Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in China
Background: Previous studies have suggested that neighborhoods characterized by higher walkability are related to a reduced risk of ischemic heart disease (IHD), whereas exposure to PM2.5 is positively associated with risk of IHD. Nevertheless, their joint impact on IHD warrants further investigatio...
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Elsevier
2025-01-01
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| Series: | Ecotoxicology and Environmental Safety |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651324015963 |
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| author | Jiayun Zhang Peng Shen Yixing Wang Zihan Li Lisha Xu Jie Qiu Jingjing Hu Zongming Yang Yonghao Wu Zhanghang Zhu Hongbo Lin Zhiqin Jiang Liming Shui Mengling Tang Mingjuan Jin Feng Tong Kun Chen Jianbing Wang |
| author_facet | Jiayun Zhang Peng Shen Yixing Wang Zihan Li Lisha Xu Jie Qiu Jingjing Hu Zongming Yang Yonghao Wu Zhanghang Zhu Hongbo Lin Zhiqin Jiang Liming Shui Mengling Tang Mingjuan Jin Feng Tong Kun Chen Jianbing Wang |
| author_sort | Jiayun Zhang |
| collection | DOAJ |
| description | Background: Previous studies have suggested that neighborhoods characterized by higher walkability are related to a reduced risk of ischemic heart disease (IHD), whereas exposure to PM2.5 is positively associated with risk of IHD. Nevertheless, their joint impact on IHD warrants further investigation. Methods: This prospective cohort study was performed in Yinzhou, Ningbo, China, comprising 47,516 participants. Individual-level walkability and PM2.5 were evaluated using a commercial walkability database and a land use regression (LUR) model, respectively. Hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) were calculated using two Cox proportional hazards models: one based on two-year average PM2.5 levels prior to baseline, and the other incorporating time-varying PM2.5 assessed on a monthly scale. Dose-response relationships were explored using restricted cubic spline (RCS) functions. Interactions on both additive and multiplicative scales were assessed via relative excess risk due to interaction (RERI) and likelihood-ratio tests. Joint effects were explored and visualized using a 3D wireframe plot. Results: Over a median follow-up of 5.14 years, 1735 incident cases of IHD were identified. Adjusted HRs (95 % CIs) were 1.56 (1.34–1.81) per 10 μg/m3 increase in PM2.5 and 0.96 (0.94–0.98) per 10-unit increase in walkability, with both exposures exhibiting non-linear dose-response relationships. Walkability and PM2.5 were positively correlated (rs = 0.12, P < 0.001), and a multiplicative interaction was detected (Pinteraction = 0.019). Conclusion: Walkability was inversely associated with risk of IHD, whereas exposure to PM2.5 was positively associated with IHD. Notably, the pernicious effects of PM2.5 could be attenuated in areas with higher levels of walkability. Our findings underscore the significance of walkable urban design, air quality improvement, as preventive strategies for IHD. |
| format | Article |
| id | doaj-art-97701435fe4d4d9ebd5dd5059a1868ab |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Ecotoxicology and Environmental Safety |
| spelling | doaj-art-97701435fe4d4d9ebd5dd5059a1868ab2025-02-12T05:29:26ZengElsevierEcotoxicology and Environmental Safety0147-65132025-01-01290117520Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in ChinaJiayun Zhang0Peng Shen1Yixing Wang2Zihan Li3Lisha Xu4Jie Qiu5Jingjing Hu6Zongming Yang7Yonghao Wu8Zhanghang Zhu9Hongbo Lin10Zhiqin Jiang11Liming Shui12Mengling Tang13Mingjuan Jin14Feng Tong15Kun Chen16Jianbing Wang17Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, ChinaDepartment of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo 315040, ChinaDepartment of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, ChinaDepartment of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, ChinaDepartment of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, ChinaDepartment of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, ChinaDepartment of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, ChinaDepartment of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, ChinaDepartment of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, ChinaDepartment of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, ChinaDepartment of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo 315040, ChinaDepartment of Chronic Disease and Health Promotion, Yinzhou District Center for Disease Control and Prevention, Ningbo 315040, ChinaYinzhou District Health Bureau of Ningbo, Ningbo 315100, ChinaDepartment of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, ChinaDepartment of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, ChinaNingbo Municipal Center for Disease Control and Prevention, Ningbo 315010, China; Correspondence to: Ningbo Municipal Center for Disease Control and Prevention, 1166 Fanjiangan Road, Ningbo 315010, China.Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; Correspondence to: Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Hangzhou 310058, China.Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, China; Correspondence to: Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children’s Health, 866 Yuhangtang Road, Hangzhou 310058, China.Background: Previous studies have suggested that neighborhoods characterized by higher walkability are related to a reduced risk of ischemic heart disease (IHD), whereas exposure to PM2.5 is positively associated with risk of IHD. Nevertheless, their joint impact on IHD warrants further investigation. Methods: This prospective cohort study was performed in Yinzhou, Ningbo, China, comprising 47,516 participants. Individual-level walkability and PM2.5 were evaluated using a commercial walkability database and a land use regression (LUR) model, respectively. Hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) were calculated using two Cox proportional hazards models: one based on two-year average PM2.5 levels prior to baseline, and the other incorporating time-varying PM2.5 assessed on a monthly scale. Dose-response relationships were explored using restricted cubic spline (RCS) functions. Interactions on both additive and multiplicative scales were assessed via relative excess risk due to interaction (RERI) and likelihood-ratio tests. Joint effects were explored and visualized using a 3D wireframe plot. Results: Over a median follow-up of 5.14 years, 1735 incident cases of IHD were identified. Adjusted HRs (95 % CIs) were 1.56 (1.34–1.81) per 10 μg/m3 increase in PM2.5 and 0.96 (0.94–0.98) per 10-unit increase in walkability, with both exposures exhibiting non-linear dose-response relationships. Walkability and PM2.5 were positively correlated (rs = 0.12, P < 0.001), and a multiplicative interaction was detected (Pinteraction = 0.019). Conclusion: Walkability was inversely associated with risk of IHD, whereas exposure to PM2.5 was positively associated with IHD. Notably, the pernicious effects of PM2.5 could be attenuated in areas with higher levels of walkability. Our findings underscore the significance of walkable urban design, air quality improvement, as preventive strategies for IHD.http://www.sciencedirect.com/science/article/pii/S0147651324015963WalkabilityFine particulate matterIschemic heart diseaseProspective cohort studyInteractionDose-response relationship |
| spellingShingle | Jiayun Zhang Peng Shen Yixing Wang Zihan Li Lisha Xu Jie Qiu Jingjing Hu Zongming Yang Yonghao Wu Zhanghang Zhu Hongbo Lin Zhiqin Jiang Liming Shui Mengling Tang Mingjuan Jin Feng Tong Kun Chen Jianbing Wang Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in China Ecotoxicology and Environmental Safety Walkability Fine particulate matter Ischemic heart disease Prospective cohort study Interaction Dose-response relationship |
| title | Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in China |
| title_full | Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in China |
| title_fullStr | Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in China |
| title_full_unstemmed | Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in China |
| title_short | Interaction between walkability and fine particulate matter on ischemic heart disease: A prospective cohort study in China |
| title_sort | interaction between walkability and fine particulate matter on ischemic heart disease a prospective cohort study in china |
| topic | Walkability Fine particulate matter Ischemic heart disease Prospective cohort study Interaction Dose-response relationship |
| url | http://www.sciencedirect.com/science/article/pii/S0147651324015963 |
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