More Than 50,000 People Participated in the Study, and the Team of Professor Wu Xifeng of Zhejiang University Published a New Study: Health Is Related to the Level of Greening in Office Spaces

As the material basis for human survival and development, the ecological environment has a subtle impact on human health. In recent years, in addition to promoting the improvement of medical technology and improving the social security system, scientists in related fields have focused their attention on studying the relationship between the ecological environment and human health.

Recently, Environment International published an article by the School of Public Health of Zhejiang University.Wu XifengThe paper jointly published by the professor's research group, titled "Beneficial associations between outdoor visible greenness at the workplace and metabolic syndrome in Chinese adults", mainly studied the beneficial associations between outdoor visible greenness at the workplace and metabolic syndrome in adults.

The so-called metabolic syndrome (Metabolic syndrome, MetS) is a group of metabolically interrelated clinical syndromes, mainly including obesity, hyperglycemia, dyslipidemia and hypertension. It is an important risk factor for many diseases such as diabetes, cardiovascular and cerebrovascular diseases.

In fact, the research that green environment may play a certain preventive role in Mets is not an isolated case. More and more studies have found that there is indeed a certain degree of correlation between the two. However, most of the current studies mainly useNormalized Difference Vegetation Index The Normalized Difference Vegetation Index (NDVI) is used to assess individual green space exposure levels. These indicators lack the ability to distinguish between green space types and can only provide a bird’s-eye view, so they may not accurately reflect people’s actual perceived green space exposure levels.

In addition, most studies in the past have evaluated green space exposure in the living environment of participants, but have ignored green space exposure in adults' work environments. It should be noted that adults may spend more time in the workplace than in the residential environment. Therefore, it is very meaningful to study whether there is a beneficial association between the level of visible greenery in the workplace and metabolic syndrome in adults.

In view of this,Professor Wu Xifeng's research group used a convolutional neural network model to evaluate visible green exposure based on the Green View Index (GVI) of street view images.The research team used a logistic regression model to evaluate the level of outdoor visible greenery in the working environment of more than 50,000 adults in Hangzhou and confirmed the beneficial association between the two. This suggests that green environmental factors may be beneficial to MetS  It provides the latest epidemiological basis for prevention and also provides important guidance for positive public health intervention from the perspective of urban planning.

Research highlights:

* Evaluate outdoor visible greenery using the Green View Index (GVI) based on street view images using a convolutional neural network model 

* A higher green landscape index around the workplace is beneficial for reducing the risk of MetS in adults
* This type of protection was stronger in men, but no differences were observed among age groups

Paper address:
https://doi.org/10.1016/j.envint.2023.108327
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Research method: massive data, AI-assisted

In order to ensure the effectiveness of the research and avoid errors as much as possible, the research team selected an extremely large sample of more than 50,000 people.The study population consisted of 51,552 participants who underwent health examinations at the Health Management Center of the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2018 to December 2021. The research team analyzed a total of 1,182 workplaces involved by these participants.

To estimate each participant's GVI exposure level, the research team set up a living area within a 15-minute walk of their workplace. The research team used the Isochrone API provided by the Mapbox global open mapping platform to obtain the boundaries of the living circle using the geocoding of the participant's workplace address as coordinates.

Mapbox Platform Links:

https://docs.mapbox.com/playground/isochrone/

Afterwards, the research team collected more than 580,000 street view images from 51,552 participants. Semantic segmentation was performed using Google's third-generation convolutional neural network model DeepLab V3. The research team extracted the GVI of all collection points within the 15-minute living circle of each participant's workplace from the street view images. The GVI value range is 0 to 1, indicating the degree of exposure to outdoor visible green, and the larger the value, the higher the exposure.

In the study of the association between GVI and MetS, the research team used a logistic regression model to analyze the association between visible greening levels and the risk of metabolic syndrome by adjusting covariates such as participants' age, gender, and smoking and drinking history.

Research results: The association is significant, especially in men

The results showed that higher GVI levels in the work environment were significantly associated with a lower risk of MetS.In the 15-minute workplace living zone, the lowest quartile of GVI exposure (QuartileCompared with participants in the lowest quartile of GVI exposure, participants in the highest quartile of GVI exposure had a significantly reduced risk of MetS by 17% (95% CI: 11–22%, model 1).

In addition, the research team also analyzed age and gender factors. According to the age analysis, the research team divided the participants into two groups based on the age of 45, namely the 18-45 group and the 46-60 group. The number of participants in the first group was 36,577, and the MetS prevalence was 10.94%. The number of participants in the second group was 14,975, and the MetS prevalence was 23.06%.

Compared with participants in the lowest quartile of GVI exposure, participants in the highest quartile of GVI had a 14% lower odds of developing MetS in the 18-45 age group (95% CI: 6-22%), and participants in the highest quartile of GVI had a 15% lower odds of developing MetS in the 46-60 age group (95% CI: 6-24%).

In the analysis by sex, data from males showed that higher GVI exposure was significantly associated with lower odds of MetS, while no significant association was found in females.

After adjusting for all complex factors, the research team found that higher GVI exposure levels were associated with lower hypertension,Low high-density lipoproteinemia, obesity and diabetes. Compared with participants in the lowest quartile, participants in the highest quartile of GVI exposure had a lower risk of developing the above diseases by 20% (95% CI: 13–25%), 14% (95% CI: 9–19%), 12% (95% CI: 7–17%) and 10% (95% CI: 3–17%), respectively.

Based on the above findings of the linear association between GVI and MetS, the research team also conducted a scenario analysis to explore the risk of MetS in adults under different GVI conditions.

Taking the average GVI as a reference, as the GVI increases by 10%, 20% and 30%, the risk of MetS in adults can be reduced by 4% (95% CI: 3–6%), 9% (95% CI: 6–11%) and 20% (95% CI: 15–26%), respectively. When GVI decreased by 10%, 20% and 50%, respectively, the risk of Mets in adults would increase by 5% (95% CI: 3–6%), 10% (95% CI: 7–13%) and 26% (95% CI: 17–35%), respectively.

In addition, after additional adjustment for socioeconomic status and NDVI, the researchers found that the results were consistent with those of the primary analysis, suggesting that the team's findings on the association between GVI and MetS are robust.

Building a sustainable "healthy city" is urgent

As a challenging global epidemic health issue, our attention to MetS cannot but be urgent. At present, the global incidence of MetS is estimated to have reached 25.4%, and in China, the incidence of MetS is even higher, reaching 31.1% as of 2017. This has brought a certain burden to my country's healthcare system and socioeconomic growth, so it is urgent to better understand and intervene in potential risks.

The causes of MetS are varied, which means that there are also many ways to prevent and intervene in MetS. From a personal perspective, maintaining a healthy lifestyle, doing necessary exercise, maintaining a reasonable diet, etc. are all behaviors that can ensure good health to a certain extent. But at the same time, in addition to individual factors, active intervention through external factors is also a crucial means.

The research results of Professor Wu Xifeng's research group show that a high level of outdoor visible greenery within a 15-minute living circle near the workplace may play a certain degree of preventive and protective role in the risk of MetS in adults, especially adult men. This is different from other preventive measures for MetS. This study mainly emphasizes the impact of the urban construction environment on people's physical and mental health.

In fact, my country has always attached great importance to the construction of a good and healthy ecological environment. The Ministry of Environmental Protection emphasized in the "Chinese Citizens' Environmental and Health Literacy (Trial)" released in 2013 that "a good environment is the basis of survival and the guarantee of health." This study undoubtedly provides an important scientific basis for urban construction to improve the health level of residents from a medical perspective, and also opens up an exploration of a natural, inclusive and sustainable solution for residents' health.