背景:虽然已经报道了绿色暴露对健康的益处,特定于肺功能的发现不一致。本研究的目的是基于安徽省多个城市的慢性阻塞性肺疾病(COPD)监测数据库,评估绿色暴露与多个肺功能指标的相关性。
方法:我们使用归一化植被指数(NDVI)的年平均值评估了每个当地社区或村庄周围1000米缓冲区的绿色度。考虑了三种类型的肺功能指标,即阻塞性通气功能障碍的指标(FVC,FEV1,FEV1/FVC,和FEV1/FEV3);大气道功能障碍(PEF)的指标;小气道功能障碍的指标(FEF25%,FEF50%,FEF75%,MMEF,FEV3、FEV6和FEV3/FVC)。线性混合效应模型用于通过调整年龄来分析绿色暴露与肺功能的关联。性别,教育水平,职业,residence,吸烟状况,结核病史,肺病家族史,室内空气污染,职业暴露,PM2.5和体重指数。
结果:共招募了2768名参与者进行调查。NDVI的四分位数间距(IQR)增加与更好的FVC(153.33mL,95CI:44.07mL,262.59mL),FEV1(109.09mL,95CI:30.31mL,187.88mL),FEV3(138.04mL,95CI:39.43mL,236.65mL),FEV6(145.42mL,95CI:42.36mL,248.47mL)。然而,与PEF没有显著关联,FEF25%,FEF50%,FEF75%,MMEF,FEV1/FVC,FEV1/FEV6、FEV3/FVC。分层分析显示,在不到60年的时间内,NDVI的IQR增加与肺功能改善有关。女性,城市人口,不吸烟者,PM2.5浓度中等的地区和BMI小于28kg/m2的个体。基于另一种绿色指数(增强植被指数,EVI)和NDVI的年最大值与主要分析保持一致。
结论:我们的研究结果支持绿色暴露与肺功能改善密切相关。
While benefits of greenness exposure to health have been reported, findings specific to lung function are inconsistent. The purpose of this
study is to assess the correlations of greenness exposure with multiple lung function indicators based on chronic obstructive pulmonary disease (COPD) monitoring database from multiple cities of Anhui province in China.
We assessed the greenness using the annual average of normalized difference vegetation index (NDVI) with a distance of 1000-meter buffer around each local community or village. Three types of lung function indicators were considered, namely indicators of obstructive ventilatory dysfunction (FVC, FEV1, FEV1/FVC, and FEV1/FEV3); an indicator of large-airway dysfunction (PEF); indicators of small-airway dysfunction (FEF25%, FEF50%, FEF75%, MMEF, FEV3, FEV6, and FEV3/FVC). Linear mixed effects model was used to analyze associations of greenness exposure with lung function through adjusting age, sex, educational level, occupation, residence, smoking status, history of tuberculosis, family history of lung disease, indoor air pollution, occupational exposure, PM2.5, and body mass index.
A total of 2768 participants were recruited for the investigations. An interquartile range (IQR) increase in NDVI was associated with better FVC (153.33mL, 95%CI: 44.07mL, 262.59mL), FEV1 (109.09mL, 95%CI: 30.31mL, 187.88mL), FEV3 (138.04mL, 95%CI: 39.43mL, 236.65mL), FEV6 (145.42mL, 95%CI: 42.36mL, 248.47mL). However, there were no significant associations with PEF, FEF25%, FEF50%, FEF75%, MMEF, FEV1/FVC, FEV1/FEV6, FEV3/FVC. The stratified analysis displayed that an IQR increase in NDVI was related with improved lung function in less than 60 years, females, urban populations, nonsmokers, areas with medium concentrations of PM2.5 and individuals with BMI of less than 28 kg/m2. Sensitivity analyses based on another greenness indice (enhanced vegetation index, EVI) and annual maximum of NDVI remained consistent with the main analysis.
Our findings supported that exposure to greenness was strongly related with improved lung function.