Publications by authors named "Payam Dadvand"

107 Publications

Associations of objective and perceived greenness measures with cardiovascular risk factors in Philadelphia, PA: A spatial analysis.

Environ Res 2021 Mar 22;197:110990. Epub 2021 Mar 22.

Urban Health Collaborative Drexel University Philadelphia, PA, USA; Department of Environmental and Occupational Health, Dornsife School of Public Health Drexel University Philadelphia, PA, USA. Electronic address:

There is mounting scientific evidence that greenness is associated with improved cardiovascular health. However, few studies have distinguished between vegetation type, measured perceived green space access, or investigated heterogeneity of associations across categories of neighborhood sociodemographic and racial/ethnic composition. We conducted an ecologic spatial analysis of associations of three objective measures of greenness (percent vegetation cover, percent tree canopy cover, and greenness density), and one measure of perceived access to green spaces with census tract level percentages of the adult population who were obese, ever had a high blood pressure diagnosis, and ever had a diabetes diagnosis, in the city of Philadelphia, PA, year 2013. We explored effect modification by census-tract level percent living in poverty and percent non-Hispanic Black categories. We used data from the Southeastern Pennsylvania Household Health Survey (SEPAHH) linked with high-resolution landcover, remotely sensed, and American Community Survey data and estimated associations using spatial lag models. We observed modest protective associations between percent of the adult population reporting perceived access to green spaces and percent with the cardiovascular risk factors, particularly in moderate and high poverty census tracts. Percent tree canopy cover was also protective against the cardiovascular risk factors, particularly in census tracts with low percentages of the population living in poverty and with low percent non-Hispanic Black populations. These results suggest that perceived access to green spaces and objectively measured high tree canopy cover, may protect against cardiovascular disease, but associations may vary across neighborhood sociodemographic categories.
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http://dx.doi.org/10.1016/j.envres.2021.110990DOI Listing
March 2021

Editorial: The Benefits of Nature-Based Solutions to Psychological Health.

Front Psychol 2021 4;12:646627. Epub 2021 Feb 4.

Department of Agricultural and Environmental Sciences, University of Bari Aldo Moro, Bari, Italy.

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http://dx.doi.org/10.3389/fpsyg.2021.646627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889499PMC
February 2021

Ultraviolet radiation as a predictor of sex hormone levels in postmenopausal women: A European multi-center study (ECRHS).

Maturitas 2021 Mar 2;145:49-55. Epub 2021 Jan 2.

ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.

Background: Solar ultraviolet radiation (UVR) affects the body through pathways that exhibit positive as well as negative health effects such as immunoregulation and vitamin D production. Different vitamin D metabolites are associated with higher or lower concentrations of estrogens and may thus alter the female sex hormone balance.

Objective: To study whether exposure to UVR, as a modifiable lifestyle factor, is associated with levels of sex hormones (17β-estradiol, estrone, estrone 3-sulfate, testosterone, dehydroepiandrosterone sulfate), gonadotropins (follicle stimulating hormone, luteinizing hormone) as well as sex hormone binding globulin in postmenopausal women, and thus investigate whether managing UVR exposure can influence the hormone balance, with potential benefits for the biological aging process.

Methods: The study included 580 postmenopausal women from six European countries, participating in the European Community Respiratory Health Survey (2010-2014). Average UVR exposure during the month before blood sampling was estimated based on personal sun behavior and ambient levels. Hormone concentrations were measured in serum using state-of-the-art methods. Subsequently we applied linear mixed-effects models, including center as random intercept, hormone concentrations (one at a time) as outcome and UVR, age, skin type, body mass index, vitamin D from dietary sources, smoking, age at completed full-time education and season of blood sampling as fixed-effect predictors.

Results: One interquartile range increase in UVR exposure was associated with decreased levels of 17β-estradiol (-15.6 pmol/L, 95 % Confidence Interval (CI): -27.69, -3.51) and estrone (-13.36 pmol/L, 95 % CI: -26.04, -0.68) and increased levels of follicle stimulating hormone (9.34IU/L, 95 % CI: 2.91, 15.77) and luteinizing hormone (13.86 IU/daL, 95 % CI: 2.48, 25.25).

Conclusions: Exposure to UVR is associated with decreased estrogens and increased gonadotropins in postmenopausal women, a status associated with osteoporosis, lung function decline and other adverse health effects. This study indicates that managing UVR exposure has potential to influence the hormone balance and counteract adverse health conditions after menopause.
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http://dx.doi.org/10.1016/j.maturitas.2020.12.011DOI Listing
March 2021

Environment and the COVID-19 pandemic.

Environ Res 2021 04 29;195:110819. Epub 2021 Jan 29.

Centre for Environmental Sciences, Hasselt University, Agoralaan Gebouw D, 3590, Diepenbeek, Belgium; Department of Public Health & Primary Care, University of Leuven, 3000, Leuven, Belgium.

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http://dx.doi.org/10.1016/j.envres.2021.110819DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7845501PMC
April 2021

Polycyclic aromatic hydrocarbons exposures and telomere length: A cross-sectional study on preschool children.

Environ Res 2021 04 23;195:110757. Epub 2021 Jan 23.

ISGlobal, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.

Exposure to polycyclic aromatic hydrocarbons (PAHs) has been associated with shorter telomere length (TL), a marker of ageing at cellular level. However, the available evidence on this association among children is still scarce. We therefore aimed to assess, the relationship between urinary 1-hydroxipayrene (1-OHP), a marker of exposure to PAHs, and relative leukocyte TL (LTL) in children at preschool age. Our study was based on 200 children enrolled from 27 randomly-selected kindergartens in the city of Sabzevar, Iran (2017). 1-OHP levels in the participants' urine samples were measured using solid phase extraction (SPE) method and high-performance liquid chromatography (HPLC). Moreover, real-time PCR was used to measure the LTL in the participants' blood samples. Linear mixed effects models, controlled for relevant covariates, were applied to investigate the association of 1-OHP concentration and LTL. The median (interquartile range (IQR)) of relative LTL and urinary 1-OHP were 0.83 (0.7) and 257 (375.5) ng/L, respectively. In the fully adjusted model, an IQR increase in urinary 1-OHP was related to -0.05 (95% confidence interval (CI): 0.09, -0.01, P-value = 0.02) decrease in relative LTL. This association was similar among boys and girls; however, we observed indications for a stronger association for those children whose parents had university education. Our study suggested an inverse relationship between urinary 1-OHP and LTL in children at preschool age. However, further longitudinal research with repeated measures of PAHs and LTL are needed to confirm these findings.
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http://dx.doi.org/10.1016/j.envres.2021.110757DOI Listing
April 2021

Quality of urban green spaces influences residents' use of these spaces, physical activity, and overweight/obesity.

Environ Pollut 2021 Feb 29;271:116393. Epub 2020 Dec 29.

ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain.

The quality characteristics of urban green spaces (UGS) have been suggested to play a critical role in their use and their potentials to exert health effects. However, epidemiological studies evaluating such a role are scarce. These studies have generally focused on a limited number of quality dimensions. We studied the association between 10 UGS quality dimensions, assessed through a comprehensive multidimensional tool, and physical activity, overweight/obesity, and UGS use. Our study was based on 2053 adults participating in the Barcelona Health Survey (2016) and the quality of 149 UGS located in Barcelona, Spain. For each participant, we abstracted the average and maximum quality score separately for each of the 10 quality dimensions and an overall quality score for the UGS within 300 m of the participant's residential address. Data on the study outcomes were obtained through face-to-face interviews. We developed logistic regression and negative binomial models to assess our evaluated associations and conducted mediation analyses between the different outcomes. We observed that the overall quality of UGS was associated with higher likelihood of engaging in moderate-to-vigorous physical activity (OR:1.13; 95% CI:1.00-1.27), lower risk of overweight/obesity (OR: 0.88; 95% CI: 0.79-0.98), and increased use of UGS (exponentiated regression coefficient: 1.08; 95% CI:1.01-1.15). For the quality dimensions, we observed different patterns of associations depending on the outcome; however, bird biodiversity and amenities seem to be relevant to all of our evaluated outcomes. The mediation analysis suggested that UGS use mediate the association between quality and physical activity, while physical activity mediates the association between quality and overweight/obesity. The novel results from this study will allow decision-makers better design UGS and directly pinpoint relevant quality dimensions to promote physical activity, reduce the risk of overweight/obesity and boost the use of UGS amongst citizens.
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http://dx.doi.org/10.1016/j.envpol.2020.116393DOI Listing
February 2021

Child buccal telomere length and mitochondrial DNA content as biomolecular markers of ageing in association with air pollution.

Environ Int 2021 02 31;147:106332. Epub 2020 Dec 31.

Centre for Environmental Sciences, Hasselt University, Agoralaan gebouw D, BE-3590 Hasselt, Belgium; Risk and Health Impact Assessment, Sciensano, Juliette Wytsmanstraat 14, BE-1050 Brussels, Belgium.

Background: Pro-inflammatory conditions such as air pollution might induce biological ageing. However, the available evidence on such an impact in children is still very scarce. We studied in primary schoolchildren the association of ambient residential air pollution exposure with telomere length (TL) and mitochondrial DNA content (mtDNAc), two important targets of the core axis of ageing.

Methods: Between 2012 and 2014, buccal TL and mtDNAc were repeatedly assessed using qPCR in 197 Belgian primary schoolchildren (mean age 10.3 years) as part of the COGNAC study. At the child's residence, recent (week), sub-chronic (month) and chronic (year) exposure to nitrogen dioxide (NO), particulate matter ≤ 2.5 µm (PM) and black carbon (BC) were estimated using a high resolution spatiotemporal model. A mixed-effects model with school and subject as random effect was used while adjusting for a priori chosen covariates.

Results: An interquartile range (IQR) increment (1.9 µg/m) in chronic PM exposure was associated with a 8.9% (95% CI: -15.4 to -1.9%) shorter TL. In contrast to PM, chronic exposure to BC and NO was not associated with TL but recent exposure to BC and NO showed significant inverse associations with TL: an IQR increment in recent exposure to BC (0.9 µg/m) and NO (10.2 µg/m) was associated with a 6.2% (95% CI: -10.6 to -1.6%) and 6.4% (95% CI: -11.8 to -0.7%) shorter TL, respectively. Finally, an IQR increment in chronic PM exposure was associated with a 12.7% (95% CI: -21.7 to -2.6%) lower mtDNAc. However, no significant associations were seen for NO and BC or for other exposure windows.

Conclusion: Chronic exposure to PM below the EU threshold was associated with child's shorter buccal TL and lower mtDNAc, while traffic-related pollutants (BC and NO) showed recent effects on telomere biology. Our data add to the literature on air pollution-induced effects of TL and mtDNAc, two measures part of the core axis of cellular ageing, from early life onwards.
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http://dx.doi.org/10.1016/j.envint.2020.106332DOI Listing
February 2021

Subjective Proximity to Green Spaces and Blood Pressure in Children and Adolescents: The CASPIAN-V Study.

J Environ Public Health 2020 11;2020:8886241. Epub 2020 Dec 11.

Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

Evidence favoring a beneficial association between greenness and blood pressure (BP) in adults is accumulating. However, children and adolescents have been understudied accordingly. Methodologically, the data on "exposure" to residential green spaces are commonly satellite-derived, including rare existing studies on the relationship between proximity to green spaces and BP in children. Despite perfectly obliterating subjective biases, remote sensing methods of greenness data collection fail to address pragmatic interaction with such settings. This study aimed to assess the relationship between subjective proximity to green spaces and average/elevated BP in children. Through our study, systolic and diastolic BPs of 12,340 schoolchildren living in CASPIAN-V study areas were examined and recorded. We performed surveys to obtain the data on their proximity to green spaces, defined as having access to such spaces within a 15-minute walk from their homes. Linear mixed-effects models with BP as the outcome variable and the measure of exposure to green spaces as fixed-effect predictor were applied. The analysis was adjusted for several covariates. We found that perceived residential proximity to green spaces was associated with -0.08 mmHg (95% confidence intervals (CIs): -0.58, 0.41; value = 0.72) reduction in systolic BP and -0.09 (95% CIs: -0.49, 0.31; value = 0.66) reduction in diastolic BP. We also observed statistically nonsignificant odds ratio of 1.03 (95% CIs: 0.76, 1.39), 0.96 (95% CIs: 0.80, 1.16), and 0.98 (95% CIs: 0.82, 1.16) for isolated systolic/diastolic hypertension and hypertension, respectively. Our observations remained consistent after adjustment for height, parental employment, low birth weight, parental obesity, single parent, and breastfeeding. In conclusion, subjective proximity to green spaces might not be associated with a lower mean BP in children. Well-designed studies applying both subjective and objective data should be performed to elaborate on the relationship further.
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http://dx.doi.org/10.1155/2020/8886241DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748899PMC
February 2021

Defining pathways to healthy sustainable urban development.

Environ Int 2021 01 5;146:106236. Epub 2020 Nov 5.

Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Campus Charité Mitte, 10117 Berlin, Germany.

Goals and pathways to achieve sustainable urban development have multiple interlinkages with human health and wellbeing. However, these interlinkages have not been examined in depth in recent discussions on urban sustainability and global urban science. This paper fills that gap by elaborating in detail the multiple links between urban sustainability and human health and by mapping research gaps at the interface of health and urban sustainability sciences. As researchers from a broad range of disciplines, we aimed to: 1) define the process of urbanization, highlighting distinctions from related concepts to support improved conceptual rigour in health research; 2) review the evidence linking health with urbanization, urbanicity, and cities and identify cross-cutting issues; and 3) highlight new research approaches needed to study complex urban systems and their links with health. This novel, comprehensive knowledge synthesis addresses issue of interest across multiple disciplines. Our review of concepts of urban development should be of particular value to researchers and practitioners in the health sciences, while our review of the links between urban environments and health should be of particular interest to those outside of public health. We identify specific actions to promote health through sustainable urban development that leaves no one behind, including: integrated planning; evidence-informed policy-making; and monitoring the implementation of policies. We also highlight the critical role of effective governance and equity-driven planning in progress towards sustainable, healthy, and just urban development.
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http://dx.doi.org/10.1016/j.envint.2020.106236DOI Listing
January 2021

Urban-Related Environmental Exposures during Pregnancy and Placental Development and Preeclampsia: a Review.

Curr Hypertens Rep 2020 09 3;22(10):81. Epub 2020 Sep 3.

Obstetrics and Gynecology Department, High Risk Unit, Sant Pau University Hospital, C/Sant Quintí, 89, 08041, Barcelona, Spain.

Purpose Of Review: To summarize the current knowledge of the pathophysiological implications and the clinical role of urban-related environmental exposures in pregnancy.

Recent Findings: The ongoing urbanization worldwide is leading to an increasing number of pregnant women being exposed to higher levels of urban-related environmental hazards such as air pollution and noise and, at the same time, having less contact with natural environments. Pregnancy represents a particular and vulnerable life period both for women and their children. Extensive physiological and metabolic changes, as well as changes to the cardiovascular and respiratory systems during pregnancy, could result in increased sensitivity to damage by environmental factors. Exposure to air pollution and noise is associated with placental dysfunction and damage, which, in turn, could lead to maternal complications such as preeclampsia. In contrast, more contact with greenspace during pregnancy seems to mitigate these adverse impacts. These findings open up new challenges for our understanding of the potential effect of urban living on placental function and preeclampsia, and offer new clinical and research opportunities.
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http://dx.doi.org/10.1007/s11906-020-01088-4DOI Listing
September 2020

Prenatal greenspace exposure and cord blood cortisol levels: A cross-sectional study in a middle-income country.

Environ Int 2020 11 18;144:106047. Epub 2020 Aug 18.

ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain Maternal and Child Health Development Network, Madrid, Spain. Electronic address:

Exposure to greenspace has been associated with reduced stress; however, the available evidence on such an association for the fetus is still very scarce. We, for the first time, investigated the association between maternal greenspace exposure and the level of cortisol, a stress hormone, in the cord blood. Our study was based on a cohort of 150 pregnant women in Sabzevar, Iran (2018). We comprehensively assessed greenspace exposure for each participant through (i) residential surrounding greenspace (using two satellite-derived vegetation indices), (ii) residential proximity to green spaces, (iii) maternal visual access to greenspace, (iv) use of public and private green spaces, (v) having a private garden, and (vi) the number of plant pots at home. Linear regression models were developed to assess the association of each indicator of greenspace exposure with cord blood cortisol levels, controlled for the relevant covariates. We observed that a higher residential surrounding greenspace (100 m buffer), having a window with greenspace view, window greenspace coverage of more than 50%, frequently looking at greenspace through window, residential proximity to large green spaces, and more time spent in green spaces were associated with lower cortisol levels in the cord blood. The findings for residential surrounding greenspace at 300 m and 500 m buffers, residential proximity to any green space regardless of its size, having a private garden, and number of plant pots at home were not conclusive. While about one-third of the association between residential surrounding greenspace (100 m buffer) could be mediated through reduction in exposure to air pollution, we did not observe any strong evidence for such a mediatory role for the visual access to greenspace. The findings stratified for parental education and housing type showed mixed patterns. Our findings suggest that more greenspace exposure might reduce cortisol level in the cord blood.
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http://dx.doi.org/10.1016/j.envint.2020.106047DOI Listing
November 2020

Residential urban greenspace and hypertension: A comparative study in two European cities.

Environ Res 2020 12 16;191:110032. Epub 2020 Aug 16.

ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain. Electronic address:

Background: Living in green areas has been associated with several health benefits; however, the available evidence on such benefits for hypertension is still limited. This study aimed to investigate and compare the association between residential exposure to greenspace and hypertension in Barcelona, Spain and Brussels, Belgium.

Methods: This cross-sectional study was based on data from the 2016 Barcelona Health Interview Survey (HIS) (n = 3400) and the 2013 Belgian HIS (n = 2335). Both surveys were harmonized in terms of outcomes, confounders and exposure assessment. Residential exposure to greenspace was characterized as 1) surrounding greenspace (normalized difference vegetation index (NDVI) and modified soil-adjusted vegetation index 2 (MSAVI2)) across buffers of 100 m, 300 m, and 500 m; 2) surrounding green space across 300 m and 500 m buffers; and 3) Euclidean distance to the nearest green space. Our outcome was self-reported hypertension. We developed logistic regression models to evaluate the city-specific association between each greenspace measure and hypertension, adjusting for relevant covariates.

Results: One interquartile range (IQR) increase in residential distance to the nearest green space was associated with higher risk of hypertension in Barcelona [odds ratio (OR): 1.15; 95%CI 1.03-1.29 (IQR: 262.2)], but not in Brussels [OR: 0.95; 95%CI 0.77-1.17 (IQR: 215.2)]. Stratified analyses suggested stronger associations in older participants (≥65 years) for both cities. Findings for residential surrounding green space and greenspace were not conclusive. However, in Brussels, we found protective associations in older participants for both residential surrounding greenspace metrics [NDVI 300 m buffer OR: 0.51; 95%CI 0.32-0.81 (IQR: 0.21) and MSAVI2 300 m buffer OR: 0.51; 95%CI 0.32-0.83 (IQR: 0.18)]. We did not find any indication for the modification of our evaluated associations by sex and education level.

Conclusion: Our study suggests that living closer to greenspace could be associated with lower risk of hypertension, particularly in older age. Future research is needed to replicate our findings in other settings and shed light on potential underlying mechanism(s).
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http://dx.doi.org/10.1016/j.envres.2020.110032DOI Listing
December 2020

Exposure to greenspace and birth weight in a middle-income country.

Environ Res 2020 10 8;189:109866. Epub 2020 Jul 8.

ISGlobal, Barcelona, Spain; Pompeu FabraUniversity, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address:

An emerging body of evidence has associated exposure to greenspace during pregnancy with improved fetal growth; however, all available studies have been conducted in high-income countries and the available evidence evaluating such an association for visual access to greenspace, use of green spaces and indoor plants is non-existent. We aimed to evaluate the association between a comprehensive array of indicators of exposure to greenspace during pregnancy, including the aforementioned indicators, and birth weight, in a middle-income country and evaluating air pollution and visual access as possible mechanisms underlying the association. This study was based on 301 pregnant women residing in Su et al. (2019). For each pregnant woman, we characterized exposure to residential surrounding greenspace, visual access to greenspace, residential proximity to green space, use of green spaces, and the number of plant pots at home. We used linear regression models adjusted for relevant covariates including measures of socioeconomic status. We found positive associations of maternal exposure to residential surrounding greenspace across a 100 m buffer, frequent viewing of greenspace through the window, percentage of window area covered by greenspace, residential proximity to any green space regardless of its area, time spent in public green spaces and total time spent in public and private green spaces with birth weight. We also observed positive associations of maternal exposure to residential surrounding greenspace across 300 m and 500 m buffers, residential proximity to a green space with an area ≥5000 m, and indoor plant pots with birth weight, but none of these associations were statistically significant. The magnitude of the associations tended to be higher among parents with lower socioeconomic status. Mediation through air pollution or visual access was not established. Findings from this study suggested a positive role of different aspects of exposure to greenspace during pregnancy on birth weight in a middle-income country.
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http://dx.doi.org/10.1016/j.envres.2020.109866DOI Listing
October 2020

Residential Surrounding Greenspace and Mental Health in Three Spanish Areas.

Int J Environ Res Public Health 2020 08 5;17(16). Epub 2020 Aug 5.

Barcelona Institute for Global Health (ISGlobal), 08003 Barcelona, Spain.

Exposure to greenspace has been related to improved mental health, but the available evidence is limited and findings are heterogeneous across different areas. We aimed to evaluate the associations between residential exposure to greenspace and specific psychopathological and psychosomatic symptoms related to mental health among mothers from a Spanish birth cohort. Our study was based on data from 1171 women participating in two follow-ups of a population-based cohort in Valencia, Sabadell, and Gipuzkoa (2004-2012). For each participant, residential surrounding greenspace was estimated as the average of the satellite-based Normalized Difference Vegetation Index (NDVI) across different buffers around the residential address at the time of delivery and at the 4-year follow-up. The Symptom Checklist 90 Revised (SCL-90-R) was applied to characterize mental health at the 4-year follow-up. We developed mixed-effects logistic regression models controlled for relevant covariates to evaluate the associations. Higher residential surrounding greenspace was associated with a lower risk of somatization and anxiety symptoms. For General Severity Index (GSI), obsessive-compulsive, interpersonal sensitivity, depression, hostility, phobic anxiety, paranoid ideation, and psychoticism symptoms, we generally observed protective associations, but none attained statistical significance. Findings from this study suggested a potential positive impactof greenspace on mental health.
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http://dx.doi.org/10.3390/ijerph17165670DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460179PMC
August 2020

Association of greenspace exposure with telomere length in preschool children.

Environ Pollut 2020 Nov 21;266(Pt 1):115228. Epub 2020 Jul 21.

ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address:

Exposure to greenspace has been associated with a wide range of health benefits; however, the available evidence on the association of this exposure with telomere length (TL), an early marker of ageing, is still scarce. We investigated the association of greenspace exposure with TL in a sample of 200 preschool children (aged 5-7 years) residing in Sabzevar, Iran (2017). We comprehensively characterized different aspects of greenspace exposure encompassing residential, kindergarten, and total (including both residential and kindergarten) surrounding greenspace (using satellite-derived Normalized Difference Vegetation Index), residential and kindergarten distance to green spaces, time spent in private gardens and public green spaces, and the number of plant pots at home. Relative leukocyte TL (LTL) in blood samples of the study participants was measured using quantitative polymerase chain reaction (qPCR). We applied mixed effects linear regression models with kindergarten and qPCR plate as random effects, to estimate the association of indicators of greenspace exposure (one at a time) with LTL, controlled for relevant covariates. We observed an inverse association between distance from home and kindergarten to green spaces larger than 5000 m and LTL. Moreover, higher total surrounding greenspace at 300m and 500m buffers and higher surrounding greenspace at 300m buffer around kindergarten and home were associated with longer LTL. Furthermore, longer time spent (h/week) in the public green spaces was associated with longer LTL. Our findings for residential and kindergarten distance to any green space (regardless of the size), residential surrounding greenspace at 100m and 500m buffers, kindergarten surrounding greenspace at 100m buffer, time spent in private gardens (h/week) and the number of plant pots at home were not conclusive. Our findings were generally suggestive for a positive association between greenspace exposure and LTL in preschool children. More studies are needed to confirm these findings in other settings with different climates and populations.
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http://dx.doi.org/10.1016/j.envpol.2020.115228DOI Listing
November 2020

Long-Term Greenspace Exposure and Progression of Arterial Stiffness: The Whitehall II Cohort Study.

Environ Health Perspect 2020 06 26;128(6):67014. Epub 2020 Jun 26.

ISGlobal, Barcelona, Spain.

Background: Arterial stiffness, and its progression with age, is an important indicator of cardiovascular aging. Greenspace exposure may protect against arterial stiffness by promoting physical activity, fostering social cohesion, and reducing stress and exposure to air pollution and noise.

Objectives: The aim of this study was to investigate the association of long-term exposure to outdoor greenspace with arterial stiffness and its progression over time.

Methods: This prospective cohort study was based on 4,349 participants (55-83 years of age) of the Whitehall II Study, United Kingdom. Arterial stiffness was assessed in two medical examinations (2007-2009 and 2012-2013) by measuring the carotid-femoral pulse wave velocity (cf-PWV). Residential surrounding greenspace was characterized using satellite-based indices of greenspace including normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and vegetation continuous fields (VCF) across buffers of 500 and surrounding the participants' residential locations at each follow-up. The association between the greenspace indicators and baseline cf-PWV and 4-year progression of cf-PWV was assessed using linear mixed-effects models with the participant as a random effect, controlling for demographic, lifestyle, and (individual and area) socioeconomic factors.

Results: No statistically significant associations were observed between residential surrounding greenspace and baseline or 4-y progression of cf-PWV; interquartile range (IQR) increases in NDVI, EVI, and VCF in the buffer were associated with [95% confidence interval (CI): , 0.04], (95% CI: , 0.05), and (95% CI: , 0.04) in baseline cf-PWV and (95% CI: , 0.14), (95% CI: , 0.14), and (95% CI: , 0.09) in 4-y progression in cf-PWV, respectively. The associations were similar when using buffers.

Conclusions: We did not observe any consistent association between residential surrounding greenspace and arterial stiffness. https://doi.org/10.1289/EHP6159.
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http://dx.doi.org/10.1289/EHP6159DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319656PMC
June 2020

Land-Use Change and Cardiometabolic Risk Factors in an Urbanizing Area of South India: A Population-Based Cohort Study.

Environ Health Perspect 2020 04 3;128(4):47003. Epub 2020 Apr 3.

Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.

Background: Land-use changes in city fringes due to urbanization can lead to a reduction of greenspace that may reduce its associated health benefits.

Objectives: We evaluated the association between changes in residential surrounding built-up land use and cardiometabolic risk factors in an urbanizing peri-urban area of south India and explored the mediating roles of air pollution, physical activity, and stress in these associations.

Methods: We analyzed data on 6,039 adults from the third follow-up of the Andhra Pradesh Children and Parent Study (APCAPS) cohort (2010-2012). We generated trajectories of change in residential surrounding built-up land use (buffer areas) from 1995-2009 (stable, slow increase, fast increase) using remote sensing data and image classification methods. We estimated associations between built-up land use trajectories and natural log-transformed blood pressure, waist circumference, triglycerides, fasting glucose, and non-high-density lipoprotein (non-HDL) cholesterol using linear mixed models. We accounted for multiple mediators and the multilevel structure of the data in mediation analyses.

Results: We observed positive associations between a fast increase in built-up land use within of the home and all cardiometabolic risk factors. Compared with participants with stable trajectories, those with the largest increase in built-up land use had 1.5% (95% CI: 0.1, 2.9) higher systolic blood pressure, 2.4% (95% CI: 0.6, 4.3) higher diastolic blood pressure, 2.1% (95% CI: 0.5, 3.8) higher waist circumference, and 1.6% (95% CI: , 3.8) higher fasting glucose in fully adjusted models. Associations were positive, but not statistically significant, for triglycerides, fasting glucose, and non-HDL cholesterol. Physical activity and ambient particulate matter in aerodynamic diameter () partially mediated the estimated associations. Associations between fast build-up and all cardiometabolic risk factors except non-HDL cholesterol were stronger in women than men.

Discussion: Increases in built-up land use surrounding residences were consistently associated with higher levels of cardiometabolic risk factors. Our findings support the need for better integration of health considerations in urban planning in rapidly urbanizing settings. https://doi.org/10.1289/EHP5445.
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http://dx.doi.org/10.1289/EHP5445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228094PMC
April 2020

Association of exposure to air pollution and telomere length in preschool children.

Sci Total Environ 2020 Jun 14;722:137933. Epub 2020 Mar 14.

Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran; Pompeu Fabra University, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address:

Exposure to air pollution is associated with adverse health effects; however, the available evidence of its association with telomere length (TL), an early marker of ageing, in children is still scarce with no study available for preschool children. This study aimed to investigate the association of exposure to air pollution and traffic indicators at home and kindergarten with relative leukocyte TL (LTL) in preschool children. This cross-sectional study included 200 preschool children (5-7 years old) recruited from 27 kindergartens in Sabzevar, Iran (2017). Outdoor annual average levels PM, PM, and PM at residential address and kindergartens were estimated applying land use regression (LUR) models. Moreover, indoor levels of PMs at kindergartens were measured for four days in each season resulting in a total of 16 days of measurements for each kindergarten. Total streets length in different buffers and distance to major road were calculated as traffic indicators at residential address and kindergartens. We applied quantitative real-time polymerase chain reaction (qRT-PCR) to measure relative LTL in blood samples obtained from children. Mixed linear regression models were developed with qPCR plate and kindergarten as random effects, to estimate association of each pollutant and traffic indicator with LTL, controlled for relevant covariates. Higher concentrations of outdoor PM, PM, and PM, at home and kindergartens were associated with shorter relative LTL. Similarly, increase in indoor PM concentrations at kindergartens was associated with shorter relative LTL (β = -0.18, 95% CI: -0.36, -0.01, P-value < 0.01). Moreover, higher total street length in 100 m buffer around residence and lower residential distance to major roads were associated with shorter relative LTL (β = -0.25, 95% CI: -0.37, -0.13, P-value < 0.01, and 0.32, 95% CI: 0.20, 0.44, P-value < 0.01, respectively). Overall, our study suggested that higher exposure to air pollution and traffic at kindergarten and residential home were associated with shorter relative LTL in preschool children.
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http://dx.doi.org/10.1016/j.scitotenv.2020.137933DOI Listing
June 2020

Association of exposure to air pollution and green space with ovarian reserve hormones levels.

Environ Res 2020 05 3;184:109342. Epub 2020 Mar 3.

ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.

Exposure to air pollution has been associated with adverse health effects while exposure to greenspace has been associated with public health benefits. However, the available evidence on the association of exposure to air pollution with ovarian reserve markers is still scarce, with no study on such an association with greenspace exposure. Therefore, this study aimed to investigate the association of exposure to particulate matter with diameter of less than 1, 2.5 and 10 μm (PM, PM, PM), traffic indicators (distance from women's residence to major roads and total street length in different buffers around women's residential address) and greenspace indicators (residential surrounding greenspace and distance to green spaces) with serum levels of anti-müllerian hormone (AMH) and follicle stimulating hormone (FSH) as markers of ovarian reserve. This cross-sectional study was based on 67 women residing in Sabzevar, Iran (2018). Basal serum levels of FSH and AMH were measured by the enzyme-linked immunosorbent assays (ELISA). Land use regression models were used to estimate PMs concentrations at residential addresses and the average of normalized difference vegetation index (NDVI) in different buffers was used to characterize residential surrounding greenspace. Multiple linear regression models were developed to estimate the association of AMH and FSH with exposure to air pollution, traffic, and greenspace (one at a time) controlled for relevant covariates. In fully adjusted models, there was an inverse association between exposure to PM, PM as well as total street length in 100 m buffer around women's residence and AMH level (β = -0.89, 95% confidence interval (CI): -1.43, -0.35, P-value ≤ 0.01, β = -1.11, 95% CI: -1.67, -0.55, P-value ≤ 0.01 and β = -0.76, 95% CI: -1.48, -0.50, P-value = 0.03, respectively). Moreover, increase in distance from home to nearest major road as well as residential surrounding greenspace (100 m buffer) and decrease in residential distance to a green space larger than 5000 m were associated with increase in serum level of AMH. However, we did not observe any significant association between exposure to air pollution, traffic, and greenspace with FSH level. Overall, our findings supported a beneficial association of exposure to greenspace and detrimental association of exposure to air pollution with ovarian reserve.
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http://dx.doi.org/10.1016/j.envres.2020.109342DOI Listing
May 2020

Maternal exposure to ambient particulate matter and green spaces and fetal renal function.

Environ Res 2020 05 23;184:109285. Epub 2020 Feb 23.

ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.

Exposure to air pollution has been associated with different harmful effects and exposure to greenspace has been related to improved human health. However, the available evidence on the impact of these exposures on renal function is still scarce. The aim of this study was to determine the relationship between exposure to ambient levels of PM, PM, PM and indicators of exposure to traffic as well as greenspace during pregnancy and fetal renal function based on the umbilical cord blood. This study was based on 150 pregnant women residing in Sabzevar, Iran (2018). Multiple linear regression models were developed to estimate the association of glomerular filtration rate (GFR), creatinine (Cr) and blood urea nitrogen (BUN) with exposure to air pollution, traffic, and greenspace (one at a time) controlled for relevant covariates. There was an inverse significant association between exposure to PM, PM PM and total street length in a 100 m buffer around the home and eGFR. Increase in distance to major road and residential surrounding greenness (100 m buffer) was associated with increase in eGFR. We observed a significant direct association between exposure to PMs as well as street length in 100 m buffer and serum level of Cr. There was also an inverse association between distance to major road and NDVI in 100 m buffer and Cr. The associations for blood urea nitrogen (BUN) were not statistically significant. Our results suggest that exposure to air pollution during pregnancy could have negative impact and exposure to greenspace could have positive impact on renal function of fetal.
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http://dx.doi.org/10.1016/j.envres.2020.109285DOI Listing
May 2020

Maternal exposure to ambient air pollution during pregnancy and lipid profile in umbilical cord blood samples; a cross-sectional study.

Environ Pollut 2020 Jun 21;261:114195. Epub 2020 Feb 21.

Non-communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran. Electronic address:

Adverse health effects of exposure to air pollution have been investigated in many previous studies. However, there is no study available on the association between maternal exposure to air pollution during pregnancy and cord blood lipid profile. This study, based on 150 mother-newborn pairs residing in Sabzevar, Iran (2018), evaluated the association of exposure to ambient air pollution as well as traffic indicators (total street length in different buffers around residential address and distance to major roads) during entire pregnancy with lipid levels cord blood lipid profile. Concentrations of PM, PM, and PM at maternal residential address were estimated using land use regression (LUR) models. We measured triglyceride (TAG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) levels and TC/HDL-C and TAG/HDL-C ratio in the cord blood samples to characterize their lipid profile. Multiple linear regression models were developed to estimate the association of exposure to air pollution and traffic indicators with cord blood lipid profile controlled for relevant covariates. Higher concentrations of PM and PM were associated with higher levels of TAG, TC, HDL-C, TC/HDL-C, and TAG/HDL-C in cord blood samples. Moreover, higher concentration of PM was associated with higher levels of TAG, TC and LDL-C. There was also a positive association between total street length in 100 m buffer around home and serum levels of TC, TAG, LDL-C and TC/HDL ratio (β = 3.73, 95% confidence intervals (CI): 1.76, 5.71; β = 2.75, 95% CI: 0.97, 4.53; β = 1.87, 95% CI: 0.64, 3.09; β = 0.06, 95% CI: 0.01, 0.11, respectively). However, the associations for total street length in larger buffers and distance to major roads were not statistically significant. Our findings support a relationship between exposure to air pollution during pregnancy and increase in cord blood lipid levels.
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http://dx.doi.org/10.1016/j.envpol.2020.114195DOI Listing
June 2020

Long-Term Exposure to Residential Greenspace and Healthy Ageing: a Systematic Review.

Curr Environ Health Rep 2020 03;7(1):65-88

Instituto de Salud Global de Barcelona (ISGlobal), Barcelona Biomedical Research Park (PRBB), Doctor Aiguader 88, 08003, Barcelona, Spain.

Purpose Of Review: We systematically reviewed the available observational evidence on the association between long-term exposure to residential outdoor greenspace and health at older age and rated the evidence as sufficient, limited, or inadequate.

Recent Findings: We identified 59 studies, ranging from poor to very good quality. The health outcomes included mental health (N = 12, of which three were longitudinal studies and eight were rated to be of good quality), cognitive function (N = 6; two longitudinal studies, five of good/very good quality), physical capability (N = 22; five longitudinal studies, six of good/very good quality), cardiometabolic risk (N = 9; one longitudinal study, five of good/very good quality), morbidity (N = 11; three longitudinal studies, six of good/very good quality) and perceived wellbeing (N = 9; all cross-sectional, two of good quality). The evidence for a beneficial association with greenspace was rated limited for morbidity and inadequate for mental health, cognitive function, physical capability, cardiometabolic risk and perceived wellbeing. The reviewed studies provided inadequate/limited but suggestive evidence for a beneficial association between greater long-term greenspace exposure and healthy ageing. This review highlights the need of longitudinal studies that assess the association between long-term greenspace exposure and the trajectory of objective indicators of ageing.
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http://dx.doi.org/10.1007/s40572-020-00264-7DOI Listing
March 2020

Maternal exposure to air pollution during pregnancy and cortisol level in cord blood.

Sci Total Environ 2020 Apr 10;713:136622. Epub 2020 Jan 10.

ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.

Exposure to air pollution has been associated with disorders of the endocrine system and hypothalamic-pituitary-adrenal (HPA) axis; however, the available evidence on these associations is still scarce. This study aimed to investigate, for the first time, the association of exposure to PM, PM, and PM, as well as traffic indicators (distance to major roads and total street length in different buffers around maternal residential address) during pregnancy with cortisol level in cord blood samples. This cross-sectional study was carried out based on 150 mother-newborn pairs in Sabzevar, Iran (2018). Land use regression models were applied to estimate air pollution exposure during the entire pregnancy at maternal residential addresses. Multiple linear regression models were applied to estimate the association of exposure to air pollution during pregnancy and cord blood cortisol levels, controlled for relevant covariates. There was a significant positive association between exposure to PM and PM and cortisol levels in cord blood (β = 2.55, 95% confidence intervals (CI) = 0.57, 4.52, P-value = 0.01, and β = 3.09, 95% CI: 1.28, 4.90, P-value < 0.01, respectively). Moreover, there was a significant positive association between total street length in a 100 m buffer around maternal residence and cortisol level. Each one interquartile range (IQR) increase in distance from home to major roads was associated with a -2.58 (95% CI: -4.85, -0.30, P-value = 0.03) decrease in cord blood cortisol level. The median (IQR) of the cord blood cortisol levels for the first and fourth quartiles of distance to major roads were 50.7 (19.5) and 38.2 (20.4) ng/mL, respectively. The associations for total street length in 300 m and 500 m buffers and PM exposure were not statistically significant. Our findings suggest a direct association of exposure to air pollution during pregnancy and cortisol levels at cord blood.
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http://dx.doi.org/10.1016/j.scitotenv.2020.136622DOI Listing
April 2020

Urban natural environments and motor development in early life.

Environ Res 2019 12 30;179(Pt A):108774. Epub 2019 Sep 30.

The School of Population and Public Health, The University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada; The Department of Forest and Conservation Sciences, The University of British Columbia, 2424 Main Mall, Vancouver, BC, V6T 1Z4, Canada. Electronic address:

An emerging body of evidence has associated natural environments with improved brain development in children; however, these studies have mainly focused on cognition and available evidence for motor development is still scarce. This study aimed to evaluate the protective association of neighbourhood greenspace with motor development deficits in children. We obtained data on motor development deficits (separately for fine and gross motor developments) at sub-district level from routine medical check-up of children prior to enrolment into primary schools in the city of Berlin (2015-2016). Neighbourhood natural environments across the sub-districts were measured with three different metrics: the average of satellite-based normalized difference vegetation index (NDVI), the share of public green spaces, and the share of both public blue and green spaces (composite nature) across the sub-district. We applied negative binominal models to estimate the association between neighbourhood natural environments and fine and gross motor development deficits (one at a time), controlled for relevant sociodemographic indicators. Higher neighbourhood public green space and composite nature were significantly associated with lower risk of motor development deficits; however, the association were not statistically significant when using NDVI. Our findings, if confirmed by future studies, could provide evidence for implementing targeted interventions to enhance motor development in urban children.
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http://dx.doi.org/10.1016/j.envres.2019.108774DOI Listing
December 2019

Long-term exposure to greenspace and metabolic syndrome: A Whitehall II study.

Environ Pollut 2019 Dec 13;255(Pt 2):113231. Epub 2019 Sep 13.

ISGlobal, Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. Electronic address:

Background: Metabolic syndrome is an important risk factor for non-communicable diseases, particularly type 2 diabetes, coronary heart disease, and stroke. Long-term exposure to greenspace could be protective of metabolic syndrome, but evidence for such an association is lacking. Accordingly, we investigated the association between long-term exposure to greenspace and risk of metabolic syndrome.

Methods: The present longitudinal study was based on data from four clinical examinations between 1997 and 2013 in 6076 participants of the Whitehall II study, UK (aged 45-69 years at baseline). Long-term exposure to greenspace was assessed by satellite-based indices of greenspace including Normalized Difference Vegetation Index (NDVI) and Vegetation Continuous Field (VCF) averaged across buffers of 500 and 1000 m surrounding the participants' residential location at each follow-up. The ascertainment of metabolic syndrome was based on the World Health Organization (WHO) definition. Hazard ratios for metabolic syndrome were estimated using Cox proportional hazards regression models, controlling for age, sex, ethnicity, lifestyle factors, and socioeconomic status.

Results: Higher residential surrounding greenspace was associated with lower risk of metabolic syndrome. An interquartile range increase in NDVI and VCF in the 500 m buffer was associated with 13% (95% confidence interval (CI): 1%, 23%) and 14% (95% CI: 5%, 22%) lower risk of metabolic syndrome, respectively. Greater exposure to greenspace was also associated with each individual component of metabolic syndrome, including a lower risk of high levels of fasting glucose, large waist circumference, high triglyceride levels, low HDL cholesterol, and hypertension. The association between residential surrounding greenspace and metabolic syndrome may have been mediated by physical activity and exposure to air pollution.

Conclusions: The findings of the present study suggest that middle-aged and older adults living in greener neighbourhoods are at lower risk of metabolic syndrome than those living in neighbourhoods with less greenspace.
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http://dx.doi.org/10.1016/j.envpol.2019.113231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7441228PMC
December 2019

Association of residential air pollution, noise, and greenspace with initial ischemic stroke severity.

Environ Res 2019 12 5;179(Pt A):108725. Epub 2019 Sep 5.

Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA. Electronic address:

Background And Purpose: A number of environmental risk factors of acute ischemic stroke have been identified, but few studies have evaluated the influence of the outdoor environment on stroke severity. We assessed the association of residential ambient fine particulate matter air pollution (PM), noise, and surrounding greenspace with initial stroke severity.

Methods: We obtained data on patients hospitalized with acute ischemic stroke from a hospital-based prospective stroke register (2005-2014) in Barcelona. We estimated residential PM based on an established land use regression model, greenspace as the average satellite-based Normalized Difference Vegetation Index (NDVI) within a 300 m buffer of the residence, and daily (Lday), evening (Levening), night (Lnight) and average noise (Lden) level at the street nearest to the residential address using municipal noise models. Stroke severity was assessed at the time of hospital presentation using the National Institute of Health Stroke Scale (NIHSS).We used logistic regression and binomial models to evaluate the associations of PM greenspace, and noise with initial stroke severity adjusting for potential confounders.

Results: Among 2761 patients, higher residential surrounding greenspace was associated with lower risk of severe stroke (OR for NIHSS>5, 0.75; 95% CI: 0.60-0.95), while, living in areas with higher Lden was associated with a higher risk of severe stroke (OR, 1.30; 95% CI: 1.02-1.65). PM was not associated with initial stroke severity.

Conclusions: In an urban setting, surrounding greenspace and traffic noise at home are associated with initial stroke severity, suggesting an important influence of the built environment on the global burden of ischemic stroke.
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http://dx.doi.org/10.1016/j.envres.2019.108725DOI Listing
December 2019

A systematic review of multi-dimensional quality assessment tools for urban green spaces.

Health Place 2019 09 13;59:102198. Epub 2019 Sep 13.

Environment and Human Health Lab (EH(2) Lab), Institut de Ciència i Tecnologia Ambientals (ICTA-UAB), Universitat Autònoma de Barcelona, 08193, Cerdanyola del Vallès, Barcelona, Spain; Geography Department, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, 08193, Barcelona, Spain.

We conducted a systematic review of quality assessment tools for urban green spaces to evaluate their replicability, comparability and validity. We assessed the characteristics of 15 published, multi-dimensional, direct observation tools regarding: publication, development, features and included dimensions. Even though all tools show acceptable inter-rater variability, there is a notable variability in their characteristics, from required time to conduct the assessment to the number of included items. Additionally, some specific dimensions are underrepresented, and the study units' definitions are feeble. We showcased the need for new tools that are more comprehensive and include more consistent reporting measures.
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http://dx.doi.org/10.1016/j.healthplace.2019.102198DOI Listing
September 2019

Residential surrounding greenspace and age at menopause: A 20-year European study (ECRHS).

Environ Int 2019 11 19;132:105088. Epub 2019 Aug 19.

Barcelona Institute for Global Health, Barcelona, Spain.

Background: Menopause is associated with a number of adverse health effects and its timing has been reported to be influenced by several lifestyle factors. Whether greenspace exposure is associated with age at menopause has not yet been investigated.

Objective: To investigate whether residential surrounding greenspace is associated with age at menopause and thus reproductive aging.

Methods: This longitudinal study was based on the 20-year follow-up of 1955 aging women from a large, population-based European cohort (ECRHS). Residential surrounding greenspace was abstracted as the average of satellite-based Normalized Difference Vegetation Index (NDVI) across a circular buffer of 300 m around the residential addresses of each participant during the course of the study. We applied mixed effects Cox models with centre as random effect, menopause as the survival object, age as time indicator and residential surrounding greenspace as time-varying predictor. All models were adjusted for smoking habit, body mass index, parity, age at menarche, ever-use of contraception and age at completed full-time education as socio-economic proxy.

Results: An increase of one interquartile range of residential surrounding greenspace was associated with a 13% lower risk of being menopausal (Hazard Ratio: 0.87, 95% Confidence Interval: 0.79-0.95). Correspondingly the predicted median age at menopause was 1.4 years older in the highest compared to the lowest NDVI quartile. Results remained stable after additional adjustment for air pollution and traffic related noise amongst others.

Conclusions: Living in greener neighbourhoods is associated with older age at menopause and might slow reproductive aging. These are novel findings with broad implications. Further studies are needed to see whether our findings can be replicated in different populations and to explore the potential mechanisms underlying this association.
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http://dx.doi.org/10.1016/j.envint.2019.105088DOI Listing
November 2019

Low Childhood Nature Exposure is Associated with Worse Mental Health in Adulthood.

Int J Environ Res Public Health 2019 05 22;16(10). Epub 2019 May 22.

Barcelona Institute for Global Health (ISGlobal), Doctor Aiguader 88, 08003 Barcelona, Spain.

Exposure to natural outdoor environments (NOE) is associated with health benefits; however, evidence on the impact of NOE exposure during childhood on mental health (MH) and vitality in adulthood is scarce. This study was based on questionnaire data collected from 3585 participants, aged 18-75, in the PHENOTYPE project (2013) in four European cities. Mixed models were used to investigate associations between childhood NOE exposure and (i) MH; (ii) vitality (perceived level of energy and fatigue); and (iii) potential mediation by perceived amount, use, satisfaction, importance of NOE, and residential surrounding greenness, using pooled and city-level data. Adults with low levels of childhood NOE exposure had, when compared to adults with high levels of childhood NOE exposure, significantly worse mental health (coef. -4.13; 95% CI -5.52, -2.74). Childhood NOE exposure was not associated with vitality. Low levels of childhood NOE exposure were associated with lower importance of NOE (OR 0.81; 95% CI 0.66, 0.98) in adulthood. The association with perceived amount of NOE differed between cities. We found no evidence for mediation. Childhood NOE exposure might be associated with mental well-being in adulthood. Further studies are needed to confirm these findings and to identify mechanisms underlying long-term benefits of childhood NOE exposure.
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http://dx.doi.org/10.3390/ijerph16101809DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6572245PMC
May 2019

Association between Early Life Exposure to Air Pollution and Working Memory and Attention.

Environ Health Perspect 2019 05;127(5):57002

ISGlobal (Barcelona Institute for Global Health), Barcelona, Catalonia, Spain.

Background: Although previous studies have reported negative associations between exposure to air pollution and cognition, studies of the effects of prenatal and postnatal exposures in early childhood have been limited.

Objectives: We sought to assess the role exposure to fine particulate matter ([Formula: see text]) during different prenatal and postnatal windows may play in children's cognitive development at school age.

Methods: Within the Brain Development and Air Pollution Ultrafine Particles in School Children (BREATHE) Project, we estimated residential [Formula: see text] exposures by land use regression for the prenatal period and first seven postnatal years of 2,221 children from Barcelona, Spain. The participants ([Formula: see text]) completed computerized tests assessing working memory, attentiveness, and conflict network during four visits in 2012–2013. We used linear mixed effects and distributed lag models to assess the period of exposure to [Formula: see text] in association with cognitive development.

Results: Inverse associations were identified between [Formula: see text] exposure during the fifth and sixth postnatal years and working memory, with boys showing much higher vulnerability. Regarding attention functions, exposure to higher [Formula: see text] levels during the prenatal period and from the fourth postnatal year were associated with a reduction in conflict network performance, though we found no association with attentiveness. The overall estimated cumulative effect of a [Formula: see text] increase in [Formula: see text] resulted in a reduction in the working memory [Formula: see text] score of [Formula: see text] [95% confidence interval (CI): [Formula: see text], [Formula: see text]] points and an increase in the conflict attentional network of 11.31 (95% CI: 6.05, 16.57) milliseconds, indicating a poorer performance.

Conclusions: Early life exposure to [Formula: see text] was associated with a reduction in fundamental cognitive abilities, including working memory and conflict attentional network. https://doi.org/10.1289/EHP3169.
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http://dx.doi.org/10.1289/EHP3169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791117PMC
May 2019