Relationships among green space, ambient fine particulate matter, and cancer incidence in Taiwan: A 16-year retrospective cohort study

Ying-Jhen Huang; Ping-Hsien Lee; Li-Chi Chen; Bo-Cheng Lin; Changqing Lin; Ta-Chien Chan

doi:10.1016/j.envres.2022.113416

Relationships among green space, ambient fine particulate matter, and cancer incidence in Taiwan: A 16-year retrospective cohort study

Environ Res. 2022 Sep;212(Pt C):113416. doi: 10.1016/j.envres.2022.113416. Epub 2022 May 4.

Authors

Ying-Jhen Huang¹, Ping-Hsien Lee¹, Li-Chi Chen¹, Bo-Cheng Lin², Changqing Lin³, Ta-Chien Chan⁴

Affiliations

¹ Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.
² Department of Real Estate and Built Environment, National Taipei University, New Taipei City, Taiwan.
³ Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China.
⁴ Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan; Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. Electronic address: tachien@sinica.edu.tw.

PMID: 35523280
DOI: 10.1016/j.envres.2022.113416

Abstract

Introduction: Green space and air pollution have been recognized as vital health determinants. There is a paucity of studies examining the interplay between green space, fine particulate matter (PM_2.5), and the incidence of specific cancers.

Objective: We aimed to explore the contributions of green space and ambient PM_2.5 to the risk of specific cancers in terms of the most common cancers based on incidence or mortality rate in Taiwan and to ascertain the interaction between green space and PM_2.5 and their role in cancer risk.

Materials and methods: This retrospective longitudinal cohort study included 407,415 participants. Data were obtained from the 2000-2015 Mei Jau Health Examination Database linked to the Taiwan Cancer Registry and Causes of Death datasets. All participants were aged ≥20 years and had no history of cancer. The environmental exposure were the normalized difference vegetation index (NDVI) and the 2-year average PM_2.5 at baseline. Multivariate adjusted hazard ratios (HRs) were calculated using Cox proportional hazards models. We adjusted for covariates including demographics, anthropometrics, comorbidities, health behaviors, biochemical data, and environmental factors.

Results: During a median follow-up of 10.37 years, 11,576 cancer cases were reported. PM_2.5 exposure increased the risk of all cancers (HR: 1.11, [95% CI: 1.06-1.15]), stomach cancer (HR: 1.27, [1.02-1.58]), endocrine gland cancer (HR: 2.13, [1.39-3.26]), breast cancer (HR: 1.12, [1.03-1.22]), and lung cancer (HR: 1.12, [1.01-1.24]). An increase in NDVI reduced the risk of prostate cancer (HR: 0.93, [0.88-0.99]) and lung cancer (HR: 0.95, [0.91-0.99]). NDVI influenced the incidence of prostate and all cancers by reducing PM_2.5 concentrations.

Conclusion: Long-term PM_2.5 exposure is associated with an increased risk of some types of cancers. In contrast, an increase in environmental green space exposure is associated with lowering of the risk of prostate and lung cancer.

Keywords: Air pollution; Cancer incidence; Green space; NDVI; PM(2.5).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / analysis
Air Pollution* / adverse effects
Air Pollution* / analysis
Environmental Exposure / analysis
Humans
Incidence
Longitudinal Studies
Lung Neoplasms* / chemically induced
Lung Neoplasms* / epidemiology
Male
Parks, Recreational
Particulate Matter / analysis
Retrospective Studies
Taiwan / epidemiology

Substances

Air Pollutants
Particulate Matter