Residing in areas with high residential greenspace is associated with increased COPD risk and decreased lung function of adults in eastern China

Le-Yun Tan; Yao Wang; Li Yang; Cheng-Shui Chen; Fan Zhang; Ming-Tao Yu; Pi Guo; Qing-Ying Zhang

doi:10.1016/j.hrtlng.2025.01.008

Residing in areas with high residential greenspace is associated with increased COPD risk and decreased lung function of adults in eastern China

Heart Lung. 2025 Jan 25:70:329-338. doi: 10.1016/j.hrtlng.2025.01.008. Online ahead of print.

Authors

Le-Yun Tan¹, Yao Wang¹, Li Yang², Cheng-Shui Chen³, Fan Zhang⁴, Ming-Tao Yu¹, Pi Guo¹, Qing-Ying Zhang⁵

Affiliations

¹ Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China.
² Zhejiang Provincial Key Laboratory of Interventional Pulmonology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Wenzhou Medical University, 325000, China.
³ Department of Pulmonary and Critical Care Medicine, the Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou 324000, China; Zhejiang Province Endoscope Development and Endoscopy Research Center, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou 324000, China.
⁴ Oncology Research Laboratory, Cancer Hospital of Shantou University Medical College, Shantou 515041, China.
⁵ Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong 515041, China. Electronic address: qyzhang@stu.edu.cn.

PMID: 39864326
DOI: 10.1016/j.hrtlng.2025.01.008

Abstract

Background: Evidence for a relation between residential greenspace and respiratory health is scarce and controversial.

Objectives: The purpose of this study was to explore the association between residential greenspace and its interaction with particulate matter (PM_2.5) and risk of chronic obstructive pulmonary disease (COPD) and lung function.

Methods: A total of 3,759 adults were recruited from Wenzhou in this study. Lung function measurements included forced expiratory volume in 1 s (FEV1); forced vital capacity (FVC); FEV1/FVC ratio; peak expiratory flow (PEF); forced expiratory flow (FEF) at 25 %, 50 %, and 75 %; and maximal mid-expiratory flow (MMEF). The Normalized Difference Vegetation Index (NDVI) was used to characterize the greenspace.

Results: The mean (SD) age of study participants was 62.8(10.2) years, with 51.8 % female. NDVI was positively associated with risk of COPD (odds ratio [OR]: 1.26, 95 % CI: 1.04-1.54) and inversely with lung function: the βs (95 % CIs) for FEV1; FVC; FEV1/FVC ratio; PEF; FEF25 %, 50 %, and 75 %; and MMEF were -0.09 (-0.12, -0.06); -0.07 (-0.10, -0.04); -1.39 (-2.06, -0.72); -0.66 ( -0.74, -0.57); -0.52 (-0.61, -0.43), -0.22 (-0.28, -0.15), and -0.05 (-0.09, -0.01); and -0.17 (-0.22, -0.12), respectively. In high PM_2.5 areas, NDVI was positively associated with COPD risk (OR: 5.40, 95 % CI: 3.45-8.58) and inversely with FEV1/FVC ratio (β:8.29, 95 % CI:9.82, -6.76) and FVC (β:0.13, 95 %CI:0.21, 0.06), and in low PM_2.5 areas, was positively associated with risk of COPD (OR: 1.75, 95 % CI: 1.12-2.80) and inversely with FEV1/FVC ratio (β:3.45, 95 % CI:4.80, 2.11).

Conclusions: High residential greenspace may be associated with increased risk of COPD and decreased lung function in adults, particularly in areas with high PM_2.5.

Keywords: Chronic obstructive pulmonary disease; Lung function; NDVI; PM(2.5); Residential greenspace.