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Potential pathways linking urban green spaces to improved health include relaxation, stress alleviation, and improved immune system functioning. Epigenetic age acceleration (EAA) is a composite biomarker of biological aging based on DNA methylation measurements; it is predictive of morbidity and mortality. This cross-sectional study of 116 adult residents of a metropolitan area in central North Carolina investigated associations between exposure to residential green spaces and EAA using four previously developed epigenetic age formulas. DNA methylation tests of white blood cells were conducted using Illumina MethylationEPIC v1.0 assays. EAA values were calculated as residuals from the linear regression model of epigenetic age on chronological age. Residential greenness was characterized using tree cover, total vegetated land cover, and normalized difference vegetation index (NDVI) data. An interquartile range (IQR) increase in distance-to-residence weighted average greenness within 500 m of residence was consistently associated with a reduced EAA adjusted for sociodemographic covariates, smoking status, white blood cell fractions, and the two-dimensional spline function of geographic coordinates. The reduction in the EAA estimates for the four EAA measures ranged from − 1.0 to − 1.6 years for tree cover, from − 1.2 to − 1.5 years for vegetated land cover, and from − 0.9 to − 1.3 years for the NDVI; 11 of the 12 associations were statistically significant (p < 0.05). This study produced new evidence linking reduced epigenetic aging to greater greenness near residences. [ABSTRACT FROM AUTHOR]

Abstract Objective The aim of this study was to investigate the associations between residential greenness, air pollution (PM2.5, PM10, and NO2), and the risk of visual impairment in Chinese middle-aged and elderly adults. Methods The data were used from the China Health and Retirement Longitudinal Study (CHARLS), focusing on adults aged 45 years and older. Exposure to residential greenness was assessed using the Normalized Difference Vegetation Index (NDVI), while air pollution exposure (PM2.5, PM10, and NO2) was estimated from the ChinaHighAirPollutants dataset. Visual impairment was self-reported and categorized as distance visual impairment (DVI) and near visual impairment (NVI). Cox proportional hazards models were applied to investigate the associations between residential greenness, air pollution, and visual impairment. Furthermore, we investigated the potential modification and mediation relationship between residential greenness, air pollution and visual impairment. Results A total of 9,591 participants were included in this study. During a 7-year period, 2,650 cases of DVI and 3,130 cases of NVI were identified. In the single exposure model, a higher level of residential greenness was associated with a significantly reduced risk of both DVI and NVI. Specifically, for every 0.1 unit increase in NDVI, the hazard ratio (HR) was 0.68 (95%CI: 0.65,0.71) for DVI, and 0.67 (95%CI: 0.64,0.69) for NVI. Conversely, exposure to air pollution was positively associated with increased risks for both DVI and NVI. For each 10 µg/m3 increase in PM2.5, the HR was 1.60 (95%CI: 1.56,1.65) for DVI and 1.64 (95%CI: 1.60,1.69) for NVI. Similarly, PM10 and NO2 exposure showed elevated risks with HR of 1.28 (95%CI: 1.27,1.30) and 1.73 (95%CI: 1.62,1.85) for DVI, and 1.30 (95%CI: 1.28,1.32) and 1.82 (95%CI: 1.72,1.94) for NVI, respectively. The multiple exposure model also showed significant association between residential greenness, air pollution and visual impairment risk. Additionally, the adverse effects of PM2.5, PM10, and NO2 were attenuated in areas with the highest levels of residential greenness. Mediation analysis revealed that air pollution mediated a significant portion of the association between residential greenness and visual impairment. Conclusion This study suggests that increased residential greenness may reduce the risk of visual impairment, partially by mitigating air pollution exposure. These findings highlight the environmental benefits to improve air quality and enhance green spaces, thereby promoting visual health in aging populations.

Objective: The aim of this study was to investigate the associations between residential greenness, air pollution (PM2.5, PM10, and NO2), and the risk of visual impairment in Chinese middle-aged and elderly adults. Methods: The data were used from the China Health and Retirement Longitudinal Study (CHARLS), focusing on adults aged 45 years and older. Exposure to residential greenness was assessed using the Normalized Difference Vegetation Index (NDVI), while air pollution exposure (PM2.5, PM10, and NO2) was estimated from the ChinaHighAirPollutants dataset. Visual impairment was self-reported and categorized as distance visual impairment (DVI) and near visual impairment (NVI). Cox proportional hazards models were applied to investigate the associations between residential greenness, air pollution, and visual impairment. Furthermore, we investigated the potential modification and mediation relationship between residential greenness, air pollution and visual impairment. Results: A total of 9,591 participants were included in this study. During a 7-year period, 2,650 cases of DVI and 3,130 cases of NVI were identified. In the single exposure model, a higher level of residential greenness was associated with a significantly reduced risk of both DVI and NVI. Specifically, for every 0.1 unit increase in NDVI, the hazard ratio (HR) was 0.68 (95%CI: 0.65,0.71) for DVI, and 0.67 (95%CI: 0.64,0.69) for NVI. Conversely, exposure to air pollution was positively associated with increased risks for both DVI and NVI. For each 10 µg/m3 increase in PM2.5, the HR was 1.60 (95%CI: 1.56,1.65) for DVI and 1.64 (95%CI: 1.60,1.69) for NVI. Similarly, PM10 and NO2 exposure showed elevated risks with HR of 1.28 (95%CI: 1.27,1.30) and 1.73 (95%CI: 1.62,1.85) for DVI, and 1.30 (95%CI: 1.28,1.32) and 1.82 (95%CI: 1.72,1.94) for NVI, respectively. The multiple exposure model also showed significant association between residential greenness, air pollution and visual impairment risk. Additionally, the adverse effects of PM2.5, PM10, and NO2 were attenuated in areas with the highest levels of residential greenness. Mediation analysis revealed that air pollution mediated a significant portion of the association between residential greenness and visual impairment. Conclusion: This study suggests that increased residential greenness may reduce the risk of visual impairment, partially by mitigating air pollution exposure. These findings highlight the environmental benefits to improve air quality and enhance green spaces, thereby promoting visual health in aging populations. [ABSTRACT FROM AUTHOR]

ObjectivesWe aimed to quantify the relationships of surrounding residential greenness with abdominal obesity and dyslipidemia.MethodsA systematic search was conducted in January 2024 through 5 electronic databases including Pubmed, Scopus, Web of Science, and CINHAL (Complete and GreenFILE). The DerSimonian and Laird method was used to calculate the pooled odds ratios (ORs) and their respective 95% confidence intervals (CIs). The study protocol was registered in PROSPERO (CRD42024528548).ResultsEleven cross-sectional studies involving 564,254 individuals with a mean age of 55.95 years were included. A significant inverse relationship was observed between increased surrounding greenness and lower odds of abdominal obesity (OR: 0.80; 95% CI: 0.70–0.91), elevated TG (OR: 0.97; 95% CI: 0.96–0.97), and low HDL-C levels (OR: 0.98; 95% CI: 0.95–1.00).ConclusionAbdominal obesity and elevated triglyceride levels could be reduced in the general adult population by increasing residential greenness. These findings underscore the importance of integrating greenness into urban planning and public health policies to promote healthier environments. Interventions such as the development of urban green spaces could play a crucial role in reducing cardiometabolic risk factors.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024528548

Residential exposure to greenness has shown positive influences on pregnancy outcomes like birth weight, preterm births, and small to gestational age (SGA) deliveries. We aimed to comprehensively review and investigate these associations by conducting a systematic review with meta-analysis. Relevant studies were retrieved from PubMed, EMBASE, ScienceDirect, and Google Scholar databases before June 2023. Summary effect estimates included birth weight, low birth weight (LBW), preterm births, and SGA which were calculated for 0.1 unit increase in residential greenness exposure. Overall quality of the evidence was examined through Joanna Briggs Institute (JBI) critical appraisal tool. The review included 31 articles and found a statistically significant increase in birth weight measured at 250 m buffer distance (β = 8.95, 95% CI = 1.63–16.27). Green spaces were also associated with lower odds of LBW (OR = 0.97, 95% CI = 0.96–0.98). Residential greenness had positive impacts on pregnancy outcomes that calls for emphasis on urban planning, especially in developing countries. [ABSTRACT FROM AUTHOR]

Background: The association between greenness exposure and semen quality and the underlying mechanism are unclear. Objectives: To assess the association between greenness exposure and semen quality and whether the association is mediated by air pollutant exposure. Methods: We collected data from 10,273 men in Zhejiang, China, whose wives received assisted reproductive technology from 2015 to 2021. The mean exposure concentrations of air pollutants and greenness indices (normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI)) in the 300 m, 400 m, 800 m, and 1000 m buffer zones were assessed from 0–90 days prior to semen testing on the basis of the patient’s residential address. A multivariate linear mixed-effects model was used to evaluate the associations, and mediation analysis was used to investigate the influences of air pollutant exposure and body mass index (BMI) on the associations. Results: The average (standard deviation) age of the participants was 33.1 (5.2) years. After adjusting for confounders, progressive motility was positively associated with the NDVI400m (β (95 % CI): 1.744 (0.834, 2.655)) and SAVI400m (β (95 % CI): 1.484 (0.591, 2.377)). Furthermore, we found that NO2 and CO exposure significantly mediated part of the association between greenness exposure and progressive motility. Similar results are observed in the sensitivity analysis. Conclusions: Our results suggest that greater greenness exposure is associated with higher semen quality and can be partially mediated by lower NO2 and CO exposure levels.

Objective: Early life microbial exposure influences the composition of gut microbiota. We investigated how early life factors, and the green living environment around infants’ homes, influence the development of gut microbiota during infancy by utilizing data from the Steps to Healthy Development follow-up study (the STEPS study). Methods: The gut microbiota was analyzed at early (∼3 months, n = 959), and late infancy (∼13 months, n = 984) using 16S rRNA amplicon sequencing, and combined with residential green environment, measured as (1) Normalized Difference Vegetation Index, (2) Vegetation Cover Diversity, and (3) Naturalness Index within a 750 m radius. We compared gut microbiota diversity and composition between early and late infancy, identified significant individual and family level early life factors influencing gut microbiota, and determined the role of the residential green environment measures on gut microbiota development. Results: Alpha diversity (t-test, p

This study aimed to investigate the association between residential greenness and tinnitus and the potential interaction between greenness and genetic predisposition to tinnitus. The normalized difference vegetation index (NDVI) is used to measure residential greenness. The tinnitus is defined based on self‐reported. In the cross‐sectional analyses, logistic regression models are used for the baseline sample of the United Kingdom Biobank cohort. In the secondary analysis, a Cox proportional hazard model is used for a subsample of participants who completed the tinnitus questionnaire at follow‐up. In the cross‐sectional analysis including 106471 participants, higher residential greenness is associated with lower odds of tinnitus for each interquartile range increase in continuous NDVI, with an adjusted odds ratio of 0.97 (95% confidence interval: 0.95 to 0.99) for tinnitus. A similar association is observed in the longitudinal analysis, with an adjusted hazard ratio of 0.92 (95% confidence interval: 0.86 to 0.98) for the association of NDVI increased per interquartile range with incident tinnitus. Moreover, there is a significant interaction between greenness and genetic predisposition to tinnitus (P < 0.05). This study suggested that residential greenness is negatively associated with tinnitus. Greenness and genetic predisposition to tinnitus are found to have a significant interaction. [ABSTRACT FROM AUTHOR]

The global population is at risk of vitamin D deficiency due to low exposure to sunlight and low intake of the vitamin through diet. The aim of this study was to investigate in women the association between vitamin D status and parathyroid hormone (PTH), ultraviolet radiation, lifestyle, ethnicity, social conditions, and residential greenness. A 1-year longitudinal study assessed vitamin D status in 309 women living at latitude 51°14′ N. Blood samples were taken four times throughout the year for analysis of 25(OH)D and serum PTH concentration. After each seasonal visit, the individuals completed 4-day diet diaries and used two dosimeter badges for 1 week to estimate weekly UVR exposure. A questionnaire was applied to provide information about lifestyle and their ethnicity. Residential greenness was measured by Normalized Difference Vegetation Index (NDVI), within a 1000 m radius around each participant's home address. Women living in greener spaces were more likely to have improved vitamin D status (RR: 1.51; 95%CI: 1.13–2.02), as well as those who were more exposed to UVR (RR: 2.05; 95%CI: 1.44–2.92). Our results provide an insight into the connection between residential greenness, lifestyle, and vitamin D status comparing two ethnicities in a country with a temperate climate and with a high degree of urbanization. [ABSTRACT FROM AUTHOR]

Purpose: This population‐based study examines the associations between physical activity (PA), residential environmental greenness, and cardiac health measured by resting short‐term heart rate variability (HRV). Methods: Residential greenness of a birth cohort sample (n = 5433) at 46 years was measured with normalized difference vegetation index (NDVI) by fixing a 1 km buffer around each participant's home. Daily light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and the combination of both (MVPA) were measured using a wrist‐worn accelerometer for 14 days. Resting HRV was measured with a heart rate monitor, and generalized additive modeling (GAM) was used to examine the association between PA, NDVI, and resting HRV. Results: In nongreen areas, men had less PA at all intensity levels compared to men in green areas. Women had more LPA and total PA and less MPA, MVPA, and VPA in green residential areas compared to nongreen areas. In green residential areas, men had more MPA, MVPA, and VPA than women, whereas women had more LPA than men. GAM showed positive linear associations between LPA, MVPA and HRV in all models. Conclusions: Higher LPA and MVPA were significantly associated with increased HRV, irrespective of residential greenness. Greenness was positively associated with PA at all intensity levels in men, whereas in women, a positive association was found for LPA and total PA. A positive relationship of PA with resting HRV and greenness with PA was found. Residential greenness for promoting PA and heart health in adults should be considered in city planning. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: High blood pressure (HBP) and diabetes mellitus (DM) are two of the most prevalent cardiometabolic disorders globally, especially among individuals with lower socio-economic status (SES). Studies have linked residential greenness to decreased risks of HBP and DM. However, there has been limited evidence on whether SES may modify the associations of residential greenness with HBP and DM. Methods: Based on a national representative cross-sectional study among 44,876 adults, we generated the normalized difference vegetation index (NDVI) at 1 km spatial resolution to characterize individuals’ residential greenness level. Administrative classification (urban/rural), nighttime light index (NLI), individual income, and educational levels were used to characterize regional urbanicity and individual SES levels. Results: We observed weaker inverse associations of NDVI with HBP and DM in rural regions compared to urban regions. For instance, along with per interquartile range (IQR, 0.26) increment in residential NDVI at 0∼5 year moving averages, the ORs of HBP were 1.04 (95%CI: 0.94, 1.15) in rural regions and 0.85 (95%CI: 0.79, 0.93) in urban regions (P = 0.003). Along with the decrease in NLI levels, there were continuously decreasing inverse associations of NDVI with DM prevalence (P for interaction

BackgroundResidential green spaces (RGS) are a crucial aspect of urban life, which provide residents with a positive living environment both for mental and physical well-being. However, extreme heat events caused by global warming and local urban heat island effects are threatening the public health of rapidly growing populations. This is especially true for mental health. Depression is a mental illness that can be impacted by extreme heat events, i.e., heatwaves.ObjectiveThis study aimed to investigate the potential for residential green spaces (RGS) to alleviate depression by reducing heat stress sensitivity during extreme heat events.MethodsWe conducted a literature review using scientometric analysis with CiteSpace to summarize existing research on the relationships between RGS, depression, and heatwaves. We proposed a conceptual framework for the relationship between RGS and depression, and that extreme heat events may be an important contributor to depression.ResultsOur review found that RGS can provide ecosystem services that lower ambient temperatures through evaporative cooling, radiation reflection, humidity regulation, and shading. Different types of RGS, i.e., small green spaces, green roofs, green walls, and street trees, have varying cooling capacities. The mechanisms by which RGS alleviate depression during heatwaves involve green space composition, exposure, physical activity, social contacts, and cohesion. And we proposed a conceptual framework for the relationship between RGS and depression, and that extreme heat events may be an important contributor to depression.ConclusionWe present a multidimensional RGS evaluation roadmap to inform green space design for reducing depression during heatwaves. Establishing RGS multidimensional evaluation can guide future research on leveraging RGS to build resilience against extreme heat and improve public mental health.

UNLABELLED: We aimed to explore whether higher levels of residential greenness were related to lower odds of disabilities in activities of daily living (ADL) and instrumental activities of daily living (IADL). METHODS: We included older adults 65 years of age or older from the Chinese Longitudinal Healthy Longevity Survey. Our exposure was Normalized Difference Vegetation Index in 500 m radius around residence. Our outcome was ADL and IADL. We used binary logistic regression and mixed-effects logistic regression to estimate the odds of ADL and IADL disabilities. RESULTS: A total of 36,803 and 32,316 participants were included for the analysis of ADL and IADL, with 71.6% free of ADL disability and 47.3% free of IADL disability. In the logistic regression model, compared with the participants living in the lowest quartile of residential greenness, those in the highest quartile had a 28% (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.65, 0.79) lower odds of ADL disability and a 14% (OR = 0.86; 95% CI = 0.77, 0.95) lower odds of IADL disability. A similar association was found in the mixed-effects logistic regression models. During the follow-up period, 5,004 and 4,880 healthy participants developed ADL and IADL disabilities. Per 0.1-unit increase in baseline annual average Normalized Difference Vegetation Index (NDVI) was related to an OR of 0.95 of developing ADL disability (95% CI = 0.93, 0.98) and IADL disability (95% CI = 0.91, 0.98). CONCLUSIONS: Our study suggests that increasing green space is associated with lower odds of ADL and IADL disabilities, which may reduce caregiver burden of long-term care for Chinese older adults.

Growing evidence shows that residential greenness is beneficial for various health outcomes, but the link between residential greenness and hearing impairment has not been explored. We aimed to explore the link between residential greenness and hearing impairment using baseline data from the UK Biobank. We used data from 107,516 participants between the ages of 40 and 69 years in the UK Biobank from 2006 to 2010. The normalized difference vegetation index (NDVI) was used to measure the residential greenness. We defined hearing impairment using the digital triplet test. Logistic regression models were conducted to examine the association of residential greenness with hearing impairment. Each interquartile increment in NDVI was associated with 19% lower odds of hearing impairment (odds ratio, OR 0.81; 95% confidence interval, 95% CI 0.79–0.83). Compared with participants in the first NDVI quartile, those in the second, third, and fourth NDVI quartiles had lower odds of hearing impairment (OR 0.69, 95% CI 0.65–0.73 for the second; OR 0.76, 95% CI 0.72–0.81 for the third; OR 0.68, 95% CI 0.65–0.72 for the fourth). Age and Townsend deprivation index showed moderating effects on this association. Our findings showed a negative association between residential greenness and hearing impairment, which might provide potential value for developing cost-effective greenness design and configuration interventions to reduce the risk of hearing impairment. [ABSTRACT FROM AUTHOR]

Background: The impact of heat waves on perinatal outcomes has become a focus of attention. However, the association between heat waves and preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA) and large for gestational age (LGA) remains controversial. Furthermore, whether residential greenness can mitigate the adverse effects of heat waves on birth outcomes still unclear., Methods: This study employed a retrospective cohort design based on data from the ELEFANT project, conducted in Tianjin, China, spanning from 2011 to 2019. We assessed heat waves exposure by creating 12 definitions of extreme heat with varying relative temperatures (90th, 95th, 97.5th and 99th percentiles) and durations (at least 2, 3, or 4 consecutive days). Residential greenness levels were evaluated using the MODIS Normalized Difference Vegetation Index (NDVI). Cox proportional hazards regression models were fitted to estimate the risks of PTB, LBW, SGA and LGA in relation to heatwaves exposure and the multiplicative and additive interactions of heat waves and greenness on adverse birth outcomes across different pregnancy periods, including pre-pregnancy., Results: Our findings indicate that heatwaves significantly increase the risks of PTB by 2.4%-15.6%, LBW by 7.6%-18 %, SGA by 3.6%-88.4%, and LGA by 2%-3.4%. The lack of residential greenness exhibited a synergistic interaction with heatwaves on PTB, SGA and LGA (RERI >0), especially during milder heat events during entire pregnancy. For LBW, interactions between greenness and heatwaves were limited. Furthermore, we identified that heatwave was significantly associated with high risk of adverse birth outcomes among mothers living in rural areas., Conclusions: Prioritizing greenspace can help mitigate the effects of heatwaves, offering a viable and cost-effective approach to protecting maternal and fetal health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Inc.)

Background: Both ambient ozone exposure and residential greenness are linked to the aging process. However, their interactive effect on molecular biomarkers of aging (telomere length (TL) and mitochondrial DNA copy number (mtDNA-CN)) remains unclear. Methods: This study was conducted among 6418 rural Chinese adults. The concentration of ambient ozone was assessed using a random forest model. Residential greenness was represented by the normalized difference vegetation index (NDVI). Molecular biomarkers of aging (relative TL and relative mtDNA-CN) were determined by quantitative real-time polymerase chain reaction. Generalized linear regression models were applied to investigate the independent and combined effects of ambient ozone and residential greenness on relative TL and relative mtDNA-CN. Results: The estimated percent changes and 95 % confidence intervals (CIs) of relative TL in response to per-unit increase in ambient ozone were –22.43 % (–23.74 %, −21.18 %), −14.19 % (−15.63 %, −12.72 %) and −4.50 % (−6.57 %, −2.27 %) for participants with low (NDVI ≤ 0.53), moderate (0.54–0.55) and high (≥0.56) residential greenness exposure, respectively, while the corresponding figures of relative mtDNA-CN were −12.63 % (−13.84 %, −11.31 %), −9.52 % (−10.60 %, −8.33 %) and 2.12 % (0.20 %, 4.19 %). Furthermore, negative interactive effects between ambient ozone and residential greenness exposure on molecular biomarkers of aging were observed (P for interaction

Background As industrialization and urbanization are accelerating, the distribution of green areas is decreasing, particularly in developing countries. Since the 2000s, the effects of surrounding greenness on self-perceived health, including physical and mental health, longevity, and obesity have been reported. However, the effects of surrounding green space on chronic kidney disease are not well understood. Therefore, we investigated the impact of residential greenness on the mortality of chronic kidney disease patients and progression from chronic kidney disease to end-stage renal disease (ESRD). Methods Using a large-scale observational study, we recruited chronic kidney disease patients (n = 64,565; mean age, 54.0 years; 49.0% of male) who visited three Korean medical centers between January 2001 and December 2016. We investigated the hazard ratios of clinical outcomes per 0.1-point increment of exposure to greenness using various models. Results During the mean follow-up of 6.8 ± 4.6 years, 5,512 chronic kidney disease patients developed ESRD (8.5%) and 8,543 died (13.2%). In addition, a 0.1-point increase in greenness reduced all-cause mortality risk in chronic kidney disease and ESRD patients and progression of chronic kidney disease to ESRD in a fully adjusted model. The association between mortality in ESRD patients and the normalized difference vegetation index was negatively correlated in people aged >65 years, who had normal weight, were nonsmokers, and lived in a nonmetropolitan area. Conclusion Chronic kidney disease patients who live in areas with higher levels of greenness are at reduced risk of all-cause mortality and progression to ESRD.

BackgroundEvidence on the hypertensive effects of long-term air pollutants exposure are mixed, and the joint hypertensive effects of air pollutants are also unclear. Sparse evidence exists regarding the modifying role of residential greenness in such effects.MethodsA cross-sectional study was conducted in typically air-polluted areas in northern China. Particulate matter with diameter < 1 μm (PM1), particulate matter with diameter < 2.5 μm (PM2.5), particulate matter with diameter < 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) were predicted by space–time extremely randomized trees model. We used the Normalized Difference Vegetation Index (NDVI) to reflect residential green space. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were examined. We also calculated the pulse pressure (PP) and mean arterial pressure (MAP). Generalized additive model and quantile g-computation were, respectively, conducted to investigate individual and joint effects of air pollutants on blood pressure. Furthermore, beneficial effect of NDVI and its modification effect were explored.ResultsLong-term air pollutants exposure was associated with elevated DBP and MAP. Specifically, we found a 10-μg/m3 increase in PM2.5, PM10, and SO2 were associated with 2.36% (95% CI: 0.97, 3.76), 1.51% (95% CI: 0.70, 2.34), and 3.54% (95% CI: 1.55, 5.56) increase in DBP; a 10-μg/m3 increase in PM2.5, PM10, and SO2 were associated with 1.84% (95% CI: 0.74, 2.96), 1.17% (95% CI: 0.52, 1.83), and 2.43% (95% CI: 0.71, 4.18) increase in MAP. Air pollutants mixture (one quantile increase) was positively associated with increased values of DBP (8.22%, 95% CI: 5.49, 11.02) and MAP (4.15%, 95% CI: 2.05, 6.30), respectively. These identified harmful effect of air pollutants mainly occurred among these lived with low NDVI values. And participants aged ≥50 years were more susceptible to the harmful effect of PM2.5 and PM10 compared to younger adults.ConclusionsOur study indicated the harmful effect of long-term exposure to air pollutants and these effects may be modified by living within higher green space place. These evidence suggest increasing residential greenness and air pollution control may have simultaneous effect on decreasing the risk of hypertension.

Background: A growing body of studies have reported the health benefits of greenness. However, less is known about the potential beneficial effects of residential greenness on gut microbiota, which is essential to human health. In this study, we aim to examine the association between residential greenness and gut microbiota in a population-based cohort study. Methods: We included 1758 participants based on the China Multi-Ethnic Cohort (CMEC) study and collected their stool samples for 16S sequencing to derive gut microbiota data. Residential greenness was estimated using the satellite-based data on enhanced vegetation index (EVI) and the normalized differential vegetation index (NDVI) in circular buffers of 250 m, 500 m, and 1000 m. The relationships between residential greenness levels and the composition of gut microbiota, measured by standardized α-diversity and taxonomic composition, were assessed using linear regression and Spearman correlation weighted by generalized propensity scores. Results: Higher greenness levels were significantly positively associated with standardized α-diversity. Per interquartile range (IQR) increase of EVI and NDVI in the circular buffer of 250 m were associated with the increments of 0.995(95% confidence interval (CI): 0.212–1.778) and 0.653(95% CI: 0.160–1.146) in the standardized Shannon index. For the taxonomic composition of gut microbiota, higher greenness levels were significantly correlated with 29 types of microbial taxonomic composition. NDVI in the circular buffer of 250 m was associated with increased Firmicutes (r = 0.102, adjusted p value = 0.004), which was the dominant composition in the gut microbiota. Conclusions: Increased amounts of residential greenness may support healthy gut microbiota by benignly altering their composition. These findings suggested that green spaces should be designed to support diverse gut microbiota and ultimately optimize health benefits.

Residential greenness may be beneficial for cardiovascular health, but the evidence is still scarce, especially in developing countries. This study aimed to assess the associations between exposure to residential greenness and 10-year atherosclerotic cardiovascular disease (ASCVD) risk in a large rural Chinese adult population. This was a cross-sectional study based on 31,162 participants aged 35–74 years with complete data on predictors of the 10-year ASCVD risk from the Henan Rural Cohort Study. The satellite-derived Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) were used to quantify residential greenness in a buffer radius of 500 m, 1000 m, and 3000 m. The high 10-years ASCVD risk was defined as the estimated risk ≥10% based on prediction equations from the China-PAR Project for Chinese populations. Multivariable-adjusted logistic regression models were performed to estimate the associations of greenness exposures with high 10-year ASCVD risk, and mediation analyses were employed to the potential mediators. For per interquartile range (IQR) increase in NDVI500−m, NDVI1000−m, NDVI3000−m, EVI500−m, EVI1000−m, and EVI3000−m, the adjusted OR (95% CI) of high 10-years ASCVD risk was 0.828 (0.793–0.866), 0.850 (0.817–0.885), 0.823 (0.792–0.855), 0.848 (0.809–0.889), 0.863 (0.826–0.901), 0.843 (0.805–0.883), respectively. Strong associations of NDVI500−m and EVI500−m with high 10-years ASCVD risk were found among participants with lower education level and lower averaged monthly income. The associations of greenness exposures with high 10-year ASCVD risk were partially explained by particulate matter with an aerodynamic diameter ≤1 µm, BMI, and physical activity. Enhancing residential greenness exposure may be beneficial for reducing the high 10-year ASCVD risk in rural Chinese adults.

Background: Exposure to residential greenness has been associated with benefits on certain reproductive health outcomes. However, its potential benefits on semen quality remain unknown. Objectives: To quantitatively explore the association between exposure to residential greenness and semen quality. Methods: We investigated 9142 sperm donation volunteers who underwent 38,682 semen examinations at Guangdong provincial human sperm bank in China during 2016–2019. Exposure to residential greenness was assessed using mean daily Normalized Difference Vegetation Index (NDVI) at each subject’s residential address with a 400 m buffer during 0–90 days before each semen collection. Multivariate linear mixed models and linear regression models were used to assess the association between exposure to residential greenness and semen quality. Results: An interquartile range increase in exposure to residential greenness was significantly associated with a 0.034 (95% confidence interval [CI]: 0.005, 0.063) ml, 4.06 (95% CI: 0.76, 7.37) × 106, and 0.32% (95% CI: 0.22%, 0.41%) increase in semen volume, total sperm number, and normal forms, respectively; similar trends were observed across quartiles of exposure to residential greenness (all p-values for liner trend

Background: Population-based studies on the associations of long-term exposure to particulate matter (PM) with androgen and progesterone are still scant. Residential greenness is benefits health by promoting physical activity, reducing air pollution, and improving mental health, but it remains unclear whether it is related to androgen and progesterone levels among humans. Aims: This study aimed to explore the individual and interactive effects of PM and residential greenness on serum testosterone and progesterone levels among rural Chinese adults. Methods: A total of 6017 subjects were recruited from the baseline of the Henan Rural Cohort Study in 2016. Serum testosterone and progesterone were measured with liquid chromatography-tandem mass spectrometry. Particulate matters (PM) (PM1, PM2.5, and PM10) were assessed by machine learning algorithms. Residential greenness was assessed using the normalized difference vegetation index (NDVI) within 500-m, 1000-m, and 3000-m buffers around participants’ residences. The effects of air pollutants and residential greenness and their interaction on serum testosterone and progesterone levels were assessed using linear mixed-effects models with township as a random intercept. Results: After adjusting for potential confounding factors, a 1 μg/m3 increase in PM2.5 or PM10 was associated with a 0.037 or 0.030 ng/ml increase in serum testosterone, respectively, in females and with a 0.111 or 0.182 ng/ml decrease in serum progesterone, respectively, in males. A 1 μg/m3 increase in PM1, PM2.5 or PM10 was associated with a 0.222, 0.306, or 0.295 ng/ml decrease in serum progesterone, respectively, among females. Moreover, a 0.1-unit increase in NDVI was associated with a 0.310 ng/ml increase in serum testosterone and a 0.170 ng/ml increased in serum progesterone in males, as well as with a 0.143 ng/ml increase in serum progesterone in females. Interaction effects of PM and residential greenness on serum testosterone and progesterone levels were observed, indicating that the effects of residential greenness on serum testosterone and progesterone were modified by high levels of PM. In addition, physical activity significantly mediated 2.92% of the estimated association between greenness and testosterone levels. Conclusions: Our study suggested that long-term exposure to PM was positively associated with serum testosterone in males but negatively associated with progesterone levels in both genderssin. In addition, positive associations of residential greenness with serum testosterone and progesterone levels were observed, but they were modified by high levels of PM. Furthermore, the estimated effects of residential greenness on testosterone levels were partly mediated by physical activity.

Background: Although many studies demonstrated reduced mortality risk with higher greenness, few studies examined the modifying effect of greenness on air pollution-health associations. We evaluated residential greenness as an effect modifier of the association between long-term exposure to fine particles (PM2.5) and mortality.Methods: We used data from all Medicare beneficiaries in North Carolina (NC) and Michigan (MI) (2001-2016). We estimated annual PM2.5 averages using ensemble prediction models. We estimated mortality risk per 1 μg/m3 increase using Cox proportional hazards modeling, controlling for demographics, Medicaid eligibility, and area-level covariates. We investigated health disparities by greenness using the Normalized Difference Vegetation Index with measures of urbanicity and socioeconomic status.Results: PM2.5 was positively associated with mortality risk. Hazard ratios (HRs) were 1.12 (95% confidence interval (CI) = 1.12 to 1.13) for NC and 1.01 (95% CI = 1.00 to 1.01) for MI. HRs were higher for rural than urban areas. Within each category of urbanicity, HRs were generally higher in less green areas. For combined disparities, HRs were higher in low greenness or low SES areas, regardless of the other factor. HRs were lowest in high-greenness and high-SES areas for both states.Conclusions: In our study, those in low SES and high-greenness areas had lower associations between PM2.5 and mortality than those in low SES and low greenness areas. Multiple aspects of disparity factors and their interactions may affect health disparities from air pollution exposures. Findings should be considered in light of uncertainties, such as our use of modeled PM2.5 data, and warrant further investigation. [ABSTRACT FROM AUTHOR]

Introduction/aims: Application of remote sensing-based metrics of exposure to vegetation in epidemiological studies of residential greenness is typically limited to several standard products. The Normalized Difference Vegetation Index (NDVI) is the most widely used, but its precision varies with vegetation density and soil color/moisture. In areas with heterogeneous vegetation cover, the Soil-adjusted Vegetation Index (SAVI) corrects for soil brightness. Linear Spectral Unmixing (LSU), measures the relative contribution of different land covers, and estimates percent of each over a unit area. We compared the precision of NDVI, SAVI and LSU for quantifying residential greenness in areas with high spatial heterogeneity in vegetation cover. Methods: NDVI, SAVI, and LSU in a 300 m radius surrounding homes of 3,188 cardiac patients living in Israel (Eastern Mediterranean) were derived from Landsat 30 m spatial resolution imagery. Metrics were compared to assess shifts in exposure quartiles and differences in vegetation detection as a function of overall greenness, climatic zones, and population density, using NDVI as the reference method. Results: For the entire population, the dispersion (SD) of the vegetation values detected was 60% higher when greenness was measured using LSU compared to NDVI: mean (SD) NDVI: 0.17 (0.05), LSU (%): 0.23 (0.08), SAVI: 0.12 (0.03). Importantly, with an increase in population density, the sensitivity of LSU, compared to NDVI, doubled: There was a 95% difference between the LSU and NDVI interquartile range in the highest population density quartile vs 47% in the lowest quartile. Compared to NDVI, exposures estimated by LSU resulted in 21% of patients changing exposure quartiles. In urban areas, the shift in exposure quartile depended on land cover characteristics. An upward shift occurred in dense urban areas, while no shift occurred in high and low vegetated urban areas. Conclusions: LSU was shown to outperform the commonly used NDVI in terms of accuracy and variability, especially in dense urban areas. Therefore, LSU potentially improves exposure assessment precision, implying reduced exposure misclassification.

Background: Epidemiological studies on the association of residential greenness with sleep quality are limited in China. Objective: This study aims to investigate the association of long-term exposure to residential greenness with sleep quality in rural China. Methods: In our study, 27,654 rural residents were selected from 4 counties of Henan Province by a multi-stage stratified cluster sampling method. Participants’ sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), two satellite-derived vegetation indexes, were used to assess the level of residential greenness. Long-term greenness exposure was defined as the averages of NDVI and EVI during the three years prior to the baseline survey. The relationship between sleep quality and greenness was assessed using the mixed-effect linear regression models. Results: Among 27,654 rural residents, the mean age was 55.89 years (standard deviation, SD = 12.22) and 60.18% of them were female. In the crude model, the PSQI score decreased with per interquartile range (IQR) increase in EVI and NDVI [ΔPSQI score (95% confidence interval, 95%CI): −0.073 (−0.115, −0.030) and −0.047 (−0.089, −0.002)]. After controlling potential confounders, ΔPSQI scores and 95%CIs were −0.055 (−0.095, −0.012) and −0.090 (−0.151, −0.025) associated with per IQR increment in EVI and NDVI. The results of stratified analyses showed the effect of residential greenness on sleep was stronger among males and individuals with higher household income and educational attainment than females and those with lower household income and educational attainment. Moreover, the modification effect of air pollution was observed in the greenness-sleep association. Conclusions: Our study indicated that higher residential greenness was significantly associated with better sleep quality in Chinese rural population, which highlights the significant effect of green space on human health.

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

Background: Although studies have examined the association between residential greenness and birth weight, there is no evidence regarding the association between residential greenness and fetal growth in utero. We aimed to investigate the associations of residential greenness with both fetal growth in utero and birth weight. Methods: A birth cohort (2014–2017) with 18,665 singleton pregnancies was established in Tongzhou Maternal and Child hospital of Beijing, China. Residential greenness was matched with maternal residential address and estimated from remote satellite data using normalized difference vegetation index with 200 m and 500 m buffers (NDVI-200 and NDVI-500). Fetal parameters including estimated fetal weight (EFW), abdominal circumference (AC), head circumference (HC) and femur length (FL) were assessed by ultrasound measurements during pregnancy. Fetal parameters were standardized as gestational-age- and gender-adjusted Z-score and undergrowth was defined as Z-score

The impact of residential greenness on incident idiopathic pulmonary fibrosis (IPF) is unknown. We aimed to assess the association between residential greenness and incident IPF, identify underlying pathways, and further evaluate the effect among different genetic subgroups. 469,348 participants in the UK Biobank were included and followed until December 2020. Normalized difference vegetation index (NDVI) within 300-, 500-, 1000-, and 1500-m buffers (NDVI 300m , NDVI 500m , NDVI 1000m , and NDVI 1500m) were employed as indicators of greenness. The polygenic risk score (PRS) was constructed based on 13 independent SNPs. Cox models were fitted to assess the association of residential greenness with incident IPF. Casual mediation analyses were applied to evaluate potential mediators. After a median follow-up of 11.85 years, 1574 IPF cases were identified. We found residential greenness inversely associated with incident IPF. The HRs (95%CIs) for each interquartile increase of NDVI 300m , NDVI 500m , NDVI 1000m , NDVI 1500m were 0.93 (0.87, 0.99), 0.92 (0.86, 0.98), 0.89 (0.83, 0.95), and 0.89 (0.83, 0.95), respectively. The association was stronger among individuals with intermediate or high genetic risk. In mediation analyses, the main mediators identified were PM 2.5 and NO 2 , with proportion mediated estimated to be 31.92% and 40.61% respectively for NDVI 300m. Residential greenness was associated with reduced risk of incident IPF. [Display omitted] • Residential greenness inversely associated with incident IPF. • Greenness and IPF incidence correlated more strongly in those with higher genetic risk. • The effects of greenness were more pronounced in female, nonsmokers, urban dwellers, and those over 60 and retired. • Potential mediators might contribute to the association, especially air pollution. [ABSTRACT FROM AUTHOR]

Contacts with nature are linked with reduced morbidity and mortality. Hypothesized pathways include relaxation, physical activity, and improved immune function. This cross-sectional study of 320 adults in central North Carolina assessed health benefits of residential greenness using allostatic load (AL) and systemic inflammation (INFL) indices, composite biomarker-based measures of physiological dysregulation and inflammation, respectively. Distance-to-residence weighted tree cover and vegetated land cover measures were estimated within 500 m of each residence; 37 biomarkers of immune, neuroendocrine, cardiovascular, and metabolic functions were dichotomized at distribution or health-based cut-offs. AL was calculated as a sum of potentially unhealthy values of all biomarkers; INFL was based on a subset of 18 immune biomarkers. Regression analysis used generalized additive models for Poisson-distributed outcome. An interquartile range (IQR) increase in tree cover was associated with 0.89 (95 % Confidence Limits 0.82; 0.97) and 0.90 (0.79; 1.03)-fold change in AL and INFL, respectively. Greater daily outdoor time was associated with reduced AL and INFL, while leisure screen time, problems with sleeping, and common chronic infections were linked with increased AL and INFL. Among 138 individuals spending more than 1 h outdoors daily, an IQR increase in tree cover was associated with 0.76 (0.67; 0.86) and 0.81 (0.65; 1.02)-fold changes in AL and INFL, respectively. Among individuals with residential tree cover above the 50th percentile, spending more than 3 h outdoors daily was associated with 0.54 (0.37; 0.78) and 0.28 (0.15; 0.54)-fold changes in AL and INFL, respectively, compared to spending less than 30 min outdoors; there were no significant effects in the low tree cover stratum. Consistent but weaker effects were observed for vegetated land cover. Interaction effects of tree and vegetative cover and time spent outdoors on AL and INFL were statistically significant. This biomarker-based approach can help to assess public health benefits of green spaces. Note: The background image was produced by Andrey Egorov using the Midjourney AI generative software. [Display omitted] • Used multiple biomarkers to calculate allostatic load and inflammation indices. • Residential greenness is linked with reduced allostatic load and inflammation. • Significant interaction effects of greenness and time outdoors on both indices. • Sleeping problems and high screen time had detrimental effects on both indices. [ABSTRACT FROM AUTHOR]

Studies of residential greenness and depression symptoms among community-dwelling older adults in China are limited. However, understanding the role of greenness in depression symptoms among older adults can inform depression prevention and interventions. This study explored the relationship between residential greenness and depression symptoms among community-dwelling older adults in China. A cluster random sampling method was used to survey 7512 community-dwelling adults aged 60 and above from three towns in Shanghai. Depression symptoms were assessed using the Geriatric Depression Scale (GDS30). Residential greenness was measured using the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI). Long-term greenspace exposure was defined as the mean NDVI and EVI in the three years prior to the baseline survey. Controlling for the covariates, the relationship between greenness and depression symptoms was assessed using binomial logistic regression and mixed-effects linear regression. Interaction analysis was conducted to explore which covariates potentially alter the association. We also assessed the mediating role of physical activity. The prevalence of depression symptoms among the participants was 13.72%. Higher residential greenness was associated with lower odds of depression symptoms, after adjusting for covariates. In the logistic regression analysis, the odds of depression symptoms decreased with increasing NDVI and EVI. In linear regression analysis, GDS30 scores decreased with increasing NDVI and EVI. Interaction analyses revealed that higher NDVI and EVI were more protective against depression among male individuals and older adults living with others than among female individuals and older adults living alone. Additionally, physical activity had a masking effect on residential greenness and depression symptoms. Higher residential greenness is associated with lower odds of depression symptoms in community-dwelling Chinese older adults. Increasing urban and neighborhood green spaces may contribute to the prevention and intervention of depression symptoms in community-dwelling older adults. • This study showed a relationship between residential greenness and depression symptoms among older adults in China. • Physical activity mediated the effect of residential greenness on depression symptoms. • This study suggested the beneficial effects of greenness on the mental health of older Chinese adults. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of maternal ozone exposure on fetal growth during pregnancy, as well as the combined effect and interaction of ozone and residential greenness. We included a total of 14990 singleton pregnancies from the Fujian Birth Cohort Study. During pregnancy, fetal growth parameters including estimated fetal weight (EFW), femur length (FL), head circumference (HC), and abdominal circumference (AC). To investigate the associations between ozone exposure and the above-mentioned outcomes, generalized estimating equation approach and generalized linear regression were used, as appropriate. In the adjusted models, we observed that the Z scores of EFW (−0.031 (−0.048, −0.014)), FL (−0.021 (−0.038, −0.004)), and AC (−0.025 (−0.042, −0.007)) decreased with per interquartile range (IQR) increase of ozone concentration. Compared to participants with low ozone exposure and high NDVI, those with high ozone exposure and low NDVI experienced the largest decrease in Z scores for EFW (−0.049 (−0.079, −0.02)), FL (−0.034 (−0.063, −0.004)), HC (−0.034 (−0.065, −0.004)), and AC (−0.041 (−0.072, −0.01)), respectively. Interestingly, we discovered the effect modification of NDVI on the relationship between ozone exposure and fetal growth restriction (P for interaction < 0.05). This study established a negative relationship of maternal ozone exposure and fetal growth. Of importance, this study discovered the joint effect and interaction between ozone and residential greenness exposure. [Display omitted] • Maternal ozone exposure is significantly associated with fetal growth restriction. • Maternal exposure to ozone and greenness has a combined effect on fetal growth. • Greenness may modify the association between ozone exposure and fetal growth. [ABSTRACT FROM AUTHOR]

Nature exposure can promote human health and well-being. Additionally, there is some, albeit mixed, evidence that this relationship is stronger for socio-economically disadvantaged groups (equigenesis). Using a cross-sectional survey of the Austrian population (N = 2300), we explored the relationships between both residential greenness and recreational nature visits, and affective (WHO-5 Well-Being Index) and evaluative (Personal Well-Being Index-7) subjective well-being. Partially supporting the equigenesis hypothesis, regression analyses controlling for potential confounders found that recreational visit frequency, but not residential greenness, moderated the effect of income-related disparities in both subjective well-being metrics. Results suggest that merely making neighborhoods greener may not itself help reduce inequalities in subjective well-being. Additionally, greater efforts are also needed to support individuals from all sectors of society to access natural settings for recreation as this could significantly improve the well-being of some of the poorest in society. • We explored well-being, residential greenness and recreational visits. • No evidence for links between subjective well-being and residential greenness. • Positive association between well-being and recreational nature visit frequency. • Nature visits associated with smaller income-related inequalities in well-being. • Promoting recreational use of nature may help reduce inequalities in well-being. [ABSTRACT FROM AUTHOR]

While a growing body of literature suggests beneficial impacts of greenness on several health outcomes, relatively few studies have examined greenness as an effect modifier to impacts of air pollution on health outcomes, and results from the existing studies are inconclusive. We performed a comprehensive, systematic review of previous literature on greenness as a potential effect modifier for associations between particulate matter air pollution and health. After initial screening of 7814 studies, we identified 20 eligible studies. We summarized findings on study characteristics based on several criteria: health outcome, air pollution exposure, source of air pollution data, study location, study period, and median year of the study period. We evaluated characteristics of effect modification by greenness on air pollution and health associations based on the number of greenness metrics applied, type of greenness metric (e.g. normalized difference vegetation index, land use), data source for greenness, and spatial resolution and buffer size. We also summarized evidence for effect modification by greenness based on strength and direction of evidence for each study and overall evidence of effect modification by greenness by several study characteristics. Our systematic review showed that only a limited number of studies have been conducted on greenness as an effect modifier for air pollution-health associations. We found differences in several study characteristics such as greenness assessment (e.g. greenness metrics applied, spatial resolution, and data sources) across studies. Collectively, the studies provide suggestive evidence for the hypothesis that areas with high greenness have lower impacts of air pollution on health, although some studies reported inconsistent findings. The findings from our review provide valuable knowledge on how greenness affects associations between air pollution and health and could help identify critical areas for future study.

The association between residential greenness and allostatic load (AL), a marker of composite physiological burden and predictor of chronic disease, remains understudied. This study comprised 212,600 UK Biobank participants recruited over 2007 and 2010 at the baseline. Residential greenness was modeled as the normalized difference vegetation index (NDVI) from high spatial resolution (0.50 m) color infrared imagery and measured within a 0.5 km radial catchment. AL was measured as a composite index from 13 biomarkers comprising three physiological systems (metabolic, cardiovascular, and inflammatory systems) and two organ systems (liver and kidney). Multilevel mixed-effects generalized linear models with a random intercept for UK Biobank assessment centers were employed to examine the association between residential greenness and AL. Each interquartile range (IQR = 0.24) increment in NDVI greenness was associated with lower AL (beta (β) = -0.28, 95% confidence interval (CI) = -0.55, -0.01). Consistently, relative to the lowest NDVI greenness quintile, participants in the highest quintile had lower AL (β = -0.64, 95% CI = -1.02, -0.26). The proportion of the association between greenness and AL mediated by the physical activity was 3.2%. In conclusion, residential greenness was protectively associated with AL, a composite marker of wear and tear and general health.

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

Highlights • Telomere lengths are cellular memories of exposures to inflammation and oxidative stress. • Residential green space, low traffic exposure, and long-term lower exposure to particulate air pollution are associated with longer telomeres. • Adverse environmental exposures may have a long lasting molecular footprint on the ageing process, as reflected by shorter telomere length. • Shorter telomeres reflect higher disease susceptibility and a potential shorter life expectancy. • Adequate reductions in, and protections against, pollutants may lead to decreased comorbidities and increased life-expectancy. Abstract Studies suggest that leukocyte telomere length is an index of systemic ageing. Here, we discuss telomere length as a marker of biological ageing in relation to residential landscape (greenness), residential air pollution and work-related exposures. Telomere lengths are memories of cumulative oxidative and inflammatory stress, and show to have inverse associations with the risk of non-communicable diseases. For this reason, telomeres are considered as markers of biological ageing. Studies at birth, in children, young adulthood, and elderly show that residential green space, lower traffic exposure and long-term lower exposure to particulate air pollution are associated with longer telomeres. Work-related exposures including exposure to toxic metals, polycyclic aromatic hydrocarbons and particulate matter are associated with shorter telomeres for a given age. In contrast to chronic exposures, evidence is present of the observation that recent exposure is associated with longer telomeres. Our overview shows that the magnitude of residential and work-related environmental factors on telomere length are often as important as many classical lifestyle factors. [ABSTRACT FROM AUTHOR]