• Associations of combined exposures to surrounding green, air pollution and traffic noise on mental health.

      Klompmaker, Jochem O; Hoek, Gerard; Bloemsma, Lizan D; Wijga, Alet H; van den Brink, Carolien; Brunekreef, Bert; Lebret, Erik; Gehring, Ulrike; Janssen, Nicole A H (2019-08-01)
      In this cross-sectional study, we linked data from a Dutch national health survey among 387,195 adults including questions about psychological distress, based on the Kessler 10 scale, to an external database on registered prescriptions of anxiolytics, hypnotics & sedatives and antidepressants. We added data on residential surrounding green in a 300 m and a 1000 m buffer based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), modeled annual average air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and modeled road- and rail-traffic noise (Lden and Lnight) to the survey. We used logistic regression to analyze associations of surrounding green, air pollution and traffic noise exposure with poor mental health.
    • Residential surrounding green, air pollution, traffic noise and self-perceived general health.

      Klompmaker, Jochem O; Janssen, Nicole A H; Bloemsma, Lizan D; Gehring, Ulrike; Wijga, Alet H; van den Brink, Carolien; Lebret, Erik; Brunekreef, Bert; Hoek, Gerard (2019-09-17)
      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.