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Luque-García L, Muxika-Legorburu J, Mendia-Berasategui O, Lertxundi A, García-Baquero G, Ibarluzea J. Green and blue space exposure and non-communicable disease related hospitalizations: A systematic review. ENVIRONMENTAL RESEARCH 2024; 245:118059. [PMID: 38157973 DOI: 10.1016/j.envres.2023.118059] [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: 07/17/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
The global increase in non-communicable diseases (NCDs) presents a critical public health concern. Emerging evidence suggests that exposure to natural environments may reduce the risk of developing NCDs through multiple pathways. The present systematic review aims to synthesize and evaluate the observational evidence regarding associations between exposure to green and blue spaces and hospital admissions related to NCDs. A comprehensive literature search strategy was conducted in Embase (Ovid), PubMed, and Web of Science. The risk of bias and quality of the evidence were assessed using The Navigation Guide methodology, an approach specifically designed for environmental health research. Of 3060 search results, 17 articles were included. Notably, the majority of the studies (n = 14; 82.4%) were published from 2020 onwards. Most studies were conducted in the United States (n = 6; 35.3%) and China (n = 4; 23.5%). Exposure to green spaces was assessed through all studies, while only three included blue spaces. In terms of study design, cohort design was employed in nearly half of the studies (n = 8; 47.1%), followed by case-crossover design (n = 3, 17.6%). Over 75% of the included studies (n = 13) had a high or probably high rating in the risk of bias assessment. The studies encompassed diverse NCD outcome domains; cardiovascular diseases (CVDs) (n = 10), respiratory diseases (RSDs) (n = 2), heat-related diseases (n = 1), metabolic diseases (n = 2), cancer (n = 1), neurodegenerative diseases (NDDs) (n = 2), and mental health disorders (n = 2). The present review suggests that a clear link between blue space exposure and NCD hospital admissions is not evident. However, exposure to green spaces appears to predominantly have a protective effect, although the direction of the association varies across different outcome domains. The heterogeneity among the outcome domains together with the limited number of studies, emphasizes the need for more robust evidence.
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Affiliation(s)
- L Luque-García
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain.
| | - J Muxika-Legorburu
- Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain
| | - O Mendia-Berasategui
- Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain
| | - A Lertxundi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain
| | - G García-Baquero
- Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Faculty of Biology, University of Salamanca, Avda Licenciado Méndez Nieto S/n, 37007, Salamanca, Spain
| | - J Ibarluzea
- Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain
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Xu Z, Han Z, Wang J, Jin R, Li Z, Wu Z, Zhao Z, Lv S, Zhao X, Liu Y, Guo X, Tao L. Association Between Long-Term Exposure to Fine Particulate Matter Constituents and Progression of Cerebral Blood Flow Velocity in Beijing: Modifying Effect of Greenness. GEOHEALTH 2023; 7:e2023GH000796. [PMID: 37449300 PMCID: PMC10337285 DOI: 10.1029/2023gh000796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/23/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
Few studies have explored the effects of fine particulate matter (PM2.5) and its constituents on the progression of cerebral blood flow velocity (BFV) and the potential modifying role of greenness. In this study, we investigated the association of PM2.5 and its constituents, including sulfate (SO4 2-), nitrate (NO3 -), ammonium (NH4 +), organic matter (OM), and black carbon (BC), with the progression of BFV in the middle cerebral artery. Participants from the Beijing Health Management Cohort who underwent at least two transcranial Doppler sonography examinations during 2015-2020 were recruited. BFV change and BFV change rate were used to define the progression of cerebral BFV. Linear mixed effects models were employed to analyze the data, and the weighted quantile sum regression assessed the contribution of PM2.5 constituents. Additionally, greenness was examined as a modifier. Among the examined constituents, OM exhibited the strongest association with BFV progression. An interquartile range increase in PM2.5 and OM exposure concentrations was associated with a decrease of -16.519 cm/s (95% CI: -17.837, -15.201) and -15.403 cm/s (95% CI: -16.681, -14.126) in BFV change, and -10.369 cm/s/year (95% CI: -11.387, -9.352) and -9.615 cm/s/year (95% CI: -10.599, -8.632) in BFV change rate, respectively. Furthermore, stronger associations between PM2.5 and BFV progression were observed in individuals working in areas with lower greenness, those aged under 45 years, and females. In conclusion, reducing PM2.5 levels in the air, particularly the OM constituent, and enhancing greenness could potentially contribute to the protection of cerebrovascular health.
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Affiliation(s)
- Zongkai Xu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Ze Han
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Jinqi Wang
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Rui Jin
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Zhiwei Li
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Zhiyuan Wu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
- Center of Precision HealthSchool of Medical and Health SciencesEdith Cowan UniversityJoondalupWAAustralia
| | - Zemeng Zhao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Shiyun Lv
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiaoyu Zhao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Yueruijing Liu
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Xiuhua Guo
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
| | - Lixin Tao
- Beijing Municipal Key Laboratory of Clinical EpidemiologyDepartment of Epidemiology and Health StatisticsSchool of Public HealthCapital Medical UniversityBeijingChina
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