The association of air pollution and greenness with mortality and life expectancy in Spain: a small-area study

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• dc.contributor.author Keijzer, Carmen de, 1992-
• dc.contributor.author Agis, David
• dc.contributor.author Ambrós, Albert
• dc.contributor.author Arévalo, Gustavo
• dc.contributor.author Baldasano, Jose M.
• dc.contributor.author Bande, Stefano
• dc.contributor.author Barrera Gómez, Jose
• dc.contributor.author Benach, Joan
• dc.contributor.author Cirach, Marta
• dc.contributor.author Dadvand, Payam
• dc.contributor.author Ghigo, Stefania
• dc.contributor.author Martinez Solanas, Èrica
• dc.contributor.author Nieuwenhuijsen, Mark J.
• dc.contributor.author Cadum, Ennio
• dc.contributor.author Basagaña Flores, Xavier
• dc.contributor.author MED-HISS Study group
• dc.date.accessioned 2023-10-26T06:40:56Z
• dc.date.available 2023-10-26T06:40:56Z
• dc.date.issued 2017
• dc.description.abstract Background: Air pollution exposure has been associated with an increase in mortality rates, but few studies have focused on life expectancy, and most studies had restricted spatial coverage. A limited body of evidence is also suggestive for a beneficial association between residential exposure to greenness and mortality, but the evidence for such an association with life expectancy is still very scarce. Objective: To investigate the association of exposure to air pollution and greenness with mortality and life expectancy in Spain. Methods: Mortality data from 2148 small areas (average population of 20,750 inhabitants, and median population of 7672 inhabitants) covering Spain for years 2009-2013 were obtained. Average annual levels of PM10, PM2.5, NO2 and O3 were derived from an air quality forecasting system at 4×4km resolution. The normalized difference vegetation index (NDVI) was used to assess greenness in each small area. Air pollution and greenness were linked to standardized mortality rates (SMRs) using Poisson regression and to life expectancy using linear regression. The models were adjusted for socioeconomic status and lung cancer mortality rates (as a proxy for smoking), and accounted for spatial autocorrelation. Results: The increase of 5μg/m3 in PM10, NO2 and O3 or of 2μg/m3 in PM2.5 concentration resulted in a loss of life in years of 0.90 (95% credibility interval CI: 0.83, 0.98), 0.13 (95% CI: 0.09, 0.17), 0.20years (95% CI: 0.16, 0.24) and 0.64 (0.59, 0.70), respectively. Similar associations were found in the SMR analysis, with stronger associations for PM2.5 and PM10, which were associated with an increased mortality risk of 3.7% (95% CI: 3.5%, 4.0%) and 5.7% (95% CI: 5.4%, 6.1%). For greenness, a protective effect on mortality and longer life expectancy was only found in areas with lower socioeconomic status. Conclusions: Air pollution concentrations were associated to important reductions in life expectancy. The reduction of air pollution should be a priority for public health.
• dc.description.sponsorship This work was supported by the European Union through the project LIFE12 ENV/IT/000834 MED HISS and by the PHENOTYPE project (Positive Health Effects of the Natural Outdoor Environment in Typical Populations in Different Regions in Europe) funded by the European Commission Seventh Framework Programme (Grant No. 282996). Payam Dadvand is funded by a Ramón y Cajal Fellowship (RYC-2012-10995) awarded by the Spanish Ministry of Economy and Competitiveness. We are thankful to Marcel F. Jonker for sharing the analysis codes.
• dc.format.mimetype application/pdf
• dc.identifier.citation Keijzer C de, Agis D, Ambrós A, Arévalo G, Baldasano JM, Bande S, Barrera-Gómez J, Benach J, Cirach M, Dadvand P, Ghigo S, Martinez-Solanas È, Nieuwenhuijsen M, Cadum E, Basagaña X; MED-HISS Study group. The association of air pollution and greenness with mortality and life expectancy in Spain: a small-area study. Environ Int. 2017 Feb;99:170-6. DOI: 10.1016/j.envint.2016.11.009
• dc.identifier.doi http://dx.doi.org/10.1016/j.envint.2016.11.009
• dc.identifier.issn 0160-4120
• dc.identifier.uri http://hdl.handle.net/10230/58136
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Environ Int. 2017 Feb;99:170-6
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/282996
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.envint.2016.11.009
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Air pollution
• dc.subject.keyword Greenness
• dc.subject.keyword Mortality
• dc.subject.keyword NO(2)
• dc.subject.keyword Ozone
• dc.subject.keyword Particulate matter
• dc.title The association of air pollution and greenness with mortality and life expectancy in Spain: a small-area study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion