Greenness, air pollution, and mortality risk: a retrospective cohort study of patients with lung cancer in China

ABSTRACT

The association between long-term exposure to air pollution and mortality from lung cancer has been established, yet evaluations of the potential mitigating effects of greenness on this impact are scarce. We conducted a cohort study in Pingyi County. A two-level Cox proportional hazards regression model was used to examine the associations among long-term exposure to air pollution, residential greenness, and lung cancer mortality. Among the examined pollutants, nitrogen dioxide exhibited the most significant adverse effects and highest risk of lung cancer mortality, with hazard ratio (HR) = 2.783 (95% confidence interval [CI]: 1.885–4.107) for all-cause mortality, HR = 2.492 (95%CI: 1.659–3.741) for tumour-related mortality, and HR = 2.431 (95%CI: 1.606–3.678) for lung cancer mortality. Higher greenness values were associated with a reduced risk of lung cancer mortality. These findings suggest the importance of implementing strategies for increasing greenness to reduce the health impacts of air pollution.

KEYWORDS:

• Air pollution
• lung cancer
• greenness
• mortality
• modification

Acknowledgements

We would like to thank all of our teachers and students for their assistance with this work. We thank Analisa Avila, MPH, ELS, of Liwen Bianji (Edanz) (www.liwenbianji.cn) for editing the language of a draft of this manuscript.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Authors’ contributions

Changqiang Zhou: Writing-original draft, Software, Methodology, Formal analysis, Writing -review & editing. Juan Xv: Methodology, Data Curation, Interpreting data. Yue Wu:Data Curation, Interpreting data.Wanning Xia: Data Curation, Statistical analysis. Xianjie Jia: Supervision, Project administration. Shixue Li: Interpreting data, Supervision, Project administration.

Data availability statement

Data will be made available on request.

Additional information

Funding

The work was supported by the Natural Science Major Project of the Anhui Provincial Education Department[number: 2023AH040288].