Long-term exposure to residential green and blue spaces and anxiety and depression in adults: A cross-sectional study
Long-term exposure to residential green and blue spaces and anxiety and depression in adults: A cross-sectional study
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DOI：
10.1016/j.envres.2018.01.012
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发表时间：
2018-04-01
影响因子：
8.3
通讯作者：
Nieuwenhuijsen, Mark
中科院分区：
文献类型：
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作者：
Gascon, Mireia;Sanchez-Benavides, Gonzalo;Nieuwenhuijsen, Mark
背景：尽管暴露在自然户外环境中一直与感知的总体健康状况改善有关，但关于这种暴露与特定心理健康障碍(如抑郁和焦虑)之间的保护性关联的现有证据仍然有限。目的：本研究的目的是评估长期暴露在居民区绿色和蓝色空间对焦虑、抑郁和相关药物摄入量的影响。此外，我们的目标是探索这种关联的潜在中介和影响因素。方法：这项研究基于现有的成人队列(阿尔法阿尔茨海默病及其家族)，包括2013-2014年从巴塞罗那招募的958名成年参与者。对于每个参与者，为不同的缓冲区(100米、300米和500米)生成了住宅绿色和蓝色暴露指标[周围绿度(NDVI)、绿量(土地覆盖)和进入主要绿地和蓝色空间的机会]。参与者报告了他们被医生诊断为焦虑和抑郁障碍的病史以及相关药物的摄入量。结果：周围环境绿色度的增加与苯二氮类药物自我报告病史的减少相关[例如，在300m缓冲区中NDVI四分位范围(IQR)增加的优势比OR(95%CI)=0.62(0.43，0.89)]，进入主要绿地与自我报告的抑郁症病史相关[OR(95%CI)=0.18(0.06，0.58)]。没有观察到与蓝色空间有统计学意义的关联。空气污染(0.8%至29.6%)和噪声(2.2%至5.3%)在观察到的联系中起了一定的作用，而身体活动和社会支持起到了次要作用。结论：我们的发现表明，绿地对成年人的心理健康(抑郁和焦虑)具有潜在的保护作用，但需要进一步的研究，特别是纵向研究，以提供这些好处的进一步证据，以及暴露于空气污染和噪音等暴露的中介作用。
Background: Although exposure to natural outdoor environments has been consistently associated with improved perceived general health, available evidence on a protective association between this exposure and specific mental health disorders such as depression and anxiety is still limited.Objective: The aim of this study was to evaluate the effects of long-term exposure to residential green and blue spaces on anxiety and depression and intake of related medication. Additionally, we aimed to explore potential mediators and effect modifiers of this association.Methods: The study was based on an existing adult cohort (ALFA Alzheimer and Families) and includes 958 adult participants from Barcelona recruited in 2013-2014. For each participant residential green and blue exposure indicators [surrounding greenness (NDVI), amount of green (land-cover) and access to major green spaces and blue spaces] were generated for different buffers (100 m, 300 m and 500 m). Participants reported their history of doctor-diagnosed anxiety and depressive disorders and intake of related medication. Logistic regression models were applied to assess the corresponding associations.Results: Increasing surrounding greenness was associated with reduced odds of self-reported history of benzodiazepines [e.g. Odds ratio - OR (95%CI) = 0.62 (0.43, 0.89) for 1-interquartile range (IQR) increase in NDVI in a 300 m buffer] and access to major green spaces was associated with self-reported history of depression [OR (95%CI) = 0.18 (0.06, 0.58)]. No statistically significant associations were observed with blue spaces. Air pollution (between 0.8% and 29.6%) and noise (between 2.2% and 5.3%) mediated a proportion of the associations observed, whereas physical activity and social support played a minor role.Conclusion: Our findings suggest a potential protective role of green spaces on mental health (depression and anxiety) in adults, but further studies, especially longitudinal studies, are needed to provide further evidence of these benefits and of the mediation role of exposures like air pollution and noise.