TY - JOUR
T1 - Residential surrounding green, air pollution, traffic noise and self-perceived general health
AU - Klompmaker, Jochem O.
AU - Janssen, Nicole A.H.
AU - Bloemsma, Lizan D.
AU - Gehring, Ulrike
AU - Wijga, Alet H.
AU - van den Brink, Carolien
AU - Lebret, Erik
AU - Brunekreef, Bert
AU - Hoek, Gerard
N1 - Funding Information:
This research was carried out in the framework of, and funded by the RIVM Strategic Program (SPR; S/121004 HERACLES), in which expertise and innovative projects prepare RIVM to respond to future issues in health and sustainability. The Dutch Public Health Monitor 2012 (Gezondheidsmonitor Volwassenen GGD-en, CBS en RIVM) was conducted by 28 Public Health Services (GGD), Statistics Netherlands (CBS) and National Institute for Public Health and the Environment (RIVM). Statistical analyses were further facilitated by CBS.
Publisher Copyright:
© 2019 The Authors
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Self-perceived general health (SGH) is one of the most inclusive and widely used measures of health status and a powerful predictor of mortality. However, only a limited number of studies evaluated associations of combined environmental exposures on SGH. Our aim was to evaluate associations of combined residential exposure to surrounding green, air pollution and traffic noise with poor SGH in the Netherlands. We linked data on long-term residential exposure to surrounding green based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and road- and rail-traffic noise with a Dutch national health survey, resulting in a study population of 354,827 adults. We analyzed associations of single and combined exposures with poor SGH. In single-exposure models, NDVI within 300 m was inversely associated with poor SGH [odds ratio (OR) = 0.91, 95% CI: 0.89, 0.94 per IQR increase], while NO2 was positively associated with poor SGH (OR = 1.07, 95% CI: 1.04, 1.11 per IQR increase). In multi-exposure models, associations with surrounding green and air pollution generally remained, but attenuated. Joint odds ratios (JOR) of combined exposure to air pollution, rail-traffic noise and decreased surrounding green were higher than the odds ratios of single-exposure models. Studies including only one of these correlated exposures may overestimate the risk of poor SGH attributed to the studied exposure, while underestimating the risk of combined exposures.
AB - Self-perceived general health (SGH) is one of the most inclusive and widely used measures of health status and a powerful predictor of mortality. However, only a limited number of studies evaluated associations of combined environmental exposures on SGH. Our aim was to evaluate associations of combined residential exposure to surrounding green, air pollution and traffic noise with poor SGH in the Netherlands. We linked data on long-term residential exposure to surrounding green based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and road- and rail-traffic noise with a Dutch national health survey, resulting in a study population of 354,827 adults. We analyzed associations of single and combined exposures with poor SGH. In single-exposure models, NDVI within 300 m was inversely associated with poor SGH [odds ratio (OR) = 0.91, 95% CI: 0.89, 0.94 per IQR increase], while NO2 was positively associated with poor SGH (OR = 1.07, 95% CI: 1.04, 1.11 per IQR increase). In multi-exposure models, associations with surrounding green and air pollution generally remained, but attenuated. Joint odds ratios (JOR) of combined exposure to air pollution, rail-traffic noise and decreased surrounding green were higher than the odds ratios of single-exposure models. Studies including only one of these correlated exposures may overestimate the risk of poor SGH attributed to the studied exposure, while underestimating the risk of combined exposures.
KW - General health
KW - Joint odds ratio
KW - NDVI
KW - NO
KW - PM
KW - Traffic noise
UR - http://www.scopus.com/inward/record.url?scp=85072397705&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2019.108751
DO - 10.1016/j.envres.2019.108751
M3 - Article
C2 - 31557601
AN - SCOPUS:85072397705
SN - 0013-9351
VL - 179
JO - Environmental Research
JF - Environmental Research
M1 - 108751
ER -