenspace and air pollution on mortality varies across ages, sexes, educational levels, urban and rural environments, and differential levels of both exposures in a nationwide population of Finland.

Methods: This study utilized routinely collected individual-level register data from Statistics Finland encompassing all citizens aged 30 years or older in 2000 (N = 3 003 519), followed until 2019. Greenspace was measured using the Enhanced Vegetation Index (EVI), and air pollution by the concentration of fine particulate matter ≤2.5 µm (PM2.5). Cox proportional hazards models were used to assess linear and non-linear associations between EVI, PM2.5, and mortality. Age was modeled flexibly with a natural cubic spline with four knots. Analyses were stratified by sex, educational level, and urbanicity.

Results: Both EVI and PM2.5 were independently associated with mortality (EVI: HR 0.99; 95% CI: 0.98-0.99 per IQR; PM2.5: HR 1.02; 95% CI: 1.01-1.03), with evidence of an interaction between the two (EVI × PM2.5: HR 0.99; 95% CI: 0.99-0.99). The joint association varied across age, sex, education, urbanicity, and the level of both exposures. PM2.5 was primarily linearly associated with increased mortality, accounting for EVI. In contrast, the relationship between EVI and mortality was less linear and more variable.

Conclusions: Expanding greenspace may be most beneficial in areas where it is limited and where air pollution levels are high.

绿色空间和空气污染对死亡率的共同影响:芬兰的一项全国性研究。
背景:绿色空间与降低死亡率有关,而空气污染与增加死亡率有关。我们研究了绿地和空气污染对死亡率的联合关联是否因年龄、性别、教育水平、城市和农村环境的不同而不同,以及芬兰全国人口中两者暴露的不同水平。方法:本研究使用芬兰统计局常规收集的个人层面登记数据,包括2000年所有30岁及以上的公民(N = 3 003 519),随访至2019年。采用增强植被指数(Enhanced Vegetation Index, EVI)测量绿地面积,细颗粒物浓度≤2.5µm (PM2.5)测量空气污染。Cox比例风险模型用于评估EVI、PM2.5和死亡率之间的线性和非线性关联。采用四节自然三次样条灵活建模。分析按性别、教育水平和城市化程度进行分层。结果:EVI和PM2.5与死亡率独立相关(EVI: HR 0.99; 95% CI: 0.98-0.99 / IQR; PM2.5: HR 1.02; 95% CI: 1.01-1.03),两者之间存在相互作用(EVI × PM2.5: HR 0.99; 95% CI: 0.99-0.99)。这种联合关联因年龄、性别、教育程度、城市化程度和两种暴露水平而异。PM2.5主要与死亡率增加呈线性关系,并与EVI相关。相比之下,EVI和死亡率之间的关系不是线性的,而是可变的。结论:在绿地有限和空气污染水平高的地区,扩大绿地可能是最有益的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International journal of epidemiology
International journal of epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
13.60
自引率
2.60%
发文量
226
审稿时长
3 months
期刊介绍: The International Journal of Epidemiology is a vital resource for individuals seeking to stay updated on the latest advancements and emerging trends in the field of epidemiology worldwide. The journal fosters communication among researchers, educators, and practitioners involved in the study, teaching, and application of epidemiology pertaining to both communicable and non-communicable diseases. It also includes research on health services and medical care. Furthermore, the journal presents new methodologies in epidemiology and statistics, catering to professionals working in social and preventive medicine. Published six times a year, the International Journal of Epidemiology provides a comprehensive platform for the analysis of data. Overall, this journal is an indispensable tool for staying informed and connected within the dynamic realm of epidemiology.
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