Eco-Health Relationship Bibliography

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Abbey DE, N Nishino, WF McDonnell, et al. 1999. Long-term inhalable particles and other air pollutants related to mortality in nonsmokers. Am. J. Respir. Crit. Care Med. 159(2): 373-38.

Long-term ambient concentrations of inhalable particles less than 10 micro-m in diameter (PM10) (1973- 1992) and other air pollutantstotal suspended sulfates, sulfur dioxide, ozone (O3), and nitrogen dioxidewere related to 1977-1992 mortality in a cohort of 6,338 nonsmoking California Seventh-day Adventists. In both sexes, PM10 showed a strong association with mortality for any mention of nonmalignant respiratory disease on the death certificate, adjusting for a wide range of potentially confounding factors, including occupational and indoor sources of air pollutants. The adjusted relative risk (RR) for this cause of death as associated with an interquartile range (IQR) difference of 43 d/yr when PM10 exceeded 100 micro-g/m3 was 1.18 (95% confidence interval [CI]: 1.02, 1.36). In males, PM10 showed a strong association with lung cancer deaths-RR for an IQR was 2.38 (95% CI: 1.42, 3.97). Ozone showed an even stronger association with lung cancer mortality for males with an RR of 4.19 (95% CI: 1.81, 9.69) for the IQR difference of 551 h/yr when O3 exceeded 100 parts per billion. Sulfur dioxide showed strong associations with lung cancer mortality for both sexes. Other pollutants showed weak or no association with mortality.

Abrahams, AD, AJ Parsons, J Wainwright. 1994. Resistance to overland flow on semiarid grassland and shrubland hillslopes, Walnut Gulch, southern Arizona. Journal of Hydrology 154 (1-4) 431-446.

One hundred and thirty six experiments were conducted on runoff plots on semiarid grassland and shrubland hillslopes at Walnut Gulch, Arizona. Graphs of Darcy-Weisbach friction factor f against Reynolds number Re are positively sloping or convex-upward for the grassland and predominantly negatively sloping for the shrubland. These trends are attributed to the progressive inundation of the roughness elements, with the submergence of the gravel on the shrubland being greater than the submergence of the plants on the grassland.

The f-Re relations are of little value as models for predicting flow resistance at locations other than where they were developed because each location has its own unique relation which is a function of the surface properties at that location. Consequently, multivariate models that include surface properties among their predictive variables were derived for the grassland and shrubland hillslopes using multiple regression analysis. On the grassland 69.5% of the variation in f is accounted for by basal plant stem and litter cover, whereas on the shrubland 56.3% of the variation is explained by gravel cover and gravel size. The inclusion of Re improves the explained variation by 5.4% on the grassland and 7.6% on the shrubland. These results suggest that for most purposes the extra effort involved in measuring or modeling flow rate is not worth the small improvement in predictive accuracy and, therefore, that the practice of estimating resistance to overland flow solely on the basis of surface properties is entirely reasonable.

A comparison of the two sets of experiments reveals that both infiltration and resistance to flow are higher on grassland than shrubland. Consequently, where shrubland has replaced grassland during the past century, in addition to the ground surface becoming more exposed to raindrop impact, overland flow has increased in volume and velocity. Together these changes have resulted in accelerated erosion in the form of rill development and stripping of the soil A horizon.

Adam M, T Schikowski, et al 2015. Adult lung function and long-term air pollution exposure. ESCAPE: a multicentre cohort study and meta-analysis. European Respiratory Journal, 45(1): 38-50.

The chronic impact of ambient air pollutants on lung function in adults is not fully understood. The objective of this study was to investigate the association of long-term exposure to ambient air pollution with lung function in adult participants from five cohorts in the European Study of Cohorts for Air Pollution Effects (ESCAPE).

Residential exposure to nitrogen oxides (NO2, NOx) and particulate matter (PM) was modelled and traffic indicators were assessed in a standardised manner. The spirometric parameters forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from 7613 subjects were considered as outcomes. Cohort-specific results were combined using meta-analysis.

We did not observe an association of air pollution with longitudinal change in lung function, but we observed that a 10 µg/m(-3) increase in NO2 exposure was associated with lower levels of FEV1 (-14.0 mL, 95% CI -25.8 to -2.1) and FVC (-14.9 mL, 95% CI -28.7 to -1.1). An increase of 10 µg/m(-3) in PM10, but not other PM metrics (PM2.5, coarse fraction of PM, PM absorbance), was associated with a lower level of FEV1 (-44.6 mL, 95% CI -85.4 to -3.8) and FVC (-59.0 mL, 95% CI -112.3 to -5.6). The associations were particularly strong in obese persons.

This study adds to the evidence for an adverse association of ambient air pollution with lung function in adults at very low levels in Europe.

Adams P, GE Hendershot, MA Marano, eds.1999. Current estimates from the National Health Interview Survey, 1996. Hyattsville, MD: US Department of Health and Human Services, Public Health Service, Office of Health Research, Statistics and Technology. National Center for Health Statistics; 1999 (200): 1 - 203.

No abstract provided.

Adevi AA and F Martensson. 2013. Stress rehabilitation through garden therapy: The garden as a place in the recovery from stress. Urban Forestry & Urban Greening 12(2): 230-237.

In a rehabilitation programme for people with stress disorder, a garden room can be an important ingredient. Stress disorder has been the most common cause of sick leave in Sweden since the 1990s. The study is about the therapeutic role of nature in the form of a garden, as participants experienced it during the recovery process. The research subjects were on sick leave due to stress related symptoms and took part in rehabilitation at the Alnarp Rehabilitation Garden in southern Sweden. The article is based on interviews with five participants who describe their experiences of garden therapy and what they perceive as essential for their recovery. The garden was associated with many positive experiences of interacting with people and greenery and perceived as a safe and useful arena in their recovery. The participants described how nature affords positive sensory experiences, physical and psychological well-being, but also how nature and the garden facilitate beneficial social interactions with other participants and caregivers. Importance was also allocated to the symbolism of nature as associated to one's own growth and the passing of time. They conceptualised the recovery process as initiated by more traditional forms of therapies but reinforced and consolidated by the access to nature and the garden rooms. In a dynamic psychological perspective on place, the study illustrates the potential role of using nature as a venue to facilitate self-regulation of physiological, psychological and social needs.

Adinolfi C, GP Suarez-Caceres, & P Carinanos. 2014. Relation between visitors' behaviour and characteristics of green spaces in the city of Granada, south-eastern Spain. Urban Forestry & Urban Greening, 13(3): 534-542.

This paper examines the relation between visitor behaviour and certain features of a number of major green spaces in the city of Granada, south-eastern Spain, focussing on key urban, ecological and landscape-related issues. Information on user profiles and numbers, the various uses made of these areas, their design, plant species richness and local urban and sociological background, was collected by means of in situ observation in a total of ten urban green spaces with surface areas of over 5000 m2. Findings indicated that these spaces were used largely for purposes directly related to well-being: recreational and sporting activities, socialising, or simply relaxing. Interestingly, the most common activities in each space were governed by features intrinsic to the space itself: accessibility, design, maintenance and plant richness and distribution, all of which affected the health-related attributes and aesthetic value of the space. The study also highlighted a number of serious deficiencies in certain green spaces, which will need to be addressed in future action plans and replanning projects as an essential step in ensuring that they meet the real needs and expectations of the target population. The information provided by this research may prove particularly valuable for improving the systemic functions of green spaces in Mediterranean cities sharing similar bioclimatic and sociological features, and for ensuring that they fulfil the role assigned to green spaces in sustainable cities.

Adjei PO and FK Agyei. 2015. Biodiversity, environmental health and human well-being: analysis of linkages and pathways. Environment, Development and Sustainability, 17(5): 1085-1102.

Well-being, a condition of positive physical, social and mental state of life, has become a prime focus of research in recent years as people seek to achieve and sustain it. Interacting with the natural environment has been established as a way of acquiring well-being benefits. However, the extent to which well-being depends on various aspects of the environment particularly biodiversity has received less attention. This paper examines the relationship between the level of biodiversity in an environment and human well-being. The depression and happiness scale was employed to sample 236 visitors of eight green spaces in Anglesey and Gwynedd, North Wales, while also noting socio-demographic and environmental factors such as perceived naturalness, density of visitors and noise level to establish the relationship. In each green space, the levels of native and introduced plant diversity were estimated. The paper established that level of ecological diversity determines level of people's wellness and happiness derived from a green environment. Visitors to green spaces with higher plant diversity receive higher levels of happiness. Significantly too, diversity of introduced species was a better predictor than native plant diversity. Perceived naturalness, density of visitors and visitors' age was also predictors of happiness. It is concluded that increasing the level of biodiversity in an environment could improve people's well-being. However, the finding about introduced versus native species deserves more attention.

Akbari H, DM Kurn, SE Bretz, JW Hanford. 1997. Peak power and cooling energy savings of shade trees. Energy and Buildings 25(2): 139-48.

In summer of 1992, we monitored peak power and cooling energy savings from shade trees in two houses in Sacramento, CA. The collected data include air-conditioning electricity use, indoor and outdoor dry bulb temperatures and humidities, roof and ceiling surface temperatures, inside and outside wall temperatures, insolation, and wind speed and direction. Shade trees at the two monitored houses yielded seasonal cooling energy savings of 30%, corresponding to an average daily savings of 3.6 and 4.8 kWh/d. Peak demand savings for the same houses were 0.6 and 0.8 kW (about 27% savings in one house and 42% in the other). The monitored houses were modeled with the DOE-2.1E simulation program. The simulation results underestimated the cooling energy savings and peak power reductions by as much as twofold.

Alcock I, MP White, et al. 2013. Longitudinal effects on mental health of moving to greener and less green urban areas. Environmental Science & Technology 48(2): 1247-1255.

Despite growing evidence of public health benefits from urban green space there has been little longitudinal analysis. This study used panel data to explore three different hypotheses about how moving to greener or less green areas may affect mental health over time. The samples were participants in the British Household Panel Survey with mental health data (General Health Questionnaire scores) for five consecutive years, and who relocated to a different residential area between the second and third years (n=1064; observations=5320). Fixed-effects analyses controlled for time-invariant individual level heterogeneity and other area and individual level effects. Compared to premove mental health scores, individuals who moved to greener areas (n=594) had significantly better mental health in all three postmove years (P=.015; P=.016; P=.008), supporting a "shifting baseline" hypothesis. Individuals who moved to less green areas (n=470) showed significantly worse mental health in the year preceding the move (P=.031) but returned to baseline in the postmove years. Moving to greener urban areas was associated with sustained mental health improvements, suggesting that environmental policies that increase urban green space may have sustainable public health benefits.

Almanza E, M Jerrett, et al. 2012. A study of community design, greenness, and physical activity in children using satellite, GPS and accelerometer data. Health & Place 18(1): 46-54.

This study examined relationships between greenness exposure and free-living physical activity behavior of children in smart growth and conventionally designed communities. Normalized Difference Vegetation Index (NDVI) was used to quantify children's (n=208) greenness exposure at 30-s epoch accelerometer and GPS data points. A generalized linear mixed model with a kernel density smoothing term for addressing spatial autocorrelation was fit to analyze residential neighborhood activity data. Excluding activity at home and during school-hours, an epoch-level analysis found momentary greenness exposure was positively associated with the likelihood of contemporaneous moderate-to-vigorous physical activity (MVPA). This association was stronger for smart growth residents who experienced a 39% increase in odds of MVPA for a 10th to 90th percentile increase in exposure to greenness (OR=1.39, 95% CI 1.36 - 1.44). An individual-level analysis found children who experienced >20 min of daily exposure to greener spaces (>90th percentile) engaged in nearly 5 times the daily rate of MVPA of children with nearly zero daily exposure to greener spaces (95% CI 3.09-7.20).

Almasi A, AR Mousavi, et al. 2014. Dust storms and environmental health impacts. Journal of Middle East Applied Science and Technology, 3(8): 353-6.

One of the arid and semi -arid climatic phenomena and areas adjacent to these areas, phenomena are dust and to dust storms, which have affected large areas of the atmosphere, causing atmospheric blur reduction horizontal and vertical viewing many effects on other environmental, social, economic and health. One of the most devastating effects of Hurricane dust phenomenon that happens it can cause environmental damage and the onset or exacerbation respiratory diseases, heart disease, air and ground traffic, tourism, agriculture. This study investigates the phenomenon of dust and its impact on the environment and health are identified.

American Cancer Society - Cancer Facts and Figures 2011. Accessed February 2013.

Amoly E, P Dadvand, et al. 2014. Green and blue spaces and behavioral development in Barcelona schoolchildren: the BREATHE project. Environmental health perspectives, 122(12): 1351.

Background: Green spaces have been associated with improved mental health in children; however, available epidemiological evidence on their impact on child behavioral development is scarce.

Objectives: We investigated the impact of contact with green spaces and blue spaces (beaches) on indicators of behavioral development and symptoms of attention deficit/hyperactivity disorder (ADHD) in schoolchildren.

Methods: This study was based on a sample of 2,111 schoolchildren (7-10 years of age) from 36 schools in Barcelona in 2012. We obtained data on time spent in green spaces and beaches and Strengths and Difficulties Questionnaires (SDQ) from parents, and ADHD/DSM-IV questionnaires from teachers. Surrounding greenness was abstracted as the average Normalized Difference Vegetation Index (NDVI) in buffers of 100 m, 250 m, and 500 m around each home address. Proximity to green spaces was defined as living within 300 m of a major green space (>= 0.05 km2). We applied quasi-Poisson mixed-effects models (with school random effect) to separately estimate associations between indicators of contact with green spaces and SDQ and ADHD total and subscale scores.

Results: We generally estimated beneficial associations between behavioral indicators and longer time spent in green spaces and beaches, and with residential surrounding greenness. Specifically, we found statistically significant inverse associations between green space playing time and SDQ total difficulties, emotional symptoms, and peer relationship problems; between residential surrounding greenness and SDQ total difficulties and hyperactivity/inattention and ADHD/DSM-IV total and inattention scores; and between annual beach attendance and SDQ total difficulties, peer relationship problems, and prosocial behavior. For proximity to major green spaces, the results were not conclusive.

Conclusion: Our findings support beneficial impacts of contact with green and blue spaces on behavioral development in schoolchildren.

Amorim JH, J Valente, et al. 2013. Pedestrian exposure to air pollution in cities: modeling the effect of roadside trees. Advances in Meteorology 2013: 1-7.

The exposure of students to traffic-emitted carbon monoxide (CO) in their daily walk to school is evaluated, with a particular emphasis on the effect of trees and route choice.The study is focused on the city centre of Aveiro, in central Portugal. Time evolution of the georeferenced location of an individual is tracked with a GPS for different alternative walking routes to a school. Spatial distribution of CO concentration is simulated with a computational fluid dynamics (CFD) model. An exposure model is developed that associates the georeferenced location of the student with the computed air quality levels (at an average breathing height) for that specific grid cell. For each individual, the model calculates the instantaneous exposure at each time frame and the mean value for a given period. Results show a general benefit induced by the trees over the mean exposure of the student in each route. However, in the case of instantaneous exposure values, this is not consistent along the entire period. Also, the variability of the estimated exposure values indicates the potential error that can be committed when using a single value of air quality as a surrogate of air pollution exposure.

Andersen ZJ, A de Nazelle, et al. 2015. A study of the combined effects of physical activity and air pollution on mortality in elderly urban residents: the Danish diet, cancer, and health cohort. Environmental health perspectives, 123(6): 557-563.

Background Physical activity reduces, whereas exposure to air pollution increases, the risk of premature mortality. Physical activity amplifies respiratory uptake and deposition of air pollutants in the lung, which may augment acute harmful effects of air pollution during exercise.

Objectives We aimed to examine whether benefits of physical activity on mortality are moderated by long-term exposure to high air pollution levels in an urban setting.

Methods A total of 52,061 subjects (50-65 years of age) from the Danish Diet, Cancer, and Health cohort, living in Aarhus and Copenhagen, reported data on physical activity in 1993-1997 and were followed until 2010. High exposure to air pollution was defined as the upper 25th percentile of modeled nitrogen dioxide (NO2) levels at residential addresses. We associated participation in sports, cycling, gardening, and walking with total and cause-specific mortality by Cox regression, and introduced NO2 as an interaction term.

Results In total, 5,534 subjects died: 2,864 from cancer, 1,285 from cardiovascular disease, 354 from respiratory disease, and 122 from diabetes. Significant inverse associations of participation in sports, cycling, and gardening with total, cardiovascular, and diabetes mortality were not modified by NO2. Reductions in respiratory mortality associated with cycling and gardening were more pronounced among participants with moderate/low NO2 [hazard ratio (HR) = 0.55; 95% CI: 0.42, 0.72 and 0.55; 95% CI: 0.41, 0.73, respectively] than with high NO2 exposure (HR = 0.77; 95% CI: 0.54, 1.11 and HR = 0.81; 95% CI: 0.55, 1.18, p-interaction = 0.09 and 0.02, respectively).

Conclusions In general, exposure to high levels of traffic-related air pollution did not modify associations, indicating beneficial effects of physical activity on mortality. These novel findings require replication in other study populations.

Anderson NB, Ed. 2004. Hostility: Psychophysiology. Encyclopedia of health and behavior. Thousand Oaks CA: Sage Publications. pp 529.

No abstract provided.

Annerstedt M, P-O Ostergren, et al. 2012. Green qualities in the neighbourhood and mental health - results from a longitudinal cohort study in Southern Sweden. BMC Public Health 12(1): 337.

BACKGROUND:Poor mental health is a major issue worldwide and causality is complex. For diseases with multifactorial background synergistic effects of person- and place- factors can potentially be preventive. Nature is suggested as one such positive place-factor. In this cohort study we tested the effect of defined green qualities (Serene, Space, Wild, Culture, Lush) in the environment at baseline on mental health at follow-up. We also studied interaction effects on mental health of those place factors and varied person factors (financial stress, living conditions, and physical activity).

METHODS:Data on person factors were extracted from a longitudinal (years 1999/2000 and 2005) population health survey (n=24945). The participants were geocoded and linked to data on green qualities from landscape assessments, and stored in the Geographical Information System (GIS). Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated, and multivariate logistic analyses were performed.

RESULTS:Mental health was not affected by access to the chosen green qualities, neither in terms of amount nor in terms of any specific quality. However, we found a reduced risk for poor mental health at follow-up among women, through a significant interaction effect between physical activity and access to the qualities Serene or Space. For men the tendencies were similar, though not significant. Regarding the other three green qualities, as well as amount of qualities, no statistically certain synergistic effects were found. Likewise, no significant synergies were detected between green qualities and the other person-factors. Only advanced exercise significantly reduced the risk for poor mental health among women, but not for men, compared to physical inactivity.

CONCLUSIONS:The results do not directly support the hypothesis of a preventive mental health effect by access to the green qualities. However, the additive effect of serene nature to physical activity contributed to better mental health at follow-up. This tendency was equal for both sexes, but statistically significant only for women.Objective landscape assessments may be important in detangling geographic determinants of health. This study stresses the importance of considering interaction effects when dealing with disorders of multifactorial background.

Anxiety Disorders Association of America - Understanding Anxiety.

Understanding Anxiety -- -- Accessed February 2013.

Araya M, M Olivares, F Pizarro, et al. 2004. Community-based randomized double-blind study of gastrointestinal effects and copper exposure in drinking water. Environmental Health Perspectives 112(10): 1068-73.

We assessed gastrointestinal effects in 1,365 adults exposed to either < 0.01 (controls), 2, 4, or 6 mg copper/L of drinking water for 2 months in a randomized, double-blind community-based study. The risk of symptoms increased with increasing Cu exposure and decreased with time. The best model by counting-process analysis included Cu concentration and sex. The risk of symptoms remained significantly higher in women than in men during weeks 1-4 for all concentrations tested; at week I comparison with the < 0.01-mg/L group showed that differences became significant in women at 4 mg/L [relative risk (RR) = 1.53; 95% confidence interval (CI), 1.02-2.05), and in men at 6 mg/L (RR = 1.9; 95% CI, 1.02-2-79). At week 2 for men and week 4 in women, the Cu concentration required to obtain significant differences on symptom report was > 6 mg Cu/L. We conclude that exposure to Cu in drinking water results in gastrointestinal symptoms, which are modulated by Cu concentration, time, and sex.

Armson D, P Stringer, et al. 2012. The effect of tree shade and grass on surface and globe temperatures in an urban area. Urban Forestry & Urban Greening 11(3): 245-255.

The process of urbanisation alters the thermal balance of an area resulting in an urban heat island effect where cities can be several degrees centigrade warmer than the surrounding rural landscape. This increased heat can make cities uncomfortable places and, during heat waves, can pose serious health risks. This study looked at the role that trees and grass can play in reducing regional and local temperatures in urban areas during the summer within the urban landscape of Manchester, UK. In June and July 2009 and 2010, we monitored the surface temperatures of small plots composed of concrete and grass in the presence or absence of tree shading, and measured globe temperatures above each of the surfaces. The same measures were also recorded at mid-day on larger expanses of asphalt and grass in an urban park. Both surface and shade greatly affected surface temperatures. Grass reduced maximum surface temperatures by up to 24 degrees C, similar to model predictions, while tree shade reduced them by up to 19 degrees C. In contrast, surface composition had little effect upon globe temperatures, whereas shading reduced them by up to 5-7 degrees C. These results show that both grass and trees can effectively cool surfaces and so can provide regional cooling, helping reduce the urban heat island in hot weather. In contrast grass has little effect upon local air or globe temperatures, so should have little effect on human comfort, whereas tree shade can provide effective local cooling.

Arnold E. 1992. World atlas of desertification. UNEP, London.

No abstract provided.

Arthritis Foundation - Osteoarthritis. Accessed February 2013.

Aspinall P, P Mavros, et al. 2013. The urban brain: analysing outdoor physical activity with mobile EEG. British Journal of Sports Medicine 2013(0): 1-6.

Background: Researchers in environmental psychology, health studies and urban design are interested in the relationship between the environment, behaviour settings and emotions. In particular, happiness, or the presence of positive emotional mindsets, broadens an individual's thought-action repertoire with positive benefits to physical and intellectual activities, and to social and psychological resources. This occurs through play, exploration, or similar activities. In addition, a body of restorative literature focuses on the potential benefits to emotional recovery from stress offered by green space and 'soft fascination'. However, access to the cortical correlates of emotional states of a person actively engaged within an environment has not been possible until recently. This study investigates the use of mobile electroencephalography (EEG) as a method to record and analyze the emotional experience of a group of walkers in three types of urban environment including a green space setting.

Methods: Using Emotiv EPOC, a low-cost mobile EEG recorder, participants took part in a 25 min walk through three different areas of Edinburgh. The areas (of approximately equal length) were labelled zone 1 (urban shopping street), zone 2 (path through green space) and zone 3 (street in a busy commercial district). The equipment provided continuous recordings from five channels, labelled excitement (short-term), frustration, engagement, long-term excitement (or arousal) and meditation.

Results: A new form of high-dimensional correlated component logistic regression analysis showed evidence of lower frustration, engagement and arousal, and higher meditation when moving into the green space zone; and higher engagement when moving out of it.

Conclusions: Systematic differences in EEG recordings were found between three urban areas in line with restoration theory. This has implications for promoting urban green space as a mood-enhancing environment for walking or for other forms of physical or reflective activity.

Assessing xeriscaping as a sustainable heat island mitigation approach for a desert city

Metropolitan Phoenix has been amongst the most rapidly urbanizing cities in the USA, and is also subject to an urban heat island (UHI) of significant intensity and extent. There is a need to mitigate its detrimental effects through sustainable methods, such as through the application of low-water demand, xerophytic trees with broad canopies within residential yards (i.e. xeriscaping). Urban xeriscaping has the potential to reduce urban water use, urban temperatures and outdoor thermal discomfort, but evaluating its effectiveness has not been widely researched. In this study, we used a micro-scale urban climate model (ENVI-met) to generate xeriscaping scenarios in two residential areas with different existing surface vegetation cover (mesic vs. xeric). We subsequently examined the resulting impacts of xeriscaping on near-surface temperatures and outdoor thermal comfort over different spatial scales and temporal periods. Compared to existing conditions, xerophytic shade trees have strong UHI mitigation potential in existing xeric residential areas in Phoenix, with greater cooling occurring at (i.) microscales (approx. 2.5°C) vs. local-scales (approx. 1.1°C), and during (ii.) nocturnal (0500h) vs. daytime periods (1700h) under high xeriscaping scenarios. Conversely, increased xeriscaping resulted in net warming and increased thermal discomfort over mesic residential neighborhoods over all spatial scales and temporal periods. These varying results over different residential land cover in Phoenix therefore must be considered by stakeholders when considering xeriscaping as a UHI mitigation method.

Astell-Burt T, R Mitchell, & T Hartig. 2014. The association between green space and mental health varies across the lifecourse. A longitudinal study. Journal of epidemiology and community health, 68(6): 578-83.

Background Epidemiological studies on green space and health have relied almost exclusively on cross-sectional designs, restricting understanding on how this relationship could vary across the lifecourse.

Methods We used multilevel linear regression to analyse variation in minor psychiatric morbidity over nine annual waves of the British Household Panel Survey (1996-2004). The sample was restricted to residents of urban areas who remained within their neighbourhoods for at least 12 months. The 12-item General Health Questionnaire and confounders were reported for 29,626 male and 35,781 female observations (person-years). This individual-level dataset was linked to a measure of green space availability within each ward of residence. Regression models included age, gender, employment status, household tenure, marital status, education, smoking status and household income.

Results When not considering age, green space was associated with better mental health among men, but not women. Interaction terms fitted between age and green space revealed variation in the association between green space and mental health across the lifecourse and by gender. For men, the benefit of more green space emerged in early to mid-adulthood. Among older women, a curvilinear association materialised wherein those with a moderate availability of green space had better mental health.

Conclusions These findings illustrate how the relationship between urban green space and health can vary across the lifecourse, and they highlight the need for longitudinal studies to answer why green space may be better for health at some points in the lifecourse than others.

Astell-Burt T, X Feng , & GS Kolt. 2014. Greener neighborhoods, slimmer people? Evidence from 246,920 Australians. International journal of obesity, 38(1): 156-9.

Although there is growing consensus that population-level improvements in cardiovascular health depend upon environments that promote healthy lifestyles, evidence to support large-scale investments in neighborhood greenery to tackle obesity is inconsistent and has not focused on adults in middle-to-old age who experience the greatest burden of chronic health problems. Multilevel linear and multinomial logit regression models were fitted to investigate association between body mass index and an objective measure of green space in a sample of 246,920 Australian adults aged 45 years and older (The 45 and Up Study). Proximity to green space was constructed using catchment areas of 1 km radius around each participant. Women with over 80% proximity to green space had relative risk ratios of 0.90 (95% confidence interval: 0.83, 0.97) for overweight and 0.83 (0.74, 0.94) for obese. No similarly protective association was found for men. These results were consistent after controlling for moderate-to-vigorous physical activity (MVPA) and sitting time, each of which was favorably associated with green space proximity in men and women. Large-scale investments to enhance green spaces may promote MVPA and reduce sedentary behavior in middle-to-older-aged adults, but the impact on obesity may not benefit everyone to the same extent.

Astell-Burt T, X Feng, & GS Kolt. 2014. Is neighborhood green space associated with a lower risk of type 2 diabetes? Evidence from 267,072 Australians. Diabetes Care, 37(1): 197-201.

OBJECTIVE Lifestyle interventions for type 2 diabetes mellitus (T2DM) are best positioned for success if participants live in supportive neighborhood environments. Deprived neighborhoods increase T2DM risk. Parks and other "green spaces" promote active lifestyles and therefore may reduce T2DM risk. We investigated association between neighborhood green space and the risk of T2DM in a large group of adult Australians.

RESEARCH DESIGN AND METHODS Multilevel logit regression was used to fit associations between medically diagnosed T2DM and green space exposure among 267,072 participants in the 45 and Up Study. Green space data were obtained from the Australian Bureau of Statistics, and exposure was calculated using a 1-km buffer from a participant's place of residence. Odds ratios (ORs) were controlled for measures of demographic, cultural, health, diet, active lifestyles, socioeconomic status, and neighborhood circumstances.

RESULTS The rate of T2DM was 9.1% among participants in neighborhoods with 0-20% green space, but this rate dropped to approximately 8% for participants with over 40% green space within their residential neighborhoods. The risk of T2DM was significantly lower in greener neighborhoods, controlling for demographic and cultural factors, especially among participants residing in neighborhoods with 41-60% green space land use (OR 0.87; 95% CI 0.83-0.92). This association was consistent after controlling for other explanatory variables and did not vary according to neighborhood circumstances.

CONCLUSIONS People in greener surroundings have a lower risk of T2DM. Planning, promoting, and maintaining local green spaces is important in multisector initiatives for addressing the T2DM epidemic.

Astell-Burt TF, K Xiaoqi, S Gregory. 2013. Does access to neighbourhood green space promote a healthy duration of sleep? Novel findings from a cross-sectional study of 259,319 Australians. BMJ Open 3(8): 1-6.

Objectives: Experiments demonstrate that exposure to parks and other "green spaces" promote favourable psychological and physiological outcomes. As a consequence, people who reside in greener neighbourhoods may also have a lower risk of short sleep duration (<6 h). This is potentially important as short sleep duration is a correlate of obesity, chronic disease and mortality, but so far this hypothesis has not been previously investigated.

Design: Cross-sectional data analysis.

Setting: New South Wales, Australia.

Participants: This study investigated whether neighbourhood green space was associated with a healthier duration of sleep (to the nearest hour) among 259,319 Australians who completed the 45 and Up Study baseline questionnaire between 2006 and 2009 inclusive.

Primary and secondary outcome measures: Multinomial logit regression was used to investigate the influence of an objective measure of green space on categories of sleep duration: 8 h (normal); between 9 and 10 h (mid-long sleep); over 10 h (long sleep); between 6 and 7 h (mid-short sleep); and less than 6 h (short sleep). Models were adjusted for psychological distress, physical activity and a range of demographic and socioeconomic characteristics.

Results: People living in greener neighbourhoods reported a lower risk of short sleep. For example, compared with participants living in areas with 20% green space land-use, the relative risk ratios for participants with 80%+ green space was 0.86 (95% CI 0.81 to 0.92) for durations between 6 and 7 h, and 0.68 (95% CI 0.57 to 0.80) for less than 6 h sleep. Unexpectedly, the benefit of more green space for achieving 8 h of sleep was not explained by controls for psychological distress, physical activity or other socioeconomic factors.

Conclusions: Green space planning policies may have wider public health benefits than previously recognised. Further research in the role of green spaces in promoting healthier sleep durations and patterns is warranted.

Astell-Burt TF, K Xiaoqi, S Gregory. 2013. Mental health benefits of neighbourhood green space are stronger among physically active adults in middle-to-older age: Evidence from 260,061 Australians. Preventive Medicine 2013(57): 601-606.

Objective: While many studies report that green spaces promote mental health, some suggest the psychological benefits of physical activity are amplified if participation occurs within greener environs. We investigated whether this relationship could be observed among adults in middle-to-older age.

Method: Multilevel logit regression was used to investigate association between green space and psychological distress (Kessler scores of 22 +) among 260,061 Australians over 45 years old living in New South Wales (2006-2009). Physical activity was measured using the Active Australia survey. Percentage green space was estimated within a 1-kilometre of residence.

Results: In comparison to residents of the least green areas, those in the greenest neighbourhoods were at a lower risk of psychological distress (Odds Ratio 0.83, 95% CI: 0.76, 0.92) and were less sedentary (0.81: 0.77, 0.87). An interaction was observed between physical activity and green space (p=0.0028). More green space did not appear to benefit mental health among the least active (0.99: 0.85, 1.15), but there was a protective association for the more physically active (0.82: 0.67, 0.99).

Conclusion: For adults in middle-to-older age, green spaces are not only important for promoting physical activity, but the mental health benefits of greener environs appear contingent upon those active lifestyles.

Astell-Burt TF, K Xiaoqi, S Gregory. 2013. Neighbourhood green space and the odds of having skin cancer: multilevel evidence of survey data from 267 072 Australians. Journal of Epidemiology and Community Health 2014(68) 370-374.

Background: If green spaces encourage people to spend more time outdoors in physical, recreational and social activities, this could have unintended but important consequences for health in countries where levels of ultraviolet (UV) radiation are non-trivial. We investigated whether people who lived in neighbourhoods containing lots of green space were likely to spend more time outdoors and, subsequently, were more likely to report a case of skin cancer.

Methods: Multilevel logit regression was used to fit associations between self-reported medically diagnosed skin cancer (melanoma and non-melanoma) and an objective measure of green space. These models were adjusted for measures of susceptibility (skin colour and tanning), socioeconomic variables, demographic and cultural characteristics (eg, ancestry and country of birth). Mediation analyses were conducted using self-reported measures of time spent outdoors and participation in moderate-to-vigorous physical activity (MVPA).

Results: Descriptive analyses reported a positive association between green space and skin cancer (p<0.001). Time outdoors and in MVPA was also higher among people living in greener areas. The association between green space and skin cancer was robust after adjustment. In comparison to people with 0-20% green space, for example, the adjusted odds of having skin cancer were 9% higher among those with >80% green space. Only 1.6% and less than 1% of the association was mediated by MVPA and time spent outdoors.

Conclusions: Neighbourhood green space is associated with higher odds of having skin cancer in Australia. The relationship between green space and health, in its broadest terms, is likely to vary by geographical context.

Atkinson RW, IC Mills, et al. 2015. Fine particle components and health-a systematic review and meta-analysis of epidemiological time series studies of daily mortality and hospital admissions. Journal of Exposure Science and Environmental Epidemiology, 25(2): 208-14.

Short-term exposure to fine particle mass (PM) has been associated with adverse health effects, but little is known about the relative toxicity of particle components. We conducted a systematic review to quantify the associations between particle components and daily mortality and hospital admissions. Medline, Embase and Web of Knowledge were searched for time series studies of sulphate (SO4(2-)), nitrate (NO3(-)), elemental and organic carbon (EC and OC), particle number concentrations (PNC) and metals indexed to October 2013. A multi-stage sifting process identified eligible studies and effect estimates for meta-analysis. SO4(2-), NO3(-), EC and OC were positively associated with increased all-cause, cardiovascular and respiratory mortality, with the strongest associations observed for carbon: 1.30% (95% CI: 0.17%, 2.43%) increase in all-cause mortality per 1 µg/m(3). For PNC, the majority of associations were positive with confidence intervals that overlapped 0%. For metals, there were insufficient estimates for meta-analysis. There are important gaps in our knowledge of the health effects associated with short-term exposure to particle components, and the literature also lacks sufficient geographical coverage and analyses of cause-specific outcomes. The available evidence suggests, however, that both EC and secondary inorganic aerosols are associated with adverse health effects.

Atwill ER, KW Tate, et al. 2006. Efficacy of natural grassland buffers for removal of Cryptosporidium parvum in rangeland runoff. Journal of food protection, 69(1): 177-84.

Our goal for this project was to estimate the retention efficiency of natural grassland buffers for Cryptosporidium parvum. Three sets of 16 plots (2.0 by 3.0 m) were established at 5, 20, and 35% slopes. Within each set of 16 plots, residual dry vegetation matter treatments of 225, 560, and 900 kg/ha were implemented, along with a noncut control averaging 4,500 kg/ha. Buffer width treatments were implemented by placing cattle fecal material containing known loads of C. parvum 0.1, 1.1, or 2.1 m up-slope of the runoff collector. Grassland buffers of 1.1 and 2.1 m generated 3.2- to 8.8-log and 3.6- to 8.8-log retention of C. parvum, respectively, across the range of residual dry vegetation matter, land slope, rainfall, and runoff conditions examined during this project. Buffers with an increased percent land slope exhibited improved the retention efficiencies, whereas buffers experiencing larger maximum annual runoff events exhibited reduced retention efficiencies. Water-quality data from the 0.1-m-wide buffer plots (effectively no buffer) demonstrated that the majority of C. parvum oocysts (98 to 99.999%) were retained in the fecal matrix for the duration of the storm season, irrespective of the presence of a vegetated buffer. In conclusion, these results support the assertion that grassland buffers are an effective method for reducing animal agricultural inputs of waterborne C. parvum into drinking and irrigation water supplies.


Babisch W, K Wolf, et al. 2014. Associations between traffic noise, particulate air pollution, hypertension, and isolated systolic hypertension in adults: the KORA study. Environmental Health Perspectives (Online), 122(5): 492.

BACKGROUND: Studies on the association between traffic noise and cardiovascular diseases have rarely considered air pollution as a covariate in the analyses. Isolated systolic hypertension has not yet been in the focus of epidemiological noise research.

METHODS: The association between traffic noise (road and rail) and the prevalence of hypertension was assessed in two study populations with a total of 4,166 participants 25-74 years of age. Traffic noise (weighted day-night average noise level; LDN) at the facade of the dwellings was derived from noise maps. Annual average PM2.5 mass concentrations at residential addresses were estimated by land-use regression. Hypertension was assessed by blood pressure readings, self-reported doctor-diagnosed hypertension, and antihypertensive drug intake.

RESULTS: In the Greater Augsburg, Germany, study population, traffic noise and air pollution were not associated with hypertension. In the City of Augsburg population (n = 1,893), where the exposure assessment was more detailed, the adjusted odds ratio (OR) for a 10-dB(A) increase in noise was 1.16 (95% CI: 1.00, 1.35), and 1.11 (95% CI: 0.94, 1.30) after additional adjustment for PM2.5. The adjusted OR for a 1-micro-g/m3 increase in PM2.5 was 1.15 (95% CI: 1.02, 1.30), and 1.11 (95% CI: 0.98, 1.27) after additional adjustment for noise. For isolated systolic hypertension, the fully adjusted OR for noise was 1.43 (95% CI: 1.10, 1.86) and for PM2.5 was 1.08 (95% CI: 0.87, 1.34).

CONCLUSIONS: Traffic noise and PM2.5 were both associated with a higher prevalence of hypertension. Mutually adjusted associations with hypertension were positive but no longer statistically significant.

Bagot KL, FC Allen, & S Toukhsati. 2015. Perceived restorativeness of children's school playground environments: Nature, playground features and play period experiences. Journal of environmental psychology, 41: 1-9.

With little research examining children's restorative environments, the design of environments supportive of children's functioning is limited. The aim of this study was to examine the predictors of perceived restorativeness of children's school playgrounds, using Attention Restoration Theory. Children (N=550, 46% boys, Mage=9.73 years, SD=1.21) from 14 schools reported playground perceived restorativeness and play period experiences (affect, physical activity, social activity, perceived affordances). Playground characteristics of nature, size, play areas, play equipment and ratio of total grounds were assessed. After controlling for gender, age and playground size, vegetation volume was the only significant naturalness measure predicting perceived restorativeness. Play period experiences explained more variance than physical characteristics. With only moderate levels of perceived restorativeness revealed, the potential for school grounds to enhance children's functioning remains. Factors contributing to children's restorative environments may differ from adults, requiring children's inclusion in the research and design of their environments.

Bai H, SS Wilhelm, et al. 2013. Perceptions of neighborhood park quality: Associations with physical activity and body mass index. Annals of Behavioral Medicine 2013(45): 39-48.

Background: Parks are important resources for physical activity (PA), yet few studies have examined how perceptions of park characteristics relate to PA and health. Purpose: This study investigated associations between perceptions of neighborhood park quality and overall moderate-to-vigorous PA (MVPA), park-based PA, and body mass index (BMI)

Methods: Data were collected via questionnaire from 893 households in Kansas City, Missouri.

Results: The newly developed neighborhood park quality scale demonstrated good test-retest and internal reliability. Residents' perceptions of neighborhood park quality were related to PA and health outcomes. Perceiving parks as a benefit was positively related to overall MVPA and park-based PA and negatively related to BMI. Perceptions of well-used parks were positively related to BMI, while perceived cleanliness was negatively related to park-based PA.

Conclusions: Better measuring and understanding how perceptions of local parks are associated with PA and health can improve appreciation of how parks facilitate active living.

Baker DB, RP Richards, TT Loftus, JW Kramer. 2004. A new flashiness index: characteristics and applications to Midwestern rivers and streams. Journal of the American Water Resources Association, 40 (2): p 503 -22.

The term flashiness reflects the frequency and rapidity of short term changes in streamflow, especially during runoff events. Flashiness is an important component of a stream's hydrologic regime. A variety of land use and land management changes may lead to increased or decreased flashiness, often to the detriment of aquatic life. This paper presents a newly developed flashiness index, which is based on mean daily flows. The index is calculated by dividing the pathlength of flow oscillations for a time interval (i.e., the sum of the absolute values of day-to-day changes in mean daily flow) by total discharge during that time interval. This index has low interannual variability, relative to most flow regime indicators, and thus greater power to detect trends. Index values were calculated for 515 Midwestern streams for the 27-year period from 1975 through 2001. Statistically significant increases were present in 22 percent of the streams, primarily in the eastern portion of the study area, while decreases were present in 9 percent, primarily in the western portion. Index values tend to decrease with increasing watershed area and with increasing unit area ground water inputs. Area compensated index values often shift at ecoregion boundaries. Potential index applications include evaluation of programs to restore more natural flow regimes.

Bakian AV, RS Huber, et al. 2015. Acute air pollution exposure and risk of suicide completion. American journal of epidemiology, 181(5): 295-303.

Research into environmental factors associated with suicide has historically focused on meteorological variables. Recently, a heightened risk of suicide related to short-term exposure to airborne particulate matter was reported. Here, we examined the associations between short-term exposure to nitrogen dioxide, particulate matter, and sulfur dioxide and completed suicide in Salt Lake County, Utah (n = 1,546) from 2000 to 2010. We used a time-stratified case-crossover design to estimate adjusted odds ratios for the relationship between suicide and exposure to air pollutants on the day of the suicide and during the days preceding the suicide. We observed maximum heightened odds of suicide associated with interquartile-range increases in nitrogen dioxide during cumulative lag 3 (average of the 3 days preceding suicide; odds ratio (OR) = 1.20, 95% confidence interval (CI): 1.04, 1.39) and fine particulate matter (diameter <=2.5 µm) on lag day 2 (day 2 before suicide; OR = 1.05, 95% CI: 1.01, 1.10). Following stratification by season, an increased suicide risk was associated with exposure to nitrogen dioxide during the spring/fall transition period (OR = 1.35, 95% CI: 1.09, 1.66) and fine particulate matter in the spring (OR = 1.28, 95% CI: 1.01, 1.61) during cumulative lag 3. Findings of positive associations between air pollution and suicide appear to be consistent across study locations with vastly different meteorological, geographical, and cultural characteristics.

Balseviciene B, L Sinkariova, et al. 2014. Impact of residential greenness on preschool children's emotional and behavioral problems. International journal of environmental research and public health, 11(7): 6757-70.

This study investigated the effects of the proximity to city parks and the influence of residential greenness on children's emotional and behavioral problems. This cross-sectional study included 1,468 mothers of children (ages 4 to 6) who were residents of the city of Kaunas, Lithuania. The mothers and their children were enrolled in the FP7 PHENOTYPE project study. The mothers reported on their parenting stress and their children's mental health. Residential greenness was characterized as an average of the satellite-derived normalized difference vegetation index (NDVI) in a 300 m buffer around each home address, and the proximity to city parks was defined as the distance from the subject's residence to the nearest park. Linear regression models were used to investigate the association among the residence distances from city parks, greenness and children's mental health problems. Farther residential distance from city parks was associated with worse mental health (except for the emotional problems subscale) in children whose mothers had a lower education level. More residential greenness was associated with worse mental health (more conditional problems and less prosocial behavior) in children whose mothers had a higher education level. These relationships have important implications for the prevention of emotional and behavioral problems in children.

Banuelos GS, ZQ Lin,et al. 2002. Phytoremediation of selenium-contaminated soils and waters: fundamentals and future prospects. Reviews on environmental health, 17(4): 291-306.

Interest in selenium pollution and remediation technology has escalated during the past two decades. Although not known to be essential for plants, selenium is an essential micronutrient for humans and animals, having important benefits for their nutrition. At high concentrations, however, selenium becomes toxic to animals and humans. A major selenium controversy in the 1980s emerged in California at the Kesterson National Wildlife Refuge; hence, scientists, environmental regulators, politicians, and the general public in the United States became aware of selenium's potential as an environmental contaminant. Consequently, extensive research has been conducted in the western United States, and a vast amount of financial resources have been allocated to develop management strategies and remediation technologies for reducing the impact of naturally occurring selenium on the biological environment. A plant-based technology, defined as 'phytoremediation', has received increasing recognition as a low-cost, environmentally friendly approach for managing the toxic effects of selenium. Plants have the ability to absorb and sequester selenium and to convert inorganic and sequester selenium and to convert inorganic selenium to volatile forms of organic compounds that are released harmlessly into the atmosphere. The present review summarizes recent research findings and information about strategies on using phytoremediation systems to detoxify selenium-contaminated soils and waters in natural and agricultural ecosystems.

Barbone F, M Bovenzi, F Cavallieri, G Stanza. 1995. Air pollution and lung cancer in Trieste, Italy. American Journal of Epidemiology 141(12): 1161-69.

To investigate the relation between air pollution and histologic type of lung cancer, the authors conducted a case-control study among men who had died in Trieste, Italy, from 1979 to 1981 and from 1985 to 1986. Through the local autopsy registry, 755 cases of lung cancer and 755 controls were identified. Information on smoking habits, occupation, and place of residence was obtained from each subject's next of kin. Air pollution at the residence of each subject was estimated from the average value of total particulate at the nearest monitoring station. Logistic regression was used to evaluate the effect of residence and air pollution on lung cancer after adjustment for age, smoking habits, likelihood of exposure to occupational carcinogens, and social group. The risk of lung cancer increased with increasing level of air pollution for all types of lung cancer combined (p = 0.022), for small cell carcinoma (p = 0.016), and for large cell carcinoma (p = 0.049). Compared with inhabitants of the residential area, residents of the rural area had a relative risk (RR) of 0.6 (95% confidence interval (Cl) 0.4-1.0). The RR was 1.5 (95% Cl 1.0-2.2) for residents of the center of the city and 1.4 (95% Cl 1.0-2.1) for residents of the industrial area. In the center of the city, the excess risk was almost completely restricted to small cell carcinoma (RR = 2.0) and to large cell carcinoma (RR = 2.6). In the industrial area, the risk was increased especially for adenocarcinoma (RR = 2.1). These results provide evidence that air pollution is a moderate risk factor for certain histologic types of lung cancer.

Barton J and J Pretty. 2010. What is the best dose of nature and green exercise for improving mental health? A multi-study analysis. Environmental Science & Technology 44(10): 3947-55.

Green exercise is activity in the presence of nature. Evidence shows it leads to positive short and long-term health outcomes. This multistudy analysis assessed the best regime of dose(s) of acute exposure to green exercise required to improve self-esteem and mood (indicators of mental health). The research used meta-analysis methodology to analyze 10 UK studies involving 1252 participants. Outcomes were identified through a priori subgroup analyses, and dose-responses were assessed for exercise intensity and exposure duration. Other subgroup analyses included gender, age group, starting health status, and type of habitat. The overall effect size for improved self-esteem was d = 0.46 (CI 0.34-0.59, p < 0.00001) and for mood d = 0.54 (CI 0.38-0.69, p < 0.00001). Dose responses for both intensity and duration showed large benefits from short engagements in green exercise, and then diminishing but still positive returns. Every green environment improved both self-esteem and mood; the presence of water generated greater effects. Both men and women had similar improvements in self-esteem after green exercise, though men showed a difference for mood. Age groups: for self-esteem, the greatest change was in the youngest, with diminishing effects with age; for mood, the least change was in the young and old. The mentally ill had one of the greatest self-esteem improvements. This study confirms that the environment provides an important health service.

Barton J, M Griffin, et al. 2012. Exercise-, nature- and socially interactive-based initiatives improve mood and self-esteem in the clinical population. Perspectives in Public Health 132(2): 89-96.

Aims: This study evaluated two existing group-based health promotion initiatives (a social club and a swimming group) and compared these to a new green exercise programme (weekly countryside and urban park walks).

Methods: Participants represented a clinical population (N = 53) and were all experiencing a range of mental health problems. They only attended one of the three programmes and sessions were held once a week for six weeks in all initiatives. Composite questionnaires incorporating two standardized measures to analyse changes in self-esteem and mood were completed before and after all sessions.

Results: A significant main effect for self-esteem and mood pre and post activity (p < 0.001) was reported after participating in a single session. The change in self-esteem was significantly greater in the green exercise group compared with the social activities club (p < 0.001). Dose responses showed that both self-esteem and mood levels improved over the six-week period and improvements were related to attendance in the green exercise group.

Conclusions: Green exercise as a health-promoting initiative for people experiencing mental ill health is equally as effective as existing programmes. Combining exercise, nature and social components in future initiatives may play a key role in managing and supporting recovery from mental ill health, suggesting a potential 'green' approach to mental healthcare and promotion.

Barton J, R Hine, and J Pretty. 2009. The health benefits of walking in greenspaces of high natural and heritage value. Journal of Integrative Environmental Sciences, 6(4): 261-78.

Lifestyles are increasingly characterised by sedentary behaviour, obesity problems, stress, mental ill-health and disconnection from nature. However, contact with nature has been shown to improve psychological health by reducing stress, enhancing mood and replenishing mental fatigue. In addition to providing a range of environmental services, greenspaces provide opportunities and incentives for 'green exercise' such as walking, cycling or horse riding. Visitor numbers indicate that many people already benefit from spending time in greenspaces, but little is known about the immediate impact of an acute exposure on their health and wellbeing. This study focuses on evaluating changes in self-esteem and mood after walking in four different National Trust sites of natural and heritage value in the East of England. The standardised measures of both self-esteem and mood were administered immediately pre- and post-activity. Self-esteem scores for visitors leaving the sites were significantly higher than those just arriving and overall mood also significantly improved. Feelings of anger, depression, tension and confusion all significantly reduced and vigour increased. Thus, the environment plays an important role in facilitating physical activities and helping to address sedentary behaviours. Walking, in particular, can serve many purposes including exercise, recreation, travel, companionship, relaxation and restoration. However, walking in greenspaces may offer a more sustainable option, as the primary reward is enhanced emotional wellbeing through both exposure to nature and participation in exercise.

Bass B, KKY Liu, BA Baskaran. 2003. Evaluating rooftop and vertical gardens as an adaptation strategy for urban areas. NRC Institute for Research in Construction, NRC Canada.

Green roof infrastructure has become a multi-million dollar industry in Germany and is gaining popularity in other European countries as well. Green roof infrastructure is more than just soil and plants on a roof, but consists of specialized membranes and drainage barriers to support the growing of vegetation on top of buildings. The benefits of this technology were researched and presented in the Canada Mortgage and Housing Corporation Report Greenbacks from Green Roofs (Peck at el., 1999). Many of the advantages of these technologies, such as the reduction of stormwater runoff, the reduction of cooling loads and the reduction of the urban heat island suggested that this technology could play a role in helping Canadian cities adapt to climate change. The goal of this research was to assess these benefits in a Canadian context.

Baumgardner D, S Varela, et al. 2012. The role of a peri-urban forest on air quality improvement in the Mexico City megalopolis. Environmental Pollution 163, April: 174-183.

Air quality improvement by a forested, peri-urban national park was quantified by combining the Urban Forest Effects (UFORE) and the Weather Research and Forecasting coupled with Chemistry (WRF-Chem) models. We estimated the ecosystem-level annual pollution removal function of the park's trees, shrub and grasses using pollution concentration data for carbon monoxide (CO), ozone (O3), and particulate matter less than 10 microns in diameter (PM10), modeled meteorological and pollution variables, and measured forest structure data. Ecosystem-level O3 and CO removal and formation were also analyzed for a representative month. Total annual air quality improvement of the park's vegetation was approximately 0.02% for CO, 1% for O3, and 2% for PM10, of the annual concentrations for these three pollutants. Results can be used to understand the air quality regulation ecosystem services of peri-urban forests and regional dynamics of air pollution emissions from major urban areas.

Bayer-Oglesby L, L Grize, et al. 2005). Decline of ambient air pollution levels and improved respiratory health in Swiss children. Environmental Health Perspectives 113(11): 1632-1637.

The causality of observed associations between air pollution and respiratory health in children is still subject to debate. If reduced air pollution exposure resulted in improved respiratory health of children, this would argue in favor of a causal relation. We investigated whether a rather moderate decline of air pollution levels in the 1990s in Switzerland was associated with a reduction in respiratory symptoms and diseases in school children. In nine Swiss communities, 9,591 children participated in cross sectional health assessments between 1992 and 2001. Their parents completed identical questionnaires on health status and covariates. We assigned to each child an estimate of regional particles with an aerodynamic diameter < 10 micro-g/m3 (PM10) and determined change in PM10 since the first survey. Adjusted for socioeconomic, health-related, and indoor factors, declining PM10 was associated in logistic regression models with declining prevalence of chronic cough [odds ratio (OR) per 10-micro-g/m3 decline = 0.65, 95% condence interval (CI), 0.54-0.79], bronchitis (OR = 0.66; 95% CI, 0.55-0.80), common cold (OR = 0.78; 95% CI, 0.68-0.89), nocturnal dry cough (OR = 0.70; 95% CI, 0.60-0.83), and conjunctivitis symptoms (OR = 0.81; 95% CI, 0.70-0.95). Changes in prevalence of sneezing during pollen season, asthma, and hay fever were not associated with the PM10 reduction. Our findings show that the reduction of air pollution exposures contributes to improved respiratory health in children. No threshold of adverse effects of PM10 was apparent because we observed the benecial effects for relatively small changes of rather moderate air pollution levels. Current air pollution levels in Switzerland still exceed limit values of the Swiss Clean Air Act; thus, children's health can be improved further.

Bealey WJ, AG McDonald, E Nemitz; RDonovan, U Dragosits, TR Duffy, D Fowler. 2006. Estimating the reduction of urban PM10 concentrations by trees within an environmental information system for planners. Journal of Environmental Management 85(1): 44-58.

Trees have been widely quoted as effective scavengers of both gaseous and particulate pollutants from the atmosphere. Recent work on the deposition of urban aerosols onto woodland allows the effect of tree planting strategies on airborne aerosol concentrations to be quantified and considered within the planning process. By identifying the potential planting locations in the local authority area, and applying them within a dispersion and deposition model, the potential magnitude of reduction in the ambient concentration of PM(10), achievable through urban tree planting, has been quantified for two UK cities. As part of the Environmental Information Systems for Planners (EISP), flow diagrams, based on planning decisions, have incorporated output from the model to make decisions on land use planning ranging from development plans and strategic planning, to development control. In this way, for any new developments that contribute to the local PM(10) level, the mitigation by planting trees can be assessed, and in some cases, reductions can be sufficient to meet air quality objectives for PM(10).

Beaumont JJ, RM Sedman, SD Reynolds et al. 2008. Cancer mortality in a Chinese population exposed to hexavalent chromium in drinking water. Epidemiology 19(1): 12-23.

Background: In 1987, investigators in Liaoning Province, China, reported that mortality rates for all cancer, stomach cancer, and lung cancer in 1970-1978 were higher in villages with hexavalent chromium (Cr+6)-contaminated drinking water than in the general population. The investigators reported rates, but did not report statistical measures of association or precision.

Methods: Using reports and other communications from investigators at the local Jinzhou Health and Anti-Epidemic Station, we obtained data on Cr+6 contamination of groundwater and cancer mortality in 9 study regions near a ferrochromium factory. We estimated: (1) person-years at risk in the study regions, based on census and population growth rate data, (2) mortality counts, based on estimated person-years at risk and previously reported mortality rates, and (3) rate ratios and 95% confidence intervals.

Results: The all-cancer mortality rate in the combined 5 study regions with Cr+6-contaminated water was negligibly elevated in comparison with the rate in the 4 combined study regions without contaminated water (rate ratio = 1.13; 95% confidence interval = 0.86-1.46), but was somewhat more elevated in comparison with the whole province (1.23; 0.97-1.53). Stomach cancer mortality in the regions with contaminated water was more substantially elevated in comparison with the regions without contaminated water (1.82; 1.11-2.91) and the whole province (1.69; 1.12-2.44). Lung cancer mortality was slightly elevated in comparison with the unexposed study regions (1.15; 0.62-2.07), and more strongly elevated in comparison with the whole province (1.78; 1.03-2.87). Mortality from other cancers combined was not elevated in comparison with either the unexposed study regions (0.86; 0.53-1.36) or the whole province (0.92; 0.58-1.38).

Conclusions: While these data are limited, they are consistent with increased stomach cancer risk in a population exposed to Cr+6 in drinking water. (C) 2008 Lippincott Williams & Wilkins, Inc.

Beck S, D Wojdyla, L Say et al. 2010. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization; 88:31-8.

Bulletin of the World Health Organization. -- -- Accessed February 2013.

Beckett KP, P Freer-Smith, G Taylor. 2000. Effective tree species for local air-quality management. Journal of Arboriculture 26(1): 12-9.

The beneficial effect that trees have on air quality is often stated in arboricultural literature but has rarely been researched. The presented study aims to identify trees from 5 contrasting species that maximize the benefit to local air quality. Results show that all trees examined captured large quantities of airborne particulates, from the health-damaging size fractions (particle diameters of 10 to 2.5 micro-m, 2.5 to 1 micro-m, and <1 micro-m). Coniferous species were found to capture more particles than did broad-leaves, with pines (Pinus spp.) capturing significantly more material than cypresses (Cupresses spp.). Of the broad-leaved species, whitebeam (Sorbus aria) captured the most and poplar (Populus spp.) the least weight of particles. Trees situated close to a busy road captured significantly more material from the largest particle size fraction than those situated at a rural, background site. There was very little variation between the 2 sites in the weight of particulates from the 2 smallest particle size fractions (i.e., the fractions that are potentially the most damaging to human health).

Beckett KP, PH Freer-Smith, and G Taylor. 1998. Urban woodlands: their role in reducing the effects of particulate pollution. Environmental pollution, 99(3): 347-60.

In recent years a substantial research effort has focused on the links between particulate air pollution and poor health. As a result the PM10 value has been set as a measure of such pollutants which can directly cause illness. Due to their large leaf areas relative to the ground on which they stand and the physical properties of their surfaces, trees can act as biological filters, removing large numbers of airborne particles and hence improving the quality of air in polluted environments. The role of vegetation and urban woodlands in reducing the effects of particulate pollution is reviewed here. The improvement of urban air quality achieved by establishing more trees in towns and cities is also illustrated.

Beil K and D Hanes. 2013. The influence of urban natural and built environments on physiological and psychological measures of stress- A pilot study. International Journal of Environmental Research and Public Health 10(4): 1250-1267.

Environments shape health and well-being, yet little research has investigated how different real-world environmental settings influence the well-known determinant of health known as stress. Using a cross-over experimental design; this pilot study investigated the effect of four urban environments on physiological and psychological stress measures. Participants (N =15) were exposed on separate days to one of the four settings for 20 min. These settings were designated as Very Natural; Mostly Natural; Mostly Built and Very Built. Visitation order to the four settings was individually randomized. Salivary cortisol and alpha-amylase; as well as self-report measures of stress; were collected before and after exposure to each setting. Gender was included as a variable in analysis; and additional data about environmental self-identity, pre-existing stress, and perceived restorativeness of settings were collected as measures of covariance. Differences between environmental settings showed greater benefit from exposure to natural settings relative to built settings; as measured by pre-to-post changes in salivary amylase and self-reported stress; differences were more significant for females than for males. Inclusion of covariates in a regression analysis demonstrated significant predictive value of perceived restorativeness on these stress measures, suggesting some potential level of mediation. These data suggest that exposure to natural environments may warrant further investigation as a health promotion method for reducing stress.

Belanger D, P Gosselin, et al. 2014. Perceived adverse health effects of heat and their determinants in deprived neighbourhoods: a cross-sectional survey of nine cities in Canada. International journal of environmental research and public health, 11(11): 11028-53.

This study identifies several characteristics of individuals who report their physical and/or mental health as being adversely affected by summertime heat and humidity, within the most disadvantaged neighbourhoods of the nine largest cities of Quebec (Canada). The study is cross-sectional by stratified representative sample; 3485 people were interviewed in their residence. The prevalence of reported impacts was 46%, mostly physical health. Female gender and long-term medical leave are two impact risk indicators in people less than 65 years of age. Low income and air conditioning at home are risk indicators at all ages. Results for having 2 or more diagnoses of chronic diseases, particularly for people self-describing as in poor health (odds ratio, OR <= 65 = 5.6; OR >= 65 = 4.2), and perceiving daily stress, are independent of age. The prevalence of reported heat-related health impacts is thus very high in those inner cities, with notable differences according to age, stress levels and long-term medical leave, previously unmentioned in the literature. Finally, the total number of pre-existing medical conditions seems to be a preponderant risk factor. This study complements the epidemiologic studies based on mortality or severe morbidity and shows that the heat-related burden of disease appears very important in those communities, affecting several subgroups differentially.

Bell JF, JS Wilson, G Liu. 2008. Neighborhood greenness and 2-year changes in body mass index of children and youth. American Journal of Preventive Medicine 35(6): 547-53.

Background: Available studies of the built environment and the BMI of children and youth suggest a contemporaneous association with neighborhood greenness in neighborhoods with high population density. The current study tests whether greenness and residential density are independently associated with 2-year changes in the BMI of children and youth.

Methods: The sample included children and youth aged 3-16 years who lived at the same address for 24 consecutive months and received well-child care from a Marion County IN clinic network within the years 1996-2002 (n=3831). Multiple linear regression was used to examine associations among age- and gender-specific BMI z-scores in Year 2, residential density, and a satellite-derived measure of greenness, controlling for baseline BMI z-scores and other covariates. Logistic regression was used to model associations between an indicator of BMI z-score increase from baseline to Time 2 and the above-mentioned predictors.

Results: Higher greenness was significantly associated with lower BMI z-scores at Time 2 reagardless of residential density characteristics. Higher residential density was not associated with Time 2 BMI z-scores in models regardless of greenness. Higher greenness was also associated with lower odds of children's and youth's increasing their BMI z-scores over 2 years (OR=.87; 95% CI=0.79, 0.97).

Conclusions: Greenness may present a target for environmental approaches to preventing child obesity.Children and youth living in greener neighborhoods had lower BMI z-scores at Time 2, presumably due to increased physical activity or time spent outdoors. Conceptualizations of walkability from adult studies, based solely on residential density, may not be relevant to children and youth in urban environments.

Bell ML and DL Davis. 2001. Reassessment of the lethal London fog of 1952: novel indicators of acute and chronic consequences of acute exposure to air pollution. Environmental Health Perspectives 109(3): 389-94.

This article develops and assesses novel indicators of respiratory and other morbidity and mortality following London's lethal smog in the winter of 1952. Public health insurance claims, hospital admission rates for cardiac and respiratory disease, pneumonia cases, mortality records, influenza reports, temperature, and air pollutant concentrations are analyzed for December-February 1952-1953 and compared with those for the previous year or years. Mortality rates for the smog episode from December 1952 to February 1953 were 50-300% higher than the previous year. Claims that the smog only elevated health risks during and immediately following the peak fog 5-9 December 1952 and that an influenza epidemic accounted fully for persisting mortality increases in the first 2 months of 1953 are rejected. We estimate about 12,000 excess deaths occurred from December 1952 through February 1953 because of acute and persisting effects of the 1952 London smog. Pollution levels during the London smog were 5-19 times above current regulatory standards and guidelines and approximate current levels in some rapidly developing regions. Ambient pollution in many regions poses serious risks to public health.

Belnap J. 2003. The world at your feet: desert biological soil crusts. Frontiers in Ecology and the Environment, 1(4): 181-9.

Desert soil surfaces are generally covered with biological soil crusts, composed of a group of organisms dominated by cyanobacteria, lichens, and mosses. Despite their unassuming appearance, these tiny organisms are surprisingly important to many processes in past and present desert ecosystems. Cyanobacteria similar to those seen today have been found as 1.2 billion-year-old terrestrial fossils, and they probably stabilized soils then as they do now. Biological crusts are vital in creating and maintaining fertility in otherwise infertile desert soils. They fix both carbon and nitrogen, much of which is leaked to the surrounding soils. They also capture nutrient-rich dust, and can stimulate plant growth. These organisms are able to tolerate extreme temperatures, drought, and solar radiation, despite having relatively little wet time for metabolic activity. Under most circumstances, they are extremely vulnerable to climate change and disturbances such as off-road vehicles and grazing livestock. Recovery times are generally measured in decades or centuries.

Belnap J. 2006. The potential roles of biological soil crusts in dryland hydrologic cycles. Hydrological processes, 20 (15): 3159-78.

Biological soil crusts (BSCs) are the dominant living cover in many drylands of the world. They possess many features that can influence different aspects of local hydrologic cycles, including soil porosity, absorptivity, roughness, aggregate stability, texture, pore formation, and water retention. The influence of biological soil crusts on these factors depends on their internal and external structure, which varies with climate, soil, and disturbance history. This paper presents the different types of biological soil crusts, discusses how crust type likely influences various aspects of the hydrologic cycle, and reviews what is known and not known about the influence of biological crusts on sediment production and water infiltration versus runoff in various drylands around the world. Most studies examining the effect of biological soil crusts on local hydrology are done by comparing undisturbed sites with those recently disturbed by the researchers. Unfortunately, this greatly complicates interpretation of the results. Applied disturbances alter many soil features such as soil texture, roughness, aggregate stability, physical crusting, porosity, and bulk density in ways that would not necessarily be the same if crusts were not naturally present. Combined, these studies show little agreement on how biological crusts affect water infiltration or runoff. However, when studies are separated by biological crust type and utilize naturally occurring differences among these types, results indicate that biological crusts in hyperarid regions reduce infiltration and increase runoff, have mixed effects in arid regions, and increase infiltration and reduce runoff in semiarid cool and cold drylands. However, more studies are needed before broad generalizations can be made on how biological crusts affect infiltration and runoff. We especially need studies that control for sub-surface soil features such as bulk density, micro- and macropores, and biological crust structure. Unlike the mixed effects of biological crusts on infiltration and runoff among regions, almost all studies show that biological crusts reduce sediment production, regardless of crust or dryland type.

Benfield JA, GN Rainbolt, et al. 2015. Classrooms with nature views: Evidence of differing student perceptions and behaviors. Environment and Behavior, 47(2): 140-57.

Viewing peaceful natural environments has been shown to restore cognitive abilities and reduce physiological arousal. As such, visual access to the natural environment is becoming more commonplace in built environments. One exception to that trend is in educational settings where windowless classrooms are used to reduce outside distractions. The current study examines differences across multiple sections of a college writing course in two types of identically designed classrooms-those with a view of a natural setting and those with a view of a concrete retaining wall. Results showed that students in the natural view classrooms were generally more positive when rating the course. Students in the natural view condition also had higher end of semester grades, but no differences in attendance were observed between conditions. Such findings suggest that classrooms with natural views offer advantages and also suggest that the inclusion of natural elements in courses could facilitate positive perceptions and better grades.

Bennet G. 1970. Bristol floods 1968. Controlled survey of effects on health of local community disaster. British Medical Journal 3(5720): 454-8.

An investigation into the health of people in Bristol flooded in July 1968 was made by means of a controlled survey and a study of mortality rates. There was a 50% increase in the number of deaths among those whose homes had been flooded, with a conspicuous rise in deaths from cancer.Surgery attendances rose by 53%, referrals to hospital and hospital admissions more than doubled. In all respects the men appeared less well able to cope with the experience of disaster than the women.

Berman MG, J Jonides, S Kaplan. 2008. The cognitive benefits of interacting with nature. Psychological Science 19(12): 1207-12.

We compare the restorative effects on cognitive functioning of interactions with natural versus urban environments. Attention restoration theory (ART) provides an analysis of the kinds of environments that lead to improvements in directed-attention abilities. Nature, which is filled with intriguing stimuli, modestly grabs attention in a bottom-up fashion, allowing top-down directed-attention abilities a chance to replenish. Unlike natural environments, urban environments are filled with stimulation that captures attention dramatically and additionally requires directed attention (e.g., to avoid being hit by a car), making them less restorative. We present two experiments that show that walking in nature or viewing pictures of nature can improve directed-attention abilities as measured with a backwards digit-span task and the Attention Network Task, thus validating attention restoration theory.

Beute F and YA de Kort. 2014. Natural resistance: Exposure to nature and self-regulation, mood, and physiology after ego-depletion. Journal of Environmental Psychology: 40, 167-78.

Positive effects of exposure to nature have been reported for stress, mood, and executive functioning. In the present research we investigated whether viewing natural scenes can also improve self-regulation. In line with recent theoretical propositions these replenishing effects were investigated in a typical ego-depletion paradigm. In two studies we found indications for beneficial effects of a short exposure to nature on lower order self-regulation (e.g., controlling impulses), but not on a higher-order executive functioning task. Furthermore, we found beneficial effects on mood and heart rate variability, a physiological measure related to exertion of self-control and stress. Importantly, beneficial effects of nature emerged even when participants had not been previously depleted, which challenges the current postulation that nature mostly has restorative benefits. We propose that nature might also have buffering or 'instorative' effects.

Beutel MW, CD Newton, et al. 2009. Nitrate removal in surface-flow constructed wetlands treating dilute agricultural runoff in the lower Yakima Basin, Washington. Ecological Engineering 35(10): 1538-1546.

Constructed treatment wetlands (CTWs) have been used effectively to treat a range of wastewaters and non-point sources contaminated with nitrogen (N). But documented long-termcase studies of CTWs treating dilute nitrate-dominated agricultural runoff are limited. This study presents an analysis of four years of water quality data for a 1.6-ha surface-flow CTW treating irrigation return flows in Yakima Basin in central Washington. The CTW consisted of a sedimentation basin followed by two surface-flow wetlands in parallel, each with three cells. Inflow typically contained 1-3 mg-N/L nitrate and <0.4 mg-N/L total Kjeldahl N (TKN). Hydraulic loading was fairly constant, ranging from around 125 cm/d in the sedimentation basin to 12 cm/d in the treatment wetlands. Concentration removal efficiencies for nitrate averaged 34% in the sedimentation basin and 90-93% in the treatment wetlands. Total N removal efficiencies averaged 21% and 57-63% in the sedimentation basin and treatment wetlands, respectively. Area-based first-order removal rate constants for nitrate in the wetlands averaged 142149 m/yr. Areal removal rates for nitrate in treatment wetlands averaged 139146 mg-N/m2 /d. Outflow from the CTW typically contained <0.1 mgN/L nitrate and <0.6 mg-N/L TKN. Rates of nitrate loss in wetlands were highly seasonal, generally peaking in the summer months (JuneAugust). Nitrate loss rates also correlated significantly with water temperature (positively) and dissolved oxygen (negatively). Based on the modified Arrhenius relationship, θ for nitrate loss in the wetlands was 1.05-1.09. The CTW also significantly affected temperature and dissolved oxygen concentration in waters flowing through the system. On average, the sedimentation basin caused an increase in temperature (+1.7 C) and dissolved oxygen (+1.5 mg/L); in contrast the wetlands caused a decrease in temperature (-1.6 C) and dissolved oxygen (-5.0 mg/L). Results show that CTWs with surface-flow wetlands can be extremely effective at polishing dilute non-point sources, particularly in semi-arid environments where warm temperatures and low oxygen levels in treatment wetland water promote biological denitrification.

Beyer KM, A Kaltenbach, et al. 2014. Exposure to neighborhood green space and mental health: evidence from the survey of the health of Wisconsin. International journal of environmental research and public health, 11(3): 3453-72.

Green space is now widely viewed as a health-promoting characteristic of residential environments, and has been linked to mental health benefits such as recovery from mental fatigue and reduced stress, particularly through experimental work in environmental psychology. Few population level studies have examined the relationships between green space and mental health. Further, few studies have considered the role of green space in non-urban settings. This study contributes a population-level perspective from the United States to examine the relationship between environmental green space and mental health outcomes in a study area that includes a spectrum of urban to rural environments. Multivariate survey regression analyses examine the association between green space and mental health using the unique, population-based Survey of the Health of Wisconsin database. Analyses were adjusted for length of residence in the neighborhood to reduce the impact of neighborhood selection bias. Higher levels of neighborhood green space were associated with significantly lower levels of symptomology for depression, anxiety and stress, after controlling for a wide range of confounding factors. Results suggest that "greening" could be a potential population mental health improvement strategy in the United States.

Bieling C, T Plieninger,et al. 2014. Linkages between landscapes and human well-being: an empirical exploration with short interviews. Ecological Economics, 105, 19-30.

Human well-being is tightly linked to the natural environment. Although this notion is well-established, it remains difficult to assess how the biophysical features of a specific area contribute towards the well-being of the people attached to it. We explore this topic using the case of four areas in Germany and Austria by performing open, single-question interviews with 262 respondents. Data reveal an outstanding relevance of nonmaterial values. Linkages between landscapes and human well-being are tied to specific features of the material environment but, likewise, practices and experiences play an important role in the creation and acknowledgment of such values. Our results accord with the conceptual outline of the cultural values model but fit to a lesser degree into the ecosystem services framework. Due to the high relevance of experiential factors, providing manifold opportunities for people to engage with their natural surroundings should be considered a strategy for fostering human well-being.

Bilenko N, LV Rossem, et al. 2015. Traffic-related air pollution and noise and children's blood pressure: results from the PIAMA birth cohort study. European journal of preventive cardiology, 22(1): 4-12.


Elevation of a child's blood pressure may cause possible health risks in later life. There is evidence for adverse effects of exposure to air pollution and noise on blood pressure in adults. Little is known about these associations in children. We investigated the associations of air pollution and noise exposure with blood pressure in 12-year-olds.


Blood pressure was measured at age 12 years in 1432 participants of the PIAMA birth cohort study. Annual average exposure to traffic-related air pollution [NO2, mass concentrations of particulate matter with diameters of less than 2.5 µm (PM2.5) and less than 10 µm (PM10), and PM2.5absorbance] at the participants' home and school addresses at the time of blood pressure measurements was estimated by land-use regression models. Air pollution exposure on the days preceding blood pressure measurements was estimated from routine air monitoring data. Long-term noise exposure was assessed by linking addresses to modelled equivalent road traffic noise levels. Associations of exposures with blood pressure were analysed by linear regression. Effects are presented for an interquartile range increase in exposure.


Long-term exposure to NO2 and PM2.5 absorbance were associated with increased diastolic blood pressure, in children who lived at the same address since birth [adjusted mean difference (95% confidence interval) [mmHg] 0.83 (0.06 to 1.61) and 0.75 (-0.08 to 1.58), respectively], but not with systolic blood pressure. We found no association of blood pressure with short-term air pollution or noise exposure.


Long-term exposure to traffic-related air pollution may increase diastolic blood pressure in children.

Birch G, M Fazeli & C Matthai. 2005. Efficiency of an infiltration basin in removing contaminants from urban stormwater. Environmental Monitoring and Assessment, 101(1), 23-38.

The efficiency of a Stormwater Infiltration Basin (SIB) to remove contaminants from urban stormwater was assessed in the current investigation. The SIB, installed in an urban suburb in eastern Sydney (Australia), was monitored over seven rainfall events to assess the removal efficiency of the remedial device for total suspended solids (TSS), nutrients (TP, TKN, Nox, TN), trace metals (Cd, Cr, Cu, Fe, Mn, Ni, Pb, Zn), organochlorine pesticides and faecal coliforms (FC) from stormwater. The weighted average concentration (WAC) of TSS in the stormwater effluent from the SIB was reduced by an average of 50%, whereas the WAC of Cu, Pb and Zn were also reduced by an average 68%, 93% and 52%, respectively. However, the WAC of Cr, Fe, Mn and Ni displays either similar concentrations as the stormwater influent (Cr and Mn), or substantially higher concentrations (Fe and Ni), due possibly to leaching of fine-grained zeolite clay particles in the filtration bed. The mean removal efficiency of the SIB for total phosphorus (TP) and total Kjeldahl nitrogen (TKN) was 51% and 65%, respectively. In contrast, the average WAC of oxidisable nitrogen (nitrate and nitrite nitrogen or Nox) is about 2.5 times greater in the effluent (1.34 0.69 mg L1) than in the incoming stormwater (0.62 0.25 mg L1). The WAC of total nitrogen (TN) was similar for stormwater at the in-flow and out-flow points. The SIB was very efficient in removing FC from stormwater; and the WAC of almost 70 (100 mL)1 at inflow was reduced to <2000 cfu (100 Ml)1 at the outflow, representing a mean removal efficiency of 96%. Due to the low concentrations of Cd, organochlorine pesticides and PAHs in the stormwater, it was not possible to assess the efficiency of the SIB in removing these contaminants.

Block AH, SJ Livesley, and NS Williams. 2012. Responding to the urban heat island: a review of the potential of green infrastructure. Victorian centre forclimate change Adaptation research Melbourne.

In Australian cities, infill development and urban sprawl are leading to the loss of vegetation and the ecosystem services that plants provide. As warming associated with urban development and climate change intensifies, vulnerable social groups will be at greater risk of heat-related morbidity and mortality. There is an urgent need to address this problem without increasing emissions of greenhouse gases. The strategic development of urban green infrastructure can help achieve this goal. This report reviews the Australian and international scientific and technical literature quantifying the cooling and energy-saving benefits of three types of green infrastructure: shade trees; green roofs; and vertical greening systems (VGS) (green walls and facades). International research demonstrates that green infrastructure can reduce surface and ambient temperatures at the micro-scale. However, there is limited research using experimental methods and validated modelling to determine the magnitude of cooling and energy-saving benefits that may be achieved at local-to city-wide scales, particularly for green roofs and VGS. The greatest thermal benefits are achieved in climates with hot, dry summers, particularly if water is available to maintain canopy health and evapotranspiration. Despite this, green infrastructure is not well established in Australia. There is a pressing need for experimental research quantifying the effects of specific plant traits, vegetation health, water availability and soil/substrate composition on the thermal performance of shade trees, green roofs and vertical greening systems. Research to determine the extent, location and mix of green infrastructure required to produce optimal cooling and energy-savings at neighbourhood and city-wide scales, in the diverse climates and ecosystems of Australian cities is also required.

Bolund P and S Hunhammar. 1999. Ecosystem services in urban areas. Ecological Economics 29(2): 293-301.

Humanity is increasingly urban, but continues to depend on Nature for its survival. Cities are dependent on the ecosystems beyond the city limits, but also benefit from internal urban ecosystems. The aim of this paper is to analyze the ecosystem services generated by ecosystems within the urban area. 'Ecosystem services' refers to the benefits human populations derive from ecosystems. Seven different urban ecosystems have been identified: street trees; lawns/parks; urban forests; cultivated land; wetlands; lakes/sea; and streams. These systems generate a range of ecosystem services. In this paper, six local and direct services relevant for Stockholm are addressed: air filtration, micro climate regulation, noise reduction, rainwater drainage, sewage treatment, and recreational and cultural values. It is concluded that the locally generated ecosystem services have a substantial impact on the quality-of-life in urban areas and should be addressed in land-use planning.

Bouchard DC, MK Williams, and RY Surampalli. 1992. Nitrate contamination of groundwater: sources and potential health effects. Journal-American Water Works Association, 84(9): 85-90.

Because nitrate contamination of groundwater is pandemic and the costs associated with remediating groundwater are high, the question of risk to human health from nitrate needs to be addressed. In order to prevent methemoglobinemia (an acute toxic response to nitrite exposure that precludes transport of oxygen by the blood), the US Environmental Protection Agency has set the maximum contaminant level for nitrate in drinking water at 10 mg nitrate-N/L. However, it is quite common for groundwater in agricultural areas to exceed this standard at some time during the year. A relationship between nitrate intake and cancer has not been conclusively demonstrated, but some evidence points to a linkage.

Bouchard M, F Laforest, et al. 2007. Hair manganese and hyperactive behaviors: Pilot study of school-age children exposed to tap water. Environmental Health Perspectives 115(1): 122-7.

Background: Neurotoxic effects are known to occur with inhalation of manganese particulates, but very few data are available on exposure to Mn in water. We undertook a pilot study in a community in Quebec (Canada) where naturally occurring high Mn levels were present in the public water system. Our objective was to test the hypothesis that greater exposure to Mn via drinking water would be reflected in higher Mn content in hair which, in turn, would be associated with increased level of hyperactive behaviors.

Methods: Forty-six children participated in the study, 24 boys and 22 girls, 6-15 years of age (median, 11 years). Their homes received water from one of two wells (W) with different Mn concentrations: W1: mean 610 micro-g/L; W2: mean 160 micro-g/L. The Revised Conners' Rating Scale for parents (CPRS-R) and for teachers (CTRS-R) were administered, providing T-scores on the following subscales: Oppositional, Hyperactivity, Cognitive Problems/Inattention, and ADHD Index.

Results: Children whose houses were supplied by W1 had higher hair Mn (MnH) than those supplied by W2 (mean 6.2 +- 4.7 g/g vs. 3.3 +- 3.0 g/g, p = 0.025). MnH was significantly associated with T-scores on the CTRS-R Oppositional (p = 0.020) and Hyperactivity (p = 0.002) subscales, after adjustment for age, sex, and income. All children with Oppositional and Hyperactivity T-scores 65 had MnH < 3.0 g/g.

Conclusions: The findings of this pilot study are sufficiently compelling to warrant more extensive investigations into the risks of Mn exposure in drinking water.

Bowler DE, LM Buyung-Ali, TM Knight and AS Pullin. 2010. A systematic review of evidence for the added benefits to health of exposure to natural environments. BMC Public Health 10: 456.

Background: There is increasing interest in the potential role of the natural environment in human health and well-being. However, the evidence-base for specific and direct health or well-being benefits of activity within natural compared to more synthetic environments has not been systematically assessed.

Methods: We conducted a systematic review to collate and synthesise the findings of studies that compare measurements of health or well-being in natural and synthetic environments. Effect sizes of the differences between environments were calculated and meta-analysis used to synthesise data from studies measuring similar outcomes.

Results: Twenty-five studies met the review inclusion criteria. Most of these studies were crossover or controlled trials that investigated the effects of short-term exposure to each environment during a walk or run. This included 'natural' environments, such as public parks and green university campuses, and synthetic environments, such as indoor and outdoor built environments. The most common outcome measures were scores of different selfreported emotions. Based on these data, a meta-analysis provided some evidence of a positive benefit of a walk or run in a natural environment in comparison to a synthetic environment. There was also some support for greater attention after exposure to a natural environment but not after adjusting effect sizes for pretest differences. Metaanalysis of data on blood pressure and cortisol concentrations found less evidence of a consistent difference between environments across studies.

Conclusions: Overall, the studies are suggestive that natural environments may have direct and positive impacts on well-being, but support the need for investment in further research on this question to understand the general significance for public health.

Brack C. 2002. Pollution mitigation and carbon sequestration by an urban forest. Environmental Pollution 116, Supplement 1(0): S195-S200.

At the beginning of the 1900s, the Canberra plain was largely treeless. Graziers had carried out extensive clearing of the original trees since the 1820s leaving only scattered remnants and some plantings near homesteads. With the selection of Canberra as the site for the new capital of Australia, extensive tree plantings began in 1911. These trees have delivered a number of benefits, including aesthetic values and the amelioration of climatic extremes. Recently, however, it was considered that the benefits might extend to pollution mitigation and the sequestration of carbon. This paper outlines a case study of the value of the Canberra urban forest with particular reference to pollution mitigation. This study uses a tree inventory, modelling and decision support system developed to collect and use data about trees for tree asset management. The decision support system (DISMUT) was developed to assist in the management of about 400,000 trees planted in Canberra. The size of trees during the 5-year Kyoto Commitment Period was estimated using DISMUT and multiplied by estimates of value per square meter of canopy derived from available literature. The planted trees are estimated to have a combined energy reduction, pollution mitigation and carbon sequestration value of US$20-67 million during the period 2008-2012.

Bradshaw CJA, NS Sodhi, et al. 2007. Global evidence that deforestation amplifies flood risk and severity in the developing world. Global Change Biology 13(11): 2379-95.

With the wide acceptance of forest-protection policies in the developing world comes a requirement for clear demonstrations of how deforestation may erode human well-being and economies. For centuries, it has been believed that forests provide protection against flooding. However, such claims have given rise to a heated polemic, and broad-scale quantitative evidence of the possible role of forests in flood protection has not been forthcoming. Using data collected from 1990 to 2000 from 56 developing countries, we show using generalized linear and mixed-effects models contrasted with information-theoretic measures of parsimony that flood frequency is negatively correlated with the amount of remaining natural forest and positively correlated with natural forest area loss (after controlling for rainfall, slope and degraded landscape area). The most parsimonious models accounted for over 65% of the variation in flood frequency, of which nearly 14% was due to forest cover variables alone. During the decade investigated, nearly 100,000 people were killed and 320 million people were displaced by floods, with total reported economic damages exceeding US$1151 billion. Extracted measures of flood severity (flood duration, people killed and displaced, and total damage) showed some weaker, albeit detectable correlations to natural forest cover and loss. Based on an arbitrary decrease in natural forest area of 10%, the model-averaged prediction of flood frequency increased between 4% and 28% among the countries modeled. Using the same hypothetical decline in natural forest area resulted in a 4-8% increase in total flood duration. These correlations suggest that global-scale patterns in mean forest trends across countries are meaningful with respect to flood dynamics. Unabated loss of forests may increase or exacerbate the number of flood-related disasters, negatively impact millions of poor people, and inflict trillions of dollars in damage in disadvantaged economies over the coming decades. This first global-scale empirical demonstration that forests are correlated with flood risk and severity in developing countries reinforces the imperative for large-scale forest protection to protect human welfare, and suggests that reforestation may help to reduce the frequency and severity of flood-related catastrophes.

Branas CC, RA Cheney, et al. 2011.A difference-in-differences analysis of health, safety, and greening vacant urban space. American Journal of Epidemiology 174(11): 1296-1306.

Greening of vacant urban land may affect health and safety. The authors conducted a decade-long difference-in-differences analysis of the impact of a vacant lot greening program in Philadelphia, Pennsylvania, on health and safety outcomes. "Before" and "after" outcome differences among treated vacant lots were compared with matched groups of control vacant lots that were eligible but did not receive treatment. Control lots from 2 eligibility pools were randomly selected and matched to treated lots at a 3:1 ratio by city section. Random-effects regression models were fitted, along with alternative models and robustness checks. Across 4 sections of Philadelphia, 4,436 vacant lots totaling over 7.8 million square feet (about 725,000 m2) were greened from 1999 to 2008. Regression-adjusted estimates showed that vacant lot greening was associated with consistent reductions in gun assaults across all 4 sections of the city (P < 0.001) and consistent reductions in vandalism in 1 section of the city (P < 0.001). Regression-adjusted estimates also showed that vacant lot greening was associated with residents' reporting less stress and more exercise in select sections of the city (P < 0.01). Once greened, vacant lots may reduce certain crimes and promote some aspects of health. Limitations of the current study are discussed. Community-based trials are warranted to further test these findings.

Brantley HL, Hagler GSW, Deshmukh PJ and Baldauf RW. 2014. Field assessment of the effects of roadside vegetation on near-road black carbon ad particulate matter. Science of the Total Environment 468-469:120-129.

One proposed method for reducing exposure to mobile source air pollution is the construction or preservation of vegetation barriers between major roads and nearby populations. This study combined stationary and mobile monitoring approaches to determine the effects of an existing, mixed-species tree stand on near-road black carbon (BC) and particulate matter concentrations. Results indicated that wind direction and time of day significantly affected pollutant concentrations behind the tree stand. Continuous sampling revealed reductions in BC behind the barrier, relative to a clearing, during downwind (12.4% lower) and parallel (7.8% lower) wind conditions, with maximum reductions of 22% during the late afternoon when winds were from the road. Particle counts in the fine and coarse particle size range (0.5-10 micro-m aerodynamic diameter) did not show change. Mobile sampling revealed BC concentration attenuation, a result of the natural dilution and mixing that occur with transport from the road, was more gradual behind the vegetation barrier than in unobstructed areas. These findings suggest that a mature tree stand can modestly improve traffic-related air pollution in areas located adjacent to the road; however, the configuration of the tree stand can influence the likelihood and extent of pollutant reductions.

Bratman GN, GC Daily, et al. 2015. The benefits of nature experience: Improved affect and cognition. Landscape and Urban Planning, 138: 41-50.

This study investigated the impact of nature experience on affect and cognition. We randomly assigned sixty participants to a 50-min walk in either a natural or an urban environment in and around Stanford, California. Before and after their walk, participants completed a series of psychological assessments of affective and cognitive functioning. Compared to the urban walk, the nature walk resulted in affective benefits (decreased anxiety, rumination, and negative affect, and preservation of positive affect) as well as cognitive benefits (increased working memory performance). This study extends previous research by demonstrating additional benefits of nature experience on affect and cognition through assessments of anxiety, rumination, and a complex measure of working memory (operation span task). These findings further our understanding of the influence of relatively brief nature experiences on affect and cognition, and help to lay the foundation for future research on the mechanisms underlying these effects.

Bratman GN, JP Hamilton, et al. 2012. The impacts of nature experience on human cognitive function and mental health. Annals of the New York Academy of Sciences 1249(1): 118-136.

Scholars spanning a variety of disciplines have studied the ways in which contact with natural environments may impact human well-being. We review the effects of such nature experience on human cognitive function and mental health, synthesizing work from environmental psychology, urban planning, the medical literature, and landscape aesthetics. We provide an overview of the prevailing explanatory theories of these effects, the ways in which exposure to nature has been considered, and the role that individuals' preferences for nature may play in the impact of the environment on psychological functioning. Drawing from the highly productive but disparate programs of research in this area, we conclude by proposing a system of categorization for different types of nature experience. We also outline key questions for future work, including further inquiry into which elements of the natural environment may have impacts on cognitive function and mental health; what the most effective type, duration, and frequency of contact may be; and what the possible neural mechanisms are that could be responsible for the documented effects.

Bratman GN, JP Hamilton, et al. 2015. Nature experience reduces rumination and subgenual prefrontal cortex activation. Proceedings of the national academy of sciences, 112(28): 8567-72.

Urbanization has many benefits, but it also is associated with increased levels of mental illness, including depression. It has been suggested that decreased nature experience may help to explain the link between urbanization and mental illness. This suggestion is supported by a growing body of correlational and experimental evidence, which raises a further question: what mechanism(s) link decreased nature experience to the development of mental illness? One such mechanism might be the impact of nature exposure on rumination, a maladaptive pattern of self-referential thought that is associated with heightened risk for depression and other mental illnesses. We show in healthy participants that a brief nature experience, a 90-min walk in a natural setting, decreases both self-reported rumination and neural activity in the subgenual prefrontal cortex (sgPFC), whereas a 90-min walk in an urban setting has no such effects on self-reported rumination or neural activity. In other studies, the sgPFC has been associated with a self-focused behavioral withdrawal linked to rumination in both depressed and healthy individuals. This study reveals a pathway by which nature experience may improve mental well-being and suggests that accessible natural areas within urban contexts may be a critical resource for mental health in our rapidly urbanizing world.

Brauman KA. 2015. Hydrologic ecosystem services: linking ecohydrologic processes to human well-being in water research and watershed management. Wiley Interdisciplinary Reviews: Water, 2(4): 345-58.

Ecosystem services, the benefits ecosystems provide to people, and hydrologic services, the subset of terrestrial ecosystem services related to water, appear with increasing frequency in water resources research and watershed management. Linking biophysical function to human well-being is central to the theory of ecosystem services, so distinctive characteristics of research on hydrologic services arise from addressing the way people are affected by ecohydrologic processes. However, based on a rapid scoping of 381 peer-reviewed studies of hydrologic services, I identified only a small fraction that appear to effectively make the link from biophysical processes to people. In their abstracts, many of the reviewed articles use the language of hydrologic services but appear to be essentially disciplinary studies, accounting for either biophysical functioning or specific beneficiaries in their analysis, but not both. In addition to guiding research, the direct link from biophysical processes to human well-being makes hydrologic services an appealing foundation for watershed management. The hydrologic services framework has been used to assess conservation benefits, evaluate management practices, prioritize siting, account for externalities, and perform trade-off or cost-benefit analysis. Hydrologic services hold potential for novel research and effective watershed management, but challenges remain in executing interdisciplinary research and in addressing the idiosyncratic demands of local management.

Braun-Fahrlander, JC Vuille, et al. 1997. Respiratory health and long-term exposure to air pollutants in Swiss schoolchildren. SCARPOL Team. Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution, Climate and Pollen. Am. J. Respir. Crit. Care Med. 155(3): 1042-9.

The impact of long-term exposure to air pollution on respiratory and allergic symptoms and illnesses was assessed in a cross-sectional study of schoolchildren (ages 6 to 15 yr, n = 4,470) living in 10 different communities in Switzerland. Air pollution measurements (particulate matter less than 10 microns in diameter [PM10], nitrogen dioxide [NO2], sulfur dioxide [SO2], and ozone) and meteorologic data were collected in each community. Reported symptom rates of chronic cough, nocturnal dry cough, and bronchitis, adjusted for individual risk factors, were positively associated with PM10, NO2, and SO2. The strongest relationship was observed for PM10 (adjusted odds ratios for chronic cough, nocturnal dry cough, and bronchitis between the most and the least polluted community for PM10 were 3.07 [95% CI: 1.62 to 5.81], 2.88 [95% CI: 1.69 to 4.89], and 2.17 [95% CI: 1.21 to 4.89], respectively). The high correlation between the average concentrations of the pollutants makes the assessment of the relative importance of each pollutant difficult. No association between long-term exposure to air pollution and classic asthmatic and allergic symptoms and illnesses was found. There was some indication that frequency of fog is a risk factor of chronic cough and bronchitis, independent of air pollution. In conclusion, this study provides further evidence that rates of respiratory illnesses and symptoms among children augment with increasing levels of air pollution even in countries like Switzerland with moderate average air pollution concentrations.

Brook RD, B Urch, et al. 2009. Insights into the mechanisms and mediators of the effects of air pollution exposure on blood pressure and vascular function in healthy humans. Hypertension 54(3): 659-67.

Fine particulate matter air pollution plus ozone impairs vascular function and raises diastolic blood pressure. We aimed to determine the mechanism and air pollutant responsible. The effects of pollution on heart rate variability, blood pressure, biomarkers, and brachial flow-mediated dilatation were determined in 2 randomized, double-blind, crossover studies. In Ann Arbor, 50 subjects were exposed to fine particles (150 micro-g/m3) plus ozone (120 parts per billion) for 2 hours on 3 occasions with pretreatments of an endothelin antagonist (Bosentan, 250 mg), antioxidant (Vitamin C, 2 g), or placebo. In Toronto, 31 subjects were exposed to 4 different conditions (particles plus ozone, particles, ozone, and filtered air). In Toronto, diastolic blood pressure significantly increased (2.9 and 3.6 mm Hg) only during particle-containing exposures in association with particulate matter concentration and reductions in heart rate variability. Flow-mediated dilatation significantly decreased (2.0% and 2.9%) only 24 hours after particle-containing exposures in association with particulate matter concentration and increases in blood tumor necrosis factor alpha. In Ann Arbor, diastolic blood pressure significantly similarly increased during all of the exposures (2.5 to 4.0 mm Hg), a response not mitigated by pretreatments. Flow-mediated dilatation remained unaltered. Particulate matter, not ozone, was responsible for increasing diastolic blood pressure during air pollution inhalation, most plausibly by instigating acute autonomic imbalance. Only particles from urban Toronto additionally impaired endothelial function, likely via slower proinflammatory pathways. Our findings demonstrate credible mechanisms whereby fine particulate matter could trigger acute cardiovascular events and that aspects of exposure location may be an important determinant of the health consequences.

Brown DK, JL Barton, VF Gladwell. 2013. Viewing nature scenes positively affects recovery of autonomic function following acute-mental stress. Environmental Science & Technology 47(11): 5562-5569.

A randomized crossover study explored whether viewing different scenes prior to a stressor altered autonomic function during the recovery from the stressor. The two scenes were (a) nature (composed of trees, grass, fields) or (b) built (composed of man-made, urban scenes lacking natural characteristics) environments. Autonomic function was assessed using noninvasive techniques of heart rate variability; in particular, time domain analyses evaluated parasympathetic activity, using root-mean-square of successive differences (RMSSD). During stress, secondary cardiovascular markers (heart rate, systolic and diastolic blood pressure) showed significant increases from baseline which did not differ between the two viewing conditions. Parasympathetic activity, however, was significantly higher in recovery following the stressor in the viewing scenes of nature condition compared to viewing scenes depicting built environments (RMSSD; 50.0 +/- 31.3 vs 34.8 +/- 14.8 ms). Thus, viewing nature scenes prior to a stressor alters autonomic activity in the recovery period. The secondary aim was to examine autonomic function during viewing of the two scenes. Standard deviation of R-R intervals (SDRR), as change from baseline, during the first 5 min of viewing nature scenes was greater than during built scenes. Overall, this suggests that nature can elicit improvements in the recovery process following a stressor.

Brown L and V Murray. 2013. Examining the relationship between infectious diseases and flooding in Europe: A systematic literature review and summary of possible public health interventions. Disaster Health, 1(2): 117-27.


Many infectious diseases are sensitive to climatic changes; specifically, flooding. This systematic literature review aimed to strengthen the quality and completeness of evidence on infectious diseases following flooding, relevant to Europe.


A systematic literature review from 2004-2012 was performed. Focused searches of the following databases were conducted: Medline, Scopus, PubMed, Cochrane Library, and Evidence Aid. Personal communications with key informants were also reviewed.


Thirty-eight studies met the inclusion criteria. Evidence suggested that water-borne, rodent-borne, and vector-borne diseases have been associated with flooding in Europe, although at a lower incidence than developing countries.


Disease surveillance and early warning systems, coupled with effective prevention and response capabilities, can reduce current and future vulnerability to infectious diseases following flooding.

Brulle RJ and DN Pellow. 2006. Environmental justice: human health and environmental inequalities. Annu. Rev. Public Health, 27: 103-24.

In this review, we provide an introduction to the topics of environmental justice and environmental inequality. We provide an overview of the dimensions of unequal exposures to environmental pollution (environmental inequality), followed by a discussion of the theoretical literature that seeks to explain the origins of this phenomenon. We also consider the impact of the environmental justice movement in the United States and the role that federal and state governments have developed to address environmental inequalities. We conclude that more research is needed that links environmental inequalities with public health outcomes.

Brydon J, I Oh, et al. 2009. Evaluation of mitigation methods to manage contaminant transfer in urban watershed. Water Qual. Res. J. Can. 44(1): 1-15.

Three case studies on trace metal contamination in urban stormwater are presented from the Greater Vancouver area of British Columbia. In the i rst case study, the spatial and temporal variability in trace metals in sediments were determined in the completely urbanized Brunette watershed. A natural lake in the middle of the watershed acts as a sediment detention system, and an analysis of the sediment core showed the historic accumulation of metal and selective organic contaminants in sediments since the early 1800s. Suspended sediments transported during storm events showed significantly higher concentrations of trace metals than bedload sediments, and the largest proportion of the geochemically active metals was found to be associated with the organic-sulphur-based fraction. Benthic organism survival tests showed mixed results with lower survival and growth in urban sediments than in control sediments from a forested watershed. In the second case study, significant correlations were obtained between percent impervious cover and trace metal concentrations in 28 subwatersheds with various degrees of urbanization. It is shown that imperviousness combined with traffic density can significantly improve the prediction of metal contamination in highly urbanized watersheds. In the third case study i ve urban stormwater detention systems were examined over one year to determine how effective these systems were in removing metal contamination. The results were highly variable depending on a wide range of physical conditions, land use activities, trafi c volume, and detention system designs. The range of total metal detention was between -15 to +72% for copper (Cu), lead (Pb), and zinc (Zn), while iron (Fe) and manganese (Mn) retention was generally poor. Labile Zn was more effectively retained in four of the five ponds, and a significant relationship was found between percent imperviousness, trafi c volume, and Zn concentrations in water, sediment, and labile form.

Budd R, A O'Geen, K S Goh, S Bondarenko & J Gan. 2009. Efficacy of Constructed Wetlands in Pesticide Removal from Tailwaters in the Central Valley, California. Environmental Science & Technology, 43(8), 2925-2930.

Pollutants in agricultural irrigation return flow (tailwater) constitute a significant nonpoint source of pollution in intensive agricultural regions such as the Central Valley of California. Constructed wetlands (CWs) represent a feasible mitigation option to remove pollutants including pesticides in the tailwater. In this study, we evaluated two CWs in the Central Valley for their performance in removing pyrethroid and organophosphate insecticides under field-scale production conditions. Both CWs were found to be highly effective in reducing pyrethroid concentrations in the tailwater, with season-average concentration reductions ranging from 52 to 94%. The wetlands also reduced the flow volume by 68-87%, through percolation and evapotranspiration. When both concentration and volume reductions were considered, the season-average removal of pyrethroids ranged from 95 to 100%. The primary mechanism for pyrethroid removal was through sedimentation of pesticide-laden particles, which was influenced by hydraulic residence time and vegetation density. Temporal analysis indicates a potential efficiency threshold during high flow periods. The season-average removal of chlorpyrifos ranged 52-61%. The wetlands, however, were less effective at removing diazinon, likely due to its limited sorption to sediment particles. Analysis of pesticide partitioning showed that pyrethroids were enriched on suspended particles in the tailwater. Monitoring of pesticide association with suspended solids and bed sediments suggested an increased affinity of pyrethroids for lighter particles with the potential to move further downstream before subject to sedimentation. Results from this study show that flow-through CWs, when properly designed, are an effective practice for mitigating hydrophobic pesticides in the irrigation tailwater.

Burkart K, F Meier, et al. 2016. Modification of heat-related mortality in an elderly urban population by vegetation (urban green) and proximity to water (urban blue): evidence from Lisbon, Portugal. Environmental health perspectives, 124(7): 927.

Background: Urban populations are highly vulnerable to the adverse effects of heat, with heat-related mortality showing intra-urban variations that are likely due to differences in urban characteristics and socioeconomic status.

Objectives: We investigated the influence of urban green and urban blue, that is, urban vegetation and water bodies, on heat-related excess mortality in the elderly > 65 years old in Lisbon, Portugal, between 1998 and 2008.

Methods: We used remotely sensed data and geographic information to determine the amount of urban vegetation and the distance to bodies of water (the Atlantic Ocean and the Tagus Estuary). Poisson generalized additive models were fitted, allowing for the interaction between equivalent temperature [universal thermal climate index (UTCI)] and quartiles of urban greenness [classified using the Normalized Difference Vegetation Index (NDVI)] and proximity to water (<= 4 km vs. > 4 km), while adjusting for potential confounders.

Results: The association between mortality and a 1°C increase in UTCI above the 99th percentile (24.8°C) was stronger for areas in the lowest NDVI quartile (14.7% higher; 95% CI: 1.9, 17.5%) than for areas in the highest quartile (3.0%; 95% CI: 2.0, 4.0%). In areas > 4 km from water, a 1°C increase in UTCI above the 99th percentile was associated with a 7.1% increase in mortality (95% CI: 6.2, 8.1%), whereas in areas <= 4 km from water, the estimated increase in mortality was only 2.1% (95% CI: 1.2, 3.0%).

Conclusions: Urban green and blue appeared to have a mitigating effect on heat-related mortality in the elderly population in Lisbon. Increasing the amount of vegetation may be a good strategy to counteract the adverse effects of heat in urban areas. Our findings also suggest potential benefits of urban blue that may be present several kilometers from a body of water.

Burnett RT, JR Brook, et al. 1997. Association between ozone and hospitalization for respiratory diseases in 16 Canadian cities. Environmental Research 72(1): 24-31

The effects of tropospheric ozone on lung function and respiratory symptoms have been well documented at relatively high concentrations. However, previous investigations have failed to establish a clear association between tropospheric ozone and respiratory diseases severe enough to require hospitalization after controlling for climate, and with gaseous and particulate air pollution at the lower concentrations typically observed in Canada today. To determine if low levels of tropospheric ozone contribute to hospitalization for respiratory disease, air pollution data were compared to hospital admissions for 16 cities across Canada representing 12.6 million people. During the 3927-day period from April 1, 1981, to December 31, 1991, there were 720,519 admissions for which the principle diagnosis was a respiratory disease. After controlling for sulfur dioxide, nitrogen dioxide, carbon monoxide, soiling index, and dew point temperature, the daily high hour concentration of ozone recorded 1 day previous to the date of admission was positively associated with respiratory admissions in the April to December period but not in the winter months. The relative risk for a 30 ppb increase in ozone varied from 1.043 (P < 0.0001) to 1.024 (P= 0.0258) depending on the selection of covariates in the regression model and subset of cities examined. The association between ozone and respiratory hospitalizations varied among cities, with relative risks ranging from 1.000 to 1.088 after simultaneous covariate adjustment. Particulate matter and carbon monoxide were also positively associated with respiratory hospitalizations. These results suggest that ambient air pollution at the relatively low concentrations observed in this study, including tropospheric ozone, is associated with excess admissions to hospital for respiratory diseases in populations experiencing diverse climates and air pollution profiles.

Buyantuyev A and J Wu. 2010. Urban heat islands and landscape heterogeneity: linking spatiotemporal variations in surface temperatures to land-cover and socioeconomic patterns. Landscape ecology, 25(1): 17-33.

The urban heat island (UHI) phenomenon is a common environmental problem in urban landscapes which affects both climatic and ecological processes. Here we examined the diurnal and seasonal characteristics of the Surface UHI in relation to land-cover properties in the Phoenix metropolitan region, located in the northern Sonoran desert, Arizona, USA. Surface temperature patterns derived from the Advanced Spaceborne Thermal Emission and Reflection Radiometer for two day-night pairs of imagery from the summer (June) and the autumn (October) seasons were analyzed. Although the urban core was generally warmer than the rest of the area (especially at night), no consistent trends were found along the urbanization gradient. October daytime data showed that most of the urbanized area acted as a heat sink. Temperature patterns also revealed intra-urban temperature differences that were as large as, or even larger than, urban-rural differences. Regression analyses confirmed the important role of vegetation (daytime) and pavements (nighttime) in explaining spatio-temporal variation of surface temperatures. While these variables appear to be the main drivers of surface temperatures, their effects on surface temperatures are mediated considerably by humans as suggested by the high correlation between daytime temperatures and median family income. At night, however, the neighborhood socio-economic status was a much less controlling factor of surface temperatures. Finally, this study utilized geographically weighted regression which accounts for spatially varying relationships, and as such it is a more appropriate analytical framework for conducting research involving multiple spatial data layers with autocorrelated structures.


Caddick N and B Smith. 2014. The impact of sport and physical activity on the well-being of combat veterans: A systematic review. Psychology of sport and exercise, 15(1): 9-18.

Objectives This review examined the potential impact of sport and physical activity upon the subjective and psychological well-being of combat veterans in the aftermath of physical or psychological combat trauma.

Design A systematic review was conducted. The question guiding this review was 'what is the impact of sport and physical activity on the well-being of combat veterans?'

Methods Key databases were searched for articles relating to the use of sport and/or physical activity in supporting combat veterans. 11 studies were identified as relevant for inclusion. Data from these studies were extracted by means of a directed content analysis, the results of which were reported in a narrative synthesis.

Results Sport and physical activity enhances subjective well-being in veterans through active coping and doing things again, PTSD symptom reduction, positive affective experience, activity in nature/ecotherapy, and quality of life. Impact on psychological well-being includes determination and inner strength, focus on ability and broadening of horizons, identity and self-concept, activity in nature/ecotherapy, sense of achievement/accomplishment, and social well-being. Participating in sport and/or physical activity can also enhance motivation for living.

Conclusions The review advances knowledge by producing a synthesis of evidence that highlights the value of sport and physical activity for supporting the well-being and rehabilitation of disabled combat veterans and combat veterans diagnosed with Post-Traumatic Stress Disorder. It also develops knowledge by identifying the type of sports and physical activities used to promote well-being, offering the first definition of combat veterans in the sport literature, taking a critical approach, and highlighting the under researched role of nature-based physical activity.

Calderon-Garciduenas L, A Vojdani, et al. 2015. Air pollution and children: neural and tight junction antibodies and combustion metals, the role of barrier breakdown and brain immunity in neurodegeneration. Journal of Alzheimer's Disease, 43(3): 1039-58.

Millions of children are exposed to concentrations of air pollutants, including fine particulate matter (PM2.5), above safety standards. In the Mexico City Metropolitan Area (MCMA) megacity, children show an early brain imbalance in oxidative stress, inflammation, innate and adaptive immune response-associated genes, and blood-brain barrier breakdown. We investigated serum and cerebrospinal fluid (CSF) antibodies to neural and tight junction proteins and environmental pollutants in 139 children ages 11.91 +- 4.2 y with high versus low air pollution exposures. We also measured metals in serum and CSF. MCMA children showed significantly higher serum actin IgG, occludin/zonulin 1 IgA, IgG, myelin oligodendrocyte glycoprotein IgG and IgM (p < 0.01), myelin basic protein IgA and IgG, S-100 IgG and IgM, and cerebellar IgG (p < 0.001). Serum IgG antibodies to formaldehyde, benzene, and bisphenol A, and concentrations of Ni and Cd were significantly higher in exposed children (p < 0.001). CSF MBP antibodies and nickel concentrations were higher in MCMA children (p = 0.03). Air pollution exposure damages epithelial and endothelial barriers and is a robust trigger of tight junction and neural antibodies. Cryptic 'self' tight junction antigens can trigger an autoimmune response potentially contributing to the neuroinflammatory and Alzheimer and Parkinson's pathology hallmarks present in megacity children. The major factor determining the impact of neural antibodies is the integrity of the blood-brain barrier. Defining the air pollution linkage of the brain/immune system interactions and damage to physical and immunological barriers with short and long term neural detrimental effects to children's brains ought to be of pressing importance for public health.

Calderon-Garciduenas L, A Calderon-Garciduenas. 2015. Air pollution and your brain: what do you need to know right now. Primary health care research & development, 16(04): 329-45.

Research links air pollution mostly to respiratory and cardiovascular disease. The effects of air pollution on the central nervous system (CNS) are not broadly recognized. Urban outdoor pollution is a global public health problem particularly severe in megacities and in underdeveloped countries, but large and small cities in the United States and the United Kingom are not spared. Fine and ultrafine particulate matter (UFPM) defined by aerodynamic diameter (<2.5-µm fine particles, PM2.5, and <100-nm UFPM) pose a special interest for the brain effects given the capability of very small particles to reach the brain. In adults, ambient pollution is associated to stroke and depression, whereas the emerging picture in children show significant systemic inflammation, immunodysregulation at systemic, intratechal and brain levels, neuroinflammation and brain oxidative stress, along with the main hallmarks of Alzheimer and Parkinson's diseases: hyperphosphorilated tau, amyloid plaques and misfolded alpha-synuclein. Animal models exposed to particulate matter components show markers of both neuroinflammation and neurodegeneration. Epidemiological, cognitive, behavioral and mechanistic studies into the association between air pollution exposures and the development of CNS damage particularly in children are of pressing importance for public health and quality of life. Primary health providers have to include a complete prenatal and postnatal environmental and occupational history to indoor and outdoor toxic hazards and measures should be taken to prevent or reduce further exposures.

Calderon-Garciduenas L, A Mora-Tiscareno, et al. 2008. Air pollution, cognitive deficits and brain abnormalities: A pilot study with children and dogs. Brain and Cognition 68(2): 117-127.

Exposure to air pollution is associated with neuroinflammation in healthy children and dogs in Mexico City. Comparative studies were carried out in healthy children and young dogs similarly exposed to ambient pollution in Mexico City. Children from Mexico City (n: 55) and a low polluted city (n:18) underwent psychometric testing and brain magnetic resonance imaging MRI. Seven healthy young dogs with similar exposure to Mexico City air pollution had brain MRI, measurement of mRNA abundance of two inflammatory genes cyclooxygenase-2, and interleukin 1 [beta] in target brain areas, and histopathological evaluation of brain tissue. Children with no known risk factors for neurological or cognitive disorders residing in a polluted urban environment exhibited significant deficits in a combination of fluid and crystallized cognition tasks. Fifty-six percent of Mexico City children tested showed prefrontal white matter hyperintense lesions and similar lesions were observed in dogs (57%). Exposed dogs had frontal lesions with vascular subcortical pathology associated with neuroinflammation, enlarged Virchow-Robin spaces, gliosis, and ultrafine particulate matter deposition. Based on the MRI findings, the prefrontal cortex was a target anatomical region in Mexico City children and its damage could have contributed to their cognitive dysfunction. The present work presents a groundbreaking, interdisciplinary methodology for addressing relationships between environmental pollution, structural brain alterations by MRI, and cognitive deficits/delays in healthy children.

Calderon-Garciduenas L, RJ Kulesza, et al. 2015. Megacities air pollution problems: Mexico City Metropolitan Area critical issues on the central nervous system pediatric impact. Environmental research, 137: 157-69.

The chronic health effects associated with sustained exposures to high concentrations of air pollutants are an important issue for millions of megacity residents and millions more living in smaller urban and rural areas. Particulate matter (PM) and ozone (O3) concentrations close or above their respective air quality standards during the last 20 years affect 24 million people living in the Mexico City Metropolitan Area (MCMA). Herein we discuss PM and O3 trends in MCMA and their possible association with the observed central nervous system (CNS) effects in clinically healthy children. We argue that prenatal and postnatal sustained exposures to a natural environmental exposure chamber contribute to detrimental neural responses. The emerging picture for MCMA children shows systemic inflammation, immunodysregulation at both systemic and brain levels, oxidative stress, neuroinflammation, small blood vessel pathology, and an intrathecal inflammatory process, along with the early neuropathological hallmarks for Alzheimer and Parkinson's diseases. Exposed brains are briskly responding to their harmful environment and setting the bases for structural and volumetric changes, cognitive, olfactory, auditory and vestibular deficits and long term neurodegenerative consequences. We need to improve our understanding of the PM pediatric short and long term CNS impact through multidisciplinary research. Public health benefit can be achieved by integrating interventions that reduce fine PM levels and pediatric exposures and establishing preventative screening programs targeting pediatric populations that are most at risk. We fully expect that the health of 24 million residents is important and blocking pediatric air pollution research and hiding critical information that ought to be available to our population, health, education and social workers is not in the best interest of our children.

Calfapietra C, S Fares, F Manes, A Morani, G Sgrigna, F Loreto. 2013. Role of Biogenic Volatile Organic Compounds (BVOC) emitted by urban trees on ozone concentration in cities: A review. Environmental Pollution 183: 71-80.

Biogenic Volatile Organic Compounds (BVOC) play a critical role in biosphere-atmosphere interactions and are key factors of the physical and chemical properties of the atmosphere and climate. However, few studies have been carried out at urban level to investigate the interactions between BVOC emissions and ozone (O3) concentration. The contribution of urban vegetation to the load of BVOCs in the air and the interactions between biogenic emissions and urban pollution, including the likely formation of O3, needs to be investigated, but also the effects of O3 on the biochemical reactions and physiological conditions leading to BVOC emissions are largely unknown. The effect of BVOC emission on the O3 uptake by the trees is further complicating the interactions BVOC-O3, thus making challenging the estimation of the calculation of BVOC effect on O3 concentration at urban level.

California Dept of Public Health. 2009. California Birth Defects Monitoring Program: Heart Defects.

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Capaldi CA, HA Passmore, et al. 2015. Flourishing in nature: A review of the benefits of connecting with nature and its application as a wellbeing intervention. International Journal of Wellbeing, 5(4).

From the increasing number of people living in urban areas to the continued degradation of the natural environment, many of us appear to be physically and psychologically disconnected from nature. We consider the theoretical explanations and present evidence for why this state of affairs might result in suboptimal levels of hedonic and eudaimonic wellbeing by reviewing the large body of research on the mental health benefits of connecting with nature. The advantages of contact with nature as a potential wellbeing intervention are discussed, and examples of how this research is being applied to reconnect individuals to nature and improve wellbeing are given. We conclude by considering the limitations of, and proposing future directions for, research in this area. Overall, evidence suggests that connecting with nature is one path to flourishing in life.

Carrus G, M Scopelliti, et al. 2015. Go greener, feel better? The positive effects of biodiversity on the well-being of individuals visiting urban and peri-urban green areas. Landscape and Urban Planning, 134: 221-8.

The literature on human experience in green environments had widely showed the positive outcomes of getting in contact with nature. This study addresses the issue of whether urban residents' evaluations of urban and peri-urban natural settings and the positive outcomes deriving from contact with such settings vary as a function of their biodiversity. A field study assessed benefits and subjective well-being reported by urban residents visiting four different typologies of green spaces, selected on the basis of urban forestry expert criteria according to a 2 by 2 factorial design. The biodiversity level (low vs. high) was crossed with the setting location (urban vs. peri-urban) as follows: urban squares with green elements, urban parks, pinewood forest plantations, and peri-urban natural protected areas. A questionnaire including measures of length and frequency of visits, perceived restorativeness, and self-reported benefits of the visit to the green spaces was administered in situ to 569 residents of four Italian medium-to-large size cities: Bari, Florence, Rome and Padua. Results showed the positive role of biodiversity upon perceived restorative properties and self-reported benefits for urban and peri-urban green spaces. Consistently with the hypotheses reported herein, a mediation role of perceived restorativeness in the relation between experience of natural settings (i.e. higher level of biodiversity) and self-reported benefits was found. The design and management implications of the findings are discussed.

Carter, R III, SN Cheuvront, et al. 2005. Epidemiology of hospitalizations and deaths from heat illness in soldiers. Medicine & Science in Sports & Exercise 37(8): 1338-44.

Purpose: Serious heat illness has received considerable recent attention due to catastrophic heat waves in the United States and Europe, the deaths of high-profile athletes, and military deployments.

Methods: This study documents heat illness hospitalizations and deaths for the U.S. Army from 1980 through 2002. Hospitalization data were obtained from the Total Army Injury Health Outcomes Database (TAIHOD) coded according to the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). North Atlantic Treaty Organization Standardization Agreement codes were searched for heat injuries in an effort to detect cases that were not found during the ICD-9-CM search.

Results: Five-thousand two-hundred forty-six soldiers were hospitalized, and 37 died due to heat illness. Our results indicate: 1) approximately 60% reduction in hospitalization rates (fewer heat exhaustion cases) over the 22-yr period; 2) fivefold increase in heat stroke hospitalization rates (1.8 per 100,000 in 1980 to 14.5 per 100,000 in 2001); 3) heat stroke cases were associated with dehydration (17%), rhabdomyolysis (25%), and acute renal failure (13%); 4) lower hospitalizations rates among African and Hispanic Americans compared with Caucasians (incidence density ratio, 0.76 [95% confidence interval, 0.71-0.82]; 5) greater rates of hospitalizations and heat strokes among recruits from northern than southern states (incidence density ratio, 1.69 [95% confidence interval, 1.42-1.90]; and 6) greater rates of hospitalizations and heat strokes among women than men (incidence density ratio, 1.18 [95% confidence interval, 1.09-1.27]).

Conclusions: Exertional heat illness continues to be a military problem during training and operations. Whereas the hospitalization rate of heat illness is declining, heat stroke has markedly increased.

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Cervinka R, K Roderer, et al. 2012. Are nature lovers happy? On various indicators of well-being and connectedness with nature. Journal of Health Psychology 17(3): 379-388.

Connectedness with nature (CN) is seen as a personal disposition relevant for environmental as well as human health. In five questionnaire studies (N = 547) we systematically investigated the relationship between various operationalizations of well-being and CN. CN was assessed with two different tools in parallel. All significant correlations were controlled for the effects of age and gender. Psychological well-being, meaningfulness and vitality were found to be robustly correlated with CN. We highlight the relevance of CN with respect to human health and further discuss conceptual differences unraveled by the concurrent application of two CN-tools.

Chang CR and MH Li. 2014. Effects of urban parks on the local urban thermal environment. Urban Forestry & Urban Greening, 13(4): 672-81.

Air temperatures in and outside of 60 parks in Taipei city were surveyed to study the effect of different urban parks on their surrounding thermal gradients. Results suggest that the factors governing the temperature of park surroundings are not identical to those of park interiors. Air-temperature gradients surrounding urban parks are influenced by both the horizontal transport of cool or warm air mass above parks and the evapotranspirative air-parcels from trees, creating a cool island larger than the boundaries of cool-island parks, a heat-island larger than the boundaries of strong heat-island parks, and a cool-ring outside weak heat-island parks. Such horizontal air movement is not easily detected using remotely sensed data. During daytime, the thermal environment within a park is dominated by the amount of solar input absorbed by unshaded paved area, which, when strong, can overflow to increase the temperatures of park surroundings; at night, despite park trees causing a warming effect inside parks, park surroundings are cooled by horizontal flow of evapotranspirative air-parcels from park trees. In business and other districts used mostly during daytime, it is recommended that parks and other open spaces be designed with less than 50% paved area and at least 30% trees, shrubs, and other shadings. In residential districts that are used mostly during nighttime, parks and other open spaces are recommended to be designed with more trees. Night irrigation, a measure commonly recommended for the conservation of water, is also recommended to further enhance this nighttime cooling.

Charalampopoulos I, I Tsiros, et al. 2013. Analysis of thermal bioclimate in various urban configurations in Athens, Greece. Urban Ecosystems 2012(16): 217-233.

The present study deals with human thermal comfort, as it is quantified by two well-known human biometeorological indices, Physiologically Equivalent Temperature (PET) and Humidex, in selected urban areas with different tree and building structures. The study took place during July 2003, at Agricultural University of Athens, Greece. Meteorological and environmental measurements were carried out at six sites. The selected sites differ in regard to sky view factor (SVF) values, environmental configuration and green (vegetation) coverage. The results of this study indicate a striking influence of site configuration on human thermal comfort. For example, in an outdoor lawn area surrounded by trees (green atrium) the PET was greater than 41 °C (human perception of "very hot") for 13% of the measurement time, while in an open building atrium (courtyard) PET was greater than 41 °C for 28 % of the time. In addition, 'comfortable' conditions as PET quantifies formed during 26% of the measurement time in green atrium but less than 15% of the time in the building atrium. Especially during daytime the difference between these two sites reached 8.7 °C according to the PET and 4.3 °C according to the Humidex. At sites with low SVF values and dense green coverage the human biometeorological conditions were improved compared to sites with high SVF values and those with buildings nearby. Significant relationships between SVF and biometeorological indices classes were indicated. The PET index better represented human comfort than Humidex.

Chawla L, K Keena, et al. 2014. Green schoolyards as havens from stress and resources for resilience in childhood and adolescence. Health & place, 28: 1-3.

This paper investigates how green schoolyards can reduce stress and promote protective factors for resilience in students. It documents student responses to green schoolyards in Maryland and Colorado in the United States under three conditions: young elementary school children's play in wooded areas during recess; older elementary school children's use of a naturalized habitat for science and writing lessons; and high school students' involvement in gardening. Drawing on ethnographic observations and interviews, it describes how the natural areas enabled students to escape stress, focus, build competence, and form supportive social groups. These findings have implications for theories of resilience and restoration and school interventions for stress management.

Chawla L. 2015. Benefits of nature contact for children. Journal of Planning Literature, 30(4): 433-52.

This review examines different ways that contact with nature can contribute to the health and well-being of children. Applying the capabilities approach to human development for a broad definition of well-being, it traces research from the 1970s to the present, following shifting research approaches that investigate different dimensions of health. A compelling body of evidence exists that trees and natural areas are essential elements of healthy communities for children. They need to be integrated at multiple scales, from landscaping around homes, schools, and childcare centers, to linked systems of urban trails, greenways, parks, and "rough ground" for children's creative play.

Chen A, XA Yao, et al. 2014. Effect of urban green patterns on surface urban cool islands and its seasonal variations. Urban Forestry & Urban Greening, 13(4): 646-54.

Urban green spaces often form urban cool islands (UCIs), which are important for human health and urban sustainability. Previous studies have emphasized the cooling effects of urban green spaces on their surrounding areas at landscape level. Less attention, however, has been directed to effects of urban green space patterns on their own UCIs at patch level. In this study, we focused on the effects of spatial patterns of urban green patches on their own surface UCIs. The urban green spaces of Beijing, China, were extracted from one QuickBird image and were classified as Trees, Shrubs, Grass, Crops, River and Lake. Land surface temperatures (LSTs) were derived from four Landsat images, each in one season. The UCI was represented by the minimum LST of each urban green patch. Results showed spatial patterns of urban green patches had significant effects on their UCIs in four seasons. In detail, the size, edge and connectivity of urban green spaces all affected the UCIs negatively, and the influence was stronger in warm seasons. Shape of urban green space also had effects on UCIs, but the effects were stronger in cool seasons. Great differences were found between predictive values of metrics for different green types. Shape metrics were more important for indicating UCIs of River, Trees and Crops than were patch size and connectivity. However, patch size and connectivity metrics were more effective in determining UCIs of Shrubs, Grass and Lake than were shape metrics. Further, among shape metrics, only shape index was a good indicator of UCIs. The results of this study suggest that a combination of specific urban green types and pattern metrics are a prerequisite for analyzing the influence of urban green patterns on UCIs and for urban green design.

Chen R, T Li, et al. 2014. Extreme temperatures and out-of-hospital coronary deaths in six large Chinese cities. Journal of epidemiology and community health, jech-2014

Background The seasonal trend of out-of-hospital coronary death (OHCD) and sudden cardiac death has been observed, but whether extreme temperature serves as a risk factor is rarely investigated. We therefore aimed to evaluate the impact of extreme temperatures on OHCDs in China. We obtained death records of 126,925 OHCDs from six large Chinese cities (Harbin, Beijing, Tianjin, Nanjing, Shanghai and Guangzhou) during the period 2009-2011.

Methods The short-term associations between extreme temperature and OHCDs were analysed with time-series methods in each city, using generalised additive Poisson regression models. We specified distributed lag non-linear models in studying the delayed effects of extreme temperature. We then applied Bayesian hierarchical models to combine the city-specific effect estimates.

Results The associations between extreme temperature and OHCDs were almost U-shaped or J-shaped. The pooled relative risks (RRs) of extreme cold temperatures over the lags 0-14 days comparing the 1st and 25th centile temperatures were 1.49 (95% posterior interval (PI) 1.26-1.76); the pooled RRs of extreme hot temperatures comparing the 99th and 75th centile temperatures were 1.53 (95% PI 1.27-1.84) for OHCDs. The RRs of extreme temperature on OHCD were higher if the patients with coronary heart disease were old, male and less educated.

Conclusions This multicity epidemiological study suggested that both extreme cold and hot temperatures posed significant risks on OHCDs, and might have important public health implications for the prevention of OHCD or sudden cardiac death.

Chiesura A. 2004. The role of urban parks for the sustainable city. Landscape and Urban Planning 68(1): 129-138.

International efforts to preserve the natural environment are mainly concerned with large, bio-diverse and relatively untouched ecosystems or with individual animal or vegetal species, either endangered or threatened with extinction. Much less attention is being paid to that type of nature close to where people live and work, to small-scale green areas in cities and to their benefits to people. Increasing empirical evidence, however, indicates that the presence of natural areas contributes to the quality of life in many ways. Besides many environmental and ecological services, urban nature provides important social and psychological benefits to human societies, which enrich human life with meanings and emotions. The main concern of this paper is to address the importance of urban nature for citizens' well being and for the sustainability of the city they inhabit. Some results of a survey conducted among visitors of an urban park in Amsterdam (The Netherlands) are presented and discussed. The issues investigated concern people's motives for urban nature, the emotional dimension involved in the experience of nature and its importance for people's general well being. Results confirm that the experience of nature in urban environment is source of positive feelings and beneficial services, which fulfill important immaterial and non-consumptive human needs. Implications for the sustainability of the city will be analyzed and discussed.

Chin MT. 2015. Basic mechanisms for adverse cardiovascular events associated with air pollution. Heart, 101(4): 253-6.

Air pollution is a significant cause of cardiovascular morbidity and mortality worldwide. Although the epidemiologic association between air pollution exposures and exacerbation of cardiovascular disease (CVD) is well established, the mechanisms by which these exposures promote CVD are incompletely understood. This review provides an overview of the components of air pollution, an overview of the cardiovascular effects of air pollution exposure, and a review of the basic mechanisms that are activated by exposure to promote CVD.

Chirino, E, A Bonet, J Bellot, and JR Sánchez. 2006. Effects of 30-year-old Aleppo pine plantations on runoff, soil erosion, and plant diversity in a semi-arid landscape in south eastern Spain, CATENA 65(1): 19-29.

Forest management policies in Mediterranean areas have traditionally encouraged land cover changes, with the establishment of tree cover (Aleppo pine) in natural or degraded ecosystems for soil conservation purposes: to reduce soil erosion and to increase the vegetation structure. In order to evaluate the usefulness of these management policies on reduced erosion in semi-arid landscapes, we compared 5 vegetation cover types (bare soil, dry grassland, shrublands, afforested dry grasslands and afforested thorn shrublands), monitored in 15 hydrological plots (8 × 2 m), in the Ventós catchment (Alicante, SE Spain), over 4 years (1996 to 1999). Each cover type represented a different dominant patch of the vegetation mosaic on the north-facing slopes of this catchment. The results showed that runoff coefficients of vegetated plots were less than 1% of the precipitation volume; whereas runoff in denuded areas was nearly 4%. Soil losses in vegetation plots averaged 0.04 Mg ha- 1 year- 1 and increased 40-fold in open-land plots. The evaluation of these forest management policies, in contrast with the natural vegetation communities, suggests that: (1) thorn shrublands and dry grassland communities with vegetation cover could control runoff and sediment yield as effectively as Aleppo pine afforestation in these communities, and (2) afforestation with a pine stratum improved the stand's vertical structure resulting in pluri-stratified communities, but reduced the species richness and plant diversity in the understorey of the plantations.

Chiu H-F, S-S Tsai, et al. 2007. Nitrate in drinking water and risk of death from bladder cancer: An ecological case-control study in Taiwan. Journal of Toxicology and Environmental Health, Part A: Current Issues 70(12): 1000 - 1004.

The relationship between nitrate levels in drinking water and bladder cancer development is controversial. A matched cancer case-control with nitrate ecology study was used to investigate the association between bladder cancer mortality occurrence and nitrate exposure from Taiwan drinking water. All bladder cancer deaths of Taiwan residents from 1999 through 2003 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on nitrate-nitrogen (NO3-N) levels in drinking water throughout Taiwan were collected from Taiwan Water Supply Corporation (TWSC). The municipality of residence for cancer cases and controls was assumed to be the source of the subject's nitrate exposure via drinking water. The adjusted odds ratios for bladder cancer death for those with high nitrate levels in their drinking water were 1.76 (1.28-2.42) and 1.96 (1.41-2.72) as compared to the lowest tertile. The results of the present study show that there was a significant positive relationship between the levels of nitrate in drinking water and risk of death from bladder cancer.

Chong S, E Lobb, et al. 2013. Neighbourhood safety and area deprivation modify the associations between parkland and psychological distress in Sydney, Australia. BMC Public Health 13(422): 1-8.

Background: The aim of this study was to investigate how perceived neighbourhood safety and area deprivation influenced the relationship between parklands and mental health.

Methods: Information about psychological distress, perceptions of safety, demographic and socio-economic background at the individual level was extracted from New South Wales Population Health Survey. The proportion of a postcode that was parkland was used as a proxy measure for access to parklands and was calculated for each individual. Generalized Estimating Equations logistic regression analyses were performed to account for correlation between participants within postcodes, and with controls for socio-demographic characteristics and socioeconomic status at the area level.

Results: In areas where the residents reported perceiving their neighbourhood to be "safe" and controlling for area levels of socio-economic deprivation, there were no statistically significant associations between the proportion of parkland and high or very high psychological distress. In the most disadvantaged neighbourhoods which were perceived as unsafe by residents, those with greater proportions of parkland, over 20%, there was greater psychological distress, this association was statistically significant (20-40% parkland: OR=2.27, 95% CI, CI=1.45-3.55; >40% parkland: OR=2.53, 95% CI=1.53-4.19).

Conclusion: Our study indicates that perceptions of neighbourhood safety and area deprivation were statistically significant effect modifiers of the association between parkland and psychological distress.

Chow, WT, D Brennan, and AJ Brazel. 2012. Urban Heat Island Research in Phoenix, Arizona: Theoretical Contributions and Policy Applications. American Meteorological Society, 93: 517-530.

Over the past 60 years, metropolitan Phoenix, Arizona, has been among the fastest-growing urban areas in the United States, and this rapid urbanization has resulted in an urban heat island (UHI) of substantial size and intensity. During this time, an uncommon amount of UHI-specific research, relative to other cities in North America, occurred within its boundaries. This review investigates the possible reasons and motivations underpinning the large body of work, as well as summarizing specific themes, approaches, and theoretical contributions arising from such study. It is argued that several factors intrinsic to Phoenix were responsible for the prodigious output: strong applied urban climate research partnerships between several agencies (such as the academy, the National Weather Service, private energy firms, and municipal governments); a high-quality, long-standing network of urban meteorological stations allowing for relatively fine spatial resolution of near-surface temperature data; and a high level of public and media interest in the UHI. Three major research themes can be discerned: 1) theoretical contributions from documenting, modeling, and analyzing the physical characteristics of the UHI; 2) interdisciplinary investigation into its biophysical and social consequences; and 3) assessment and evaluation of several UHI mitigation techniques. Also examined herein is the successful implementation of sustainable urban climate policies within the metropolitan area. The authors note the importance of understanding and applying local research results during the policy formation process.

Christen B and T Dalgaard. 2013. Buffers for biomass production in temperate European agriculture: A review and synthesis on function, ecosystem services and implementation. Biomass and Bioenergy 2013(55): 53-67.

Buffer strips on agricultural land have been shown to protect surface water quality by reducing erosion and diffuse pollution. They can also play a key role in nature conservation and flood risk mitigation as well as in the design of bioenergy landscapes resilient to changes in climate, environmental pressures from intensive agriculture and policy developments. Use of conservation buffers by farmers outside of designated schemes is limited to date, but the increasing demand for bioenergy and the combination of agricultural production with conservation calls for a much wider implementation. This paper reviews the biophysical knowledge on buffer functioning and associated ecosystem services. It describes how a three-zone buffer design, with arable fields buffered in combination by grassland, short rotation forestry (SRF) or coppice (SRC) and undisturbed vegetation along water courses, can be incorporated into farming landscapes as productive conservation elements and reflects on the potential for successful implementation. Land use plays a much greater role in determining catchment hydrology than soil type: shelterbelts or buffer strips have markedly higher infiltration capacity than arable or pasture land. Root architecture of trees, shrubs and herbaceous plants differs between species and is important for the extent of hydrological changes after establishment. Riparian buffers retain 30-99% of nitrate N and 20-100% of phosphorus from runoff and shallow groundwater. Buffers are also highly effective for pesticide removal and farmland biodiversity conservation with a high potential for low-input fuel, feed, or fibre production. Landscape amenities, sporting opportunities, and a display of land stewardship are additional benefits.

Christian H, SR Zubrick, et al. 2015. The influence of the neighborhood physical environment on early child health and development: A review and call for research. Health & place, 33: 25-36.

This review examines evidence of the association between the neighborhood built environment, green spaces and outdoor home area, and early (0-7 years) child health and development. There was evidence that the presence of child relevant neighborhood destinations and services were positively associated with early child development domains of physical health and wellbeing and social competence. Parents' perceptions of neighborhood safety were positively associated with children's social-emotional development and general health. Population representative studies using objective measures of the built environment and valid measures of early child development are warranted to understand the impact of the built environment on early child health and development.

Clatworthy JH, C Joe, PM Camic. 2013. Gardening as a mental health intervention: a review. Mental Health Review Journal 18(4): 214-225.

Purpose: The number of gardening-based mental health interventions is increasing, yet when the literature was last reviewed in 2003, limited evidence of their effectiveness was identified. The purpose of this paper is to evaluate the current evidence-base for gardening-based mental health interventions and projects through examining their reported benefits and the quality of research in this field.

Design/methodology/approach: Studies evaluating the benefits of gardening-based interventions for adults experiencing mental health difficulties were identified through an electronic database search. Information on the content and theoretical foundations of the interventions, the identified benefits of the interventions and the study methodology was extracted and synthesised.

Findings: Ten papers published since 2003 met the inclusion criteria. All reported positive effects of gardening as a mental health intervention for service users, including reduced symptoms of depression and anxiety. Participants described a range of benefits across emotional, social, vocational, physical and spiritual domains. Overall the research was of a considerably higher quality than that reviewed in 2003, providing more convincing evidence in support of gardening-based interventions. However, none of the studies employed a randomised-controlled trial design.

Research limitations/implications: There is a need for further high-quality research in this field. It is important that adequate outcome measures are in place to evaluate existing gardening-based mental health interventions/projects effectively.

Originality/value: This paper provides an up-to-date critique of the evidence for gardening-based mental health interventions, highlighting their potential clinical value.

Coe DP, IJ Flynn, et al. 2014. Children's physical activity levels and utilization of a traditional versus natural playground. Children Youth and Environments, 24(3): 1-5.

The purpose of this study was to determine differences in sedentary behaviors and moderate-to-vigorous physical activity (MVPA) levels and playground utilization of young children before and after renovating a traditional playground to incorporate more natural elements. After initial assessments, the traditional playground was converted to a natural playground. Both playgrounds consisted of a covered porch and a play area. A significantly greater proportion of children engaged in MVPA on the playground after the renovation. The average number of children using the covered porch decreased and increased for the play area. These results suggest that the use of natural playgrounds may be a way to increase MVPA in children.

Cohen D A, J S Ashwood, et al. 2006. Public Parks and Physical Activity Among Adolescent Girls. Pediatrics 118(5): e1381-e1389.

OBJECTIVES. Physical activity may be constrained or facilitated by local environments. The availability of neighborhood facilities for physical activity may be particularly relevant for youth, who are unable to drive and whose activity is often limited to the immediate distance they are able to walk or bicycle. Several studies have shown that proximity to recreational facilities and parks is one of the most important predictors of physical activity. Because the United States already has an extensive infrastructure of parks, with 70% of adults indicating that they live within walking distance of a park or playground, parks may be a potential venue for increasing physical activity. This might be particularly important for adolescent girls, whose physical activity levels decline substantially as they go through puberty. The goal of this study was to examine the association between park proximity, park type, and park features and physical activity in adolescent girls.

PATIENTS AND METHODS. This was a cross-sectional study using baseline data from the Trial of Activity for Adolescent Girls. It included 1556 grade 6 girls who were randomly selected from 6 middle schools in each of the following 6 field site areas: Washington, DC, and Baltimore, Maryland; Columbia, South Carolina; Minneapolis, Minnesota; New Orleans, Louisiana; Tucson, Arizona; and San Diego, California. Girls wore accelerometers for 6 days to measure metabolic equivalent-weighted moderate-to-vigorous physical activity, a measure accounting for the volume and intensity of activity. Metabolic equivalent-weighted moderate-to-vigorous physical activity was calculated for the hours outside of school time using 2 different cutpoints, activity levels greater than or equal to 3.0 metabolic equivalents and greater than or equal to 4.6 metabolic equivalents, the latter indicating activity at the intensity of a brisk walk or higher. We mapped all of the parks within 1 mile of each girl's home. Trained staff used a checklist to document the presence of facilities and amenities at each park, including passive amenities, such as drinking fountains, restrooms, and areas with shade, as well as active amenities like basketball courts, multipurpose fields, playgrounds, and tennis courts.

RESULTS. Mean nonschool metabolic equivalent-weighted moderate/vigorous physical activity, using the 4.6 metabolic equivalent cutoff, was 611.1 minutes (range: 49.7-4718.6 metabolic equivalent minutes per 6 days) and 1704.8 metabolic equivalent minutes per 6 days (range: 276.2-5792.6 metabolic equivalent minutes per 6 days) when using the 3.0 metabolic equivalent cutpoint. Many girls had multiple parks within a 1-mile radius of their homes: 57% had greater than or equal to 1 type of park, the majority being neighborhood or community parks; 42% had between 1 and 3 parks, 37% had greater than or equal to 4 parks, and 14% had greater than or equal to 8 parks. The type, number, and specific parks features were associated with girls' nonschool metabolic equivalent-weighted moderate/vigorous physical activity. At the 4.6 metabolic equivalent cutpoint, higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity were associated with both neighborhood and community parks (22 metabolic equivalent minutes) and miniparks (40 metabolic equivalent minutes). Each park, regardless of type, in the half-mile around each girl's home was associated with an increase in nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 2.8% or 17.2 nonschool minutes of metabolic equivalent-weighted moderate/vigorous physical activity per 6 days. Beyond a half-mile, each park increased nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 1.1% or 6.7 metabolic equivalent minutes per 6 days. For the average girl with 3.5 parks within a 1-mile radius of home, the presence of parks accounted for 36.5 extra nonschool metabolic equivalent minutes per 6 days, approximately 6% of total nonschool metabolic equivalent-weighted moderate/vigorous physical activity. Using the 3.0 metabolic equivalent cutpoint, this sums to an additional 68 metabolic equiva ent minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity over 6 days, or 4% of the total. The most common amenities in the parks were playgrounds, multipurpose fields, and picnic areas. Slightly more than one third of girls lived within a half-mile of a park with a basketball court, and < 20% had access to walking paths and tennis courts in their local park. Higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity per 6 days were associated with walking paths (13 metabolic equivalent minutes), running tracks (82 metabolic equivalent minutes), playgrounds (28 metabolic equivalent minutes), and basketball courts (30 metabolic equivalent minutes). Parks with streetlights and floodlights were also associated with an increase of 18 and 22 minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity, respectively. With the 3.0 metabolic equivalent cutoff for metabolic equivalent-weighted moderate/vigorous physical activity, additional nonschool metabolic equivalent minutes more than doubled when girls had miniparks (92 metabolic equivalent minutes), natural resource areas (36 metabolic equivalent minutes), walking paths (59 metabolic equivalent minutes), and running tracks (208 metabolic equivalent minutes) within a half-mile of their homes. Skateboard areas and special-use parks were negatively associated with nonschool metabolic equivalent-weighted moderate/vigorous physical activity in adolescent girls.

CONCLUSIONS. Adolescent girls who live near more parks, particularly near those with amenities that are conducive to walking and with active features, engage in more nonschool metabolic equivalent-weighted moderate/vigorous physical activity than those with fewer parks. Whether this is because of actual use of the parks or neighborhood choice could not be determined. Although the magnitude of the association between parks and additional minutes of metabolic equivalent-weighted moderate/vigorous physical activity was small for an individual, amounting to an average of 4%-6% of a girl's total nonschool metabolic equivalent-weighted moderate/vigorous physical activity, it is likely to have a large population-level association. Because of the potential population level impact, the use of parks to promote physical activity should be further studied.

Cohen P, O Potchter, I Schnell. 2014. The impact of an urban park on air pollution and noise levels in the Mediterranean city of Tel-Aviv, Israel. Environmental Pollution, 195: 73-83.

This study examines the influence of urban parks on air quality and noise in the city of Tel-Aviv, Israel, by investigation of an urban park, an urban square and a street canyon. Simultaneous monitoring of several air pollutants and noise levels were conducted. The results showed that urban parks can reduce NOx, CO and PM10 and increase O3 concentrations and that park's mitigation effect is greater at higher NOx and PM10 levels. During extreme events, mean values of 413ppb NOx and 80 micro-G/m3 PM10 were measured in the street while mean values of 89ppb NOx and 24 micro-G/m3 PM10 were measured in the park. Whereas summer highest O3 values of 84ppb were measured in the street, 94ppb were measured in the park. The benefit of the urban park in reducing NOx and PM10 concentrations is more significant than the disadvantage of increased O3 levels. Furthermore, urban parks can reduce noise by about 5 dB(A).

Cohen-Cline H, E Turkheimer, & GE Duncan. 2015. Access to green space, physical activity and mental health: a twin study. Journal of epidemiology and community health, 69(6): 523-9.

Background Increasing global urbanisation has resulted in a greater proportion of the world's population becoming exposed to risk factors unique to urban areas, and understanding these effects on public health is essential. The aim of this study was to examine the association between access to green space and mental health among adult twin pairs.

Methods We used a multilevel random intercept model of same-sex twin pairs (4338 individuals) from the community-based University of Washington Twin Registry to analyse the association between access to green space, as measured by the Normalised Difference Vegetation Index and self-reported depression, stress, and anxiety. The main parameter of interest was the within-pair effect for identical (monozygotic, MZ) twins because it was not subject to confounding by genetic or shared childhood environment factors. Models were adjusted for income, physical activity, neighbourhood deprivation and population density.

Results When treating twins as individuals and not as members of a twin pair, green space was significantly inversely associated with each mental health outcome. The association with depression remained significant in the within-pair MZ univariate and adjusted models; however, there was no within-pair MZ effect for stress or anxiety among the models adjusted for income and physical activity.

Conclusions These results suggest that greater access to green space is associated with less depression, but provide less evidence for effects on stress or anxiety. Understanding the mechanisms linking neighbourhood characteristics to mental health has important public health implications. Future studies should combine twin designs and longitudinal data to strengthen causal inference.

Colcombe S and AF Kramer. 2003. Fitness effects on the cognitive function of older adults: A meta-analytic study. Psychological Science 14(2): 125-30.

A meta-analytic study was conducted to examine the hypothesis that aerobic fitness training enhances the cognitive vitality of healthy but sedentary older adults. Eighteen intervention studies published between 1966 and 2001 were entered into the analysis. Several theoretically and practically important results were obtained. Most important, fitness training was found to have robust but selective benefits for cognition, with the largest fitness-induced benefits occurring for executive-control processes. The magnitude of fitness effects on cognition was also moderated by a number of programmatic and methodological factors, including the length of the fitness-training intervention, the type of the intervention, the duration of training sessions, and the gender of the study participants. The results are discussed in terms of recent neuroscientific and psychological data that indicate cognitive and neural plasticity is maintained throughout the life span.

Cole D N and T E Hall. 2010. Experiencing the restorative components of wilderness environments: Does congestion interfere and does length of exposure matter? Environment and Behavior, 42(6): 806-823.

Wilderness should provide opportunities for stress reduction and restoration of mental fatigue. Visitors, surveyed as they exited wilderness trailheads, were asked for self-assessments of stress reduction and mental rejuvenation and the extent to which they experienced various restorative components of the environment-attributes deemed by attention restorative theory to be conducive to restoration. Day and overnight hikers on both very high use and moderate use trails were studied. Most respondents reported substantial stress reduction and mental rejuvenation and most experienced the environment in ways considered conducive to restoration. At the moderate to high use levels we studied, psychological restoration did not vary significantly with level of congestion, suggesting that concern about restorative experiences is not a valid rationale for limiting use on wilderness trails. Day trips reduced stress and allowed for mental rejuvenation to the same degree that overnight trips did. However, several of the restorative components of environment were experienced to a significantly greater degree as length of trip increased.

Cole LW and SR Foster. 2001. From the ground up: Environmental racism and the rise of the environmental justice movement. New York University Press, New York.

No abstract provided.

Coley RL, WC Sullivan, FE Kuo. 1997. Where does community grow? The social context created by nature in urban public housing. Environment and Behavior 29(4): 468-94.

This study examines how the availability of nature influences the use of outdoor public spaces in two Chicago public housing developments. Ninety-six observations were collected of the presence and location of trees and the presence and location of youth and adults in semiprivate spaces at one high-rise and one low-rise public housing development. Results consistentiy indicated that natural landscaping encourages greater use of outdoor areas by residents. Spaces with trees attracted larger groups of people, as well as more mixed groups of youth and adults, than did spaces devoid of nature. In addition, more dense groupings of trees and trees that are located close to public housing buildings attracted larger groups of people. These findings suggest that natural elements such as trees promote increased opportunities for social interactions, monitorng of outdoor areas, and supervision of children in impovershed urban neighborhoods.

Coughenour C, L Coker, & TJ Bungum. 2014. Environmental and social determinants of youth physical activity intensity levels at neighborhood parks in Las Vegas, NV. Journal of community health, 39(6): 1092-6.

Parks can play an important role in youth activity. This study used observational data to evaluate the relationship of environmental and social determinants to youth physical activity intensity levels in Las Vegas neighborhood parks. System for observing play and leisure activity in youth was used to code activity levels as sedentary, walking, or vigorous in five low-income and five high-income parks. Environmental determinants included amenities, incivilities, size, high-speed streets, sidewalk condition, and temperature. Social determinants included percent minority and Hispanic, gender, and income. A multinomial logistic regression model was performed. We observed 1,421 youth, 59% male, 41% female; 21% were sedentary, 38% walking, and 41% vigorous. Males were more likely to be observed walking (OR 1.42) and vigorous (OR 2.21) when compared to sedentary. High-speed streets (OR 0.76), sidewalks condition (OR 0.34), and low-income neighborhoods (OR 0.07) was associated with decreased odds of vigorous activity; incivilities (OR 1.34) and amenities (OR 1.27) were associated with greater odds of being vigorous. Environmental and social determinants are associated with physical activity intensity levels at parks. Stakeholders should ensure quality parks, as they relate to physical activity levels in youth. Understanding environmental and social determinants that influence physical activity at parks is critical to utilizing their full potential in an effort to combat childhood obesity.

Coutts AM, E Daly, et al. 2013. Assessing practical measures to reduce urban heat: Green and cool roofs. Building and Environment, 70: 266-76.

As cities continue to grow and develop under climate change, identifying and assessing practical approaches to mitigate high urban temperatures is critical to help provide thermally comfortable, attractive and sustainable urban environments. Green and cool roofs are commonly reported to provide urban heat mitigation potential; however, their performance is highly dependent upon their design, particularly green roofs that vary in substrate depth, vegetation species, and watering regime. This study compares the insulating properties, the radiation budget and surface energy balance of four experimental rooftops, including a green roof (extensive green roof planted with Sedum) and a cool roof (uninsulated rooftop coated with white elastomeric paint), over the summer of 2011-12 in Melbourne, Australia. For the roof treatments explored here, results suggest that cool roofs, combined with insulation, provide the greatest overall benefit in terms of urban heat mitigation and energy transfer into buildings. The high albedo of the cool roof substantially reduced net radiation, leaving less energy available at the surface for sensible heating during the day. Under warm and sunny conditions, when soil moisture was limited, evapotranspiration from the green roof was low, leading to high sensible heat fluxes during the day. Irrigation improved the performance of the green roof by increasing evapotranspiration. Daytime Bowen ratios decreased from above four during dry conditions, to less than one after irrigation, yet sensible heat fluxes were still higher than for the cool roof. These results demonstrate that rooftops must be designed accordingly to target specific performance objectives, such as heat mitigation.

Currie B and B Bass. 2008. Estimates of air pollution mitigation with green plants and green roofs using the UFORE model. Urban Ecosystems 11(4): 409-422.

The purpose of this study was to investigate the effect of green roofs and green walls on air pollution in urban Toronto. The research looked at the synergistic effects on air pollution mitigation of different combinations of vegetation by manipulating quantities of trees, shrubs, green roofs and green walls in the study area. The effects of these manipulations were simulated with the Urban Forest Effects (UFORE) model developed by the USDA Forest Service Northeastern Regional Station. While UFORE contains several modules, Module-D quantifies the levels of air pollution for contaminants such as NO2 , S02 , CO, PM10 and ozone as well as hourly pollution removal rates and the economic value of pollutant removal. Six vegetation scenarios were developed within the Toronto study area to compare different subsets of vegetation and their effect on air contaminants. Results of the study indicate that grass on roofs (extensive green roofs) could augment the effect of trees and shrubs in air pollution mitigation, placing shrubs on a roof (intensive green roofs) would have a more significant impact. By extension, a 10-20% increase in the surface area for green roofs on downtown buildings would contribute significantly to the social, financial and environmental health of all citizens.


Dadvand P and A de Nazelle. 2012. Surrounding Greenness and Exposure to Air Pollution During Pregnancy: An Analysis of Personal Monitoring Data. Environ Health Perspect 120(9): 1286-1290.

Background: Green spaces are reported to improve health status, including beneficial effects on pregnancy outcomes. Despite the suggestions of air pollution-related health benefits of green spaces, there is no available evidence on the impact of greenness on personal exposure to air pollution.

Objectives: We investigated the association between surrounding greenness and personal exposure to air pollution among pregnant women and to explore the potential mechanisms, if any, behind this association.

Methods: In total, 65 rounds of sampling were carried out for 54 pregnant women who resided in Barcelona during 2008-2009. Each round consisted of a 2-day measurement of particulate matter with aerodynamic diameter < 2.5 micro-m (PM2.5) and a 1-week measurement of nitric oxides collected simultaneously at both the personal and microenvironmental levels. The study participants were also asked to fill out a time-microenvironment-activity diary during the sampling period. We used satellite retrievals to determine the surrounding greenness as the average of Normalized Difference Vegetation Index (NDVI) in a buffer of 100 m around each maternal residential address. We estimated the impact of surrounding greenness on personal exposure levels, home-outdoor and homeindoor pollutant levels, and maternal time-activity.

Results: Higher residential surrounding greenness was associated with lower personal, homeindoor, and home-outdoor PM2.5 levels, and more time spent at home-outdoor.

Conclusions: We found lower levels of personal exposure to air pollution among pregnant women residing in greener areas. This finding may be partly explained by lower home-indoor pollutant levels and more time spent in less polluted home-outdoor environment by pregnant women in greener areas.

Dadvand P, A de Nazelle, et al. 2012. Green space, health inequality and pregnancy. Environment International 40(0): 110-115.

Green spaces have been suggested to improve physical and mental health and well-being by increasing physical activity, reducing air pollution, noise, and ambient temperature, increasing social contacts and relieving psychophysiological stress. Although these mechanisms also suggest potential beneficial effects of green spaces on pregnancy outcomes, to our knowledge there is no available epidemiological evidence on this impact. We investigated the effects of surrounding greenness and proximity to major green spaces on birth weight and gestational age at delivery and described the effect of socioeconomic position (SEP) on these relationships. This study was based on a cohort of births (N = 8246) that occurred in a major university hospital in Barcelona, Spain, during 2001-2005. We determined surrounding greenness from satellite retrievals as the average of Normalized Difference Vegetation Index (NDVI) in a buffer of 100 m around each maternal place of residence. To address proximity to major green spaces, a binary variable was used to indicate whether maternal residential address is situated within a buffer of 500 m from boundaries of a major green space. For each indicator of green exposure, linear regression models were constructed to estimate change in outcomes adjusted for relevant covariates including individual and area level SEP. None of the indicators of green exposure was associated with birth weight and gestational age. After assessing effect modification based on the level of maternal education, we detected an increase in birth weight (grams) among the lowest education level group (N = 164) who had higher surrounding NDVI (Regression coefficient (95% confidence interval (CI) of 436.3 (43.1, 829.5)) or lived close to a major green space (Regression coefficient (95% CI)) of 189.8 (23.9, 355.7)). Our findings suggest a beneficial effect of exposure to green spaces on birth weight only in the lowest SEP group.

Dadvand P, I Rivas, et al. 2015. The association between greenness and traffic-related air pollution at schools. Science of The Total Environment, 523: 59-63.

Greenness has been reported to improve mental and physical health. Reduction in exposure to air pollution has been suggested to underlie the health benefits of greenness; however, the available evidence on the mitigating effect of greenness on air pollution remains limited and inconsistent. We investigated the association between greenness within and surrounding school boundaries and monitored indoor and outdoor levels of traffic-related air pollutants (TRAPs) including NO2, ultrafine particles, black carbon, and traffic-related PM2.5 at 39 schools across Barcelona, Spain, in 2012. TRAP levels at schools were measured twice during two one-week campaigns separated by 6 months. Greenness within and surrounding school boundaries was measured as the average of satellite-derived normalized difference vegetation index (NDVI) within boundaries of school and a 50 m buffer around the school, respectively. Mixed effects models were used to quantify the associations between school greenness and TRAP levels, adjusted for relevant covariates. Higher greenness within and surrounding school boundaries was consistently associated with lower indoor and outdoor TRAP levels. Reduction in indoor TRAP levels was partly mediated by the reduction in outdoor TRAP levels. We also observed some suggestions for stronger associations between school surrounding greenness and outdoor TRAP levels for schools with higher number of trees around them. Our observed reduction of TRAP levels at schools associated with school greenness can be of public importance, considering the burden of health effects of exposure to TRAPs in schoolchildren.

Dadvand P, J Sunyer, et al. 2012. Surrounding Greenness and Pregnancy Outcomes in Four Spanish Birth Cohorts. Environ Health Perspect 120 (10): 1481-1487.

Background: Green spaces have been associated with improved physical and mental health; however, the available evidence on the impact of green spaces on pregnancy is scarce.

Objectives: We investigated the association between surrounding greenness and birth weight, head circumference, and gestational age at delivery.

Methods: This study was based on 2,393 singleton live births from four Spanish birth cohorts (Asturias, Gipuzkoa, Sabadell, and Valencia) located in two regions of the Iberian Peninsula with distinct climates and vegetation patterns (2003-2008). We defined surrounding greenness as average of satellite-based Normalized Difference Vegetation Index (NDVI) (Landsat 4-5 TM data at 30 m x 30 m resolution) during 2007 in buffers of 100 m, 250 m, and 500 m around each maternal place of residence. Separate linear mixed models with adjustment for potential confounders and a random cohort effect were used to estimate the change in birth weight, head circumference, and gestational age for 1-interquartile range increase in surrounding greenness.

Results: Higher surrounding greenness was associated with increases in birth weight and head circumference [adjusted regression coefficients (95% confidence interval) of 44.2 g (20.2 g, 68.2 g) and 1.7 mm (0.5 mm, 2.9 mm) for an interquartile range increase in average NDVI within a 500-m buffer] but not gestational age. These findings were robust against the choice of the buffer size and the season of data acquisition for surrounding greenness, and when the analysis was limited to term births. Stratified analyses indicated stronger associations among children of mothers with lower education, suggesting greater benefits from surrounding greenness.

Conclusions: Our findings suggest a beneficial impact of surrounding greenness on measures of fetal growth but not pregnancy length.

Dadvand P, J Wright, et al. 2014. Inequality, green spaces, and pregnant women: roles of ethnicity and individual and neighbourhood socioeconomic status. Environment international, 71: 101-8.

Evidence of the impact of green spaces on pregnancy outcomes is limited with no report on how this impact might vary by ethnicity. We investigated the association between residential surrounding greenness and proximity to green spaces and birth weight and explored the modification of this association by ethnicity and indicators of individual (maternal education) and neighbourhood (Index of Multiple Deprivation) socioeconomic status. Our study was based on 10,780 singleton live-births from the Born in Bradford cohort, UK (2007-2010). We defined residential surrounding greenness as average of satellite-based Normalized Difference Vegetation Index (NDVI) in buffers of 50m, 100m, 250m, 500m and 1000m around each maternal home address. Residential proximity to green spaces was defined as living within 300m of a green space with an area of greater than or equal to 5000m2. We utilized mixed effects models to estimate adjusted change in birth weight associated with residential surrounding greenness as well as proximity to green spaces. We found a positive association between birth weight and residential surrounding greenness. Furthermore, we observed an interaction between ethnicity and residential surrounding greenness in that for White British participants there was a positive association between birth weight and residential surrounding greenness whereas for participants of Pakistani origin there was no such an association. For surrounding greenness in larger buffers (500m and 1000m) there were some indications of stronger associations for participants with lower education and those living in more deprived neighbourhoods which were not replicated for surrounding greenness in smaller buffer sizes (i.e. 50m, 100m, and 250m). The findings for residential proximity to a green space were not conclusive. Our study showed that residential surrounding greenness is associated with better foetal growth and this association could vary between different ethnic and socioeconomic groups.

Dadvand P, MJ Nieuwenhuijsen, et al. 2015. Green spaces and cognitive development in primary schoolchildren. Proceedings of the National Academy of Sciences, 112(26): 7937-42.

Exposure to green space has been associated with better physical and mental health. Although this exposure could also influence cognitive development in children, available epidemiological evidence on such an impact is scarce. This study aimed to assess the association between exposure to green space and measures of cognitive development in primary schoolchildren. This study was based on 2,593 schoolchildren in the second to fourth grades (7-10 y) of 36 primary schools in Barcelona, Spain (2012-2013). Cognitive development was assessed as 12-mo change in developmental trajectory of working memory, superior working memory, and inattentiveness by using four repeated (every 3 mo) computerized cognitive tests for each outcome. We assessed exposure to green space by characterizing outdoor surrounding greenness at home and school and during commuting by using high-resolution (5 m by 5 m) satellite data on greenness (normalized difference vegetation index). Multilevel modeling was used to estimate the associations between green spaces and cognitive development. We observed an enhanced 12-mo progress in working memory and superior working memory and a greater 12-mo reduction in inattentiveness associated with greenness within and surrounding school boundaries and with total surrounding greenness index (including greenness surrounding home, commuting route, and school). Adding a traffic-related air pollutant (elemental carbon) to models explained 20-65% of our estimated associations between school greenness and 12-mo cognitive development. Our study showed a beneficial association between exposure to green space and cognitive development among schoolchildren that was partly mediated by reduction in exposure to air pollution.

Dadvand P, Villanueva CM, Font-Ribera L, et al. 2014. Risks and benefits of green spaces for children: A cross-sectional study of associations with sedentary behavior, obesity, Asthma, and Allergy. Environmental Health Perspectives 122:1329-1335.

Background: Green spaces have been associated with both health benefits and risks in children; however, available evidence simultaneously investigating these conflicting influences, especially in association with different types of greenness, is scarce.

Objectives: We aimed to simultaneously evaluate health benefits and risks associated with different types of greenness in children, in terms of sedentary behavior (represented by excessive screen time), obesity, current asthma, and allergic rhinoconjunctivitis.

Methods: We conducted a cross-sectional study of a population-based sample of 3,178 schoolchildren (9-12 years old) in Sabadell, Spain, in 2006. Information on outcomes and covariates was obtained by questionnaire. We measured residential surrounding greenness as the average of satellite-derived Normalized Difference Vegetation Index (NDVI) in buffers of 100 m, 250 m, 500 m, and 1,000 m around each home address. Residential proximity to green spaces was defined as living within 300 m of a forest or a park, as separate variables. We used logistic regression models to estimate associations separately for each exposure-outcome pair, adjusted for relevant covariates.

Results: An interquartile range increase in residential surrounding greenness was associated with 11-19% lower relative prevalence of overweight/obesity and excessive screen time, but was not associated with current asthma and allergic rhinoconjunctivitis. Similarly, residential proximity to forests was associated with 39% and 25% lower relative prevalence of excessive screen time and overweight/obesity, respectively, but was not associated with current asthma. In contrast, living close to parks was associated with a 60% higher relative prevalence of current asthma, but had only weak negative associations with obesity/overweight or excessive screen time.

Conclusion: We observed two separable patterns of estimated health benefits and risks associated with different types of greenness.

Dales RE, Cakmak C, Judek S, et al. 2008. Tree Pollen and Hospitalization for Asthma in Urban Canada. Int Arch Allergy Immunol 146: 241-247.

Background: Allergy to tree pollen is common and aeroallergens have been associated with severe asthma exacerbations in the community setting. To determine the impact of different trees on asthma, we tested the association between daily hospitalizations for asthma and daily concentrations of different tree pollens in 10 large Canadian cities.

Methods: Daily time-series analyses were employed to remove unwanted temporal trends. For each family or genus, results were adjusted for day of the week, temperature, barometric pressure and relative humidity. Results were expressed as the percentage increase in asthma hospitalizations related to an increase in tree pollen concentration equivalent in magnitude to its interquartile range.

Results: For an interquartile increase in daily tree pollen concentration, percent increases in daily hospitalization for asthma were: 2.63% (95% CI 1.19-4.07) for Ulmus (elm), 2.45% (1.12-3.78) for the group containing Pinaceae (pine, fir, spruce), Tsuga (hemlock) and Larix (larch, tamarack); 2.32% (0.93-3.71) for the group containing Quercus (oak) and Castanea (chestnut), and 2.16% (0.70-3.62) for Acer (boxelder and maple). Statistically significant (p < 0.05) but small (<2%) effects were observed for Fraxinus (ash), Populus (aspen, poplar), Alnus (alder), Betula (birch) and Corylus (hazelnut).

Conclusions: Several common tree pollens are an important cause of acute exacerbations of asthma severe enough to require hospitalization.

Dales RE, H Zwanenburg, et al. 1991. Respiratory health effects of home dampness and molds among Canadian children. American Journal of Epidemiology 134(2): 196-203.

In 1988, the authors conducted a questionnaire-based study on the health effects of the indoor environment in 30 Canadian communities. This paper focuses on the association between the respiratory health of young children and home dampness and molds. A total of 17, 962 parents or guardians of schoolchildren received a questionnaire, and 14, 948 (83.2%) questionnaires were returned. Children living in mobile homes, tents, and boats were excluded as were those with cystic fibrosis, leaving 13, 495 children included in the study group. The housing stock was distributed as follows: 81% were one-family detached homes, 6% were one-family attached homes, and 13% were buildings for two or more families. Molds were reported in 32.4%, flooding in 24.1%, and moisture in 14.1% of the homes. Prevalences of all respiratory symptoms were consistently higher in homes with reported molds or dampness; i.e., adjusted odds ratios ranged from 1.32 (95% confidence interval 1.06-1.39) for bronchitis to 1.89 (95% confidence interval 1.58-2.26) for cough. The prevalence of home dampness or molds, 37.8%, indicates that it is an important public health issue. Further studies are required to elucidate the pathogenesis. Am J Epidemiol 1991; 134: 196-203.

Dallimer M, K N Irvine, et al. 2012. Biodiversity and the feel-good factor: Understanding associations between self-reported human well-being and species richness. BioScience 62(1): 47-55.

Over half of the world's human population lives in cities, and for many, urban greenspaces are the only places where they encounter biodiversity. This is of particular concern because there is growing evidence that human well-being is enhanced by exposure to nature. However, the specific qualities of greenspaces that offer the greatest benefits remain poorly understood. One possibility is that humans respond positively to increased levels of biodiversity. Here, we demonstrate the lack of a consistent relationship between actual plant, butterfly, and bird species richness and the psychological well-being of urban greenspace visitors. Instead, well-being shows a positive relationship with the richness that the greenspace users perceived to be present. One plausible explanation for this discrepancy, which we investigate, is that people generally have poor biodiversity-identification skills. The apparent importance of perceived species richness and the mismatch between reality and perception pose a serious challenge for aligning conservation and human well-being agendas.

Davies JM, PJ Beggs, et al. 2015. Trans-disciplinary research in synthesis of grass pollen aerobiology and its importance for respiratory health in Australasia. Science of the Total Environment, 534: 85-96.

Grass pollen is a major trigger for allergic rhinitis and asthma, yet little is known about the timing and levels of human exposure to airborne grass pollen across Australasian urban environments. The relationships between environmental aeroallergen exposure and allergic respiratory disease bridge the fields of ecology, aerobiology, geospatial science and public health.

The Australian Aerobiology Working Group comprised of experts in botany, palynology, biogeography, climate change science, plant genetics, biostatistics, ecology, pollen allergy, public and environmental health, and medicine, was established to systematically source, collate and analyse atmospheric pollen concentration data from 11 Australian and six New Zealand sites. Following two week-long workshops, post-workshop evaluations were conducted to reflect upon the utility of this analysis and synthesis approach to address complex multidisciplinary questions.

This Working Group described i) a biogeographically dependent variation in airborne pollen diversity, ii) a latitudinal gradient in the timing, duration and number of peaks of the grass pollen season, and iii) the emergence of new methodologies based on trans-disciplinary synthesis of aerobiology and remote sensing data. Challenges included resolving methodological variations between pollen monitoring sites and temporal variations in pollen datasets. Other challenges included "marrying" ecosystem and health sciences and reconciling divergent expert opinion. The Australian Aerobiology Working Group facilitated knowledge transfer between diverse scientific disciplines, mentored students and early career scientists, and provided an uninterrupted collaborative opportunity to focus on a unifying problem globally. The Working Group provided a platform to optimise the value of large existing ecological datasets that have importance for human respiratory health and ecosystems research. Compilation of current knowledge of Australasian pollen aerobiology is a critical first step towards the management of exposure to pollen in patients with allergic disease and provides a basis from which the future impacts of climate change on pollen distribution can be assessed and monitored.

De Val GD and H Muhlhauser. 2014. Visual quality: An examination of a South American Mediterranean landscape, Andean foothills east of Santiago (Chile). Urban Forestry & Urban Greening, 13(2): 261-71.

This study assessed landscape visual quality in a sector of Andean foothills, east of Santiago, Chile. Sample photographs were taken in four dominant native landscape types that were systematically selected on the basis of four categories of vegetation density. Visitors (n = 180) were randomly sampled from among the residents of Santiago. The results showed that native vegetation has a positive impact on visual quality. Sclerophyllous shrublands and ravines (associated with semi-arid forests) are rated higher than savannahs of "espinales" and shrublands with succulent plants (associated with semi-arid grassland with shrubs). Findings also indicate that landscape scenes with high-vegetation density have a positive effect on visual quality, while those with a low density have a negative one. The key is the amount of visual access, which also increases people's perceptions of safety and orientation. Finally, results showed that information variables are associated with people's visual appreciation. Two preference factors were found to be consistent with the model of spatial information of Kaplan and Kaplan (1989). The implications of the results for the enhancement of public consensus in the planning and management of the Andean foothills, east of Santiago, are also discussed.

Deletic A & TD Fletcher. 2006. Performance of grass filters used for stormwater treatment--a field and modeling study. Journal of Hydrology, 317(3-4), 261-275.

Grass swales and filter strips are among the simplest and most cost-effective form of stormwater control measures. Despite this, relatively few controlled studies have been undertaken to assess their performance, and very few models are available to predict their efficiency. This paper focuses on fieldperformance of grassfilters in removal of total suspended solids (TSS) from overland flow, and verification of TRAVA, a model of sediment behaviour in grassfilters (published earlier in Deletic, A., 2001. Modelling of water and sediment transport over grassed areas. Journal of Hydrology 248, 168-182; Deletic, A., 2005. Sediment behaviour in runoff over grassed surfaces. Journal of Hydrology 301, 108-122). Limited nutrient removal data were collected, at one of the field sites. The paper presents results from controlled field tests undertaken on agrassfilter strip in Aberdeen, Scotland, and agrass swale in Brisbane, Australia. In both studies TSS concentrations were recorded along the grass, for artificial inflow of water and sediment of different flow rates and sediment concentrations. In the Aberdeen study the emphasis was on performance in relation to different sediment particle sizes, while for the Brisbane swale, treatmentperformance for total nitrogen (TN), and total phosphorus (TP) were also recorded. Both experimental programmes had an unsteady input of pollutants. The Aberdeen strip reduced sediment inflow concentrations by 61-86%, whilst the Brisbane swale removed an average of 69, 46, and 56% of the total loads of TSS, TP and TN, respectively. TRAVA was used to model both the strip and swale. For the Aberdeen strip, the differences between the measured and modelled sediment loading rates were within +-25% of measured. Modelled concentrations in outflow from the Brisbane swale were within +-17% of measured. The predicted mass of total sediment removed during experiments was within +-50% of measured for the Aberdeen strip and +-11% for the Brisbane swale. TRAVA is therefore shown to be a reliable tool for prediction of the performance of grassfilters used for stormwater treatment.

Delfino RJ, AM Murphy-Moulton, et al. 1997. Effects of air pollution on emergency room visits for respiratory illnesses in Montreal, Quebec. Am. J. Respir. Crit. Care Med. 155(2): 568-76.

As an approach to evaluating the public health burden from current air pollution levels, we examined the relationship of daily emergency room (ER) visits for respiratory illnesses (25 hospitals, average 98 visits/d) to air pollution in Montreal, Canada, from June through September, 1992 and 1993. Air pollutants measured included ozone (O3), particulate matter diameter less than 10 micro-m (PM10) and less than 2.5 micro-m (PM2.5), the sulfate fraction of PM2.5 (SO4), and aerosol strong acidity (H+). Temporal trends, autocorrelation, and weather were controlled for in time-series regressions. For 1992, no significant associations with ER visits were found. However, 33% of the particulate data were missing. For 1993, 1-h maximum O3, PM10, PM2.5, and SO4 were all positively associated with respiratory visits for patients over 64 yr of age (p < 0.02). An increase to the mean level of 1-h maximum O3 (36 ppb) was associated with a 21% increase over the mean number of daily ER visits (95% confidence interval [CI]: 8 to 34%). Effects of particulates were smaller, with mean increases of 16% (4 to 28%), 12% (2 to 21%) and 6% (1 to 12%) for PM10, PM2.5, and SO4, respectively. Relative mass effects were PM2.5 > PM10 >> SO4. Ozone and PM10 levels never exceeded 67 ppb and 51 micro-g/m3, respectively (well below the U.S. National Ambient Air Quality Standards of 120 ppb and 150 micro-g/m3, respectively). The present findings have public health implications with regard to the adverse health effects of urban photochemical air pollution on older individuals.

Depledge MH, RJ Stone, and WJ Bird. 2011. Can natural and virtual environments be used to promote improved human health and wellbeing?.

No abstract provided

Derkzen ML, AJ Teeffelen, & PH Verburg. 2015. REVIEW: Quantifying urban ecosystem services based on high-resolution data of urban green space: an assessment for Rotterdam, the Netherlands. Journal of Applied Ecology, 52(4): 1020-32.

1. The urban dimension of ecosystem services (ES) is underexposed, while the importance of ES for human well-being is nowhere as evident as in cities. Urban challenges such as air pollution, noise and heat can be moderated by urban green space (UGS), simultaneously providing multiple other services. However, available methods to quantify ES cannot typically deal with the high spatial and thematic resolution land cover data that are needed to better understand ES supply in the urban context.

2. This study derives methods to quantify and map a bundle of six ES as supplied by UGS, using land cover data with high spatial and thematic resolution, and applies these to the city of Rotterdam, the Netherlands. Land cover data comprise eight classes of UGS. Methods are derived from an evidence base on the importance of UGS types for the supply of each of the six ES that was built using literature review.

3. The evidence base reveals that UGS types differ in their contribution to various ES, although the strength of the evidence varies. However, existing indicators for urban ES often do not discriminate between UGS types. To derive UGS-specific indicators, we combined methods and evidence from different research contexts (ES, non-ES, urban, non-urban).

4. Rotterdam shows high spatial variation in the amount of UGS present, and accounting for this in ES supply reveals that ES bundles depend on UGS composition and configuration. While the contribution of UGS types to ES supply differed markedly with UGS type and ES considered, we demonstrate that synergies rather than trade-offs exist among the ES analysed.

5. Synthesis and applications. Our findings underline the importance of a careful design of urban green space (UGS) in city planning for ecosystem services (ES) provision. Based on the latest insights on how different UGS provide ES, the methods presented in this study enable a more detailed quantification and mapping of the supply of ES in cities, allowing assessments of current supply of key urban ES and alternative urban designs. Such knowledge is indispensable in the quest for designing healthier and climate-resilient cities.

Diaz FJ, AT O'Geen, et al. 2010. Efficacy of constructed wetlands for removal of bacterial contamination from agricultural return flows. Agricultural Water Management 97(11): 1813-1821.

Water quality degradation from bacterial pathogens is one of the leading causes of surface water impairment in California agricultural watersheds. In the San Joaquin Valley, approximately 50 and 100% of water samples collected from three different irrigation return flows exceeded the Escherichia coli standard of 126 cfu 100 mL/1 and the enterococci standard of 33cfu 100mL/1, respectively, as required for water discharge into state waterways. These results show that runoff from irrigated crops can contribute a significant load of bacteria indicators and potentially pathogenic microorganisms to waterways. Constructed wetlands are gaining recognition as a management practice for use in irrigated agriculture to reduce bacterial loads and a wide variety of water quality contaminants in agricultural return flows prior to discharge into waterways. Based on inputoutput sampling of four wetlands, 66-91% of E. coli concentrations and 8694% of enterococci concentrations were retained in the wetlands. Removal efficiencies in terms of bacteria load were even higher, 80-87% and 88-97% for E. coli and enterococci, respectively, due to water losses (seepage and evapotranspiration) within the wetland. Of all the parameters considered, hydraulic residence time (HRT) appeared to be the factor having the greatest effect on the efficiency of bacteria indicator removal. Remarkably, a HRT of less than a day can achieve considerable bacteria indicator retention (70%), which allows for relatively small wetland areas being able to treat runoff from large agricultural areas (up to 360:1 in this study).

DiBlasi CJ, H Li, AP Davis & U Ghosh. 2008. Removal and fate of polycyclic aromatic hydrocarbon pollutants in an urban stormwater bioretention facility. Environmental Science & Technology, 43(2), 494-502.

This research investigated the removal and fate of 16 USEPA priority pollutant polycyclic aromatic hydrocarbons (PAHs) from urban stormwater runoff through a bioretention cell. Bioretention is an infiltration/filtration practice containing a mixed layer of about 90 cm of soil, sand, and organic matter, planted with appropriate vegetation. Field water quality monitoring and bioretention media core analyses were performed. The results indicate that bioretention is a promising management practice to control runoff PAH pollutants. The PAH event mean concentration (EMC) reduction ranged from 31 to 99%, with a mean discharge EMC of 0.22 g/L. The mass load decreased from a mean value of 0.0180 kg/ha yr to 0.0025 kg/ha yr, suggesting an average PAH mass load reduction of 87% to the discharging watershed. The most dominant PAH species monitored were fluoranthene and pyrene. Influent PAHs indicated strong affiliation with runoff total suspended solids (TSS). As such, PAH removal positively correlated with TSS removal. Low rainfall depth was associated with high influent PAH concentration and resulted in favorable PAH removal. Source investigation suggested that the PAHs measured in the monitored cell were from pyrogenic sources, likely resulting from vehicle combustion processes. Sealers used in parking lots and driveway coatings were also a possible source of PAHs. Media core analyses indicated that the intercepted PAH compounds transported only a few centimeters vertically in the soil media near the runoff entrance location, suggesting that a shallow cell design may be adequate for systems focusing on PAH removal.

Dicus C, K Delfino, and DR Weise. 2009. Predicted fire behavior and societal benefits in three eastern Sierra Nevada vegetation types. Fire Ecology, 5(1): 67.

We investigated potential fire behavior and various societal benefits (air pollution removal, carbon sequestration, and carbon storage) provided by woodlands of pinyon pine (Pinus monophylla) and juniper (Juniperus californica), shrublands of Great Basin sagebrush (Artemisia tridentata) and rabbitbrush (Ericameria nauseosa), and recently burned annual grasslands near a wildland-urban interface (WUI) community in the high desert of the eastern Sierra Nevada Mountains. Fire behavior simulations showed that shrublands had the greatest flame lengths under low wind conditions, and that pinyon-juniper woodlands had the greatest flame lengths when winds exceeded 25 km hr-1 and fire transitioned to the crowns. Air pollution removal capacity (PM10, O3, NO2, etc.) was significantly greater in pinyon-juniper stands, followed by shrublands and grasslands. Carbon storage (trees and burned tree snags only) did not significantly differ between pinyon-juniper and burned stands (approximately 14 000 kg ha-1), but will change as burned snags decompose. Annual C sequestration rates in pinyon-juniper stands averaged 630 kg ha-1yr-1. A landscape-level assessment showed that total compliance with residential defensible space regulations would result in minimal impact to air pollution removal capacity and carbon sequestration due to a currently low population density. Our methodology provides a practical mechanism to assess how potential management options might simultaneously impact both fire behavior and various environmental services provided by WUI vegetation.

Diener E, W Ng, J Harter, A Raksha. 2010. Wealth and happiness across the world: Material prosperity predicts life evaluation, whereas psychosocial prosperity predicts positive feeling. Journal of Personality and Social Psychology 99(1): 52-61.

The Gallup World Poll, the first representative sample of planet Earth, was used to explore the reasons why happiness is associated with higher income, including the meeting of basic needs, fulfillment of psychological needs, increasing satisfaction with one's standard of living, and public goods. Across the globe, the association of log income with subjective well-being was linear but convex with raw income, indicating the declining marginal effects of income on subjective well-being. Income was a moderately strong predictor of life evaluation but a much weaker predictor of positive and negative feelings. Possessing luxury conveniences and satisfaction with standard of living were also strong predictors of life evaluation. Although the meeting of basic and psychological needs mediated the effects of income on life evaluation to some degree, the strongest mediation was provided by standard of living and ownership of conveniences. In contrast, feelings were most associated with the fulfillment of psychological needs: learning, autonomy, using one's skills, respect, and the ability to count on others in an emergency. Thus, two separate types of prosperity-economic and social psychological-best predict different types of well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)

Dietz ME & JC Clausen. 2005. Saturation to improve pollutant retention in a rain garden. Environmental Science & Technology, 40(4), 1335-1340.

Rain gardens have been recommended as a best management practice to treat stormwater runoff. Replicate rain gardens were constructed in Haddam, CT, to treat roof runoff. The objective of this study was to assess whether the creation of a saturated zone in a rain garden improved retention of pollutants. The gardens were sized to store 2.54 cm (1 in) of runoff. Results show high retention of flow; only 0.8% overflowed. Overall, concentrations of nitrite+ nitrate-N, ammonia-N, and total-N (TN) in roof runoff were reduced significantly by the rain gardens. Total-P concentrations were significantly increased by both rain gardens. ANCOVA results show significant reductions in TN (18%) due to saturation. Redox potential also decreased in the saturated garden. Rain garden mulch was found to be a sink for metals, nitrogen, and phosphorus, but rain garden soils were a source for these pollutants. The design used for these rain gardens was effective for flow retention, but did not reduce concentrations of all pollutants even when modified. These findings suggest that high flow and pollutant retention could be achieved with the 2.54 cm design method, but the use of an underdrain could reduce overall pollutant retention.

Dobbs C, D Kendal, & CR Nitschke. 2014. Multiple ecosystem services and disservices of the urban forest establishing their connections with landscape structure and sociodemographics. Ecological Indicators, 43: 44-55.

The promotion of sustainable cities is critical under future environmental change and population growth. Cities in the present and future can ensure the provision of ecosystem services to their urban inhabitants. The urban forest is one of the main suppliers of ecosystem services in urban areas, and can provide the base information to quantify ecosystem services and disservices, detecting the areas were low provision of those occur. In this study multiple ecosystem services and disservices were quantified using transferable indicators in order to detect areas for environmental improvement. The set of spatially explicit indicators enables the detection of areas of low and high provision of ecosystem services. The analysis showed synergies existing among regulating, provisioning and supporting services, while trade-offs were found with cultural services and regulating, provisioning and supporting services. Ecosystem services provision was positively related to the amount of vegetation and negatively related to its degree of fragmentation. A high provision of ecosystem services was found in less populated areas, with more educated and affluent people, highlighting the strong relations existing between social vulnerabilities and areas of low provision of services. Results from this research provide insights on the role of policy makers on better distributed supply of ecosystem services and on how the landscape structure can be modified to plan for sustainable cities.

Dockery DW, CA Pope, et al. 1993. An Association between Air Pollution and Mortality in Six U.S. Cities. New England Journal of Medicine 329(24): 1753-9.

Background: Recent studies have reported associations between particulate air pollution and daily mortality rates. Population-based, cross-sectional studies of metropolitan areas in the United States have also found associations between particulate air pollution and annual mortality rates, but these studies have been criticized, in part because they did not directly control for cigarette smoking and other health risks.

Methods: In this prospective cohort study, we estimated the effects of air pollution on mortality, while controlling for individual risk factors. Survival analysis, including Cox proportional-hazards regression modeling, was conducted with data from a 14-to-16-year mortality follow-up of 8111 adults in six U.S. cities.

Results: Mortality rates were most strongly associated with cigarette smoking. After adjusting for smoking and other risk factors, we observed statistically significant and robust associations between air pollution and mortality. The adjusted mortality-rate ratio for the most polluted of the cities as compared with the least polluted was 1.26 (95 percent confidence interval, 1.08 to 1.47). Air pollution was positively associated with death from lung cancer and cardiopulmonary disease but not with death from other causes considered together. Mortality was most strongly associated with air pollution with fine particulates, including sulfates.

Conclusions: Although the effects of other, unmeasured risk factors cannot be excluded with certainty, these results suggest that fine-particulate air pollution, or a more complex pollution mixture associated with fine particulate matter, contributes to excess mortality in certain U.S. cities.

Dockery DW, J Cunningham, et al. 1996. Health effects of acid aerosols on North American children: respiratory symptoms. Environmental Health Perspectives 104(5): 500-05.

We examined the respiratory health effects of exposure to acidic air pollution among 13,369 white children 8 to 12 years old from 24 communities in the United States and Canada between 1988 and 1991. Each child's parent or guardian completed a questionnaire. Air quality and meteorology were measured in each community for a 1-year period. We used a two-stage logistic regression model to analyze the data, adjusting for the potential confounding effects of sex, history of allergies, parental asthma, parental education, and current smoking in the home. Children living in the community with the highest levels of particle strong acidity were significantly more likely [odds ratio (OR) = 1.66; 95% confidence interval (CI) 1.11-2.48] to report at least one episode of bronchitis in the past year compared to children living in the least-polluted community. Fine particulate sulfate was also associated with higher reporting of bronchitis (OR = 1.65; 95% CI 1.12-2.42). No other respiratory symptoms were significantly higher in association with any of the air pollutants of interest. No sensitive subgroups were identified. Reported bronchitis, but neither asthma, wheeze, cough, nor phlegm, were associated with levels of particle strong acidity for these children living in a nonurban environment.

Donovan GH and DT Butry. 2009. The value of shade: Estimating the effect of urban trees on summertime electricity use. Energy and Buildings 41(6): 662-668.

We estimated the effect of shade trees on the summertime electricity use of 460 single-family homes in Sacramento, California. Results show that trees on the west and south sides of a house reduce summertime electricity use, whereas trees on the north side of a house increase summertime electricity use. The current level of tree cover on the west and south sides of houses in our sample reduced summertime electricity use by 185 kWh (5.2%), whereas north-side trees increased electricity use by 55 kWh (1.5%). Results also show that a London plane tree, planted on the west side of a house, can reduce carbon emissions from summertime electricity use by an average of 31% over 100 years.

Donovan GH, DT Butry, et al. 2013. The relationship between trees and human health: Evidence from the spread of the Emerald Ash Borer. American Journal of Preventive Medicine 44(2): 139-145.

Background: Several recent studies have identified a relationship between the natural environment and improved health outcomes. However, for practical reasons, most have been observational, cross-sectional studies.

Purpose: A natural experiment, which provides stronger evidence of causality, was used to test whether a major change to the natural environment-the loss of 100 million trees to the emerald ash borer, an invasive forest pest-has influenced mortality related to cardiovascular and lower-respiratory diseases. Methods: Two fixed-effects regression models were used to estimate the relationship between emerald ash borer presence and county-level mortality from 1990 to 2007 in 15 U.S. states, while controlling for a wide range of demographic covariates. Data were collected from 1990 to 2007, and the analyses were conducted in 2011 and 2012.

Results: There was an increase in mortality related to cardiovascular and lower-respiratory-tract illness in counties infested with the emerald ash borer. The magnitude of this effect was greater as infestation progressed and in counties with above-average median household income. Across the 15 states in the study area, the borer was associated with an additional 6113 deaths related to illness of the lower respiratory system, and 15,080 cardiovascular-related deaths.

Conclusions: Results suggest that loss of trees to the emerald ash borer increased mortality related to cardiovascular and lower-respiratory-tract illness. This finding adds to the growing evidence that the natural environment provides major public health benefits.

Donovan GH, YL Michael, et al. 2011. Urban trees and the risk of poor birth outcomes. Health & Place 17(1): 390-393.

This paper investigated whether greater tree-canopy cover is associated with reduced risk of poor birth outcomes in Portland, Oregon. Residential addresses were geo-coded and linked to classified- aerial imagery to calculate tree-canopy cover in 50,100, and 200m buffers around each home in our sample (n5696). Detailed data on maternal characteristics and additional neighborhood variables were obtained from birth certificates and tax records.We found that a 10% increase in tree-canopy cover within 50 m of a house reduced the number of small for gestational age births by 1.42 per 1000 births (95% CI0.112.72).Results suggest that the natural environment may affect pregnancy outcomes and should be evaluated in future research.

Donovan GH, YL Michael, et al. 2015. Is tree loss associated with cardiovascular-disease risk in the Women's Health Initiative? A natural experiment. Health & place, 36: 1-7.

Data from the Women's Health Initiative were used to quantify the relationship between the loss of trees to an invasive forest pest-the emerald ash borer-and cardiovascular disease. We estimated a semi-parametric Cox proportional hazards model of time to cardiovascular disease, adjusting for confounders. We defined the incidence of cardiovascular disease as acute myocardial infarction requiring overnight hospitalization, silent MI determined from serial electrocardiograms, ischemic or hemorrhagic stroke, or death from coronary heart disease. Women living in a county infested with emerald ash borer had an increased risk of cardiovascular disease (HR=1.25, 95% CI: 1.20-1.31).

Du W, D FitzGerald, et al. 2010. Health impacts of floods. Prehosp Distaster Med 25(3): 265-272.

INTRODUCTION: Floods are the most common hazard to cause disasters and have led to extensive morbidity and mortality throughout the world. The impact of floods on the human community is related directly to the location and topography of the area, as well as human demographics and characteristics of the built environment.

OBJECTIVES: The aim of this study is to identify the health impacts of disasters and the underlying causes of health impacts associated with floods. A conceptual framework is developed that may assist with the development of a rational and comprehensive approach to prevention, mitigation, and management.

METHODS: This study involved an extensive literature review that located < 500 references, which were analyzed to identify common themes, findings, and expert views. The findings then were distilled into common themes.

RESULTS: The health impacts of floods are wide ranging, and depend on a number of factors. However, the health impacts of a particular flood are specific to the particular context. The immediate health impacts of floods include drowning, injuries, hypothermia, and animal bites. Health risks also are associated with the evacuation of patients, loss of health workers, and loss of health infrastructure including essential drugs and supplies. In the medium-term, infected wounds, complications of injury, poisoning, poor mental health, communicable diseases, and starvation are indirect effects of flooding. In the long-term, chronic disease, disability, poor mental health, and poverty-related diseases including malnutrition are the potential legacy.

CONCLUSIONS: This article proposes a structured approach to the classification of the health impacts of floods and a conceptual framework that demonstrates the relationships between floods and the direct and indirect health consequences.

Duncan DT, M Sharifi, et al. 2014. Characteristics of walkable built environments and BMI z-scores in children: evidence from a large electronic health record database. Environ Health Perspect, 122: 1359-1365.

Background: Childhood obesity remains a prominent public health problem. Walkable built environments may prevent excess weight gain.

Objectives: We examined the association of walkable built environment characteristics with body mass index (BMI) z-score among a large sample of children and adolescents.

Methods: We used geocoded residential address data from electronic health records of 49,770 children and adolescents 4 to < 19 years of age seen at the 14 pediatric practices of Harvard Vanguard Medical Associates from August 2011 through August 2012. We used eight geographic information system (GIS) variables to characterize walkable built environments. Outcomes were BMI z-score at the most recent visit and BMI z-score change from the earliest available (2008-2011) to the most recent (2011-2012) visit. Multivariable models were adjusted for child age, sex, race/ethnicity, and neighborhood median household income.

Results: In multivariable cross-sectional models, living in closer proximity to recreational open space was associated with lower BMI z-score. For example, children who lived in closest proximity (quartile 1) to the nearest recreational open space had a lower BMI z-score (beta = -0.06; 95% CI: -0.08, -0.03) compared with those living farthest away (quartile 4; reference). Living in neighborhoods with fewer recreational open spaces and less residential density, traffic density, sidewalk completeness, and intersection density were associated with higher cross-sectional BMI z-score and with an increase in BMI z-score over time.

Conclusions: Overall, built environment characteristics that may increase walkability were associated with lower BMI z-scores in a large sample of children. Modifying existing built environments to make them more walkable may reduce childhood obesity.

Duncan MJ, ND Clarke, et al. 2014. The effect of green exercise on blood pressure, heart rate and mood state in primary school children. International journal of environmental research and public health, 11(4): 3678-88.

The aim of this study was exploratory and sought to examine the effect on blood pressure (BP), heart rate (HR) and mood state responses in primary school children of moderate intensity cycling whilst viewing a green environment compared to exercise alone. Following ethics approval and parental informed consent, 14 children (seven boys, seven girls, Mean age +/- SD = 10 +/- 1 years) undertook two, 15 min bouts of cycling at a moderate exercise intensity in a counterbalanced order. In one bout they cycled whilst viewing a film of cycling in a forest setting. In the other condition participants cycled with no visual stimulus. Pre-, immediately post-exercise and 15 min post-exercise, BP, HR and Mood state were assessed. Analysis of variance, indicated significant condition X time interaction for SBP (p = 0.04). Bonferroni post-hoc pairwise comparisons indicated that systolic blood pressure (SBP) 15 min post exercise was significantly lower following green exercise compared to the control condition (p = 0.01). There were no significant differences in diastolic blood pressure (DBP) (all p greater than 0.05). HR immediately post exercise was significantly higher than HR pre exercise irrespective of green exercise or control condition (p = 0.001). Mood scores for fatigue were significantly higher and scores for vigor lower 15 min post exercise irrespective of green exercise or control condition (both p = 0.0001). Gender was not significant in any analyses (p greater than 0.05). Thus, the present study identifies an augmented post exercise hypotensive effect for children following green exercise compared to exercise alone.

Dunne EJ, N Culleton, et al. 2005. An integrated constructed wetland to treat contaminants and nutrients from dairy farmyard dirty water. Ecological Engineering, 24(3): 219-32.

Water pollution by agriculture can include inappropriately managed dairy farmyard dirty water. In Ireland, dairy farmyard dirty water includes farmyard runoff, parlour washings, and silage/farmyard manure effluents. The objectives of this study were to determine (i) the quality and quantity of dirty water generated at a farm-scale and (ii) the seasonal effectiveness of a constructed wetland to treat farmyard dirty water. The wetland system was 4800 m2 in area and treated dirty water from a 42-cow organic dairy unit with an open yard area of 2031 m2. Monthly dirty water inflow rate to the wetland ranged between 3.6 and 18.5 m3 d-1. Farmyard dirty water accounted for 27% of hydrological inputs to the wetland, whereas rainfall on wetland, along with wetland bank inflows accounted for 45 and 28%, respectively. Farmyard dirty water quality and quantity did not vary with season. Yearly mass loads discharged to the wetland were 47 +/- 10 kg yr-1 of soluble reactive phosphorus (SRP), 128 +/- 35 kg yr-1 of NH4+, 5484 +/- 1433 kg yr-1 of organic material as measured by five-day biological oxygen demand (BOD5), and 1570 +/- 465 kg yr-1 of total suspended solids (TSS). Phosphorus retention by the wetland varied with season (5-84%) with least amounts being retained during winter.

Dussaillant AR, CH Wu, KW Potter. 2004. Richards Equation Model of a Rain Garden. Journal of Hydrologic Engineering 9(3): 219-225.

Traditional stormwater management does not mitigate groundwater depletion resulting from groundwater pumping and reduction in recharge. Infiltration practices, such as rain gardens, offer a potentially effective approach for addressing groundwater depletion. A rain garden is a landscaped garden in a shallow depression that receives the stormwater from nearby impervious surfaces, focusing recharge. We have developed a numerical model that can be applied in rain garden design and evaluation. Water flow through the rain garden soil is modeled over three layers: a root zone, a middle storage layer of high conductivity, and a subsoil lower layer. To continuously simulate recharge, runoff, and evapotranspiration, the model couples the Richards Equation with a surface water balance. The model was applied to the climate of southern Wisconsin. Simulation results show that very high recharge rates are possible during the non-snowfall season. (The model does not handle snowmelt.) A rain garden with an area of about 10-20% of the contributing impervious area maximizes groundwater recharge. Increasing the depression depth increases recharge and saturation times, affecting plant survival. Rain garden feasibility also depends on the subsoil hydraulic conductivity.

Duvall J and R Kaplan. 2013. Exploring the benefits of outdoor experiences on veterans. Ann Arbor 2013(1001): 48109-1041.

No abstract provided.

Duvall J and R Kaplan. 2014. Enhancing the well-being of veterans using extended group-based nature recreation experiences. Journal of Rehabilitation Research & Development, 51(5): 685-96.

Physical and mental health issues associated with military service persist as challenges for many veterans. This study draws on existing research showing the value of engaging in nature-based recreation to examine the effects of such experiences on veterans specifically. Four organizations, offering 12 different programs each lasting 4-7 d, were included in the study. Ninety-eight veterans were recruited and surveyed 1 wk before, 1 wk after, and approximately 1 mo after participating in these extended group-based outdoor experiences. In addition to background information, the survey instrument assessed changes in psychological well-being, social functioning, and life outlook. The results showed significant improvements in each of these domains 1 wk after the outdoor experience. Some improvements persisted over the next month, but to a lesser degree. The positive changes were particularly strong for veterans who initially reported more severe ongoing health issues. Overall, the findings suggest that extended group-based nature recreation experiences that bring veterans together can have significant positive effects on veterans struggling with serious health problems.

Dvorak B and A Volder. 2012. Rooftop temperature reduction from unirrigated modular green roofs in south-central Texas. Urban Forestry & Urban Greening (0). In press.

Modular green roofs were investigated to better understand surface and membrane level temperature expectations of unirrigated green roofs during hot summer conditions in south-central Texas. We used three succulent monocultures, Sedum kamtschaticum, Delosperma cooperi, Talinum calycinum syn. Phemeranthus calycinus and one unplanted control module, each replicated 3 times. Media surface and below media temperatures were monitored, as well as soil water content and general weather conditions (RH, air temperature). Temperatures at the surface and below the media surface were compared with temperatures of a standard roof surface. We found that diurnal surface temperature reductions were very stable throughout the summer. Much larger temperature reductions were achieved below the modules than at the soil surface. Temperature reductions at the soil surface were predominantly driven by soil volumetric water content (VWC) and, to a lesser degree, air temperature while species and percent cover had small modifying effects through interactions with VWC and air temperature. Temperature reductions below the modules were driven by surface soil temperature, while increasing VWC led to a small decrease in temperature reductions at the membrane level. Mean daily temperature reductions achieved were 18.0 degrees C at the soil surface and 27.5 degrees C below the module, thus demonstrating that unirrigated, succulent-based green roofs can provide significant rooftop temperature reductions during hot, dry summer conditions.

Dwyer JF, EG McPherson, et al. 1992. Assessing the benefits and costs of the urban forest. Journal of Arboriculture 18(5): 227-234.

With effective planning and management, urban trees and forests will provide a wide range of important benefits to urbanites. These include a more pleasant, healthful, and comfortable environment to live, work, and play in, savings in the costs of providing a wide range of urban services, and substantial improvements in individual and community wellbeing. Urban forestry plans should begin with consideration of the contribution that trees and forests can make to people's needs. Planning and management efforts should focus on how the forest can best meet those needs. Past planning and management efforts have not been as effective as they might have been because planners and managers have underestimated the potential benefits that urban trees and forests can provide, and have not understood the planning and management efforts needed to provide those benefits, particularly the linkages between benefits and characteristics of the urban forest and its management.

Dzhambov AM and DD Dimitrova. 2015. Green spaces and environmental noise perception. Urban Forestry & Urban Greening, 14(4): 1000-8.

Physical reduction of noise exposure is no longer considered the only preventive approach towards noise mitigation. Urban green spaces constitute an important factor in ameliorating the negative perception of noise in cities. The aim of this study was to explore the associations between several objective and self-rated indicators of interaction with green spaces and noise perception. In a small scale cross-sectional survey of residents of Plovdiv, Bulgaria we collected data on noise sensitivity (NS), noise annoyance (NA) and several green space variables. A conceptual mediation model in which the effects of green spaces on NA were hypothesized to be mediated through NS was tested. While most green space variables had significant indirect effects on NA, the only one having a significant total effect was distance to the nearest green space; that is, living closer to a green space was associated with lower NA. It seemed that while the other aspects of interaction with green spaces could reduce the susceptibility to noise, they could not do so for NA. In conclusion, interaction with green spaces had a beneficial impact on noise perception, but we still lack hard evidence regarding the mechanisms underlying these effects.

Dzhambov AM, DD Dimitrova, & ED Dimitrakova. 2014. Association between residential greenness and birth weight: Systematic review and meta-analysis. Urban Forestry & Urban Greening, 13(4): 621-9.

Birth weight is extensively investigated as an outcome of interacting with greenery in mothers' living environment, because it is one of the major causes for neonatal and infant mortality, as well as a correlate of some adverse effects in childhood and beyond. Conversely, in modern urban-ecological systems the access to greenery is limited. The aim of this study was to answer the question whether green spaces and generally greenery in the living environment of pregnant women are associated with the birth weight of their infants and what the direction of that effect is. MEDLINE, EMBASE and the Internet were searched for relevant publications in English and Spanish. Eight studies were identified and included in the analyses (total n = 214,940). We report quality effects meta-analyses based on correlation and standardized regression coefficients as estimates of effect size. Neighbourhood greenness within 100-m buffer was weakly and positively associated with birth weight. The pooled correlation coefficient was 0.049 (95% CI: 0.039, 0.059) and the pooled standardized regression coefficient was 0.001 (95% CI: -0.001, 0.003). There was, however, considerable heterogeneity between the studies. Using more sensitive measures for greenness and taking into account green space functionality and quality, adjusting for environmental exposures, and assessing individual attitudes towards nature, might yield clearer picture, higher statistical power and more precise results in future research. Our findings endorse the emphasis put on urban forestry and landscape management as closely related to public health and propose a more naturalistic, humanitarian and person-centered approach in future studies.


Edwards NJ, B Giles-Corti, et al. 2014. The effect of proximity on park and beach use and physical activity among rural adolescents. Journal of physical activity & health, 11(5).

Background: Associations between access to environments and levels of physical activity (PA) among adolescents have been established; however the influence of neighborhood design barriers (eg, major roads) on these relationships is less understood.

Methods: In 2006, adolescents (n = 1304) in rural Western Australia completed the Up4it Physical Activity Survey measuring frequency and duration of organized and nonorganized physical activity by season. Geographic Information Systems (GIS) were used to objectively measure distance to nearest park and beach and busy road barriers en route to these destinations.

Results: Proximity to parks and beaches was associated with use of these environments for PA among adolescents, but this relationship attenuated after adjustment for presence of a major road. Park and beach use was positively associated with achieving recommended levels of PA. Paradoxically, proximity to these environments was not associated with achieving recommended levels of PA. Results suggest access to parks and beaches is necessary but may be insufficient to achieve recommended levels of PA. These relationships varied by season.

Conclusions: Strategies should be put in place to encourage use of proximate supportive environments. Planning neighborhoods to reduce barriers to access and interventions to overcome seasonal variations in behavior may improve participation levels among adolescents.

Egan BM, Y Zhao, RN Axon. 2010. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. The Journal of the American Medical Association 303(20): 2043-2050.

Context: Hypertension is a major risk factor for cardiovascular disease and treatment and control of hypertension reduces risk. The Healthy People 2010 goal was to achieve blood pressure (BP) control in 50% of the US population.

Objective: To assess progress in treating and controlling hypertension in the United States from 1988-2008.

Design, Setting, and Participants: The National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 1999-2008 in five 2-year blocks included 42,856 adults aged older than 18 years, representing a probability sample of the US civilian population.

Main Outcome: Measures Hypertension was defined as systolic BP of at least 140 mm Hg and diastolic BP of at least 90 mm Hg, self-reported use of antihypertensive medications, or both. Hypertension control was defined as systolic BP values of less than 140 mm Hg and diastolic BP values of less than 90 mm Hg. All survey periods were age-adjusted to the year 2000 US population.

Results: Rates of hypertension increased from 23.9% (95% confidence interval [CI], 22.7%-25.2%) in 1988-1994 to 28.5% (95% CI, 25.9%-31.3%; P <.001) in 1999-2000, but did not change between 1999-2000 and 2007-2008 (29.0%; 95% CI, 27.6%-30.5%; P=.24). Hypertension control increased from 27.3% (95% CI, 25.6%-29.1%) in 1988-1994 to 50.1% (95% CI, 46.8%-53.5%; P=.006) in 2007-2008, and BP among patients with hypertension decreased from 143.0/80.4 mm Hg (95% CI, 141.9-144.2/79.6-81.1 mm Hg) to 135.2/74.1 mm Hg (95% CI, 134.2-136.2/73.2-75.0 mm Hg; P=.02/ P < .001). Blood pressure control improved significantly more in absolute percentages between 1999-2000 and 2007-2008 vs 1988-1994 and 1999-2000 (18.6%; 95% CI, 13.3%-23.9%; vs 4.1%; 95% CI, 0.5% to 8.8%; P< .001). Better BP control reflected improvements in awareness (69.1%; 95% CI, 67.1%-71.1%; vs 80.7%; 95% CI, 78.1%-83.0%; P for trend=.03), treatment (54.0%; 95% CI, 52.0%-56.1%; vs 72.5%; 95% CI, 70.1%-74.8%; P=.004), and proportion of patients who were treated and had controlled hypertension (50.6%; 95% CI, 48.0%-53.2%; vs 69.1%; 95% CI, 65.7%-72.3%; P=.006). Hypertension control improved significantly between 1988-1994 and 2007-2008, across age, race, and sex groups, but was lower among individuals aged 18 to 39 years vs 40 to 59 years (P< .001) and 60 years or older (P< .001), and in Hispanic vs white individuals (P=.004).

Conclusions: Blood pressure was controlled in an estimated 50.1% of all patients with hypertension in NHANES 2007-2008, with most of the improvement since 1988 occurring after 1999-2000. Hypertension control was significantly lower among younger than middle-aged individuals and older adults, and Hispanic vs white individuals.

Egoh B, B Reyers, et al. 2009. Spatial congruence between biodiversity and ecosystem services in South Africa. Biological conservation, 142(3): 553-62.

Ecosystems services sustain humans all over the world. The unsustainable use of ecosystem services around the world has led to widespread degradation which now threatens human health and livelihoods. Although the maintenance of ecosystem services is often used to justify biodiversity conservation actions, it is still unclear how ecosystem services relate to different aspects of biodiversity and to what extent the conservation of biodiversity will ensure the provision of services. The aim of this study was to find out whether biodiversity priorities, biomes, species richness and vegetation diversity hotspots co-occur in space with ecosystem services. The distribution of the ranges and hotspots of five ecosystem services (surface water supply, water flow regulation, carbon storage, soil accumulation, and soil retention) was assessed in South African biomes. Coincidence, overlap, and correlation analyses were used to assess spatial congruence between ecosystem services and species richness (plants and animals) and vegetation diversity hotspots. The grassland and savanna biomes contained significant amounts of all five ecosystem services. There was moderate overlap and a generally positive but low correlation between ecosystem services hotspots and species richness and vegetation diversity hotspots. Species richness was mostly higher in the hotspots of water flow regulation and soil accumulation than would be expected by chance. The water services showed varying levels of congruence with species richness hotspots and vegetation diversity hotspot. These results indicate that actions taken to conserve biodiversity in South Africa will also protect certain ecosystem services and ecosystem services can be used to strengthen biodiversity conservation in some instances.

Eldridge DJ and D Freudenberger. 2005. Ecosystem wicks: woodland trees enhance water infiltration in a fragmented agricultural landscape in eastern Australia. Austral Ecology, 30(3): 336-47.

Since European settlement, Eucalyptus box woodlands have been substantially modified by agricultural practices, and in many areas in southern Australia are now restricted to scattered or clumped trees. We report here on a study to examine the impact of trees on water flow (infiltration) in an agricultural landscape with substantial areas of extant native vegetation. We examined infiltration through coarse- and fine-textured soils within four landscape strata, the zones below Eucalyptus melliodora and Callitris glaucophylla canopies, the intertree zone dominated by perennial grasses and a landscape homogenized by cultivation and dominated by annual crops. We measured sorptivity, the early phase of water flow, and steady-state infiltration with disc permeameters at two supply potentials. These different potentials enabled us to separate infiltration into (i) flow through large (biopores) and small pores and (ii) flow through small pores only where biopores are prevented from conducting water. On the fine-textured soils, both sorptivity and steady-state infiltration were significantly greater (approximately fivefold) under the timbered strata compared with the grassy slopes or cultivation. Differences were attributable to the greater proportion of macropores below the tree canopies compared with the nontimbered strata. The lack of a significant difference on the coarse-textured soils, despite their macropore status, was attributed to differences in surface litter and plant cover, which would maintain continuous macropores at the surface and thus conduct large amounts of water. The tendency of slopes covered by cryptogamic crusts and grasses to shed run-off and for the trees to absorb substantial quantities of water reinforced the important ecological service provided by trees, which moderates large run-off events and captures small amounts of water leaking from the grassy patches. In the absence of these 'ecosystem wicks', run-off would find its way into regional groundwater and contribute to rising salinity.

Eldridge DJ, MA Bowker, et al. 2010. Interactive effects of three ecosystem engineers on infiltration in a semi-arid Mediterranean grassland. Ecosystems. 2010 Jun 1;13(4):499-510.

The redistribution of water in semi-arid environments is critical for the maintenance and survival of vegetation patches. We used a systems approach to examine the interactive effects of three engineers-Stipa tenacissima, biological soil crusts, and the European rabbit (Oryctolagus cuniculus)-on infiltration processes in a model gypseous semi-arid Mediterranean grassland. We measured the early (sorptivity) and later (steady-state infiltration) stages of infiltration at two supply potentials using disk permeameters, which allowed us to determine the relative effects of different engineers and soil micropores on water flow through large macropores. We detected few effects under tension when flow was restricted to matrix pores, but under ponding, sorptivity and steady-state infiltration adjacent to Stipa tussocks were 2-3 times higher than in intact or rabbit-disturbed biological soil crusts. Structural Equation Modeling (SEM) showed that both Stipa and biological soil crust cover exerted substantial and equal positive effects on infiltration under ponding, whereas indirectly, rabbit disturbance negatively affected infiltration by reducing crust cover. Under tension, when macropores were prevented from conducting water, Stipa had a direct negative effect and biological soil crust cover was relatively unimportant. More complex SEM models demonstrated that (1) Stipa primarily influenced biological soil crusts by reducing their richness, (2) rabbits exerted a small negative effect on crust richness, and (3) lichens were negatively, and mosses positively, correlated with a derived "infiltration" axis. Our results highlight the importance of biological soil crusts as key players in the maintenance of infiltration processes in Stipa grasslands, and demonstrate the modulating role played by rabbits through their surface disturbances.

Ellaway A, G Morris, et al. 2009. Associations between health and different types of environmental incivility: a Scotland-wide study. Public health, 123(11): 708-13.

Objectives: Concern about the impact of the environment on health and well being has tended to focus on the physical effects of exposure to toxic and infectious substances, and on the impact of large scale infrastructures. Less attention has been paid to the possible psychosocial consequences of people's subjective perceptions of their everyday, street level environment, such as the incidence of litter and graffiti. As little is known about the potential relative importance for health of perceptions of different types of environmental incivility, a module was developed for inclusion in the 2004 Scottish Social Attitudes survey in order to investigate this relationship.

Study design: A random sample of 1637 adults living across a range of neighbourhoods throughout Scotland was interviewed.

Methods: Respondents were asked to rate their local area on a range of possible environmental incivilities. These incivilities were subsequently grouped into three domains: (i) street level incivilities (e.g. litter, graffiti); (ii) large scale infrastructural incivilities (e.g. telephone masts); and (iii) the absence of environmental goods (e.g. safe play areas for children). For each of the three domains, the authors examined the degree to which they were thought to pose a problem locally, and how far these perceptions varied between those living in deprived areas and those living in less deprived areas. Subsequently, the relationships between these perceptions and self assessed health and health behaviours were explored, after controlling for gender, age and social class.

Results: Respondents with the highest levels of perceived street level incivilities were almost twice as likely as those who perceived the lowest levels of street level incivilities to report frequent feelings of anxiety and depression. Perceived absence of environmental goods was associated with increased anxiety (2.5 times more likely) and depression (90% more likely), and a 50% increased likelihood of being a smoker. Few associations with health were observed for perceptions of large scale infrastructural incivilities.

Conclusions: Environmental policy needs to give more priority to reducing the incidence of street level incivilities and the absence of environmental goods, both of which appear to be more important for health than perceptions of large scale infrastructural incivilities.

Ellaway A, S Macintyre, et al. 2005. Graffiti, greenery, and obesity in adults: secondary analysis of European cross sectional survey. BMJ 331(7517): 611-612.

No abstract provided.

EMedicine Health - Chronic Kidney Disease.

Chronic Kidney Disease. -- -- Accessed February 2013.

Escobedo FJ and DJ Nowak. 2009. Spatial heterogeneity and air pollution removal by an urban forest. Landscape and Urban Planning 90(3-4): 102-110.

Estimates of air pollution removal by the urban forest have mostly been based on mean values of forest structure variables for an entire city. However, the urban forest is not uniformly distributed across a city because of biophysical and social factors. Consequently, air pollution removal function by urban vegetation should vary because of this spatial heterogeneity. This paper presents a different approach to evaluate how the spatial heterogeneity of the urban forest influences air pollution removal at the socioeconomic subregion scale. Air pollution removal for July 1997 to June 1998 and July 2000 to June 2001 were estimated using measured urban forest structure data from three socioeconomic subregions in Santiago, Chile. Dry deposition was estimated using hourly climate, mixing height, and pollutant concentration data. Pollution removal rates among the three socioeconomic subregions were different because of heterogeneous urban forest structure and pollution concentrations. Air pollution removal per square meter of tree cover was greatest in the low socioeconomic subregion. Pollution removal during 1997-1998 was different from 2000 to 2001 due to pollution concentration differences. Seasonal air quality improvement also differed among the subregions. Results can be used to design management alternatives at finer administrative scales such as districts and neighborhoods that maximize the pollution removal rates by the urban forest in a subregion. Policies that affect the functionality of urban forest structure must consider spatial heterogeneity and scale when making region-wide recommendations. Similarly, when modeling the functionality of the urban forest, models must capture this spatial heterogeneity for inter-city comparisons.

Eskenazi B, K Harley, et al. 2004. Association of in utero organophosphate pesticide exposure and fetal growth and length of gestation in an agricultural population. Environmental Health Perspectives 112(10): 1116-24.

Although pesticide use is widespread, little is known about potential adverse health effects of in utero exposure. We investigated the effects of organophosphate pesticide exposure during pregnancy on fetal growth and gestational duration in a cohort of low-income, Latina women living in an agricultural community in the Salinas Valley, California. We measured nonspecific metabolites of organophosphate pesticides (dimethyl and diethyl phosphates) and metabolites specific to malathion (malathion dicarboxylic acid), chlorpyrifos [O,O-diethyl O-(3,5,6-trichloro-2-pyridinyl) phosphoro-thioate], and parathion (4-nitrophenol) in maternal urine collected twice during pregnancy. We also measured levels of cholinesterase in whole blood and butyryl cholinesterase in plasma in maternal and umbilical cord blood. We failed to demonstrate an adverse relationship between fetal growth and any measure of in utero organophosphate pesticide exposure. In fact, we found increases in body length and head circumference associated with some exposure measures. However, we did find decreases in gestational duration associated with two measures of in utero pesticide exposure: urinary dimethyl phosphate metabolites [adjusted = 0.41 weeks per log10 unit increase; 95% confidence interval (CI), 0.75-0.02; p=0.02], which reflect exposure to dimethyl organophosphate compounds such as malathion, and umbilical cord cholinesterase (adjusted== 0.34 weeks per unit increase; 95% CI, 0.13-0.55; p=0.001). Shortened gestational duration was most clearly related to increasing exposure levels in the latter part of pregnancy. These associations with gestational age may be biologically plausible given that organophosphate pesticides depress cholinesterase and acetylcholine stimulates contraction of the uterus. However, despite these observed associations, the rate of preterm delivery in this population (6.4%) was lower than in a U.S. reference population.

Estabrooks PA, RE Lee, et al. 2003. Resources for physical activity participation: Does availability and accessibility differ by neighborhood socioeconomic status? Annals of Behavioral Medicine, 25: 100-104.

The purpose of this study was to determine whether the availability and accessibility of physical activity resources differed by neighborhood socioeconomic status (SES) in a small U.S. city (population = 133,046). U.S. census tracts (N =32) were used to represent neighborhoods and categorized into high, medium, or low SES on the basis of the percentage of unemployed individuals, per capita income, and percentage of the population below the poverty threshold. We developed a geographic information system to generate a comprehensive list of physical activity resources available within each census tract in the city. We identified 112 parks, 33 sport facilities, 15 fitness clubs, 11 community centers, and 5 walking/biking trails. The total number of physical activity resources varied by neighborhood SES (p <.05); low-SES (M =4.5-/+2.3) and medium-SES (M =4.9-/+2.6) neighborhoods had significantly fewer resources than high-SES (M =8.4-/+3.5) neighborhoods. Low-, medium-, and high-SES neighborhoods did not differ on the number of pay-for-use facilities; however, low-SES (M =3.1-/+1.5) and medium-SES (M =3.8-/+1.6) neighborhoods had significantly fewer free-for-use resources than high- (M =6.1-/+2.4) SES neighborhoods (p <.01). Data suggest that individuals from lower SES neighborhoods may have limited ability to control their physical activity in the face of inaccessible environments. Community research and promotion efforts should include assessment and targeting of available and accessible physical activity resources.

Evans GW, SD Colome, DF Shearer. 1988. Psychological reactions to air pollution. Environmental Research 45(1): 1-15.

Interviews with a large representative sample of Los Angeles residents reveal that these citizens are somewhat aware and concerned about air pollution, but not knowledgeable about its causes. Direct behaviors to reduce causes of pollution or one's exposure to it are rare. A moderate percentage of people seek out information about air pollution or complain about it. Fewer follow state health advisories by reducing automobile driving or restricting activity during air pollution episodes. Preliminary modeling of citizen compliance with air pollution health advisories suggests that personal beliefs about negative health effects are a important predictor of compliance. Finally, modest but significant relationships are noted between ambient photochemical oxidants and anxiety symptoms. The latter finding controls for age, socioeconomic status, and temperature.

Eze IC, LG Hemkens, et al. 2015. Association between ambient air pollution and diabetes mellitus in Europe and North America: systematic review and meta-analysis. Environmental Health Perspectives (Online), 123(5): 381.

BACKGROUND: Air pollution is hypothesized to be a risk factor for diabetes. Epidemiological evidence is inconsistent and has not been systematically evaluated.

OBJECTIVES: We systematically reviewed epidemiological evidence on the association between air pollution and diabetes, and synthesized results of studies on type 2 diabetes mellitus (T2DM).

METHODS: We systematically searched electronic literature databases (last search, 29 April 2014) for studies reporting the association between air pollution (particle concentration or traffic exposure) and diabetes (type 1, type 2, or gestational). We systematically evaluated risk of bias and role of potential confounders in all studies. We synthesized reported associations with T2DM in meta-analyses using random-effects models and conducted various sensitivity analyses.

RESULTS:We included 13 studies (8 on T2DM, 2 on type 1, 3 on gestational diabetes), all conducted in Europe or North America. Five studies were longitudinal, 5 cross-sectional, 2 case-control, and 1 ecologic. Risk of bias, air pollution assessment, and confounder control varied across studies. Dose-response effects were not reported. Meta-analyses of 3 studies on PM2.5 (particulate matter <= 2.5 µm in diameter) and 4 studies on NO2 (nitrogen dioxide) showed increased risk of T2DM by 8-10% per 10-µg/m3 increase in exposure [PM2.5: 1.10 (95% CI: 1.02, 1.18); NO2: 1.08 (95% CI: 1.00, 1.17)]. Associations were stronger in females. Sensitivity analyses showed similar results.

CONCLUSION: Existing evidence indicates a positive association of air pollution and T2DM risk, albeit there is high risk of bias. High-quality studies assessing dose-response effects are needed. Research should be expanded to developing countries where outdoor and indoor air pollution are high.


Faber Taylor A and F E Kuo. 2011. Could Exposure to Everyday Green Spaces Help Treat ADHD? Evidence from Children's Play Settings. Applied Psychology: Health and Well-Being 3(3): 281-303.

Background: An estimated 4.4 million children in the United States suffer from Attention Deficit/Hyperactivity Disorder (ADHD), and most would benefit from a low-cost, side-effect-free way of managing their symptoms. Previous research suggests that after isolated exposures to greenspace, children's ADHD symptoms are reduced. This study examined whether routine exposures to greenspace, experienced through children's everyday play settings, might yield ongoing reductions in ADHD symptoms.

Methods: Data on 421 children's ADHD symptoms and usual play settings were collected using a national Internet-based survey of parents.

Results: Findings suggest that everyday play settings make a difference in overall symptom severity in children with ADHD. Specifically, children with ADHD who play regularly in green play settings have milder symptoms than children who play in built outdoor and indoor settings. This is true for all income groups and for both boys and girls. Interestingly, for hyperactive children, the apparent advantage of green spaces is true only for relatively open green settings.

Conclusions: These and previous findings collectively suggest that it is time for randomised clinical trials testing the impacts of regular exposure to greenspace as a treatment for ADHD.

Faber Taylor A and FE Kuo. 2009. Children with attention deficits concentrate better after walk in the park. Journal of Attention Disorders 12(5): 402-409.

Objective: In the general population, attention is reliably enhanced after exposure to certain physical environments, particularly natural environments. This study examined the impacts of environments on attention in children with ADHD.

Method: In this within subjects design, each participant experienced each of three treatments (environments) in single blind controlled trials. Seventeen children 7 to12 years old professionally diagnosed with ADHD experienced each of three environments-a city park and two other well-kept urban settings-via individually guided 20-minute walks. Environments were experienced 1 week apart, with randomized assignment to treatment order. After each walk, concentration was measured using Digit Span Backwards.

Results: Children with ADHD concentrated better after the walk in the park than after the downtown walk (p = .0229) or the neighborhood walk (p = .0072). Effect sizes were substantial (Cohen's d =.52 and .77, respectively) and comparable to those reported for recent formulations of methylphenidate.

Conclusion: Twenty minutes in a park setting was sufficient to elevate attention performance relative to the same amount of time in other settings. These findings indicate that environments can enhance attention not only in the general population but also in ADHD populations. "Doses of nature" might serve as a safe, inexpensive, widely accessible new tool in the tool kit for managing ADHD symptoms. (J. of Att. Dis. 2009; 12(5) 402-409)

Faber Taylor A, F E Kuo, et al. 2002. Views of Nature and Self-Disciplione: Evidence from Inner City Children. Journal of Environmental Psychology 22(1-2): 49-63.

Children growing up in the inner city are at risk of academic underachievement, juvenile delinquency, teenage pregnancy, and other important negative outcomes. Avoiding these outcomes requires self-discipline. Self-discipline, in turn, may draw on directed attention, a limited resource that can be renewed through contact with nature. This study examined the relationship between near-home nature and three forms of self-discipline in 169 inner city girls and boys randomly assigned to 12 architecturally identical high-rise buildings with varying levels of nearby nature. Parent ratings of the naturalness of the view from home were used to predict children's performance on tests of concentration, impulse inhibition, and delay of gratification. Regressions indicated that, on average, the more natural a girl's view from home, the better her performance at each of these forms of self-discipline. For girls, view accounted for 20% of the variance in scores on the combined self-discipline index. For boys, who typically spend less time playing in and around their homes, view from home showed no relationship to performance on any measure. These findings suggest that, for girls, green space immediately outside the home can help them lead more effective, self-disciplined lives. For boys, perhaps more distant green spaces are equally important.

Faber Taylor A, F Kuo, W Sullivan. 2001. Coping with ADD: The surprising connection to green play settings. Environment and Behavior 33(1): 54-77.

Attention Restoration Theory suggests that contact with nature supports attentional functioning, and a number of studies have found contact with everyday nature to be related to attention in adults. Is contact with everyday nature also related to the attentional functioning of children? This question was addressed through a study focusing on children with Attention Deficit Disorder (ADD). This study examined the relationship between children's nature exposure through leisure activities and their attentional functioning using both within and between-subjects comparisons. Parents were surveyed regarding their child's attentional functioning after activities in several settings. Results indicate that children function better than usual after activities in green settings and that the "greener" a child's play area, the less severe his or her attention deficit symptoms. Thus, contact with nature may support attentional functioning in a population of children who desperately need attentional support.

Fan Y, KV Das, and Q Chen. 2011. Neighborhood green, social support, physical activity, and stress: Assessing the cumulative impact. Health & place, 17(6): 1202-11.

We estimate the cumulative stress mitigating impact of neighborhood greenness by investigating whether neighborhood green mitigates stress directly, and indirectly by encouraging physical activity and/or fostering social support. Using data from a recent community health survey in Chicago and two-stage instrumental variables regression modeling, we find that different components of neighborhood green play distinct roles in influencing stress. Park spaces are found to indirectly mitigate stress by fostering social support. Overall neighborhood vegetation is found to have direct stress mitigation impact, yet the impact is counteracted by its negative effect on social support. When comparing the effect size, park spaces show a more positive impact on health and well-being than the overall neighborhood vegetation level. Policy makers are recommended to focus on creating structured green spaces with public recreation and socialization opportunities rather than simply conserving green spaces in the neighborhood. Previous studies, as they often investigate the direct impact only and rarely use multiple measures of greenness, may have mis-estimated health benefits of neighborhood green.

FAO - Dryland Forestry 2018. Accessed April 2018.

Farley K and J Veitch. 2001. A Room With A View: A review of the effects of windows on work and well-being. IRC-RR-136.

The paper concerns the effects of windows on work and well-being. Literature from a variety of disciplines was reviewed although most recent research was found in the area of environmental psychology. The most consistent finding in the literature is that people prefer natural rather than built or urban views from windows. Windows with views of nature were found to enhance work and well-being in a number of ways including increasing job satisfaction, interest value of the job, perceptions of selfproductivity, perceptions of physical working conditions, life satisfaction, and decreasing intention to quit and the recovery time of surgical patients. However, the access to a view did not improve the performance of students or actual productivity of office workers. The positive psychological and health effects of natural views were explained in the context of recent psychological theories. The direction and potential for future research is discussed.

Fearnley EJ, RJ Magalhaes, et al. 2014. Environmental correlates of mental health measures for women in Western Australia. EcoHealth, 11(4): 502-11.

A recent study in Western Australia identified area level associations between soil salinisation and hospital admissions for depression. Our study assessed the quantitative relationship between mental health measures at the individual level and location specific environmental measurements on salinity, as well as two other indicators of environmental degradation and change: land surface temperature and normalised difference vegetation index, a proxy for rainfall. Location-specific environmental measurements were linked to individual mental health scores of women in three age cohorts from the Australian Longitudinal Study on Women's Health using a geographic information system. Bayesian geostatistical linear regression models were developed to assess associations between environmental exposures and mental health scores of women. In contrast to previous studies using area level measures, our study found no associations between individual level measurements of mental health scores for women in south-west Western Australia and salinity, LST or NDVI.

Feyisa GL, K Dons, & H Meilby. 2014. Efficiency of parks in mitigating urban heat island effect: An example from Addis Ababa. Landscape and Urban Planning, 123: 87-95.

Urban green infrastructure can to a certain extent mitigate urban warming. However, the cooling effect of plants varies with space, time and plant-specific properties. To contribute to our understanding of the cooling effect of vegetation on urban surface and air temperature, 21 parks in Addis Ababa were studied. Air temperature and humidity were measured for 60 plots in nine of the parks for 15 days. Furthermore, the thermal band of Landsat ETM+ was used to examine the cooling impact of all 21 parks on a larger spatial scale. Linear mixed-effects models were used to examine the relationship between characteristics of the vegetation and observed temperature. It emerged that Eucalyptussp. had a significantly higher cooling effect than any other species group (P < 0.05) and the species with the least effect on temperature were Grevillea and Cupressus. On a larger spatial scale, the cooling effect of parks on their surroundings (Park Cooling Intensity, PCI) was positively related to the NDVI and area of parks (P < 0.01). A negative relationship was observed between PCI and park shape index (SI). The range within which the cooling effect could be observed (Park Cooling Distance, PCD) was positively related to SI and park area. The maximum PCI was 6.72°C and the maximum PCD was estimated at 240m. We conclude that the cooling effect is mainly determined by species group, canopy cover, size and shape of parks. Thus, the study provides insights regarding the importance of species choice and spatial design of green spaces in cooling the environment.

Finlay J, T Franke, et al. 2015. Therapeutic landscapes and wellbeing in later life: Impacts of blue and green spaces for older adults. Health & place, 34: 97-106.

This paper extends the concept of therapeutic landscapes by investigating how green and blue spaces affect older adult health and wellbeing. We draw on interview data from participants aged 65-86 years old who described their everyday experiences with green and especially blue spaces across Metro Vancouver, Canada. Landscapes embedded with therapeutic qualities included parks, gardens, street greenery, lakes, and the ocean. Interactions with these spaces influenced participants' perceived physical, mental, and social health. Issues of safety, accessibility, and personal perception complicated this relationship. Overall, the findings indicate that nature plays a nuanced and influential role in the everyday lives of older adults. Better understanding how older adults experience health and landscape is critical towards developing everyday contact with nature that can improve quality of life for ageing populations.

Flegal KM, MD Carroll, et al. 2010. Prevalence and trends in obesity among US adults, 1999-2008. The Journal of the American Medical Association 303(3): 235-241.

Context: The prevalence of obesity increased in the United States between 1976-1980 and 1988-1994 and again between 1988-1994 and 1999-2000.

Objective: To examine trends in obesity from 1999 through 2008 and the current prevalence of obesity and overweight for 2007-2008.

Design, Setting, and Participants: Analysis of height and weight measurements from 5555 adult men and women aged 20 years or older obtained in 2007-2008 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Data from the NHANES obtained in 2007-2008 were compared with results obtained from 1999 through 2006.

Main Outcome: Measure Estimates of the prevalence of overweight and obesity in adults. Overweight was defined as a body mass index (BMI) of 25.0 to 29.9. Obesity was defined as a BMI of 30.0 or higher.

Results: In 2007-2008, the age-adjusted prevalence of obesity was 33.8% (95% confidence interval [CI], 31.6%-36.0%) overall, 32.2% (95% CI, 29.5%-35.0%) among men, and 35.5% (95% CI, 33.2%-37.7%) among women. The corresponding prevalence estimates for overweight and obesity combined (BMI >25) were 68.0% (95% CI, 66.3%-69.8%), 72.3% (95% CI, 70.4%-74.1%), and 64.1% (95% CI, 61.3%-66.9%). Obesity prevalence varied by age group and by racial and ethnic group for both men and women. Over the 10-year period, obesity showed no significant trend among women (adjusted odds ratio [AOR] for 2007-2008 vs 1999-2000, 1.12 [95% CI, 0.89-1.32]). For men, there was a significant linear trend (AOR for 2007-2008 vs 1999-2000, 1.32 [95% CI, 1.12-1.58]); however, the 3 most recent data points did not differ significantly from each other.

Conclusions In 2007-2008, the prevalence of obesity was 32.2% among adult men and 35.5% among adult women. The increases in the prevalence of obesity previously observed do not appear to be continuing at the same rate over the past 10 years, particularly for women and possibly for men.

Flom B, C Johnson, et al. 2011. The Natural School Counselor: Using nature to promote mental health in schools. Journal of Creativity in Mental Health 6(2): 118-131.

As children and adolescents spend less time outdoors, research increasingly demonstrates that natural environments play an important role in healthy development. School counselors work to optimize student learning and psychosocial development, while serving as frontline professionals promoting mental health among youth. This literature review examines outcomes of recent research on the connection between nature, mental health, and learning in school-aged youth. It outlines opportunities for infusing nature into all aspects of the school counseling program. Two case examples illustrate how creative school counselors incorporate outdoor environments into their comprehensive school counseling programs.

Flouri E, E Midouhas, & H Joshi. 2014. The role of urban neighbourhood green space in children's emotional and behavioural resilience. Journal of environmental psychology, 40: 179-86.

This study explored the role of relative quantity of green space in urban English neighbourhoods in predicting parent-reported emotional and behavioural problems from early to middle childhood (ages 3, 5, 7) and in buffering the effects of multiple risk factors (neighbourhood disadvantage, family poverty and adverse life events) on child adjustment. We modelled data from 6384 Millennium Cohort Study children using multilevel growth curve modelling. Neighbourhood green space was measured with the percentage of green space within a standard small area. We found that access to garden and use of parks and playgrounds were related to fewer conduct, peer and hyperactivity problems. Neighbourhood green space was generally unrelated to child adjustment, but poor children in urban neighbourhoods with more greenery had fewer emotional problems from age 3 to 5 than their counterparts in less green neighbourhoods. Neighbourhood green space may promote emotional well-being in poor urban children in early childhood.

Food and Drug Administration (FDA) - Foodborne Illness (Gastrointestinal).

Foodbourne Illness (Gastrointestinal). -- -- Accessed February 2013.

Foraster M, N Kunzli, et al. 2014. High blood pressure and long-term exposure to indoor noise and air pollution from road traffic. Environmental Health Perspectives (Online), 122(11): 1193.

BACKGROUND: Traffic noise has been associated with prevalence of hypertension, but reports are inconsistent for blood pressure (BP). To ascertain noise effects and to disentangle them from those suspected to be from traffic-related air pollution, it may be essential to estimate people's noise exposure indoors in bedrooms.

OBJECTIVES: We analyzed associations between long-term exposure to indoor traffic noise in bedrooms and prevalent hypertension and systolic (SBP) and diastolic (DBP) BP, considering long-term exposure to outdoor nitrogen dioxide (NO2).

METHODS: We evaluated 1,926 cohort participants at baseline (years 2003-2006; Girona, Spain). Outdoor annual average levels of nighttime traffic noise (Lnight) and NO2 were estimated at postal addresses with a detailed traffic noise model and a land-use regression model, respectively. Individual indoor traffic Lnight levels were derived from outdoor Lnight with application of insulations provided by reported noise-reducing factors. We assessed associations for hypertension and BP with multi-exposure logistic and linear regression models, respectively.

RESULTS: Median levels were 27.1 dB(A) (indoor Lnight), 56.7 dB(A) (outdoor Lnight), and 26.8 micro-g/m3 (NO2). Spearman correlations between outdoor and indoor Lnight with NO2 were 0.75 and 0.23, respectively. Indoor Lnight was associated both with hypertension (OR = 1.06; 95% CI: 0.99, 1.13) and SBP (beta = 0.72; 95% CI: 0.29, 1.15) per 5 dB(A); and NO2 was associated with hypertension (OR = 1.16; 95% CI: 0.99, 1.36), SBP (beta = 1.23; 95% CI: 0.21, 2.25), and DBP (beta superset = 0.56; 95% CI: -0.03, 1.14) per 10 micro-g/m3. In the outdoor noise model, Lnight was associated only with hypertension and NO2 with BP only. The indoor noise-SBP association was stronger and statistically significant with a threshold at 30 dB(A).

CONCLUSION: Long-term exposure to indoor traffic noise was associated with prevalent hypertension and SBP, independently of NO2. Associations were less consistent for outdoor traffic Lnight and likely affected by collinearity.

Francis J, LJ Wood, et al. 2012. Quality or quantity? Exploring the relationship between Public Open Space attributes and mental health in Perth, Western Australia. Social science & medicine, 74(10): 1570-7.

Mental health is a public health priority globally. Public Open Space (POS) may enhance mental health by facilitating contact with nature and the development of supportive relationships. Despite growing interest in the influence of the built environment on mental health, associations between POS attributes and mental health remain relatively unexplored. In particular, few studies have examined the relative effects of the quantity and quality of POS within a neighbourhood on mental health. Guided by a social-ecological framework, this study investigated the relationship between POS attributes (i.e., quantity and quality) and better mental health (i.e., low risk of psychological distress) in residents of new housing developments in the Perth metropolitan area, Western Australia. The extent to which relationships between POS attributes and mental health were confounded by psychosocial factors (e.g., social support, sense of community) and frequent use of POS was also explored. Data were obtained from a cross-sectional survey (n=911), a POS audit, and Geographical Information Systems, and was analysed using logistic regression. Approximately 80% of survey participants were at low risk of psychological distress. Residents of neighbourhoods with high quality POS had higher odds of low psychosocial distress than residents of neighbourhoods with low quality POS. This appeared to be irrespective of whether or not they used POS. However, the quantity of neighbourhood POS was not associated with low psychological distress. From a mental health perspective, POS quality within a neighbourhood appears to be more important than POS quantity. This finding has policy implications and warrants further investigation.

Franco O H, C de Laet, et al. 2005. EFfects of physical activity on life expectancy with cardiovascular disease. Archives of Internal Medicine 165 (20): 2355-2360.

Background: Physical inactivity is a modifiable risk factor for cardiovascular disease. However, little is known about the effects of physical activity on life expectancy with and without cardiovascular disease. Our objective was to calculate the consequences of different physical activity levels after age 50 years on total life expectancy and life expectancy with and without cardiovascular disease.

Methods: We constructed multistate life tables using data from the Framingham Heart Study to calculate the effects of 3 levels of physical activity (low, moderate, and high) among populations older than 50 years. For the life table calculations, we used hazard ratios for 3 transitions (healthy to death, healthy to disease, and disease to death) by levels of physical activity and adjusted for age, sex, smoking, any comorbidity (cancer, left ventricular hypertrophy, arthritis, diabetes, ankle edema, or pulmonary disease), and examination at start of follow-up period.

Results: Moderate and high physical activity levels led to 1.3 and 3.7 years more in total life expectancy and 1.1 and 3.2 more years lived without cardiovascular disease, respectively, for men aged 50 years or older compared with those who maintained a low physical activity level. For women the differences were 1.5 and 3.5 years in total life expectancy and 1.3 and 3.3 more years lived free of cardiovascular disease, respectively.

Conclusions: Avoiding a sedentary lifestyle during adulthood not only prevents cardiovascular disease independently of other risk factors but also substantially expands the total life expectancy and the cardiovascular disease-free life expectancy for men and women. This effect is already seen at moderate levels of physical activity, and the gains in cardiovascular disease-free life expectancy are twice as large at higher activity levels.

Frazier TG, CA Tate. 2013. A GIS methodology to assess exposure of coastal infrastructure to storm surge & sea-level rise: A case study of Sarasota County, Florida. Journal of Geography & Natural Disasters 3(1): 1-12.

Storm surge is the leading cause of loss of life and property from hurricanes. Recent research using geographical information system (GIS) technology has demonstrated sea level rise (SLR) will increase storm surge inundation zones. While effective and accepted GIS models exist for framing surge inundation there is a lack of depth information and consideration of SLR that may be critical for examining the exposure of coastal assets to current and future storm surge hazards. There is a need for a methodology that relates depth to inundation and asset exposure, and is supported by recent hazard vulnerability and resilience literature. Furthermore, new data has been collected that facilitates more detailed SLR modelling than available in previous research. Researchers provide a framework for GIS depth modelling of contemporary and SLR enhanced storm surge that is superior to two-dimensional inundation modelling for examining exposure of societal assets to storm surge and SLR in Sarasota County, Florida. The effectiveness of this framework is demonstrated in a GIS by comparing inundation modelling, depth modelling, and SLR modelling as applied to the exposure of flood-depth sensitive infrastructure in Sarasota County, Florida.

Freedman A, A Gross, et al. 2014. Salt uptake and evapotranspiration under arid conditions in horizontal subsurface flow constructed wetland planted with halophytes. Ecological engineering, 70: 282-6.

The use of halophytes in constructed wetlands (CWs) for phytodesalination has been recently suggested as a strategy for dealing with excess salt, which causes land degradation and has detrimental effects on agricultural productivity. Salinity in drylands is enhanced by strong solar radiation and increased evapotranspiration, and poses additional challenges for decentralized water-treatment systems such as CWs. We tested the potential use of a horizontal subsurface flow CW (HSSF CW) planted with the halophyte Bassia indicato polish treated municipal wastewater quality and reduce salinity, using a pilot system containing eight flow cells. The system was operated under continuous flow of synthetic, secondary level-treated wastewater at a rate of 480-660 ml/h, which resulted in a retention time of approximately 2 days. Water fluxes, and nutrient and salt concentrations in the water were measured and compared to those in flow cells without plants. Plant height was measured periodically and biomass and salt concentrations were recorded at harvest. Removal of biological oxygen demand, and reduction in fecal coliforms and turbidity were evident and similar in planted and non-planted cells. Significant salt uptake was measured in the planted cells, with the amount of Na+ uptake directly related to plant biomass; however, the overall salinity of the treated wastewater increased despite salt uptake by B. indica due to enhanced evapotranspiration. This study reaffirms the notion that halophytes in CWs have the potential capacity for direct uptake of salts. Nevertheless, efficient salt phytoremediation in arid and semi-arid climates will require specific application of plants and relatively short hydraulic residence time to minimize evapotranspiration.

Freeman C, K J M Dickinson, et al. 2012. "My garden is an expression of me": Exploring householders' relationships with their gardens. Journal of Environmental Psychology 32(2): 135-143.

Domestic gardens offer immense potential as sites for native biodiversity conservation. In urban areas they often comprise the largest land use, thus presenting an accessible and immediate way for urban dwellers to connect with nature and to support and enhance native biodiversity. This paper presents findings from a study of 55 domestic gardens undertaken in Dunedin, New Zealand, which explores householders' relationships with their gardens. The study data was derived from two interviews with householders, two photo exercises (approximately a year apart), together with a number of biological studies of the gardens. Gardens proved to be very important for our householders; for physical and mental health, as an expression of ownership and identity, as sites for social relationships, for connecting with nature and as site of domestic produce production. Householders' connections with nature were idiosyncratic, multifaceted and exhibited in ways that are more complex and varied than those usually considered by those working in the natural sciences and indeed biophilia supporters. We emphasize the importance of the people side of nature in seeking to build and support positive ecological change in the urban environment and the value of combining natural and social science approaches.

French J, R Ing, S Von Allmen, R Wood. 1983. Mortality from flash floods: a review of National Weather Service Reports, 1969-81. Public Health Reports 98(6): 584-588

Of all weather-related disasters that occur in the United States, floods are the main cause of death, and most flood-related deaths are attributed to flash floods. Whenever a weather-related disaster involves 30 or more deaths or more than $100 million in property damage, the National Weather Service (NWS) forms a survey team to investigate the disaster and write a report of findings. All NWS survey reports on flash floods issued during 1969-81 were reviewed to determine the mortality resulting from such floods, the effect of warnings on mortality, and the circumstances contributing to death. A total of 1,185 deaths were associated with 32 flash floods, an average of 37 deaths per flash flood. The highest average number of deaths per event was associated with the four flash floods in which dams broke after heavy rains. Although there were 18 flash floods in 1977-81 and only 14 in 1969-76, the number of deaths was 2Y2 times greater during the earlier period. More than twice as many deaths were associated with flash floods for which the survey team considered the warnings inadequate than with those with warnings considered adequate. Ninety-three percent of the deaths were due to drowning and 42 percent of these drownings were car related. The other drownings occurred in homes, at campsites, or when persons were crossing bridges and streams. The need for monitoring dams during periods of heavy rainfall is highlighted.

Frumkin H 2001. Beyond toxicity: Human health and the natural environment. American Journal of Preventive Medicine 20(3): 234-240.

Research and teaching in environmental health have centered on the hazardous effects of various environmental exposures, such as toxic chemicals, radiation, and biological and physical agents. However, some kinds of environmental exposures may have positive health effects. According to E.O. Wilson's "biophilia" hypothesis, humans are innately attracted to other living organisms. Later authors have expanded this concept to suggest that humans have an innate bond with nature more generally. This implies that certain kinds of contact with the natural world may benefit health. Evidence supporting this hypothesis is presented from four aspects of the natural world: animals, plants, landscapes, and wilderness. Finally, the implications of this hypothesis for a broader agenda for environmental health, encompassing not only toxic outcomes but also salutary ones, are discussed. This agenda implies research on a range of potentially healthful environmental exposures, collaboration among professionals in a range of disciplines from public health to landscape architecture to city planning, and interventions based on research outcomes.

Fuller RA, KN Irvine, et al. 2007. Psychological benefits of green space increase with biodiversity. Biology Letters 3(4): 390-394.

The world's human population is becoming concentrated into cities, giving rise to concerns that it is becoming increasingly isolated from nature. Urban public greenspaces form the arena of many people's daily contact with nature and such contact has measurable physical and psychological benefits. Here we show that these psychological benefits increase with the species richness of urban greenspaces. Moreover, we demonstrate that greenspace users can more or less accurately perceive species richness depending on the taxonomic group in question. These results indicate that successful management of urban greenspaces should emphasize biological complexity to enhance human well-being in addition to biodiversity conservation.


Gallagher LG, TF Webster, et al. 2010. Using residential history and groundwater modeling to examine drinking water exposure and breast cancer. Environmental Health Perspectives 118(6): 749-55.

BACKGROUND: Spatial analyses of case control data have suggested a possible link between breast cancer and groundwater plumes in upper Cape Cod, Massachusetts.

OBJECTIVE: We integrated residential histories, public water distribution systems, and groundwater modeling within geographic information systems (GIS) to examine the association between exposure to drinking water that has been contaminated by wastewater effluent and breast cancer.

METHODS: Exposure was assessed from 1947 to 1993 for 638 breast cancer cases who were diagnosed from 1983 to 1993 and 842 controls; we took into account residential mobility and drinking water source. To estimate the historical impact of effluent on drinking water wells, we modified a modular three-dimensional finite-difference groundwater model (MODFLOW) from the U.S. Geological Survey. The analyses included latency and exposure duration.

RESULTS: Wastewater effluent impacted the drinking water wells of study participants as early as 1966. For < 0-5 years of exposure (versus no exposure), associations were generally null. Adjusted odds ratios (AORs) for < 10 years of exposure were slightly increased, assuming latency periods of 0 or 10 years [AOR = 1.3; 95% confidence interval (Cl), 0.9-1.9 and AOR = 1.6; 95% CI, 0.8-3.2, respectively]. Statistically significant associations were estimated for ever-exposed versus never-exposed women when a 20-year latency period was assumed (AOR = 1.9; 95% Cl, 1.0-3.4). A sensitivity analysis that classified exposures assuming lower well-pumping rates showed similar results.

CONCLUSION: We investigated the hypothesis generated by earlier spatial analyses that exposure to drinking water contaminated by wastewater effluent may be associated with breast cancer. Using a detailed exposure assessment, we found an association with breast cancer that increased with longer latency and greater exposure duration.

Gao J, Y Sun, et al. 2015. Impact of extreme high temperature on mortality and regional level definition of heat wave: A multi-city study in China. Science of the Total Environment, 505: 535-44.


Few multi-city studies have been conducted to explore the regional level definition of heat wave and examine the association between extreme high temperature and mortality in developing countries.


The purpose of the present study was to investigate the impact of extreme high temperature on mortality and to explore the local definition of heat wave in five Chinese cities.


We first used a distributed lag non-linear model to characterize the effects of daily mean temperature on non-accidental mortality. We then employed a generalized additive model to explore the city-specific definition of heat wave. Finally, we performed a comparative analysis to evaluate the effectiveness of the definition.


For each city, we found a positive non-linear association between extreme high temperature and mortality, with the highest effects appearing within 3 days of extreme heat event onset. Specifically, we defined individual heat waves of Beijing and Tianjin as being two or more consecutive days with daily mean temperatures exceeding 30.2°C and 29.5°C, respectively, and Nanjing, Shanghai and Changsha heat waves as >=3 consecutive days with daily mean temperatures higher than 32.9°C, 32.3°C and 34.5°C, respectively. Comparative analysis generally supported the definition.


We found extreme high temperatures were associated with increased mortality, after a short lag period, when temperatures exceeded obvious threshold levels. The city-specific definition of heat wave developed in our study may provide guidance for the establishment and implementation of early heat-health response systems for local government to deal with the projected negative health outcomes due to heat waves.

Gariepy G, A Blair, et al. 2014. Neighbourhood characteristics and 10-year risk of depression in Canadian adults with and without a chronic illness. Health & place, 30: 279-86.

The neighbourhood environment could play a role in the risk of depression in adults and those with a chronic illness. We investigated the effects of a range of neighbourhood characteristics on the 10-year risk of depression in a representative sample of 9,026 Canadian adults and subsamples with a chronic condition. Characteristics of neighbourhoods were not significantly related to the risk of depression in the general sample and subsamples with a chronic condition. However, residing near a park was significantly associated with a lower risk of depression for people living in crowded households, and having a local health service nearby was protective for those living in materially deprived neighbourhoods. Living in a neighbourhood that was both socially advantaged and offered cultural services was also associated with lower risk of depression. Additional research is needed for smaller effect size detection. Future intervention research is warranted for health policy recommendations.

Gascon M, M Triguero-Mas, et al. 2015. Mental health benefits of long-term exposure to residential green and blue spaces: a systematic review. International journal of environmental research and public health, 12(4): 4354-79.

Many studies conducted during the last decade suggest the mental health benefits of green and blue spaces. We aimed to systematically review the available literature on the long-term mental health benefits of residential green and blue spaces by including studies that used standardized tools or objective measures of both the exposures and the outcomes of interest. We followed the PRISMA statement guidelines for reporting systematic reviews and meta-analysis. In total 28 studies were included in the systematic review. We found limited evidence for a causal relationship between surrounding greenness and mental health in adults, whereas the evidence was inadequate in children. The evidence was also inadequate for the other exposures evaluated (access to green spaces, quality of green spaces, and blue spaces) in both adults and children. The main limitation was the limited number of studies, together with the heterogeneity regarding exposure assessment. Given the increase in mental health problems and the current rapid urbanization worldwide, results of the present systematic review should be taken into account in future urban planning. However, further research is needed to provide more consistent evidence and more detailed information on the mechanisms and the characteristics of the green and blue spaces that promote better mental health. We provide recommendations for future studies in order to provide consistent and evidence-based recommendations for policy makers.

Gatersleben B and M Andrews. 2013. When walking in nature is not restorative-The role of prospect and refuge. Health & Place 2013(20): 91-101.

People tend to recover more quickly from stress and mental fatigue in natural than in urban environments. But natural environments may not always be restorative. Dense wooded areas may evoke fear and stress and require directed attention to avoid getting lost or tripping over. Little is known about the restorative potential of such environments. Two experiments were conducted to examine restoration in natural settings with different levels of accessibility, prospect (clear field of vision) and refuge (places to hide). An on-line survey examined perceived restoration of environments presented in a slide show. An experiment examined actual restoration in response to walks in a real outdoor setting and in response to videos of the same walks (in a laboratory). The findings demonstrate that exposure to natural environments with high levels of prospect and low levels of refuge, is indeed restorative. However, exposure to natural environments low in prospect and high in refuge is not, and may even further increase levels of stress and attention fatigue. These findings demonstrate that natural places may not always be restorative places.

Gatseva PD and MD Argirova. 2008. High-nitrate levels in drinking water may be a risk factor for thyroid dysfunction in children and pregnant women living in rural Bulgarian areas. International Journal of Hygiene and Environmental Health 211(5-6): 555-9.

Nitrate inhibits the accumulation of iodide in thyroid gland. The aim of present study was to evaluate the influence of this ion on the iodine status of two risk population groups. Subjects of study were pregnant women and children aged between 3 and 6 years from two villages in Bulgaria with high- and low-nitrate levels in drinking water. The relative risk of thyroid disorders for the pregnant women living in the village with high-nitrate levels in drinking water expressed as an odds ratio was 5.294 (95% confidence intervals 1.003-27.939; P=0.0454) and was considered as significant. Statistically significant differences were found between the goiter rate in exposed and non-exposed pregnant women. The relative risk of thyroid dysfunction for the children exposed to a high-nitrate level, expressed as an odds ratio was 2.333 (95% confidence intervals 0.8491-6.412; P=0.1396) and was considered as not significant; the goiter prevalence in the exposed children was also not statistically different. The results of the study confirmed the role of high-nitrate level in drinking water as a risk factor for thyroid dysfunction in vulnerable population groups.

George MG, X Tong, et al. 2011. Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995-2008. Annals of Neurology 70(5): 713 - 21.

Objective: The aim of this study was to determine acute stroke hospitalization rates for children and young adults and the prevalence of stroke risk factors among children and young adults hospitalized for acute stroke.

Methods: The study population consisted of 1995-2008 hospitalizations from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. Subarachnoid hemorrhage, intracerebral hemorrhage, and ischemic stroke hospitalizations were identified by the primary International Classification of Diseases, 9th ed, Clinical Modification (ICD-9-CM) code. Seven consecutive 2-year time intervals were selected. Three age groups were utilized: 5 to 14 years, 15 to 34 years, and 35 to 44 years. Stroke risk factors and comorbidities among those hospitalized with acute stroke were identified by secondary ICD-9-CM codes.

Results: During the period of study, the prevalence of hospitalizations of acute ischemic stroke increased among all age and gender groups except females aged 5 to 14 years. Females aged 15 to 34 years and males and females aged 35 to 44 years showed a decrease in the prevalence of hospitalizations for subarachnoid hemorrhage, whereas females aged 5 to 14 years showed increases for subarachnoid hemorrhage. Hypertension, diabetes, obesity, lipid disorders, and tobacco use were among the most common coexisting conditions, and their prevalence increased from 1995 to 2008 among adolescents and young adults (aged 15-44 years) hospitalized with acute ischemic stroke. Interpretation: Increases in the prevalence of ischemic stroke hospitalizations and coexisting traditional stroke risk factors and health risk behaviors were identified among acute ischemic stroke hospitalizations in young adults. Our results from national surveillance data accentuate the need for public health initiatives to reduce risk factors for stroke among adolescents and young adults.

Gidlof-Gunnarsson A and E Ohrstrom. 2007. Noise and well-being in urban residential environments: The potential role of perceived availability to nearby green areas. Landscape and Urban Planning 83(2-3): 115-126.

A growing body of literature indicates that contact with nature influence people's health and psychological well-being both directly and by moderating processes. A questionnaire study was conducted in urban residential settings with high road-traffic noise exposure (LAeq, 24h = 60-68dB). Out of 500 residents, 367 lived in dwellings with access to a quiet side (LAeq, 24h < = 45dB free field value; "noise/quiet"-condition) and 133 had no access to a quiet side ("noise/noise"-condition). The present paper examines whether perceived availability to nearby green areas affects various aspects of well-being in these two noise-condition groups. For both those with and without access to a quiet side, the results show that "better" availability to nearby green areas is important for their well-being and daily behavior by reducing long-term noise annoyances and prevalence of stress-related psychosocial symptoms, and by increasing the use of spaces outdoors. In the process of planning health-promoting urban environments, it is essential to provide easy access to nearby green areas that can offer relief from environmental stress and opportunities for rest and relaxation, to strive for lower sound levels from road traffic, as well as to design "noise-free" sections indoors and outdoors.

Gielen MH, SC van der Zee, et al. 1997. Acute effects of summer air pollution on respiratory health of asthmatic children. Am. J. Respir. Crit. Care Med. 155(6): 2105-08.

In the early summer of 1995, the acute respiratory effects of ambient air pollution were studied in a panel of 61 children, ages 7 to 13 yr, of whom 77% were taking asthma medication. Peak flow was measured twice daily with MiniWright meters at home and the occurrence of acute respiratory symptoms and medication use was registered daily by the parents in a diary. Exposure to air pollution was characterized by the ambient concentrations of ozone, PM10, and black smoke. During the study period, maximal 1-h ozone concentrations never exceeded 130 micro-g/m3, and 24-h black smoke and PM10 concentrations were never higher than 41 and 60 micro-g/m3 respectively. Associations of air pollution and health outcomes were evaluated using time series analysis. After adjusting for pollen, time trend, and day of the week, black smoke in particular was associated with acute respiratory symptoms and with medication use. Less strong associations were found for PM10 and ozone. These results suggest that in this panel of children, most of whom had asthma, relatively low levels of particulate matter and ozone in ambient air are able to increase symptoms and medication use.

Gilchrist K, C Brown, & A Montarzino. 2015. Workplace settings and wellbeing: Greenspace use and views contribute to employee wellbeing at peri-urban business sites. Landscape and Urban Planning, 138: 32-40.

Low density business developments are a near ubiquitous feature of peri-urban landscapes in the UK and in other developed countries, however little is known about how workers relate to open space in this particular type of working environment. Person-environment relationships in five urban fringe science parks in central Scotland were investigated through a survey of employees (N=366). Specifically, the study sought to explore the impact of viewing and using greenspace at these knowledge-sector workplaces on employee wellbeing. The results of a series of multiple regression analyses indicated that both use of the open space and views of some vegetation types, namely trees, lawn and shrubs or flowering plants, were positively and independently associated with self-reported wellbeing levels. This research provides new insight into the extent to which workplace greenspace contributes to employee wellbeing, whilst controlling for exposure to greenspace outside of the workplace context. Also, by investigating relationships between wellbeing and the particular physical features seen in views, the research provides evidence on how workplaces might be designed to incorporate restorative window views. These findings have relevance both for the planning and design of peri-urban business sites and for the design of interventions to promote employee wellbeing.

Giles-Corti B, MH Broomhall, et al. 2005. Increasing walking: How important is distance to, attractiveness, and size of public open space? American Journal of Preventive Medicine 28(2, Supplement 2): 169-176.

Background: Well-designed public open space (POS) that encourages physical activity is a community asset that could potentially contribute to the health of local residents.

Methods: In 1995-1996, two studies were conducted-an environmental audit of POS over 2 acres (n =516) within a 408-km2 area of metropolitan Perth, Western Australia; and personal interviews with 1803 adults (aged 18 to 59 years) (52.9% response rate). The association between access to POS and physical activity was examined using three accessibility models that progressively adjusted for distance to POS, and its attractiveness and size. In 2002, an observational study examined the influence of attractiveness on the use of POS by observing users of three pairs of high- and low-quality (based on attractiveness) POS matched for size and location.

Results: Overall, 28.8% of respondents reported using POS for physical activity. The likelihood of using POS increased with increasing levels of access, but the effect was greater in the model that adjusted for distance, attractiveness, and size. After adjustment, those with very good access to large, attractive POS were 50% more likely to achieve high levels of walking (odds ratio, 1.50; 95% confidence level, 1.062.13). The observational study showed that after matching POS for size and location, 70% of POS users observed visited attractive POS.

Conclusions: Access to attractive, large POS is associated with higher levels of walking. To increase walking, thoughtful design (and redesign) of POS is required that creates large, attractive POS with facilities that encourage active use by multiple users (e.g., walkers, sports participants, picnickers).

Gill T. 2014. The benefits of children's engagement with nature: A systematic literature review. Children Youth and Environments, 24(2): 10-34.

This paper sets out the findings of a systematic review of the research literature on the benefits that arise when children under 12 spend time in natural environments. The review also explored the relationship between these benefits and the style of children's engagement with nature. The findings support the view that spending time in nature is part of a "balanced diet" of childhood experiences that promote children's healthy development, well-being and positive environmental attitudes and values. It also points to the value of more playful engagement styles. The findings are relevant to the development of educational and planning policy and practice, and to advocacy work.

Gladwell VF, DK Brown, et al. 2013. The great outdoors: how a green exercise environment can benefit all. Extreme Physiology & Medicine 2(1): 1-7.

The studies of human and environment interactions usually consider the extremes of environment on individuals or how humans affect the environment. It is well known that physical activity improves both physiological and psychological well-being, but further evidence is required to ascertain how different environments influence and shape health. This review considers the declining levels of physical activity, particularly in the Western world, and how the environment may help motivate and facilitate physical activity. It also addresses the additional physiological and mental health benefits that appear to occur when exercise is performed in an outdoor environment. However, people's connectedness to nature appears to be changing and this has important implications as to how humans are now interacting with nature. Barriers exist, and it is important that these are considered when discussing how to make exercise in the outdoors accessible and beneficial for all. The synergistic combination of exercise and exposure to nature and thus the 'great outdoors' could be used as a powerful tool to help fight the growing incidence of both physical inactivity and non-communicable disease.

Gong Y, J Gallacher, et al. 2014. Neighbourhood green space, physical function and participation in physical activities among elderly men: the Caerphilly Prospective study. International Journal of Behavioral Nutrition and Physical Activity, 11(1): 1.

Background The built environment in which older people live plays an important role in promoting or inhibiting physical activity. Most work on this complex relationship between physical activity and the environment has excluded people with reduced physical function or ignored the difference between groups with different levels of physical function. This study aims to explore the role of neighbourhood green space in determining levels of participation in physical activity among elderly men with different levels of lower extremity physical function.

Method Using data collected from the Caerphilly Prospective Study (CaPS) and green space data collected from high resolution Landmap true colour aerial photography, we first investigated the effect of the quantity of neighbourhood green space and the variation in neighbourhood vegetation on participation in physical activity for 1,010 men aged 66 and over in Caerphilly county borough, Wales, UK. Second, we explored whether neighbourhood green space affects groups with different levels of lower extremity physical function in different ways.

Results Increasing percentage of green space within a 400 meters radius buffer around the home was significantly associated with more participation in physical activity after adjusting for lower extremity physical function, psychological distress, general health, car ownership, age group, marital status, social class, education level and other environmental factors (OR = 1.21, 95% CI 1.05, 1.41). A statistically significant interaction between the variation in neighbourhood vegetation and lower extremity physical function was observed (OR = 1.92, 95% CI 1.12, 3.28).

Conclusion Elderly men living in neighbourhoods with more green space have higher levels of participation in regular physical activity. The association between variation in neighbourhood vegetation and regular physical activity varied according to lower extremity physical function. Subjects reporting poor lower extremity physical function living in neighbourhoods with more homogeneous vegetation (i.e. low variation) were more likely to participate in regular physical activity than those living in neighbourhoods with less homogeneous vegetation (i.e. high variation). Good lower extremity physical function reduced the adverse effect of high variation vegetation on participation in regular physical activity. This provides a basis for the future development of novel interventions that aim to increase levels of physical activity in later life, and has implications for planning policy to design, preserve, facilitate and encourage the use of green space near home.

Gopal D and H Nagendra. 2014. Vegetation in Bangalore's Slums: boosting livelihoods, well-being and social capital. Sustainability, 6(5): 2459-73.

Urban greenery provides ecosystem services that play an important role in the challenging context of urban deprivation and poverty. This study assesses the social importance of vegetation through empirical assessment of 44 urban slums in the rapidly developing southern city of Bangalore, India. Vegetation played a major role in supporting nutrition by its role in food consumption, and in promoting health through the planting of species with medicinal use. Trees in slums also formed nodes for social activities including conversing and playing, domestic activities such as cooking and washing dishes, and livelihood activities such as the manufacture of broomsticks and tyre repair. Innovative methods of gardening were widely adopted, with kitchen gardens found planted in plastic bags, paint cans, old kitchen utensils and buckets, indicating the importance given to planting in environments with limited finances. Short and narrow trunked trees with medium-sized canopies and high economic value, such as Pongamia, were preferred. A greater focus on greening in slums is needed, and can provide an invaluable, inexpensive and sustainable approach to improve lives in these congested, deprived environments.

Goudie AS. 2014. Desert dust and human health disorders. Environment international, 63: 101-13.

Dust storms may originate in many of the world's drylands and have an effect not only on human health in the drylands themselves but also in downwind environments, including some major urban centres, such as Phoenix, Kano, Athens, Madrid, Dubai, Jedda, Tehran, Jaipur, Beijing, Shanghai, Seoul, Taipei, Tokyo, Sydney, Brisbane and Melbourne. In some parts of the world dust storms occur frequently throughout the year. They can transport particulate material, pollutants, and potential allergens over thousands of km from source. The main sources include the Sahara, central and eastern Asia, the Middle East, and parts of the western USA. In some parts of the world, though not all, the frequency of dust storms is changing in response to land use and climatic changes, and in such locations the health implications may become more severe. Data on the PM10 and P2.5 loadings of dust events are discussed, as are various pollutants (heavy metals, pesticides, etc.) and biological components (spores, fungi, bacteria, etc.). Particulate loadings can far exceed healthy levels. Among the human health effects of dust storms are respiratory disorders (including asthma, tracheitis, pneumonia, allergic rhinitis and silicosis) cardiovascular disorders (including stroke), conjunctivitis, skin irritations, meningococcal meningitis, valley fever, diseases associated with toxic algal blooms and mortality and injuries related to transport accidents.

Grahn P and UA Stigsdotter. 2003. Landscape planning and stress. Urban Forestry & Urban Greening 2(1): 1-18.

Stress and stress-related illnesses, as reflected in medical records, have increased dramatically among adults and children in Western societies. A growing part of the budget for medical service in Sweden is used for individuals suffering from different stress-related illnesses such as burnout syndrome, insomnia and fatigue, depression, feelings of panic, etc. In this paper, we present results from a study in which 953 randomly selected individuals in nine Swedish cities answered a questionnaire about their health and their use of different urban open green spaces in and close to the city. The results indicate that city landscape planning may affect the health of town-dwellers. Statistically significant relationships were found between the use of urban open green spaces and self-reported experiences of stress regardless of the informant's age, sex and socio-economic status. The results suggest that the more often a person visits urban open green spaces, the less often he or she will report stress-related illnesses. The same pattern is shown when time spent per week in urban open green spaces is measured. The distance to public urban open green spaces seems to be of decisive importance, as is access to a garden, in the form of a private garden or a green yard immediately adjacent to, for instance, an apartment building. People do not usually compensate for lack of green environments in their own residential area with more visits to public parks or urban forests. According to our results, laying out more green areas close to apartment houses, and making these areas more accessible, could make for more restorative environments. Outdoor areas that provide environments free from demands and stress, and that are available as part of everyday life, could have significant positive effects on the health of town-dwellers in Sweden. This may also apply to other Western societies.

Grantz DA, DL Vaughn, et al. 1998. Seeding native plants to restore desert farmland and mitigate fugitive dust and PM10. Journal of Environmental Quality, 27(5): 1209-18.

Windblown fugitive dust contributes to violations of air quality standards for particulate matter <10 pm aerodynamic diameter (PM10). In the western Mojave Desert of California, approximately 1070 ha of previously filled or over-grazed land impacted downwind metropolitan areas by wind-driven emissions of dust. A protocol of furrowing across the wind and direct seeding of three native perennial shrubs and a bunch grass helped reduce fugitive dust emissions in this area by more than 95%. Seeded species varied from 35 to 97% of living plant cover in individual years, reflecting rainfall patterns. In areas of deep sand, Indian ricegrass (Achnatherum hymenoides Roemer & Shultes) outperformed the shrubs, while fourwing saltbush [Atriplex canescens (Pursh) Nutt.] exhibited the most widespread establishment. This revegetation was achieved in an anomalous year with above average and late rainfall that eliminated early competition from annual species and later fostered abundant shrub growth. This success was not reproducible in more normal years, when minimal disturbance protocols such as broadcasting of seed on the untilled soil surface were as effective and less costly. We conclude: (i) direct seeding can lead to plant establishment in favorable years, but is likely to fail in any given year, (ii) direct seeding should be implemented with little soil disturbance, (iii) the native fourwing saltbush is the most likely species to become established in this environment, and (iv) unpredictable rainfall and temperature require that direct seeding be backed up with alternative strategies to achieve reliable dust and PM10 mitigation in arid environments.

Grazuleviciene R, A Dedele, et al. 2014. The influence of proximity to city parks on blood pressure in early pregnancy. International journal of environmental research and public health, 11(3): 2958-72.

This study investigated the effect of proximity to city parks on blood pressure categories during the first trimester of pregnancy. This cross-sectional study included 3,416 female residents of the city of Kaunas, Lithuania, who were enrolled in the FP7 PHENOTYPE project study. The women were classified into four blood pressure categories: optimal, normal, high-normal blood pressure, and hypertension. Multinomial regression models were used to investigate the association between three women's groups with respect to the residence distances from city parks (300, >300-1,000, and >1,000 m) and four blood pressure categories. When using the optimal blood pressure as the reference group, the crude and adjusted odds ratios (OR) for normal blood pressure and for high-normal blood pressure proved to be statistically significantly higher after the inclusion of the selected covariates into the regression analysis. The probability of normal blood pressure increased by 9%, and that of high-normal blood pressure--by 14% for every 300 m increase in the distance to green spaces. The findings of this study suggest a beneficial impact of nearby city parks on blood pressure amongst 20- to 45-year-old women. This relationship has important implications for the prevention of hypertension and the reduction of hypertension-related morbidity

Grazuleviciene R, I Uzdanaviciute, & S Andrusaityte. 2014. The impact of the use of city park on preschool childrens health. Global Journal on Advances Pure and Applied Sciences, 4.

We investigated the association between city park use and preschool children's health. This cohort study included 3,416 4-6 year-old children - residents of Kaunas city, Lithuania. Responses to the questionnaires completed by the parents were used to identify children's health. Multivariate logistic regression was used to analyze the association between children's health and time spent in the nearest park, controlling for potential confounders. Poor health (14.0% of children) was associated with less than 5 hours per week spent in the park, wheezing, allergy, underweight, and other factors. The use of city parks has a beneficial impact on children's health, and demonstrates the important role that public parks can play in reducing chronic diseases and poor health among children.

Greene RS, PI Kinnell, and JT Wood. 1994. Role of plant cover and stock trampling on runoff and soil-erosion from semi-arid wooded rangelands. Soil Research, 32(5): 953-73.

Relationships between plant cover, runoff and erosion of a massive red earth were investigated for a runoff zone of an intergrove area in a semi-arid wooded rangeland in eastern Australia. The measurements were carried out in small experimental paddocks with different stocking rates of sheep and kangaroos. A trailer-mounted rainfall simulator was used to apply rainfall at a time averaged rate of 30 mm h-1 to obtain runoff rates and sediment concentrations. There was a significant negative relationship (r2 = 0.58; P < 0.01) between final runoff rate and plant cover. It is probable that the plants increase infiltration and decrease runoff by (i) funnelling water down their stems and (ii) providing macropores at the base of the plant through which water can rapidly enter the soil. However, there was no significant effect of plant cover on sediment concentration. Probable reasons for this are: (i) even though plant cover will absorb raindrop energy and decrease the erosive stress on the soil, the nature of the plants investigated is such that they may not be 100% effective in protecting the soil beneath them, and (ii) the distribution of contact cover provided by the base of the plants is highly patchy and thus relatively inefficient at reducing sediment concentration. At zero cover final runoff rates from paddocks with a high and low stocking rate were similar, i.e. 23.4 and 22.3 mm h-1 respectively. However, at zero cover, the sediment concentration from the high stocking rate paddock was significantly (P < 0.01) greater than that from the low stocking rate paddock. Greater hoof activity and lower organic matter (and hence lower structural stability) of the 0.20 mm layer in the high stocking rate paddock caused the soil surface to be more susceptible to erosion. These results show that grazing by removing perennial grasses and pulverizing the surface soil can have a major impact on local water balances and erosion rates respectively within the intergrove areas. The implications of these results for the long-term stability of semi-arid mulga woodlands is briefly discussed.

Griffin DW, CA Kellogg, and EA Shinn. 2001. Dust in the wind: long range transport of dust in the atmosphere and its implications for global public and ecosystem health. Global Change and Human Health, 2(1): 20-33.

Movement of soil particles in atmospheres is a normal planetary process. Images of Martian dust devils (wind-spouts) and dust storms captured by NASA's Pathfinder have demonstrated the significant role that storm activity plays in creating the red atmospheric haze of Mars. On Earth, desert soils moving in the atmosphere are responsible for the orange hues in brilliant sunrises and sunsets. In severe dust storm events, millions of tons of soil may be moved across great expanses of land and ocean. An emerging scientific interest in the process of soil transport in the Earth's atmosphere is in the field of public and ecosystem health. This article will address the benefits and the potential hazards associated with exposure to particle fallout as clouds of desert dust traverse the globe.

Grigsby-Toussaint D, S-H Chi, et al. 2011. Where they live, how they play: Neighborhood greenness and outdoor physical activity among preschoolers. International Journal of Health Geographics 10 (1): 66.

Background: Emerging empirical evidence suggests exposure to "green" environments may encourage higher levels of physical activity among children. Few studies, however, have explored this association exclusively in pre-school aged children in the United States. We examined whether residing in neighborhoods with higher levels of greenness was associated with higher levels of outdoor physical activity among preschoolers. In addition, we also explored whether outdoor playing behaviors (e.g., active vs. quiet) were influenced by levels of neighborhood greenness independent of demographic and parental support factors.

Results : Higher levels of neighborhood greenness as measured by the Normalized Difference Vegetation Index (NDVI) was associated with higher levels of outdoor playing time among preschool-aged children in our sample. Specifically, a one unit increase in neighborhood greenness increased a child's outdoor playing time by approximately 3 minutes. A dose-response relationship was observed between increasing levels of parental support for physical activity (e.g., time spent playing with children) and child outdoor physical activity (p > 0.01).

Conclusions : Consistent with previous studies, neighborhood greenness influences physical activity behavior. However, for preschoolers, parental involvement may be more critical for improving physical activity levels.

Gronlund CJ, A Zanobetti, et al. 2014. Heat, heat waves, and hospital admissions among the elderly in the United States, 1992-2006. Environ Health Perspect, 122: 1187-1192.

Background: Heat-wave frequency, intensity, and duration are increasing with global climate change. The association between heat and mortality in the elderly is well documented, but less is known regarding associations with hospital admissions.

Objectives: Our goal was to determine associations between moderate and extreme heat, heat waves, and hospital admissions for nonaccidental causes among Medicare beneficiaries >= 65 years of age in 114 cities across five U.S. climate zones.

Methods: We used Medicare inpatient billing records and city-specific data on temperature, humidity, and ozone from 1992 through 2006 in a time-stratified case-crossover design to estimate the association between hospitalization and moderate [90th percentile of apparent temperature (AT)] and extreme (99th percentile of AT) heat and heat waves (AT above the 95th percentile over 2-8 days). In sensitivity analyses, we additionally considered confounding by ozone and holidays, different temperature metrics, and alternate models of the exposure-response relationship.

Results: Associations between moderate heat and hospital admissions were minimal, but extreme heat was associated with a 3% (95% CI: 2%, 4%) increase in all-cause hospital admissions over the subsequent 8 days. In cause-specific analyses, extreme heat was associated with increased hospitalizations for renal (15%; 95% CI: 9%, 21%) and respiratory (4%; 95% CI: 2%, 7%) diseases, but not for cardiovascular diseases. An added heat-wave effect was observed for renal and respiratory admissions.

Conclusion: Extreme heat is associated with increased hospital admissions, particularly for renal causes, among the elderly in the United States.

Grundstrom M and H Pleijel. 2014. Limited effect of urban tree vegetation on NO 2 and O 3 concentrations near a traffic route. Environmental Pollution, 189: 73-6.

Concentrations of NO2 and O3 were measured inside and outside a dense broad-leaved forest canopy adjacent to a busy traffic route in the City of Gothenburg, Sweden, with duplicate passive diffusion samplers during six one-week periods starting well before leaf senescence and ending when leaves were largely senescent. Concentrations of NO2 were lower inside the forest canopy during all periods (representing a significant effect, p = 0.016), on average by 7% or 2.7 micro-g/m3. O3 showed a more variable response with an average non-significant effect of 2% lower in the forest stand. There was no systematic trend of the difference in concentrations inside and outside the forest stand of the pollutants with the progression of autumn leaf senescence. Our study indicates that the effect of urban vegetation on air pollution concentrations is small, although it seems to exist for NO2 in a traffic polluted environment.

Guirguis K, A Gershunov, et al. 2014. The impact of recent heat waves on human health in California. Journal of Applied Meteorology and Climatology, 53(1): 3-19.

This study examines the health impacts of recent heat waves statewide and for six subregions of California: the north and south coasts, the Central Valley, the Mojave Desert, southern deserts, and northern forests. By using canonical correlation analysis applied to daily maximum temperatures and morbidity data in the form of unscheduled hospitalizations from 1999 to 2009, 19 heat waves spanning 3-15 days in duration that had a significant impact on health were identified. On average, hospital admissions were found to increase by 7% on the peak heat-wave day, with a significant impact seen for several disease categories, including cardiovascular disease, respiratory disease, dehydration, acute renal failure, heat illness, and mental health. Statewide, there were 11,000 excess hospitalizations that were due to extreme heat over the period, yet the majority of impactful events were not accompanied by a heat advisory or warning from the National Weather Service. On a regional basis, the strongest health impacts are seen in the Central Valley and the north and south coasts. The north coast contributes disproportionately to the statewide health impact during heat waves, with a 10.5% increase in daily morbidity at heat-wave peak as compared with 8.1% for the Central Valley and 5.6% for the south coast. The temperature threshold at which an impact is seen varies by subregion and timing within the season. These results suggest that heat-warning criteria should consider local percentile thresholds to account for acclimation to local climatological conditions as well as the seasonal timing of a forecast heat wave.

Guite HF, C Clark, et al. 2006. The impact of the physical and urban environment on mental well-being. Public Health 120 (12): 1117-1126.

Objectives: To examine the strength of association between physical and social factors in the built environment and mental well-being, and to determine which factors are the most important.

Study Design : A postal survey based on a theoretical model of domains that might link the physical and urban environment with mental well-being was sent to 2696 adults aged 18 years or over, in four areas of Greenwich, London. Mental health was measured using the SF36 subscales for mental health (MH) and vitality (V). Additional household and area level data were appended for each respondent from a range of sources.

Results : 1012 questionnaires were returned (38% response rate). At the univariate level significant confounders that were associated with poorer mental well-being were being female, 85+ years, unemployed or retired, on housing benefit, council tenant, two or more children, and having requested re-housing Better mental well-being was associated with being aged 65 years to 84 years (better MH and V). Within domain analysis, adjusting for each of the confounding factors, resulted in the following factors being significantly associated with being in the lowest quartile for MH score: (i) control over the internal environment (damp), (ii) design and maintenance (not liking the look of the estate/road, (iii) noise (neighbour noise), (iv) density and escape (feeling over-crowded in the home, being dissatisfied with green spaces, dissatisfied with social and entertainment facilities) being dissatisfied with community facilities (such as libraries and community centres) was only significant for vitality, (v) fear of crime and harassment (feeling unsafe to go out in the day, feeling unsafe to go out at night, agreeing that needles and syringes left lying around are a problem) (vi) social participation (not enough events to get people together, not enough places to stop and chat). When these 12 factors were entered into a single model with the significant confounders five remained significantly associated with being in the lowest quartile for MH or V: neighbour noise MH OR 2.71 [95% CI 1.48, 4.98]; feeling over-crowded in the home MH OR 2.22 [1.42, 3.48]; being dissatisfied with access to green open spaces MH OR 1.69 [1.05, 2.74]; access to community facilities V OR 1.92, [1.24, 3.00]; feeling unsafe to go out in the day MH OR 1.64 [1.02, 2.64]; V OR 1.58 [1.00, 2.49].

Conclusions: This study confirms an association between the physical environment and mental well-being across a range of domains. The most important factors that operate independently are neighbour noise, sense of over-crowding in the home and escape facilities such as green spaces and community facilities, and fear of crime. This study highlights the need to intervene on both design and social features of residential areas to promote mental well-being.

Guo Y, H Gong, & X Guo. 2015. Rhizosphere bacterial community of Typha angustifolia L. and water quality in a river wetland supplied with reclaimed water. Applied microbiology and biotechnology, 99(6): 2883-93.

Wetland plant rhizosphere microorganisms play a significant role in the purification of ecological restoration of reclaimed water replenishment wetlands. In this study, water quality discriminant analysis indicated the wetland had a distinctive role in the purification of total nitrogen (TN), total phosphorus (TP), and nitrate (NO3(-)) from reclaimed water, of which removal rates were 42.15, 47.34, and 28.56% respectively. All the sequences of 16S ribosomal RNA (16S rRNA) gene clone library were affiliated with Proteobacteria (74.50%), Bacteroidetes (6.54%), Gemmatimonadetes (5.88%), Chloroflexi (4.25%), Chlorobi (2.94%), Nitrospira (2.61%), Acidobacteria (2.29%), and Actinobacteria (0.98%). Assessment of water quality purification and rhizosphere bacterial properties revealed that the major biogeochemical reactions were nitrogen, phosphorus, carbon, and sulfur cycles (33.70, 15.40, 14.40, and 4.90%, respectively). In addition, approximately 5.90 and 4.60% of the clones are closely related with the minor biogeochemical degradations of antibiotics and halogenated hydrocarbons, which were the typical characteristics of reclaimed water wetland different from freshwater wetlands. The finding of water quality discriminant is consistent with that of bacterial community, but the latter was a more powerful method than the former which reveals possible implications of wetland plant purification on the reclaimed water.


Hajat A, M Allison, et al. 2015. Long-term exposure to air pollution and markers of inflammation, coagulation, and endothelial activation: a repeat-measures analysis in the Multi-Ethnic Study of Atherosclerosis (MESA). Epidemiology (Cambridge, Mass.), 26(3): 310.


Air pollution is associated with cardiovascular disease, and systemic inflammation may mediate this effect. We assessed associations between long- and short-term concentrations of air pollution and markers of inflammation, coagulation, and endothelial activation.


We studied participants from the Multi-Ethnic Study of Atherosclerosis from 2000 to 2012 with repeat measures of serum C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, D-dimer, soluble E-selectin, and soluble Intercellular Adhesion Molecule-1. Annual average concentrations of ambient fine particulate matter (PM2.5), individual-level ambient PM2.5 (integrating indoor concentrations and time-location data), oxides of nitrogen (NOx), nitrogen dioxide (NO2), and black carbon were evaluated. Short-term concentrations of PM2.5 reflected the day of blood draw, day prior, and averages of prior 2-, 3-, 4-, and 5-day periods. Random-effects models were used for long-term exposures and fixed effects for short-term exposures. The sample size was between 9,000 and 10,000 observations for CRP, IL-6, fibrinogen, and D-dimer; approximately 2,100 for E-selectin; and 3,300 for soluble Intercellular Adhesion Molecule-1.


After controlling for confounders, 5 µg/m3 increase in long-term ambient PM2.5 was associated with 6% higher IL-6 (95% confidence interval = 2%, 9%), and 40 parts per billion increase in long-term NOx was associated with 7% (95% confidence interval = 2%, 13%) higher level of D-dimer. PM2.5 measured at day of blood draw was associated with CRP, fibrinogen, and E-selectin. There were no other positive associations between blood markers and short- or long-term air pollution.


These data are consistent with the hypothesis that long-term exposure to air pollution is related to some markers of inflammation and fibrinolysis.

Haluza D, R Schonbauer, and R Cervinka. 2014. Green perspectives for public health: a narrative review on the physiological effects of experiencing outdoor nature, 11(5): 5445-61.

Natural environments offer a high potential for human well-being, restoration and stress recovery in terms of allostatic load. A growing body of literature is investigating psychological and physiological health benefits of contact with Nature. So far, a synthesis of physiological health outcomes of direct outdoor nature experiences and its potential for improving Public Health is missing. We were interested in summarizing the outcomes of studies that investigated physiological outcomes of experiencing Nature measuring at least one physiological parameter during the last two decades. Studies on effects of indoor or simulated Nature exposure via videos or photos, animal contact, and wood as building material were excluded from further analysis. As an online literature research delivered heterogeneous data inappropriate for quantitative synthesis approaches, we descriptively summarized and narratively synthesized studies. The procedure started with 1,187 titles. Research articles in English language published in international peer-reviewed journals that investigated the effects of natural outdoor environments on humans by were included. We identified 17 relevant articles reporting on effects of Nature by measuring 20 different physiological parameters. We assigned these parameters to one of the four body systems brain activity, cardiovascular system, endocrine system, and immune function. These studies reported mainly direct and positive effects, however, our analyses revealed heterogeneous outcomes regarding significance of results. Most of the studies were conducted in Japan, based on quite small samples, predominantly with male students as participants in a cross-sectional design. In general, our narrative review provided an ambiguous illustration of the effects outdoor nature exerted on physiological parameters. However, the majority of studies reported significant positive effects. A harmonizing effect of Nature, especially on physiological stress reactions, was found across all body systems. From a Public Health perspective, interdisciplinary work on utilizing benefits of Nature regarding health promotion, disease prevention, and nature-based therapy should be optimized in order to eventually diminish given methodological limitations from mono-disciplinary studies.

Han B, DA Cohen, et al. 2014. How much neighborhood parks contribute to local residents' physical activity in the City of Los Angeles: A meta-analysis. Preventive medicine, 69: S106-10.

Objective To quantify the contribution of neighborhood parks to population-level, moderate-to-vigorous physical activity (MVPA).

Method We studied park use in 83 neighborhood parks in Los Angeles between 2003 and 2014 using systematic observation and surveys of park users and local residents. We observed park use at least 3-4 times per day over 4-7 clement days. We conducted a meta-analysis to estimate total, age group and gender-specific park use and total MVPA time in parks.

Results An average park measuring 10 acres and with 40,000 local residents in a one-mile radius accrued 5301 h of use (SE = 1083) during one week, with 35% (1850 h) spent in MVPA and 12% (635 h) spent in vigorous physical activity (VPA). As much as a 10.7-fold difference in weekly MVPA hours was estimated across study parks. Parks' main contribution to population-level MVPA is for males, teenagers, and residents living within a half mile.

Conclusion Neighborhood parks contribute substantially to population MVPA. The contribution may depend less on size and facilities than on "demand goods" - programming and activities - that draw users to a park.

Han X, OR Burton, et al. 2013. Public attitudes about urban lawns: social opportunities provided by urban lawns in Lund, Sweden. International Academic Workshop on Social Science (IAW-SC-13) 2013: 1046-1054.

Since the 19th century, urban lawns have gradually taken center stage to become one of the main sources of greening in many cities around the world. The current published research on planting technology, maintenance techniques, the impact of lawn maintenance, preferences for manicured lawns and the biodiversity protection for historical lawns as topics, has developed and increased over time. However, what has been less researched is the relationship and interplay between the perceptions of urban residents and their use of urban lawns. More specifically, our research focused on the question of how residents view, socialize and utilize city lawns accessible to them. To provide some insight into this area of urban lawn use, our research study was conducted in Lund, Sweden a city that uses lawns as their main form of greening. To accomplish the study's objectives the city's lawns were grouped into the following categories: (1) park lawns, (2) residential neighborhood lawns, (3) lawns around public buildings, (4) lawns surrounding residential buildings, (5) lawns along greenways and (6) lawns along roads. By means of distributed open-ended questionnaires the researchers discovered two important findings. First, the socialization patterns and utilization of lawns differed between the six categories due to various factors which included the suitability of the land use. The data also showed that the efficiency of planting lawns in certain areas impacts the ability to access areas for socialization activities (i.e. roadsides and greenways). Secondly, the study revealed that the planting collocation and service facilities of lawns greatly influences residents' ability and opportunities for social interaction. Two other study findings were of interest namely that (1) the utilization of lawns among Lund's working class was somewhat lower than that of students; and (2) that socialization and use of lawns were not necessarily related to the user's accustomed environmental background. Subsequently, this article discusses key themes that include residents' attitudes, beliefs and opinions about the interaction of socializing and the meaning of those interactions in an urban environment. It is our purpose that this article spurs a more robust international dialogue about pragmatic lessons urban planners may learn about future designing efforts of urban green space in newly developing cities and established ones already confronting modern space and housing challenges.

Hansen A, P Bi, et al. 2008. The effect of heat waves on mental health in a temperate Australian city. Environmental Health Perspectives 116(10): 1369-75.

Objective: The goal of this study was to identify mental, behavioral, and cognitive disorders that may be triggered or exacerbated during heat waves, predisposing individuals to heat-related morbidity and mortality.

Design: Using health outcome data from Adelaide, South Australia, for 1993-2006, we estimated the effect of heat waves on hospital admissions and mortalities attributed to mental, behavioral, and cognitive disorders. We analyzed data using Poisson regression accounting for overdispersion and controlling for season and long-term trend, and we performed threshold analysis using hockey stick regression.

Results: Above a threshold of 26.7 C, we observed a positive association between ambient temperature and hospital admissions for mental and behavioral disorders. Compared with non-heat-wave periods, hospital admissions increased by 7.3% during heat waves. Specific illnesses for which admissions increased included organic illnesses, including symptomatic mental disorders; dementia; mood (affective) disorders; neurotic, stress related, and somatoform disorders; disorders of psychological development; and senility. Mortalities attributed to mental and behavioral disorders increased during heat waves in the 65- to 74-year age group and in persons with schizophrenia, schizotypal, and delusional disorders. Dementia deaths increased in those up to 65 years of age.

Conclusion: Our results suggest that episodes of extreme heat pose a salient risk to the health and well-being of the mentally ill.

Hansen B, P Reich, PSLake & T Cavagnaro. 2010. Minimum width requirements for riparian zones to protect flowing waters and to conserve biodiversity: a review and recommendations (pp. 101). Victoria, Australia: Department of Sustainability and Environment.

No abstract provided.

Hansmann R, S-M Hug, K. Seeland. 2007. Restoration and stress relief through physical activities in forests and parks. Urban Forestry & Urban Greening 6(4): 213-25.

A field survey assessed the restorative effects of visiting an urban forest and a city park in Zurich, Switzerland. Respondents rated their headaches, level of stress, and how balanced they felt both prior to visiting the outdoor location and at the time of being interviewed. Suffering from headaches and stress decreased significantly, and feeling well-balanced increased significantly. The recovery ratio for stress was 87%, and the reduction in headaches was 52%, in terms of the possible improvements on five-point rating scales. With respect to feeling well-balanced, the observed changes amounted to 40% of the possible enhancement. Positive effects increased with length of visit, and individuals practising sports (e.g., jogging, biking, playing ball) showed significantly higher improvements than those engaged in less strenuous activities (e.g., taking a walk or relaxing). These findings support previous research on how exercise in green spaces promotes well-being and recovery from stress.

Harlan SL and JH Declet-Barreto. 2013. Neighborhood effects on heat deaths: social and environmental predictors of vulnerability in Maricopa County, Arizona. Environ Health Perspect 121(2): 197-204.

BACKGROUND: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature-mortality relationships in cities. OBJECTIVES: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000-2008).

METHODS: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods.

RESULTS: Neighborhood scores on three factors-socioeconomic vulnerability, elderly/isolation, and unvegetated area-varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor.

CONCLUSIONS: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed.

Harlan SL, AJ Brazel, et al. 2006. Neighborhood microclimates and vulnerability to heat stress. Social science & medicine, 63(11): 2847-63.

Human exposure to excessively warm weather, especially in cities, is an increasingly important public health problem. This study examined heat-related health inequalities within one city in order to understand the relationships between the microclimates of urban neighborhoods, population characteristics, thermal environments that regulate microclimates, and the resources people possess to cope with climatic conditions. A simulation model was used to estimate an outdoor human thermal comfort index (HTCI) as a function of local climate variables collected in 8 diverse city neighborhoods during the summer of 2003 in Phoenix, USA. HTCI is an indicator of heat stress, a condition that can cause illness and death. There were statistically significant differences in temperatures and HTCI between the neighborhoods during the entire summer, which increased during a heat wave period. Lower socioeconomic and ethnic minority groups were more likely to live in warmer neighborhoods with greater exposure to heat stress. High settlement density, sparse vegetation, and having no open space in the neighborhood were significantly correlated with higher temperatures and HTCI. People in warmer neighborhoods were more vulnerable to heat exposure because they had fewer social and material resources to cope with extreme heat. Urban heat island reduction policies should specifically target vulnerable residential areas and take into account equitable distribution and preservation of environmental resources.

Harris MH, DR Gold, et al. 2015. Prenatal and childhood traffic-related pollution exposure and childhood cognition in the project viva cohort (Massachusetts, USA). Environmental health perspectives, 123(10): 1072.

Background Influences of prenatal and early-life exposures to air pollution on cognition are not well understood.

Objectives We examined associations of gestational and childhood exposure to traffic-related pollution with childhood cognition.

Methods We studied 1,109 mother-child pairs in Project Viva, a prospective birth cohort study in eastern Massachusetts (USA). In mid-childhood (mean age, 8.0 years), we measured verbal and nonverbal intelligence, visual motor abilities, and visual memory. For periods in late pregnancy and childhood, we estimated spatially and temporally resolved black carbon (BC) and fine particulate matter (PM2.5) exposures, residential proximity to major roadways, and near-residence traffic density. We used linear regression models to examine associations of exposures with cognitive assessment scores, adjusted for potential confounders.

Results Compared with children living >=200 m from a major roadway at birth, those living < 50 m away had lower nonverbal IQ [-7.5 points; 95% confidence interval (CI): -13.1, -1.9], and somewhat lower verbal IQ (-3.8 points; 95% CI: -8.2, 0.6) and visual motor abilities (-5.3 points; 95% CI: -11.0, 0.4). Cross-sectional associations of major roadway proximity and cognition at mid-childhood were weaker. Prenatal and childhood exposure to traffic density and PM2.5 did not appear to be associated with poorer cognitive performance. Third-trimester and childhood BC exposures were associated with lower verbal IQ in minimally adjusted models; but after adjustment for socioeconomic covariates, associations were attenuated or reversed.

Conclusions Residential proximity to major roadways during gestation and early life may affect cognitive development. Influences of pollutants and socioeconomic conditions on cognition may be difficult to disentangle.

Harris N, FR Minniss, & S Somerset. 2014. Refugees connecting with a new country through community food gardening. International journal of environmental research and public health, 11(9): 9202-16.

Refugees are a particularly vulnerable population who undergo nutrition transition as a result of forced migration. This paper explores how involvement in a community food garden supports African humanitarian migrant connectedness with their new country. A cross-sectional study of a purposive sample of African refugees participating in a campus-based community food garden was conducted. Semi-structured interviews were undertaken with twelve African humanitarian migrants who tended established garden plots within the garden. Interview data were thematically analysed revealing three factors which participants identified as important benefits in relation to community garden participation: land tenure, reconnecting with agri-culture, and community belonging. Community food gardens offer a tangible means for African refugees, and other vulnerable or marginalised populations, to build community and community connections. This is significant given the increasing recognition of the importance of social connectedness for wellbeing.

Hart JE, F Laden, et al. 2009. Exposure to traffic pollution and increased risk of rheumatoid arthritis. Environmental Health Perspectives 117(7): 1065-9.

Background : Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease that affects approximately 1% of the adult population, and to date, genetic factors explain less than 50% of the risk. Particulate air pollution, especially of traffic origin, has been linked to systemic inflammation in many studies.

Objectives : We examined the association of distance to road, a marker of traffic pollution exposure, and incidence of RA in a prospective cohort study.

Methods : We studied 90,297 U.S. women in the Nurses' Health Study. We used a geographic information system to determine distance to road at the residence in 2000 as a measure of traffic exposure. Using Cox proportional hazard models, we examined the association of distance to road and incident RA (1976-2004) with adjustment for a large number of potential confounders.

Results : In models adjusted for age, calendar year, race, cigarette smoking, parity, lactation, menopausal status and hormone use, oral contraceptive use, body mass index, physical activity, and census-tract-level median income and house value, we observed an elevated risk of RA [hazard ratio (HR) = 1.31; 95% confidence interval (CI), 0.98-1.74] in women living within 50 m of a road, compared with those women living 200 m or farther away. We also observed this association in analyses among nonsmokers (HR = 1.62; 95% CI, 1.04-2.52), nonsmokers with rheumatoid factor (RF)-negative RA (HR = 1.77; 95% CI, 0.93-3.38), and nonsmokers with RF-positive RA (HR = 1.51; 95% CI, 0.82-2.77). We saw no elevations in risk in women living 50-200 m from the road.

Conclusions : The observed association between exposure to traffic pollution and RA suggests that pollution from traffic in adulthood may be a newly identified environmental risk factor for RA.

Harte JL and GH Eifert. 1995. The effects of running, environment, and attentional focus on athletes catecholamine and cortisol levels and mood. Psychophysiology 32(1): 49-54.

This study was designed to examine some of the psychoneuroendocrine effects of exercise-induced emotional experiences and the mediating effects of environmental setting and subjects' attentional focus. Trained runners were tested during an outdoor run and two indoor treadmill running conditions. Excretions of catecholamines and Cortisol significantly increased after all running conditions but not after a control condition. Results indicate that patterns of endocrine and concomitant emotional change through exercise differ when environmental setting and attentional focus are altered in such a way that a normally pleasant task such as running becomes tedious and negatively evaluated. These findings support the notion that setting, attention, and cognitive appraisal may alter the emotional experience associated with physical exercise.

Hartig T, A Book A, et al. 1996. Environmental influences on psychological restoration. Scandinavian journal of psychology, 37(4): 378-93.

Research on psychological restoration and restorative environments is a needed complement to work on stress and environmental stressors. Two laboratory experiments tested the utility of two restorative environments theories, one concerned with directed attention capacity renewal and the other with stress reduction and associated changes in emotion. Various strategies were employed to distinguish restorative effects from other effects, to limit the role of arousal reduction in attentional restoration, and to begin mapping the time course for the emergence of outcomes. Both experiments tested for differential emotional and performance effects as a function of photographic environmental simulation (natural or urban environment). Across the experiments the natural environment simulation engendered generally more positive emotional self-reports. That consistent performance effects were not found in either study suggests that attentional restoration as reflected in performance is a more time-intensive process.

Hartig T, GW Evans, et al. 2003. Tracking restoration in natural and urban field settings. Journal of Environmental Psychology 23(2): 109-123.

We compared psychophysiological stress recovery and directed attention restoration in natural and urban field settings using repeated measures of ambulatory blood pressure, emotion, and attention collected from 112 randomly assigned young adults. To vary restoration needs, we had half of the subjects begin the environmental treatment directly after driving to the field site. The other half completed attentionally demanding tasks just before the treatment. After the drive or the tasks, sitting in a room with tree views promoted more rapid decline in diastolic blood pressure than sitting in a viewless room. Subsequently walking in a nature reserve initially fostered blood pressure change that indicated greater stress reduction than afforded by walking in the urban surroundings. Performance on an attentional test improved slightly from the pretest to the midpoint of the walk in the nature reserve, while it declined in the urban setting. This opened a performance gap that persisted after the walk. Positive affect increased and anger decreased in the nature reserve by the end of the walk; the opposite pattern emerged in the urban environment. The task manipulation affected emotional self-reports. We discuss implications of the results for theories about restorative environments and environmental health promotion measures.

Hartig T, M Mang, et al. 1991. Restorative effects of natural environment experiences. Environment and Behavior 23(1): 3-26.

The utility of different theoretical models of restorative experience was explored in a quasi-experimental field study and a true experiment. The former included wilderness backpacking and nonwilderness vacation conditions, as well as a control condition in which participants continued with their daily routines. The latter had urban environment, natural environment, and passive relaxation conditions. Multimethod assessments of restoration consisted of self-reports of affective states, cognitive performance, and, in the latter study, physiological measures. Convergent self-report and performance results obtained in both studies offer evidence of greater restorative effects arising from experiences in nature. Implications for theory, methodology, and design are discussed.

Hayborn D. 2011. Central Park: Nature, context and human wellbeing. Journal of Wellbeing 1(2).

This paper considers evidence that social and physical contexts, particularly natural environments, are surprisingly important for human wellbeing. In particular, the pursuit of happiness seems to be less a matter of individual choice than is commonly supposed. These ideas are explored through an examination of New York's Central Park.

Hefting MM, J-C Clement, P Bienkowski et al. 2005. The role of vegetation and litter in the nitrogen dynamics of riparian buffer zones in Europe. Ecological Engineering, 24(5), 465-482.

No abstract provided.

Herzele AV, S de Vries. 2011. Linking green space to health: A comparative study of two urban neighborhoods in Ghent, Belgium. Population and Environment.

This paper investigates the nature of the relationship between the greenness of the local environment and the health and well-being of its inhabitants by looking at a number of possible mediators within the same study: physical activity, perceived stress, ability to concentrate, social cohesion and neighbourhood satisfaction. Data were collected through a survey of residents in two neighbourhoods that differ objectively in green space provision, but which are largely similar in demographics, socio-economic factors, housing conditions and other environmental characteristics, apart from green space. Of the three dependent variables of interest: self-reported general health, bodily functioning and general well-being (happiness), it was self-reported happiness that differed significantly between the two neighbourhoods, with greater happiness in the greener neighbourhood. Amongst the possible mediators, people's satisfaction with their neighbourhood differed significantly: those living in the greener neighbourhood were more satisfied. Mediation analysis indicated that neighbourhood satisfaction fully mediates the relationship between neighbourhood greenness and happiness. Among the specific (environmental and social) neighbourhood qualities asked about, perception of neighbourhood greenness was found to be the most important predictor of neighbourhood satisfaction. Additional analysis showed that the view from the living room-green or not green-fully mediates the relationship between neighbourhood greenness and neighbourhood satisfaction. This study underscores the importance of nearby green space for people's overall well-being and suggests the need for green space to be evaluated in terms of visual proximity, that is, whether and how it is experienced from the street and the home.

Heschong Mahone Group. 2003. Windows and Classrooms: Student Performance and the Indoor Environment.

This study investigates whether daylight and other aspects of the indoor environment in elementary classrooms have an effect on student learning, as measured by improvement on standardized math and reading tests over an academic year. The study uses regression analysis to compare the performance of over 8000 3rd through 6th grade students in 450 classrooms in the Fresno Unified School District, CA. A statistical analysis was conducted in which traditional education explanatory variables, such as student and teacher demographic characteristics, were controlled for. Numerous other physical attributes of the classroom and the indoor environment are also considered as potential influences. In addition to the statistical analysis, 40 classrooms were observed during normal operation and over 100 teachers were surveyed on their classroom operating experience and preferences. Variables describing a better view out of windows are found to be positively and significantly associated with better student learning, while variables describing window glare, sun penetration and lack of visual control are associated with negative performance. In addition, attributes of classrooms associated with acoustic conditions and air quality issues are also significant. The findings are discussed relative to a previous study at San Juan Capistrano that found that more daylight improved students' performance. The results emphasize the statistical value of working with very large data sets, and of studying the interactions between environmental variables.

Hess JJ, S Saha, & G Luber. 2014. Summertime acute heat illness in US Emergency Departments from 2006 through 2010: analysis of a nationally representative sample. Environmental Health Perspectives (Online), 122(11): 1209.

Background: Patients with acute heat illness present primarily to emergency departments (EDs), yet little is known regarding these visits.

Objective: We aimed to describe acute heat illness visits to U.S. EDs from 2006 through 2010 and identify factors associated with hospital admission or with death in the ED.

Methods: We extracted ED case-level data from the Nationwide Emergency Department Sample (NEDS) for 2006-2010, defining cases as ED visits from May through September with any heat illness diagnosis (ICD-9-CM 992.0-992.9). We correlated visit rates and temperature anomalies, analyzed demographics and ED disposition, identified risk factors for adverse outcomes, and examined ED case fatality rates (CFR).

Results: There were 326,497 (95% CI: 308,372, 344,658) cases, with 287,875 (88.2%) treated and released, 38,392 (11.8%) admitted, and 230 (0.07%) died in the ED. Heat illness diagnoses were first-listed in 68%. 74.7% had heat exhaustion, 5.4% heat stroke. Visit rates were highly correlated with annual temperature anomalies (Pearson correlation coefficient 0.882, p = 0.005). Treat-and-release rates were highest for younger adults (26.2/100,000/year), whereas hospitalization and death-in-the-ED rates were highest for older adults (6.7 and 0.03/100,000/year, respectively); all rates were highest in rural areas. Heat stroke had an ED CFR of 99.4/10,000 (95% CI: 78.7, 120.1) visits and was diagnosed in 77.0% of deaths. Adjusted odds of hospital admission or death in the ED were higher among elders, males, urban and low-income residents, and those with chronic conditions.

Conclusions: Heat illness presented to the ED frequently, with highest rates in rural areas. Case definitions should include all diagnoses. Visit rates were correlated with temperature anomalies. Heat stroke had a high ED CFR. Males, elders, and the chronically ill were at greatest risk of admission or death in the ED. Chronic disease burden exponentially increased this risk.

Hibbert, Alden R. 1967. Forest treatment effects on water yield. Coweeta Hydrologic Laboratory, Southeastern Forest Experiment Station, Forest Service, U.S. Department of Agriculture, Asheville, North Carolina.

Results are reported for thirty-nine studies of the effect of altering forest cover on water yield. Taken collectively, these studies reveal that forest reduction increases water yield, and that reforestation decreases water yield. Results of individual treatments vary widely and for the most part are unpredictable. First-year response to complete forest reduction varies from 34 mm to more than 450 mm of increased streamflow. A practical upper limit of yield increase appears to be about 4.5 mm per year for each percent reduction in forest cover, but most treatments produce less than half this amount. There is strong evidence that in well-watered regions, at least, streamflow response is proportional to reduction in forest cover. As the forest regrows following treatment, increases in streamflow decline; the rate of decline varies between catchments, but appears to be related to the rate of forest recovery. Seasonal distribution of streamflow response to treatment is variable; response in streamflow may be almost immediate or considerably delayed, depending on climate, soils, topography, and other factors.

Hillsdon M, J Panter, et al. 2006. The relationship between access and quality of urban green space with population physical activity. Public Health 120(12): 1127-1132.

Objectives: This study examined the association between access to quality urban green space and levels of physical activity.

Study design: A cross-sectional examination of the relationship between access to quality urban green space and level of recreational physical activity in 4950 middle-aged (40-70 years) respondents from the European Prospective Investigation into Cancer and Nutrition (EPIC), who resided in Norwich, UK.

Methods: Using geographic information systems (GIS), three measures of access to open green space were calculated based on distance only, distance and size of green space and distance, size and quality of green space. Multiple regression models were used to determine the relationship between the three indicators of access to open green space and level of recreational physical activity.

Results: There was no evidence of clear relationships between recreational activity and access to green spaces. Non-significant associations were apparent for all variables, and there was no evidence of a clear trend in regression coefficients across quartiles of access for either the distance, size adjusted, and quality and size-adjusted models. Furthermore, the neighbourhood measures of access to green spaces showed non-significant associations with recreational physical activity.

Conclusions: Access to urban green spaces does not appear to be associated with population levels of recreational physical activity in our sample of middle-aged adults.

Hipp JA, GB Gulwadi, et al. 2016. The relationship between perceived greenness and perceived restorativeness of university campuses and student-reported quality of life. Environment and Behavior, 48(10): 1292-308.

University students are exposed to many stressors, necessitating opportunities for restoration. Research has indicated that actual experiences in nearby green spaces are associated with restorative psychological and physiological health benefits. However, the perception of greenness and restorativeness of environments might also impact health outcomes. Can green campus spaces provide restorative potential to university students? Do students perceive the greenness and restorative benefits? To explore these questions, students at three universities (convenience sample) were surveyed with items on perceived greenness of campus, perceived restorativeness of campus, and the World Health Organization Quality-of-Life Scale. Results indicate that those with higher perceived campus greenness report greater quality of life, a pathway significantly and partially mediated by perceived campus restorativeness. Future research should help identify effective ways in which university green spaces can be developed as health resources for students.

Hogg MA, D Abrams, & GN Martin. 2010. Social cognition and attitudes. In Martin, GN, Carlson, NR, Buskist, W., (Ed.), Psychology (pp 646-677). Harlow: Pearson Education Limited

No abstract provided.

Hollis GE and JR Thompson. 1993. Water resource developments and their hydrological impacts. In: G.E. Hollis, W.M. Adams, M. Aminu-Kano, Editors, The Hadejia-Nguru wetlands: Environment, Economy and Sustainable Development of a Sahelian Floodplain Wetland. 149 - 90. IUCN: Gland & Cambridge, UK.

No abstract provided.

Holtan MT, SL Dieterlen, & WC Sullivan. 2015. Social Life Under Cover Tree Canopy and Social Capital in Baltimore, Maryland. Environment and behavior. 47(5): 502-25.

To what extent does the density of the tree cover in a city relate to the amount of social capital among neighbors? To address this question, we linked social survey data (N = 361) from the Baltimore Ecosystem Study with socioeconomic, urban form, and green space data at the census block group level using a geographic information system. We found a systematically positive relationship between the density of urban tree canopy at the neighborhood block group level and the amount of social capital at the individual level (r = .241, p < .01). Multiple regression analyses showed that tree canopy added a 22.72% increase in explanatory power to the model for social capital. This research adds a new variable--neighborhood tree canopy--to the typologies of green space that affect human social connection. Trees are a relatively inexpensive and easy intervention to enhance the strength of social ties among neighbors

Hong B, KE Limburg, et al. 2012. An integrated monitoring/modeling framework for assessing human-nature interactions in urbanizing watersheds: Wappinger and Onondaga Creek watersheds, New York, USA. Environmental Modelling & Software 32(0): 1-15.

In much of the world, rapidly expanding areas of impervious surfaces due to urbanization threaten water resources. Although tools for modeling and projecting land use change and water quantity and quality exist independently, to date it is rare to find an integrated, comprehensive modeling toolkit to readily assess the future course of urban sprawl, and the uncertainties of its impact on watershed ecosystem health. We have developed a combined socio-economic-ecological toolbox, running on the ArcGIS platform, to analyze subsequent impacts on streamflow and nutrient export using the spatial pattern of urbanization in response to anticipated socio-economic conditions and scenarios. We have applied our toolbox to two New York State catchment areas, Onondaga Creek watershed and Wappinger Creek, that have undergone rapid development in the last decades. Uncertainties in temporal trends of new housing permits, spatial distribution of development detection and development potential, and stream conditions were evaluated using three separate toolsets (ArcECON, ArcGEOMOD, and ArcGWLF, respectively). The toolbox capabilities are demonstrated through a year 2020 scenario prediction and analysis, where the aforementioned tools were explicitly linked to determine future housing development, spread of impervious areas, runoff generation, and stream nitrate flux. Higher economic growth was estimated to induce increased new housing permits and spread of impervious surface areas, leading to flashier streamflow as well as worsening stream condition, which was aggravated when only the forest lands were allowed to be developed.

Honold J, T Lakes, et al. 2016. Restoration in urban spaces: Nature views from home, greenways, and public parks. Environment and Behavior, 48(6): 796-825.

Despite promising experimental findings, few studies have addressed the potential long-term health benefits of frequent contact with different kinds of urban nature. We examine the cross-sectional relations between two kinds of urban nature (neighborhood vegetation visible from the home, use of public green spaces) and health outcomes (life satisfaction, perceived general health, 2-months hair cortisol levels) in a sample population from Berlin (N=32) using a mixed-method approach. Participants whose homes had views of high amounts of diverse kinds of vegetation had significantly lower cortisol levels. Moreover, participants who regularly used a vegetated trail along a canal had significantly lower cortisol levels and reported significantly higher life satisfaction than less frequent users. In addition, vegetated routes or paths played an important role in the restorative activities and daily commutes of participants. We discuss directions for future research and recommend more consideration of greenways in urban development.

Horiuchi M, J Endo, et al. 2014. Impact of viewing vs. not viewing a real forest on physiological and psychological responses in the same setting. International journal of environmental research and public health, 11(10): 10883-901.

We investigated the impact of viewing versus not viewing a real forest on human subjects' physiological and psychological responses in the same setting. Fifteen healthy volunteers (11 males, four females, mean age 36 years) participated. Each participant was asked to view a forest while seated in a comfortable chair for 15 min (Forest condition) vs. sitting the same length of time with a curtain obscuring the forest view (Enclosed condition). Both conditions significantly decreased blood pressure (BP) variables, i.e., systolic BP, diastolic BP, and mean arterial pressure between pre and post experimental stimuli, but these reductions showed no difference between conditions. Interestingly, the Forest viewing reduced cerebral oxygenated hemoglobin (HbO2) assessed by near-infrared spectroscopy (NIRS) and improved the subjects' Profile of Mood States (POMS) scores, whereas the Enclosed condition increased the HbO2 and did not affect the POMS scores. There were no significant differences in saliva amylase or heart rate variability (HRV) between the two conditions. Collectively, these results suggest that viewing a real forest may have a positive effect on cerebral activity and psychological responses. However, both viewing and not viewing the forest had similar effects on cardiovascular responses such as BP variables and HRV.

Horwitz P and CM Finlayson. 2011. Wetlands as settings for human health: incorporating ecosystem services and health impact assessment into water resource management. BioScience 61(9): 678-688.

Reconsidering the relationship between human well-being and environmental quality is central for the management of wetlands and water resources and for public health itself. We propose an integrated strategy involving three approaches. The first is to make assessments of the ecosystem services provided by wetlands more routine. The second is to adopt the "settings" approach, most developed in health promotion, wherein wetlands are one of the settings for human health and provide a context for health policies. Finally, a layered suite of health issues in wetland settings is developed, including core requirements for human health (food and water); health risks from wetland exposures; and broader social determinants of health in wetland settings, including livelihoods and lifestyles. Together, these strategies will allow wetland managers to incorporate health impact assessment processes into their decisionmaking and to examine the health consequences of trade-offs that occur in planning, investment, development, and decisionmaking outside their direct influence.

Hosseini G, P Teymouri, et al. 2015. PM10 concentration and its composition in Sanandaj, Iran. CEST.

The present study, investigated the effect of the Middle East dust (MED) storm episodes on the concentration and composition of PM10 in Sanandaj city, Iran, from April to September, 2013. Sampling was once on every six days, and also on dusty days (DDs) using an Omni air sampler. The average PM10 concentration was 160.63 micro-g/m3 . The lowest and highest concentrations of PM10 were found in May and June, respectively. The averagePM10 concentration during the non-dusty days (NDDs) was 96.88 (micro-g /m3 ). But, it increased by 4.8 times during the DDs. Ca2+, Cl, NO3 - and Na+ had accounted for 71 % of total water soluble ions on the DDs. During the DDs,the dominant elements in PM10 were Na, Ca, Mg, Al and Fe contributing to 95.72% of total measured metals. Based on the correlation coefficient and enrichment factor analyses it was found that Al, Ca, Fe, K, Mg, Na, Sr and V on DDs were the elements with crustal sources.

House J S, Landis K R, & D Umberson. 1988. Social relationships and health. Science 241(4865): 540-545.

Recent scientific work has established both a theoretical basis and strong empirical evidence for a causal impact of social relationships on health. Prospective studies, which control for baseline health status, consistently show increased risk of death among persons with a low quantity, and sometimes low quality, of social relationships. Experimental and quasi-experimental studies of humans and animals also suggest that social isolation is a major risk factor for mortality from widely varying causes. The mechanisms through which social relationships affect health and the factors that promote or inhibit the development and maintenance of social relationships remain to be explored.

Hu Z, J Liebens, et al. 2008. Linking stroke mortality with air pollution, income, and greenness in northwest Florida: an ecological geographical study. International Journal of Health Geographics 7: 20.

BACKGROUND: Relatively few studies have examined the association between air pollution and stroke mortality. Inconsistent and inclusive results from existing studies on air pollution and stroke justify the need to continue to investigate the linkage between stroke and air pollution. No studies have been done to investigate the association between stroke and greenness. The objective of this study was to examine if there is association of stroke with air pollution, income and greenness in northwest Florida.

RESULTS: Our study used an ecological geographical approach and dasymetric mapping technique. We adopted a Bayesian hierarchical model with a convolution prior considering five census tract specific covariates. A 95% credible set which defines an interval having a 0.95 posterior probability of containing the parameter for each covariate was calculated from Markov Chain Monte Carlo simulations. The 95% credible sets are (-0.286, -0.097) for household income, (0.034, 0.144) for traffic air pollution effect, (0.419, 1.495) for emission density of monitored point source polluters, (0.413, 1.522) for simple point density of point source polluters without emission data, and (-0.289,-0.031) for greenness. Household income and greenness show negative effects (the posterior densities primarily cover negative values). Air pollution covariates have positive effects (the 95% credible sets cover positive values).

CONCLUSION: High risk of stroke mortality was found in areas with low income level, high air pollution level, and low level of exposure to green space.

Huang J, J Wang, & W Yu. 2014. The lag effects and vulnerabilities of temperature effects on cardiovascular disease mortality in a subtropical climate zone in China. International journal of environmental research and public health, 11(4): 3982-94.

This research quantifies the lag effects and vulnerabilities of temperature effects on cardiovascular disease in Changsha--a subtropical climate zone of China. A Poisson regression model within a distributed lag nonlinear models framework was used to examine the lag effects of cold- and heat-related CVD mortality. The lag effect for heat-related CVD mortality was just 0-3 days. In contrast, we observed a statistically significant association with 10-25 lag days for cold-related CVD mortality. Low temperatures with 0-2 lag days increased the mortality risk for those >=65 years and females. For all ages, the cumulative effects of cold-related CVD mortality was 6.6% (95% CI: 5.2%-8.2%) for 30 lag days while that of heat-related CVD mortality was 4.9% (95% CI: 2.0%-7.9%) for 3 lag days. We found that in Changsha city, the lag effect of hot temperatures is short while the lag effect of cold temperatures is long. Females and older people were more sensitive to extreme hot and cold temperatures than males and younger people.

Hunter RF, H Christian, et al. 2015. The impact of interventions to promote physical activity in urban green space: a systematic review and recommendations for future research. Social Science & Medicine, 124: 246-56.

Evidence is mounting on the association between the built environment and physical activity (PA) with a call for intervention research. A broader approach which recognizes the role of supportive environments that can make healthy choices easier is required. A systematic review was undertaken to assess the effectiveness of interventions to encourage PA in urban green space. Five databases were searched independently by two reviewers using search terms relating to 'physical activity', 'urban green space' and 'intervention' in July 2014. Eligibility criteria included: (i) intervention to encourage PA in urban green space which involved either a physical change to the urban green space or a PA intervention to promote use of urban green space or a combination of both; and (ii) primary outcome of PA. Of the 2405 studies identified, 12 were included. There was some evidence (4/9 studies showed positive effect) to support built environment only interventions for encouraging use and increasing PA in urban green space. There was more promising evidence (3/3 studies showed positive effect) to support PAprograms or PA programs combined with a physical change to the built environment, for increasing urban green space use and PA of users. Recommendations for future research include the need for longer term follow-up post-intervention, adequate control groups, sufficiently powered studies, and consideration of the social environment, which was identified as a significantly under-utilized resource in this area. Interventions that involve the use of PA programs combined with a physical change to the built environment are likely to have a positive effect on PA. Robust evaluations of such interventions are urgently required. The findings provide a platform to inform the design, implementation and evaluation of future urban green space and PAintervention research.

Huynh Q, W Craig, et al. 2013. Exposure to public natural space as a protective factor for emotional well-being among young people in Canada. BMC public health 13(407): 1-14.

Positive emotional well-being is fundamentally important to general health status, and is linked to many favorable health outcomes. There is societal interest in understanding determinants of emotional well-being in adolescence, and the natural environment represents one potential determinant. Psychological and experimental research have each shown links between exposure to nature and both stress reduction and attention restoration. Some population studies have suggested positive effects of green space on various indicators of health. However, there are limited large-scale epidemiological studies assessing this relationship, specifically for populations of young people and in the Canadian context. The objective of this study was to examine the relationship between exposure to public natural space and positive emotional well-being among young adolescent Canadians.

Hystad P, HW Davies, et al. 2015. Residential greenness and birth outcomes: evaluating the influence of spatially correlated built-environment factors (Doctoral dissertation, University of British Columbia).

Background: Half the world's population lives in urban areas. It is therefore important to identify characteristics of the built environment that are beneficial to human health. Urban greenness has been associated with improvements in a diverse range of health conditions, including birth outcomes; however, few studies have attempted to distinguish potential effects of greenness from those of other spatially correlated exposures related to the built environment.

Objectives: We aimed to investigate associations between residential greenness and birth outcomes and evaluate the influence of spatially correlated built environment factors on these associations.

Methods: We examined associations between residential greenness [measured using satellitederived Normalized Difference Vegetation Index (NDVI) within 100 m of study participants' homes] and birth outcomes in a cohort of 64,705 singleton births (from 1999-2002) in Vancouver, British Columbia, Canada. We also evaluated associations after adjusting for spatially correlated built environmental factors that may influence birth outcomes, including exposure to air pollution and noise, neighborhood walkability, and distance to the nearest park.

Results: An interquartile increase in greenness (0.1 in residential NDVI) was associated with higher term birth weight (20.6 g; 95% CI: 16.5, 24.7) and decreases in the likelihood of small for gestational age, very preterm (< 30 weeks), and moderately preterm (30-36 weeks) birth. Associations were robust to adjustment for air pollution and noise exposures, neighborhood walkability, and park proximity.

Conclusions: Increased residential greenness was associated with beneficial birth outcomes in this population-based cohort. These associations did not change after adjusting for other spatially correlated built environment factors, suggesting that alternative pathways (e.g., psychosocial and psychological mechanisms) may underlie associations between residential greenness and birth outcomes.

Hystad P, PJ Villeneuve, et al. 2015. Exposure to traffic-related air pollution and the risk of developing breast cancer among women in eight Canadian provinces: a case-control study. Environment international, 74: 240-8.

A few recent studies have reported positive associations between long-term exposure to traffic-related air pollution and the incidence of breast cancer. We capitalized on an existing Canadian multi-site population-based case-control study to further investigate this association.

We used the National Enhanced Cancer Surveillance System, a population-based case-control study conducted in eight of 10 Canadian provinces from 1994 to 1997. A total of 1569 breast cancer cases and 1872 population controls who reported at least 90% complete self-reported addresses over the 1975-1994 exposure period were examined. Mean exposure levels to nitrogen dioxide (NO2) (an indicator of traffic-related air pollution) were estimated for this period using three different measures: (1) satellite-derived observations; (2) satellite-derived observations scaled with historical fixed-site measurements of NO2; and (3) a national land-use regression (LUR) model. Proximity to major roads was also examined. Using unconditional logistic regression, stratified by menopausal status, we estimated odds ratios (ORs) adjusted for many individual-level and contextual breast cancer risk factors.

We observed positive associations between incident breast cancer and all three measures of NO2 exposure from 1975 to 1994. In fully adjusted models for premenopausal breast cancer, a 10 ppb increase in NO2 exposure estimated from the satellite-derived observations, the scaled satellite-derived observations, and the national LUR model produced ORs of 1.26 (95% confidence intervals (CIs): 0.92-1.74), 1.32 (95% CI: 1.05-1.67) and 1.28 (95% CI: 0.92-1.79). For postmenopausal breast cancer, we found corresponding ORs of 1.10 (95% CI: 0.88-1.36), 1.10 (95% CI: 0.94-1.28) and 1.07 (95% CI: 0.86-1.32). Substantial heterogeneity in the ORs was observed across the eight Canadian provinces and reduced ORs were observed when models were restricted to women who had received routine mammography examinations. No associations were found for road proximity measures.

This study provides some support for the hypothesis that traffic-related air pollution may be associated with the development of breast cancer, especially in premenopausal women. With the few studies available, further research is clearly needed.


Islam M N, K-S Rahman, et al. 2012. Pollution attenuation by roadside greenbelt in and around urban areas. Urban Forestry & Urban Greening 11(4): 460-464.

Greenbelts are effective tools for mitigation of traffic induced air and noise pollution. In this study, the potential role of greenbelts along the roadside for the reduction of air pollution and noise levels has been assessed by using seasonally monitored data in a megacity of Bangladesh. Correlation analysis was performed between the vegetation status, measured by canopy density and shelterbelt porosity, and the total suspended particles (TSP) removal percentage. Further, the reduction of noise level was also analyzed. The results showed that the greenbelts greatly contributed to reduce TSP pollution and it was as much as 65%. Noise level reduction was also achieved up to 17 dB when compared to the open area. Moreover, TSP removal percentage was correlated to the crown density. Area having higher crown density demonstrated less air pollution and lower level of noise compared to the area having lower crown density. Greenbelt showed better performance in summer time than winter.


Jacquemin B, V Siroux, et al. 2015. Ambient Air Pollution and Adult Asthma Incidence in Six European cohorts ESCAPE. Journal of Environmental Health Perspectives, 123(6): 613-21.

Background: Short-term exposure to air pollution has adverse effects among patients with asthma, but whether long-term exposure to air pollution is a cause of adult-onset asthma is unclear.

Objective: We aimed to investigate the association between air pollution and adult onset asthma.

Methods: Asthma incidence was prospectively assessed in six European cohorts. Exposures studied were annual average concentrations at home addresses for nitrogen oxides assessed for 23,704 participants (including 1,257 incident cases) and particulate matter (PM) assessed for 17,909 participants through ESCAPE land-use regression models and traffic exposure indicators. Meta-analyses of cohort-specific logistic regression on asthma incidence were performed. Models were adjusted for age, sex, overweight, education, and smoking and included city/area within each cohort as a random effect.

Results: In this longitudinal analysis, asthma incidence was positively, but not significantly, associated with all exposure metrics, except for PMcoarse. Positive associations of borderline significance were observed for nitrogen dioxide [adjusted odds ratio (OR) = 1.10; 95% CI: 0.99, 1.21 per 10 µg/m³ p = 0.10] and nitrogen oxides (adjusted OR = 1.04; 95% CI: 0.99, 1.08 per 20 µg/m³ p = 0.08). Nonsignificant positive associations were estimated for PM10 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 10 µg/³), PM2.5 (adjusted OR = 1.04; 95% CI: 0.88, 1.23 per 5 µg/³), PM2.5absorbance (adjusted OR = 1.06; 95% CI: 0.95, 1.19 per 10(-5)/m, traffic load (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 4 million vehicles by meters/day on major roads in a 100-m buffer), and traffic intensity (adjusted OR = 1.10; 95% CI: 0.93, 1.30 per 5,000 vehicles/day on the nearest road). A nonsignificant negative association was estimated for PMcoarse (adjusted OR = 0.98; 95% CI: 0.87, 1.14 per 5 µg/m³).

Conclusions: Results suggest a deleterious effect of ambient air pollution on asthma incidence in adults. Further research with improved personal-level exposure assessment (vs. residential exposure assessment only) and phenotypic characterization is needed.

James KA, T Byers, et al. 2015. Association between lifetime exposure to inorganic arsenic in drinking water and coronary heart disease in Colorado residents. Environmental Health Perspectives (Online), 123(2): 128.

BACKGROUND: Chronic diseases, including coronary heart disease (CHD), have been associated with ingestion of drinking water with high levels of inorganic arsenic (> 1,000 µg/L). However, associations have been inconclusive in populations with lower levels (< 100 µg/L) of inorganic arsenic exposure.

OBJECTIVES: We conducted a case-cohort study based on individual estimates of lifetime arsenic exposure to examine the relationship between chronic low-level arsenic exposure and risk of CHD.

METHODS: This study included 555 participants with 96 CHD events diagnosed between 1984 and 1998 for which individual lifetime arsenic exposure estimates were determined using data from structured interviews and secondary data sources to determine lifetime residence, which was linked to a geospatial model of arsenic concentrations in drinking water. These lifetime arsenic exposure estimates were correlated with historically collected urinary arsenic concentrations. A Cox proportional-hazards model with time-dependent CHD risk factors was used to assess the association between time-weighted average (TWA) lifetime exposure to low-level inorganic arsenic in drinking water and incident CHD.

RESULTS: We estimated a positive association between low-level inorganic arsenic exposure and CHD risk [hazard ratio (HR): = 1.38, 95% CI: 1.09, 1.78] per 15 µg/L while adjusting for age, sex, first-degree family history of CHD, and serum low-density lipoprotein levels. The risk of CHD increased monotonically with increasing TWAs for inorganic arsenic exposure in water relative to < 20 µg/L (HR = 1.2, 95% CI: 0.6, 2.2 for 20-30 µg/L; HR = 2.2; 95% CI: 1.2, 4.0 for 30-45 µg/L; and HR = 3, 95% CI: 1.1, 9.1 for 45-88 µg/L).

CONCLUSIONS: Lifetime exposure to low-level inorganic arsenic in drinking water was associated with increased risk for CHD in this population.

James P, RF Banay, et al. 2015. A review of the health benefits of greenness. Current epidemiology reports, 2(2): 131-42.

Researchers are increasingly exploring how neighborhood greenness, or vegetation, may affect health behaviors and outcomes. Greenness may influence health by promoting physical activity and social contact; decreasing stress; and mitigating air pollution, noise, and heat exposure. Greenness is generally measured using satellite-based vegetation indices or land-use databases linked to participants' addresses. In this review, we found fairly strong evidence for a positive association between greenness and physical activity and a less consistent negative association between greenness and body weight. Research suggests greenness is protective against adverse mental health outcomes, cardiovascular disease, and mortality, though most studies were limited by cross-sectional or ecological design. There is consistent evidence that greenness exposure during pregnancy is positively associated with birth weight, though findings for other birth outcomes are less conclusive. Future research should follow subjects prospectively, differentiate between greenness quantity and quality, and identify mediators and effect modifiers of greenness-health associations.

Janerich DT, AD Stark, P Greenwald, et al. 1981. Increased leukemia, lymphoma, and spontaneous abortion in Western New York following a flood disaster. Public Health Reports 96(4): 350-6.

The New York State Department of Health was asked in September 1978 to investigate a cluster of leukemias and lymphomas in a rural town in western New York State of less than 1,000 people. Four cases of these diseases had been diagnosed in the town's population in the previous 10 months. Residents were concerned about environmental hazards such as background radiation and contamination of their water supply. A total environmental study of the area was not feasible or warranted, but certain environmental studies of the area were conducted. No environmental health hazards were identified. Incidence rates for towns in the four-county area (population 281,000) surrounding the study town were analyzed, based on data from the New York State Cancer Registry. These four counties had been severely affected by the flood following the 1972 Hurricane Agnes. Examination of annual leukemia and lymphoma incidence rates for these counties for 1966--77 revealed that the rates for towns in the river valley (population 102,000), but not for nonriver-valley towns, were 20 to 50 percent above the statewide rates for 1972--77. All other cancer rates remained level throughout both periods. An analysis of spontaneous abortion rates for the four counties for 1968--77 showed a significant peak in 1973, but not for the rest of upstate New York. The peak was concentrated in the towns in the river valley. The apparent time-space cluster of leukemias and lymphomas in conjunction with a marked increase in the spontaneous abortion rate suggests an unidentified flood-related environmental exposure.

Janhall S. Review on urban vegetation and particle air pollution-Deposition and dispersion. Atmospheric Environment, 105: 130-7.

Urban vegetation affects air quality through influencing pollutant deposition and dispersion. Both processes are described by many existing models and experiments, on-site and in wind tunnels, focussing e.g. on urban street canyons and crossings or vegetation barriers adjacent to traffic sources. There is an urgent need for well-structured experimental data, including detailed empirical descriptions of parameters that are not the explicit focus of the study.

This review revealed that design and choice of urban vegetation is crucial when using vegetation as an ecosystem service for air quality improvements. The reduced mixing in trafficked street canyons on adding large trees increases local air pollution levels, while low vegetation close to sources can improve air quality by increasing deposition. Filtration vegetation barriers have to be dense enough to offer large deposition surface area and porous enough to allow penetration, instead of deflection of the air stream above the barrier. The choice between tall or short and dense or sparse vegetation determines the effect on air pollution from different sources and different particle sizes.

Janssen I and A Rosu. 2015. Undeveloped green space and free-time physical activity in 11 to 13-year-old children. International Journal of Behavioral Nutrition and Physical Activity, 12(1): 26.


Research on the association between the physical environment and physical activity in children has focused on built and developed features or total green space. The impact of natural, undeveloped green spaces is unknown. The objective of this study was to determine whether the presence of undeveloped green spaces in the home neighborhood are associated with physical activity in 11 to 13-year-olds.


This was a cross-sectional study of grade 6 to 8 urban residing Canadian students who participated in the 2009/10 Health Behaviour in School-Aged Children survey. Children self-reported the frequency they participated in physical activity in their free-time outside of school hours. Geographic Information Systems (GIS) were used to assess the proportion of land area within 1 km of participants' homes that was devoted to publicly accessible meadows (i.e., field vegetated primarily by grass and other non-woody plants) and treed areas (i.e., field vegetated primarily by trees and shrubs). Ordinal logistic regression models were used to examine the relationships between the undeveloped green space areas and free-time physical activity. Several intrapersonal, family, and neighborhood environment factors were controlled for in these regression models.


The proportion of neighborhood land covered by meadows was not associated with the physical activity outcome (p>0.6). However, the proportion of neighborhood land covered by treed areas was independently associated with the physical activity outcome (p=0.02). For each additional 5% increase in the proportion of neighborhood land covered by treed areas there was a corresponding 5% increase (95% confidence interval: 1-10% increase) in the relative odds of increasing free-time physical activity outside of school hours.


The physical activity levels of 11 to 13-year-old children was associated with the amount of space in their home neighborhood devoted to treed areas.

Jansson M, A Gunnarsson, et al. 2014. Children's perspectives on vegetation establishment: Implications for school ground greening. Urban Forestry & Urban Greening, 13(1): 166-74.

School ground greening might provide multiple benefits for children across age, gender and competence through allowing participation in the greening process and experience of nature and vegetation. However, the process of school ground greening must nurture a positive relationship between children and newly planted vegetation during the first years after establishment. This study explored how green space planning, management and maintenance approaches influence children's school ground use and experiences through a series of field observations following establishment of new vegetation in a landscaped area at a school in Malmo, Sweden. The methods included documentation of vegetation, observations of use and interviews with children and teachers on three occasions during one and a half years following the first planting. The greening approach appeared successful, especially for younger children (up to around 11 years), who were more positive and also used the area more than older children. They also used it for pretend play, which was rare in the school ground before greening. Experiences from continuous participation and physical use appeared important for children establishing a positive and caring relationship with the landscaped area. The results suggest that school ground greening should be well integrated with pedagogic activities. Damage to woody vegetation can be limited by establishing other landscape elements that are attractive for play and by using fences without hindering access.

Jardine A, P Speldewinde, et al. 2007. Dryland salinity and ecosystem distress syndrome: human health implications. EcoHealth, 4(1): 10-7.

Clearing of native vegetation for agriculture has left 1.047 million hectares of southwest Western Australia affected by dryland salinity, and this area may expand up to a further 1.7-3.4 million hectares if trends continue. Ecosystems in saline-affected regions display many of the classic characteristics of Ecosystem Distress Syndrome, one outcome of which has not yet been investigated in relation to dryland salinity: adverse human health implications. This article seeks to review existing information and identify potential adverse human health effects. Three key potential impacts on human health resulting from dryland salinity are identified: wind-borne dust and respiratory health; altered ecology of the mosquito-borne disease Ross River virus; and mental health consequences of salinity-induced environmental degradation. Given the predicted increase in extent and severity of dryland salinity over coming decades, adverse outcomes of salinity are likely to be further exacerbated, including those related to human health. There is a clear need to investigate the issues discussed in this review and also to identify other potential adverse health effects of dryland salinity. Investigations must be multidisciplinary to sufficiently examine the broad scope of these issues. The relationship between human health and salinity may also be relevant beyond Australia in other countries where secondary soil salinization is occurring.

Jariwala et al. 2014. The association between asthma-related emergency department visits and pollen and mold spore concentrations in the Bronx, 2001-2008. Journal of Asthma, 51: 79-83.

Background: The incidence of asthma morbidity and mortality is highest among minority inner-city populations. Among New York City's five boroughs, the Bronx has the highest rate of asthma-related hospitalizations and mortality. Outdoor air pollutants have been associated with increased asthma-related ED visits (AREDV) in this borough.

Objective: To better understand the contribution of pollen and mold to asthma severity in the Bronx.

Methods: The numbers of daily adult and pediatric AREDV and asthma-related hospitalizations (ARH) from 2001 to 2008 were obtained from two Bronx hospitals. AREDV and ARH data were acquired retrospectively through the Clinical Looking Glass data analysis software. Daily counts for tree, grass and weed pollen and mold spore counts from March 2001 to October 2008 were obtained from the Armonk counting station. All data were statistically analyzed and graphed as daily values.

Results: There were a total of 42,065 AREDV and 10,132 ARH at both Bronx hospitals. There were spring and winter peaks of increased AREDV. Tree pollen counts significantly correlated with total AREDV (rho = 0.3639, p < 0.001), and pediatric (rho = 0.33, p < 0.001) and adult AREDV (rho = 0.28, p < 0.001). ARH positively correlated with tree pollen counts (Spearman rho = 0.2389, p = 0.001).

Conclusions: There exists a significant association between spring AREDV and ARH and tree pollen concentrations in a highly urbanized area such as the Bronx. Early anticipation of spring pollen peaks based on ongoing surveillance could potentially guide clinical practice and minimize asthma-related ED visits in the Bronx.

Jarup L, L Hellstrom, et al. 2000. Low level exposure to cadmium and early kidney damage: the OSCAR study. Occupational and Environmental Medicine 57(10): 668-72.

OBJECTIVES: To study the dose-response relation between cadmium dose and renal tubular damage in a population of workers and people environmentally or occupationally exposed to low concentrations of cadmium.

METHODS: Early kidney damage in 1021 people, occupationally or environmentally exposed to cadmium, was assessed from cadmium in urine to estimate dose, and protein HC (a1-micro-globulin) in urine to assess tubular proteinuria.

RESULTS: There was an age and sex adjusted correlation between cadmium in urine and urinary protein HC. The prevalence of tubular proteinuria ranged from 5% among unexposed people to 50% in the most exposed group. The corresponding prevalence odds ratio was 6.0 (95% confidence interval (95% CI) 1.6 to 22) for the highest exposure group, adjusted for age and sex. Multiple logistic regression analysis showed an increasing prevalence of tubular proteinuria with urinary cadmium as well as with age. After adjustment to the mean age of the study population (53 years), the results show an increased prevalence of 10% tubular proteinuria (taking into account a background prevalence of 5%) at a urinary cadmium concentration of 1.0 nmol/mmol creatinine.

CONCLUSION: Renal tubular damage due to exposure to cadmium develops at lower levels of cadmium body burden than previously anticipated.

Jenerette GD, SL Harlan, et al. 2011. Ecosystem services and urban heat riskscape moderation: water, green spaces, and social inequality in Phoenix, USA. Ecological Applications, 21(7): 2637-51.

Urban ecosystems are subjected to high temperatures-extreme heat events, chronically hot weather, or both-through interactions between local and global climate processes. Urban vegetation may provide a cooling ecosystem service, although many knowledge gaps exist in the biophysical and social dynamics of using this service to reduce climate extremes. To better understand patterns of urban vegetated cooling, the potential water requirements to supply these services, and differential access to these services between residential neighborhoods, we evaluated three decades (1970-2000) of land surface characteristics and residential segregation by income in the Phoenix, Arizona, USA metropolitan region. We developed an ecosystem service trade-offs approach to assess the urban heat riskscape, defined as the spatial variation in risk exposure and potential human vulnerability to extreme heat. In this region, vegetation provided nearly a 25°C surface cooling compared to bare soil on low-humidity summer days; the magnitude of this service was strongly coupled to air temperature and vapor pressure deficits. To estimate the water loss associated with land-surface cooling, we applied a surface energy balance model. Our initial estimates suggest 2.7 mm/d of water may be used in supplying cooling ecosystem services in the Phoenix region on a summer day. The availability and corresponding resource use requirements of these ecosystem services had a strongly positive relationship with neighborhood income in the year 2000. However, economic stratification in access to services is a recent development: no vegetation-income relationship was observed in 1970, and a clear trend of increasing correlation was evident through 2000. To alleviate neighborhood inequality in risks from extreme heat through increased vegetation and evaporative cooling, large increases in regional water use would be required. Together, these results suggest the need for a systems evaluation of the benefits, costs, spatial structure, and temporal trajectory for the use of ecosystem services to moderate climate extremes. Increasing vegetation is one strategy for moderating regional climate changes in urban areas and simultaneously providing multiple ecosystem services. However, vegetation has economic, water, and social equity implications that vary dramatically across neighborhoods and need to be managed through informed environmental policies.

Jennings V and CJ Gaither. 2015. Approaching environmental health disparities and green spaces: an ecosystem services perspective. International journal of environmental research and public health, 12(2): 1952-68.

Health disparities occur when adverse health conditions are unequal across populations due in part to gaps in wealth. These disparities continue to plague global health. Decades of research suggests that the natural environment can play a key role in sustaining the health of the public. However, the influence of the natural environment on health disparities is not well-articulated. Green spaces provide ecosystem services that are vital to public health. This paper discusses the link between green spaces and some of the nation's leading health issues such as obesity, cardiovascular health, heat-related illness, and psychological health. These associations are discussed in terms of key demographic variables-race, ethnicity, and income. The authors also identify research gaps and recommendations for future research.

Jiang B, CY Chang, & WC Sullivan. 2014. A dose of nature: Tree cover, stress reduction, and gender differences. Landscape and Urban Planning, 132: 26-36.

Although it is well established that exposure to nearby nature can help reduce stress in individuals, the shape of the dose-response curve is entirely unclear. To establish this dose-response curve, we recruited 160 individuals for a laboratory experiment. Participants engaged in the Trier Social Stress Test (TSST) to induce psychological stress, and were then randomly assigned to view one of ten, 6-min, 3-D videos of neighborhood streets. The density of tree cover in the videos varied from 1.7% to 62.0%. We measured their stress reactions by assessing salivary cortisol and skin conductance levels. Results show a clear disparity between women and men. For women, we found no relationship between varying densities of tree cover and stress recovery. For men, the dose-response curve was an inverted-U shape: as tree cover density increased from 1.7% to 24%, stress recovery increased. Tree density between 24% to 34% resulted in no change in stress recovery. Tree densities above 34% were associated with slower recovery times. A quadratic regression using tree cover density as the independent variable and a summary stress index as the dependent variable substantiated these results [R2 = .22, F (2, 68) = 9.70, p < .001]. The implications for our understanding of the impacts of nearby nature, and for the practice of planning and landscape architecture are discussed.

Jiang B, D Li, et al. 2014. A dose-response curve describing the relationship between urban tree cover density and self-reported stress recovery. Environment and Behavior, 0013916514552321.

Although it is well established that viewing nature can help individuals recover from a stressful experience, the dose-response curve describing the relationship between tree cover density and stress recovery is totally unclear. A total of 160 participants engaged in a standard Trier Social Stress Test to induce stress. Participants were then randomly assigned to watch 1 of 10 three-dimensional videos of street scenes that varied in the density of tree cover (from 2% to 62%). Participants completed a Visual Analog Scale questionnaire at three points in the experiment. Analysis revealed a positive, linear association between the density of urban street trees and self-reported stress recovery, adjusted R2 = .05, F(1, 149) = 8.53, p < .01. This relationship holds after controlling for gender, age, and baseline stress levels. A content analysis of participants' written narratives revealed a similar but even stronger association. These findings suggest that viewing tree canopy in communities can significantly aid stress recovery and that every tree matters.

Jiang B, L Larsen,et al. 2015. A dose-response curve describing the relationship between tree cover density and landscape preference. Landscape and Urban Planning, 139: 16-25.

Does adding more and more trees to a residential street yield a reliable increase in preference? Or is there a point at which, in terms of preference, additional trees will have minimal effect, no effect, or even a negative effect? To address these questions, we selected 121 community streets in four Midwestern urban areas in the U.S. and produced a panoramic photograph of each site and then measured the density of tree cover visible at eye level (Panorama). We also collected Google Earth aerial photographs to measure the top-down tree cover density (Google) for the sites. Then, 320 individuals provided preference ratings for a randomized subset of the panoramic photographs (15 pictures per person). Through linear and curvilinear regression analysis, we found a power line model best describes the relationship between each measure of tree cover density and preference. The power lines have a similar shape: when sites are relatively barren, a slight increase in tree density yields a steep increase in preference. After tree cover density exceeded those values, however, higher tree densities yielded smaller, but still positive increases in preference. These findings suggest that to ensure a moderate level of preference, tree cover density should be not less than 41% as measured by panoramic photographs or 20% as measured by Google Earth aerial photographs. Planting trees in barren residential areas will result in considerably more impact than if the same trees were planted in already green areas. Still, the findings here demonstrate that, for preference, every tree matters.

Jim CY and W Y Chen. 2009. Ecosystem services and valuation of urban forests in China. Cities 26(4): 187-194.

Urban forests are integral components of urban ecosystems, which could generate significant ecosystem services, such as offsetting carbon emission, removing air pollutants, regulating the microclimate, and recreation. These ecosystem services contribute to improving environmental quality, quality of life, and sustainable urban development. Despite a long history of inserting vegetation in human settlements in China, modern scientific study of this natural-cum-cultural resource did not start until the 1990s. Specifically, the identification and valuation of ecosystem services provided by urban forests are relatively new but fast growing research fields. This paper reviews studies on the major ecosystem services provided by urban forests in China, including microclimatic amelioration (mainly evapotranspiration-cooling effects), carbon dioxide sequestration, oxygen generation, removal of gaseous and particulate pollutants, recreational and amenity. Various valuation techniques have been applied, most of which are still at the embryonic stage. There are rooms to improve the research scope and methods. Some pertinent research gaps and implications on current and future development of urban forestry in China were distilled from the research findings.

Johnson KB, J Anila, et al. 2013. Forest cover associated with improved child health and nutrition: evidence from the Malawi Demographic and Health Survey and satellite data. Global Health: Science and Practice 2013(1): 237-248.

Healthy forests provide human communities with a host of important ecosystem services, including the provision of food, clean water, fuel, and natural medicines. Yet globally, about 13 million hectares of forests are lost every year, with the biggest losses in Africa and South America. As biodiversity loss and ecosystem degradation due to deforestation continue at unprecedented rates, with concomitant loss of ecosystem services, impacts on human health remain poorly understood. Here, we use data from the 2010 Malawi Demographic and Health Survey, linked with satellite remote sensing data on forest cover, to explore and better understand this relationship. Our analysis finds that forest cover is associated with improved health and nutrition outcomes among children in Malawi. Children living in areas with net forest cover loss between 2000 and 2010 were 19% less likely to have a diverse diet and 29% less likely to consume vitamin A-rich foods than children living in areas with no net change in forest cover. Conversely, children living in communities with higher percentages of forest cover were more likely to consume vitamin A-rich foods and less likely to experience diarrhea. Net gain in forest cover over the 10-year period was associated with a 34% decrease in the odds of children experiencing diarrhea (P=.002). Given that our analysis relied on observational data and that there were potential unknown factors for which we could not account, these preliminary findings demonstrate only associations, not causal relationships, between forest cover and child health and nutrition outcomes. However, the findings raise concerns about the potential short- and long-term impacts of ongoing deforestation and ecosystem degradation on community health in Malawi, and they suggest that preventing forest loss and maintaining the ecosystem services of forests are important factors in improving human health and nutrition outcomes.

Johnston and Newton, 1996. Building Green, a Guide for Using Plants on Roofs and Pavement, The London Ecology Unit.

No abstract provided.

Jones, TS, AP Liang, et al. 1982. Morbidity and mortality associated with the July 1980 heat wave in St Louis and Kansas City, MO. The Journal of the American Medical Association 247(24): 3327-31.

The morbidity and mortality associated with the 1980 heat wave in St Louis and Kansas City, Mo, were assessed retrospectively. Heat-related illness and deaths were identified by review of death certificates and hospital, emergency room, and medical examiners' records in the two cities. Data from the July 1980 heat wave were compared with data from July 1978 and 1979, when there were no heat waves. Deaths from all causes in July 1980 increased by 57% and 64% in St Louis and Kansas City, respectively, but only 10% in the predominantly rural areas of Missouri. About one of every 1,000 residents of the two cities was hospitalized for or died of heat-related illness. Incidence rates (per 100,000) of heatstroke, defined as severe heat illness with documented hyperthermia, were 26.5 and 17.6 for St Louis and Kansas City, respectively. No heatstroke cases occurred in July 1979. Heatstroke rates were ten to 12 times higher for persons aged 65 years or older than for those younger than 65 years. The ratios of age-adjusted heatstroke rates were approximately 3:1 for nonwhite v white persons and about 6:1 for low v high socioeconomic status. Public health preventive measures in future heat waves should be directed toward the urban poor, the elderly, and persons of other-than-white races.

Jongeneel-Grimen B, M Droomers, et al. 2014. The relationship between physical activity and the living environment: A multi-level analyses focusing on changes over time in environmental factors. Health & place, 26: 149-60.

There is limited evidence on the causality of previously observed associations between neighborhood characteristics and physical activity (PA). We aimed to assess whether individual-level PA was associated with changes in fear of crime, social cohesion, green spaces, parking facilities, social disorder, and physical disorder that occurred over the past 3 years. In general, in neighborhoods where residents had more favorable perceptions of the environment in 2006, residents were more likely to be physically active in 2009. In addition, improvements between 2006 and 2009 with respect to perceived social cohesion, green spaces, social disorder, and physical disorder were associated with increased odds of being active in 2009. For both the levels in 2006 and trends in the period 2006-2009, the associations were somewhat stronger among women than among men, but associations did not vary by age or length of residence. For several environmental factors, we observed that not only the levels at a certain point in time, but also recent improvements over time were related to PA. These results provide new support for a causal relationship between these environmental factors and PA.

Jose S. 2009. Agroforestry for ecosystem services and environmental benefits: an overview. Agroforestry Systems 76(1): 1-10.

Agroforestry systems are believed to provide a number of ecosystem services; however, until recently evidence in the agroforestry literature supporting these perceived benefits has been lacking. This special issue brings together a series of papers from around the globe to address recent findings on the ecosystem services and environmental benefits provided by agroforestry. As prelude to the special issue, this paper examines four major ecosystem services and environmental benefits of agroforestry: (1) carbon sequestration, (2) biodiversity conservation, (3) soil enrichment and (4) air and water quality. Past and present evidence clearly indicates that agroforestry, as part of a multifunctional working landscape, can be a viable land-use option that, in addition to alleviating poverty, offers a number of ecosystem services and environmental benefits. This realization should help promote agroforestry and its role as an integral part of a multifunctional working landscape the world over.

Jung WH, JM Woo, & JS Ryu. 2015. Effect of a forest therapy program and the forest environment on female workers' stress. Urban Forestry & Urban Greening, 14(2): 274-81.

This study aims to determine the effects of forest therapy (FT) program and the frequent use of forest environment in daily life on workers' stress levels on the hypothesis that FT program and frequent use of forest environment in daily life would reduce workers' stress level both psychologically and physiologically.

Participants were workers in the healthcare and counseling service industries, which are known for their heavy emotional burden on workers, and thereby had high levels of employee stress and burnout. In total, 211 subjects were recruited and divided into two groups using a screening survey according to the frequency of using the forest environment in daily life. Of the 91 subjects who reported low frequency of use, 19 female workers volunteered to join the FT program and were assigned to the experimental group. Among the 120 subjects with a high frequency of use, 20 female workers volunteered for the assessment of stress levels and were subsequently assigned to the control group.

We measured stress levels through heart rate variability, cortisol concentration, natural killer cell activity, and scores on the Maslach Burnout Inventory-General Survey, Worker's Stress Response Inventory, and the Recovery Experience Questionnaire.

The results showed subjective stress relief after the FT program. The experimental group exhibited higher scores on the mastery factor of the Recovery Experience Questionnaire. Further, the experimental group showed more recovery experiences following participation in the FT program. The control group showed a significantly higher standard deviation in normal-to-normal intervals and the square root of the mean squared differences of successive NN intervals (measures of heart rate variability) and lower cortisol level as compared to the experimental group.

These results suggest that frequent users of the forest environment are less stressed than are low frequency users, and that the FT program relieves participants' psychosocial stress.


Kabisch N, S Qureshi, & D Haase. 2015. Human-environment interactions in urban green spaces-A systematic review of contemporary issues and prospects for future research. Environmental Impact Assessment Review, 50: 25-34.

Scientific papers on landscape planning underline the importance of maintaining and developing green spaces because of their multiple environmental and social benefits for city residents. However, a general understanding of contemporary human-environment interaction issues in urban green space is still incomplete and lacks orientation for urban planners. This review examines 219 publications to (1) provide an overview of the current state of research on the relationship between humans and urban green space, (2) group the different research approaches by identifying the main research areas, methods, and target groups, and (3) highlight important future prospects in urban green space research.

Kaczynski AT, MJ Koohsari, et al. 2014. Association of street connectivity and road traffic speed with park usage and park-based physical activity. American journal of health promotion, 28(3): 197-203.

PURPOSE: The purpose of this study was to examine associations between street connectivity and road traffic speed and neighborhood residents' use of parks and park-based physical activity. The purpose of this study was to examine associations between street connectivity and road traffic speed and neighborhood residents' use of parks and park-based physical activity.

DESIGN: Cross-sectional.

SETTING: Kansas City, Missouri.

SUBJECTS: Participants were 893 adults from randomly selected households.

MEASURES: Both self-reported park use and park-based physical activity were dichotomized as some versus none. Intersection density was calculated around each participant, and network analysis was used to determine whether participants had to travel on or cross a road with traffic speed greater than 35 miles per hour (mph) to reach the closest park.

ANALYSIS: Multilevel logistic regression examined the association between intersection density and traffic speed wit park use and park-based physical activity.

RESULTS: Compared to those in the lowest intersection density quartile, participants in the third and fourth quartiles were more likely to use parks and to engage in physical activity in parks (odds ratio [OR] = 1.76-2.34; all p < .05). Likewise, compared to those who had a high-speed road on their way to the closest park, participants with slower traffic routes to parks were more likely to use the parks (OR = 1.47; 95% confidence interval [CI] = 1.05-1.92).

CONCLUSION: In addition to park proximity and the design of park features, ensuring direct and safe access to parks through street network design and traffic speed reduction strategies may be key to facilitating park-related physical activity.

Kahn Jr, PH, B Friedman, et al. 2008. A plasma display window?--The shifting baseline problem in a technologically mediated natural world. Journal of Environmental Psychology 28(2): 192-9.

Humans will continue to adapt to an increasingly technological world. But are there costs to such adaptations in terms of human well being? Toward broaching this question, we investigated physiological effects of experiencing a HDTV quality real-time view of nature through a plasma display "window." In an office setting, 90 participants (30 per group) were exposed either to (a) a glass window that afforded a view of a nature scene, (b) a plasma window that afforded a real-time HDTV view of essentially the same scene, or (c) a blank wall. Results showed that in terms of heart rate recovery from low-level stress the glass window was more restorative than a blank wall; in turn, a plasma window was no more restorative than a blank wall. Moreover, when participants spent more time looking at the glass window, their heart rate tended to decrease more rapidly; that was not the case with the plasma window. Discussion focuses on how the purported benefits of viewing nature may be attenuated by a digital medium.

Kaplan R. 1993. The role of nature in the context of the workplace. Landscape and Urban Planning 26(1-4): 193-201.

The well-being of the workforce is clearly a matter of concern to the employer. Such concern translates to considerable costs in the form of fringe benefit packages, health promotion programs, ergonomics, and other ways to reduce absence and enhance health and satisfaction. Despite such efforts, however, one way to address well-being that entails relatively low costs has been largely ignored in the work context. Proximity and availability of the natural environment can foster many desired outcomes, even if the employee does not spend a great amount of time in the natural setting. A theoretical framework is presented that helps explain why even the view from the window can have a positive impact with respect to well-being. Results from two studies offer some substantiation. Further research on the role of nature in the workplace is essential; however, decisions to provide health promoting programs and to enhance fringe benefit packages have not been offered as a direct consequence of empirical verification. While providing windows at work may not be a simple matter, other ways to increase contact with vegetation may provide a low-cost, high-gain approach to employee well-being and effectiveness.

Kaplan S. 1995. The restorative benefits of nature: Toward an integrative framework. Journal of Environmental Psychology 15(3): 169-182.

Directed attention plays an important role in human information processing; its fatigue, in turn, has far-reaching consequences. Attention Restoration Theory provides an analysis of the kinds of experiences that lead to recovery from such fatigue. Natural environments turn out to be particularly rich in the characteristics necessary for restorative experiences. An integrative framework is proposed that places both directed attention and stress in the larger context of human-environment relationships.

Kardan O, P Gozdyra. 2015. Neighborhood greenspace and health in a large urban center. Scientific reports, 5.

Studies have shown that natural environments can enhance health and here we build upon that work by examining the associations between comprehensive greenspace metrics and health. We focused on a large urban population center (Toronto, Canada) and related the two domains by combining high-resolution satellite imagery and individual tree data from Toronto with questionnaire-based self-reports of general health perception, cardio-metabolic conditions and mental illnesses from the Ontario Health Study. Results from multiple regressions and multivariate canonical correlation analyses suggest that people who live in neighborhoods with a higher density of trees on their streets report significantly higher health perception and significantly less cardio-metabolic conditions (controlling for socio-economic and demographic factors). We find that having 10 more trees in a city block, on average, improves health perception in ways comparable to an increase in annual personal income of $10,000 and moving to a neighborhood with $10,000 higher median income or being 7 years younger. We also find that having 11 more trees in a city block, on average, decreases cardio-metabolic conditions in ways comparable to an increase in annual personal income of $20,000 and moving to a neighborhood with $20,000 higher median income or being 1.4 years younger.

Karjalainen E, T Sarjala, et al. 2010. Promoting human health through forests: overview and major challenges. Environmental Health and Preventive Medicine 15(1): 1-8.

This review aims to contribute to the ongoing discussion about human health, global change, and biodiversity by concentrating on the relationships between forests and human health. This review gives a short overview of the most important health benefits that forests provide to humans, and the risks that forests may pose to human health. Furthermore, it discusses the future challenges for the research on the links between forests and human health, and for delivering health through forests in practice. Forests provide enormous possibilities to improve human health conditions. The results of a vast amount of research show that forest visits promote both physical and mental health by reducing stress. Forests represent rich natural pharmacies by virtue of being enormous sources of plant and microbial material with known or potential medicinal or nutritional value. Forest food offers a safety net for the most vulnerable population groups in developing countries, and healthy forest ecosystems may also help in regulation of infectious diseases. Utilizing forests effectively in health promotion could reduce public health care budgets and create new sources of income. Main challenges to delivering health through forests are due to ecosystem and biodiversity degradation, deforestation, and climate change. In addition, major implementation of research results into practice is still lacking. Inadequate implementation is partly caused by insufficient evidence base and partly due to the lack of policy-makers' and practitioners' awareness of the potential of forests for improving human health. This calls for strong cooperation among researchers, policy-makers, and practitioners as well as between different sectors, especially between health and environmental professionals.

Katsouyanni K, G Touloumi, et al. 1997. Short term effects of ambient sulphur dioxide and particulate matter on mortality in 12 European cities: results from time series data from the APHEA project. BMJ 314(7095): 1658.

Objectives: To carry out a prospective combined quantitative analysis of the associations between all cause mortality and ambient particulate matter and sulphur dioxide.

Design: Analysis of time series data on daily number of deaths from all causes and concentrations of sulphur dioxide and particulate matter (measured as black smoke or particles smaller than 10 micro-m in diameter (PM10)) and potential confounders.

Setting: 12 European cities in the APHEA project (Air Pollution and Health: a European Approach).

Main outcome measure: Relative risk of death.

Results: In western European cities it was found that an increase of 50 micro-g/m3 in sulphur dioxide or black smoke was associated with a 3% (95% confidence interval 2% to 4%) increase in daily mortality and the corresponding figure for PM10 was 2% (1% to 3%). In central eastern European cities the increase in mortality associated with a 50 micro-g/m3 change in sulphur dioxide was 0.8% (-0.1% to 2.4%) and in black smoke 0.6% (0.1% to 1.1%). Cumulative effects of prolonged (two to four days) exposure to air pollutants resulted in estimates comparable with the one day effects. The effects of both pollutants were stronger during the summer and were mutually independent.

Conclusions: The internal consistency of the results in western European cities with wide differences in climate and environmental conditions suggest that these associations may be causal. The long term health impact of these effects is uncertain, but today's relatively low levels of sulphur dioxide and particles still have detectable short term effects on health and further reductions in air pollution are advisable.

Kazmierczak A. 2013. The contribution of local parks to neighbourhood social ties. Landscape and Urban Planning 109(1): 31-44.

The social ties between the residents of urban neighbourhoods are in decline due to changing work patterns, increased mobility and developments in communications. Neighbourhood open spaces, and green spaces in particular, provide opportunities for social interactions that may help the residents to establish recognition and develop relationships. This paper investigates the contribution of local parks to the development of social ties in inner-city neighbourhoods. Combining quantitative methods (questionnaire survey) with a qualitative approach (focus group discussions), the research was carried out in three inner- city neighbourhoods in Greater Manchester, UK, characterised by different levels of material deprivation and ethnic diversity. The social survey explored the associations between the respondents' visits to local parks and the number of friends and acquaintances they had. The findings suggest that local parks may support the development of social ties in inner-city areas. Associations were found between the quality of the parks, the character of visits, and the extent of social ties in the neighbourhood. The study concludes, that for inner-city parks to realise their full potential in supporting social interactions and developing social ties, they need to be well-maintained and provide good recreational facilities. The development of social ties was also found to be considerably affected by the characteristics of the individuals and the neighbourhood.

Kearney PM, M. Whelton, et al. 2005. Global burden of hypertension: analysis of worldwide data. The Lancet 365(9455): 217-23.

Background - Reliable information about the prevalence of hypertension in different world regions is essential to the development of national and international health policies for prevention and control of this condition. We aimed to pool data from different regions of the world to estimate the overall prevalence and absolute burden of hypertension in 2000, and to estimate the global burden in 2025.

Methods - We searched the published literature from Jan 1, 1980, to Dec 31, 2002, using MEDLINE, supplemented by a manual search of bibliographies of retrieved articles. We included studies that reported sex-specific and age-specific prevalence of hypertension in representative population samples. All data were obtained independently by two investigators with a standardised protocol and data-collection form.

Results - Overall, 264% (95% CI 26.0-26.8%) of the adult population in 2000 had hypertension (26.6% of men [26.0-27.2%] and 26.1% of women [25.526.6%]), and 29.2% (28.8-29.7%) were projected to have this condition by 2025 (29.0% of men [28.6-29.4%] and 29.5% of women [29.1-29.9%]). The estimated total number of adults with hypertension in 2000 was 972 million (957-987 million); 333 million (329-336 million) in economically developed countries and 639 million (625-654 million) in economically developing countries. The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1.56 billion (1.54-1.58 billion). Interpretation - Hypertension is an important public-health challenge worldwide. Prevention, detection, treatment, and control of this condition should receive high priority.

Kemperman A and H Timmermans. 2014. Green spaces in the direct living environment and social contacts of the aging population. Landscape and Urban Planning, 129: 44-54.

Green spaces in the living environment may provide a meeting place and support social contacts. When people get older they, in general, are less mobile and have more limited activity spaces. At the same time they are faced with smaller social networks due to social and health related changes. Green spaces in their direct living environment are therefore important to support their needs. The aim of this study was to better understand the nature of the relationship between various types of green spaces in the direct living environment and the extent and nature of social contacts of the aging generation, taking into account socio-demographics and other physical and social environmental characteristics. Data for this study were obtained from a survey about living surroundings from a national representative sample of 1501 persons in the age category of 60 years and over in the Netherlands conducted in 2009. The survey included both subjective and objective measurements of the direct living environment of the respondents. Specifically, a Bayesian belief network was used to formulate and estimate the direct and indirect relationships between the selected variables. Results show that social contacts among neighbors are mainly influenced by the availability of trees and grass and the perceived level of green. Green spaces support social contacts in the neighborhood. However, the safety and maintenance of the green spaces are also important; high quality green spaces support social contacts between neighbors and strengthen communities for the aging population.

Keniger LE, KJ Gaston, et al. 2013. What are the benefits of interacting with nature? Int J Environ Res Public Health 10(3): 913-35.

There is mounting empirical evidence that interacting with nature delivers measurable benefits to people. Reviews of this topic have generally focused on a specific type of benefit, been limited to a single discipline, or covered the benefits delivered from a particular type of interaction. Here we construct novel typologies of the settings, interactions and potential benefits of people-nature experiences, and use these to organise an assessment of the benefits of interacting with nature. We discover that evidence for the benefits of interacting with nature is geographically biased towards high latitudes and Western societies, potentially contributing to a focus on certain types of settings and benefits. Social scientists have been the most active researchers in this field. Contributions from ecologists are few in number, perhaps hindering the identification of key ecological features of the natural environment that deliver human benefits. Although many types of benefits have been studied, benefits to physical health, cognitive performance and psychological well-being have received much more attention than the social or spiritual benefits of interacting with nature, despite the potential for important consequences arising from the latter. The evidence for most benefits is correlational, and although there are several experimental studies, little as yet is known about the mechanisms that are important for delivering these benefits. For example, we do not know which characteristics of natural settings (e.g., biodiversity, level of disturbance, proximity, accessibility) are most important for triggering a beneficial interaction, and how these characteristics vary in importance among cultures, geographic regions and socio-economic groups. These are key directions for future research if we are to design landscapes that promote high quality interactions between people and nature in a rapidly urbanising world.

Kent ST, LA McClure,et al. 2014. Heat waves and health outcomes in Alabama (USA): The importance of heat wave definition. Environmental Health Perspectives (Online), 122(2): 151.

Background: A deeper understanding of how heat wave definition affects the relationship between heat exposure and health, especially as a function of rurality, will be useful in developing effective heat wave warning systems.

Objective: We compared the relationships between different heat wave index (HI) definitions and preterm birth (PTB) and nonaccidental death (NAD) across urban and rural areas.

Methods: We used a time-stratified case-crossover design to estimate associations of PTB and NAD with heat wave days (defined using 15 HIs) relative to non-heat wave control days in Alabama, USA (1990-2010). ZIP code-level HIs were derived using data from the North American Land Data Assimilation System. Associations with heat wave days defined using different HIs were compared by bootstrapping. We also examined interactions with rurality.

Results: Associations varied depending on the HI used to define heat wave days. Heat waves defined as having at least 2 consecutive days with mean daily temperatures above the 98th percentile were associated with 32.4% (95% CI: 3.7, 69.1%) higher PTB, and heat waves defined as at least 2 consecutive days with mean daily temperatures above the 90th percentile were associated with 3.7% (95% CI: 1.1, 6.3%) higher NAD. Results suggest that significant positive associations were more common when relative--compared with absolute--HIs were used to define exposure. Both positive and negative associations were found in each rurality stratum. However, all stratum-specific significant associations were positive, and NAD associations with heat waves were consistently positive in urban strata but not in middle or rural strata.

Conclusions: Based on our findings, we conclude that a relative mean-temperature-only heat wave definition may be the most effective metric for heat wave warning systems in Alabama.

Kessler RC, S Galeaz, et al. 2006. Mental illness and suicidality after Hurricane Katrina. Hurricane Katrina Community Advisory Group. Bulletin of the World Health Organization 84(12): 930-9.

Objective: To estimate the impact of Hurricane Katrina on mental illness and suicidality by comparing results of a post-Katrina survey with those of an earlier survey.

Methods: The National Comorbidity Survey-Replication, conducted between February 2001 and February 2003, interviewed 826 adults in the Census Divisions later affected by Hurricane Katrina. The post-Katrina survey interviewed a new sample of 1043 adults who lived in the same area before the hurricane. Identical questions were asked about mental illness and suicidality. The post-Katrina survey also assessed several dimensions of personal growth that resulted from the trauma (for example, increased closeness to a loved one, increased religiosity). Outcome measures used were the K6 screening scale of serious mental illness and mild-moderate mental illness and questions about suicidal ideation, plans and attempts.

Findings: Respondents to the post-Katrina survey had a significantly higher estimated prevalence of serious mental illness than respondents to the earlier survey (11.3% after Katrina versus 6.1% before; c1= 10.9; P < 0.001) and mildmoderate mental illness (19.9% after Katrina versus 9.7% before; c1 = 22.5; P < 0.001). Among respondents estimated to have mental illness, though, the prevalence of suicidal ideation and plans was significantly lower in the post-Katrina survey (suicidal ideation 0.7% after Katrina versus 8.4% before; c1 = 13.1; P < 0.001; plans for suicide 0.4% after Katrina versus 3.6% before; c1 = 6.0; P = 0.014). This lower conditional prevalence of suicidality was strongly related to two dimensions of personal growth after the trauma (faith in one's own ability to rebuild one's life, and realization of inner strength), without which between-survey differences in suicidality were insignificant.

Conclusion: Despite the estimated prevalence of mental illness doubling after Hurricane Katrina, the prevalence of suicidality was unexpectedly low. The role of post-traumatic personal growth in ameliorating the effects of trauma-related mental illness on suicidality warrants further investigation.

Kettles MK, SR Browning, et al. 1997. Triazine herbicide exposure and breast cancer incidence: An ecologic study of Kentucky counties. Environmental Health Perspectives 105(11): 1222-1227.

The incidence of breast cancer in the United States has steadily increased for the past three decades. Exposure to excess estrogen, in both natural and synthetic forms, has been implicated as a risk factor for the development of this disease. Considerable interest has been focused on organochlorines, such as the triazine herbicides, and their possible role in the initiation or promotion of human breast cancer. To explore this relationship, an ecologic study of Kentucky counties was designed. Exposure to triazines was estimated by use of water contamination data, corn crop production, and pesticide use data. A summary index of triazine herbicide exposure was developed to classify counties into low, medium, or high exposure levels. Data on county breast cancer rates were obtained from the state registry. A Poisson regression analysis was performed, controlling for age, race, age at first live birth, income, and level of education. Results revealed a statistically significant increase in breast cancer risk with medium and high levels of triazine exposure [odds ratio (OR) = 1.14, p < 0.0001 and OR = 1.2, p < 0.0001, respectively]. The results suggest a relationship between exposure to triazine herbicides and increased breast cancer risk, but conclusions concerning causality cannot be drawn, due to the limitations inherent in ecologic study design.

Khan S, I Ahmad, MT Shah, S Rehman & A Khaliq. 2009. Use of constructed wetland for the removal of heavy metals from industrial wastewater. Journal of Environmental Management, 90(11), 3451-3457.

No abstract provided.

Kidney and Urologic Diseases Information Clearinghouse - Chronic Kidney Disease.

Chronic Kidney Disease. -- -- Accessed April 2016.

Kihal-Talantikite W, CM Padilla, et al. 2013. Green space, social inequalities and neonatal mortality in France. BMC pregnancy and childbirth 13(191): 1-9.

Background: Few studies have considered using environmental amenities to explain social health inequalities. Nevertheless, Green spaces that promote good health may have an effect on socioeconomic health inequalities. In developed countries, there is considerable evidence that green spaces have a beneficial effect on the health of urban populations and recent studies suggest they can have a positive effect on pregnancy outcomes. To investigate the relationship between green spaces and the spatial distribution of infant mortality taking account neighborhood deprivation levels.

Methods: The study took place in Lyon metropolitan area, France. All infant deaths that occurred between 2000 and 2009 were geocoded at census block level. Each census block was assigned greenness and socioeconomic deprivation levels. The spatial-scan statistic was used to identify high risk cluster of infant mortality according to these neighborhood characteristics.

Results: The spatial distribution of infant mortality was not random with a high risk cluster in the south east of the Lyon metropolitan area (p<0003). This cluster disappeared (p=0.12) after adjustment for greenness level and socioeconomic deprivation, suggesting that these factors explain part of the spatial distribution of infant mortality. These results are discussed using a conceptual framework with 3 hypothetical pathways by which green spaces may have a beneficial effect on adverse pregnancy outcomes: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an environmental pathway.

Conclusions: These results add some evidence to the hypothesis that there is a relationship between access to green spaces and pregnancy outcomes but further research is required to confirm this.

Kim KH, E Kabir, & S Kabir. 2015. A review on the human health impact of airborne particulate matter. Environment international, 74: 136-43.

Particulate matter (PM) is a key indicator of air pollution brought into the air by a variety of natural and human activities. As it can be suspended over long time and travel over long distances in the atmosphere, it can cause a wide range of diseases that lead to a significant reduction of human life. The size of particles has been directly linked to their potential for causing health problems. Small particles of concern include "inhalable coarse particles" with a diameter of 2.5 to 10 µm and "fine particles" smaller than 2.5 µm in diameter. As the source-effect relationship of PM remains unclear, it is not easy to define such effects from individual sources such as long-range transport of pollution. Because of the potent role of PM and its associated pollutants, detailed knowledge of their human health impacts is of primary importance. This paper summarizes the basic evidence on the health effects of particulate matter. An in-depth analysis is provided to address the implications for policy-makers so that more stringent strategies can be implemented to reduce air pollution and its health effects.

King KL, S Johnson, et al. 2014. Differences in magnitude and spatial distribution of urban forest pollution deposition rates, air pollution emissions, and ambient neighborhood air quality in New York City. Landscape and Urban Planning, 128: 14-22.

Urban forest pollution removal potential has not been well explored at the neighborhood resolution and in relation to neighborhood-level emissions. In NYC's five counties, modeled NO2; removed by the primarily-deciduous urban forest ranges from <1% (New York) to 13% (Richmond) of total emissions; modeled PM10 removal ranges from <4% (New York) to 20% (Richmond). Across a 900 m3 grid, average traffic NO2 emissions are over an order of magnitude greater than canopy removal; PM10 canopy removal slightly exceeds average traffic emissions. NO2 and PM10 removal are weakly but significantly inversely correlated in space with traffic emissions at the grid level (r = -0.126, p < 0.0001). Land Use Regression modeling of monitored levels of NO2 and PM2.5 reveals an inverse correlation with tree cover in winter (leaf-off) and summer (leaf-on) suggesting that canopy indicators represent lack of pollution sources rather than active pollution removal. Tree canopy deposition likely has at most a small impact on neighborhood air quality relative to emissions. Planners should emphasize a holistic view of the benefits of urban trees when prioritizing urban neighborhoods for tree planting.

Kinnafick FE and CThogersen-Ntoumani. 2014. The effect of the physical environment and levels of activity on affective states. Journal of Environmental Psychology, 38: 241-51.

The physical environment and physical activity can independently improve positive affect. The current studies investigated the effects of two opposing environments (urban versus natural) and levels of activity (walking and sitting) on affective states in either a laboratory (study 1) or an outdoor setting (study 2). While doing each activity (walking and sitting in each environment), participants watched film clips of urban or natural outdoor settings (study 1), or were naturally immersed in an urban or a natural environment (study 2). Measures of affect were administered pre, mid and post each condition. Findings highlighted the benefits of being immersed in a natural outdoor environment with physical activity being key for positive effects on energy. Short bouts of sedentary behaviour increased state negative affect, tiredness, and decreased energy levels. Attempts by policy-makers, urban planners and public health promoters should encourage greater use of natural open space to promote acute psychological well-being.

Klein PM and R Coffman. 2015. Establishment and performance of an experimental green roof under extreme climatic conditions. Science of the Total Environment, 512: 82-93.

Green roofs alter the surface energy balance and can help in mitigating urban heat islands. However, the cooling of green roofs due to evapotranspiration strongly depends on the climatic conditions, and vegetation type and density. In the Southern Central Plains of the United States, extreme weather events, such as high winds, heat waves and drought conditions pose challenges for successful implementation of green roofs, and likely alter their standard performance. The National Weather Center Experimental Green Roof, an interdisciplinary research site established in 2010 in Norman, OK, aimed to investigate the ecological performance and surface energy balance of green roof systems.

Starting in May 2010, 26 months of vegetation studies were conducted and the radiation balance, air temperature, relative humidity, and buoyancy fluxes were monitored at two meteorological stations during April-October 2011. The establishment of a vegetative community trended towards prairie plant dominance. High mortality of succulents and low germination of grasses and herbaceous plants contributed to low vegetative coverage. In this condition succulent diversity declined. Bouteloua gracilis and Delosperma cooperi showed typological dominance in harsh climatic conditions, while Sedum species experienced high mortality. The plant community diversified through volunteers such as Euphorbia maculate and Portulaca maculate. Net radiation measured at a green-roof meteorological station was higher than at a control station over the original, light-colored roofing material. These findings indicate that the albedo of the green roof was lower than the albedo of the original roofing material. The low vegetative coverage during the heat and drought conditions in 2011, which resulted in the dark substrate used in the green roof containers being exposed, likely contributed to the low albedo values. Nevertheless, air temperatures and buoyancy fluxes were often lower over the green roof indicating that higher evapotranspiration rates compensated for the higher net radiation at the green roof.

Klemm W, BG Heusinkveld, et al. 2015. Psychological and physical impact of urban green spaces on outdoor thermal comfort during summertime in The Netherlands. Building and environment, 83: 120-8.

Green infrastructure can improve thermal comfort in outdoor urban spaces in moderate climates. The impact of green spaces on thermal comfort is often exclusively investigated through meteorological variables and human-biometeorological indices. Yet, studies on perceived thermal comfort are scarce. As thermal comfort is a property of human perception of the thermal environment, this knowledge is crucial for understanding the relationship between green spaces and thermal comfort.

We investigated inhabitants' long-term perception of thermal comfort on warm summer days in three Dutch cities by means of questionnaires. Additionally, we examined the daytime cooling effect of green spaces in Utrecht, in order to find physical evidence to verify thermal comfort perception. To this end we used bicycles equipped with micrometeorological sensors. We compared thermal conditions of 13 parks with thermal conditions in the city centre and in the open grassland outside the city. And we analysed dependences between thermal conditions and spatial variables of parks (size, tree canopy, upwind vegetation cover).

Our results demonstrate that green infrastructure improves generally perceived thermal comfort. People evaluated green urban spaces as the most thermally comfortable spaces which was in line with the physical thermal investigations. Physiological equivalent temperature (PET) in parks on average was 1.9 K lower than in the city centre and 5 K lower than in the surrounding grasslands during the hottest period of the day. Thermal variance between parks was significantly influenced by tree canopy cover (mean radiant temperature p = 0.00005) and upwind vegetation cover (air temperature p = 0.013), not significantly for park size.

Kline JD, RS Rosenberger, EM White. 2011. A national assessment of physical activity in US National Forests. Journal of Forestry 109(6): 343-51.

In an era of declining timber harvests on federal lands, the US Forest Service has sought to better describe the public benefits associated with the nation's continued investment in managing the national forests. We considered how national forests contribute to public health by providing significant outdoor recreation opportunities. Physical inactivity has become a persistent national concern owing to its association with chronic diseases, obesity, and other public health concerns. We estimated the net energy expenditure (in calories) for a range of outdoor recreation activities engaged in by visitors to national forests. We conclude that national forest contributions to physical activity among the American public likely are significant and could be enhanced with continued and targeted investments in recreation infrastructure and public outreach.

Klok L, Zwart S, Verhagen H, Mauri E. 2012. The surface heat island of Rotterdam and its relationship with urban surface characteristics. Resources, Conservation and Recycling, 64: 23-9.

Thermal infrared high resolution satellite images from Landsat sensors were used to spatially quantify the surface heat island (SHI) of Rotterdam in the Netherlands. Based on surface temperature maps retrieved on 15 summer days since 1984, the average surface temperature of each district and neighbourhood within the city was compared to the rural surface temperature outside the city, defined as the SHI intensity. The results showed that the daytime SHI intensity of Rotterdam can be as large as 10 °C. Differences in the SHI between the neighbourhoods can be explained by urban surface characteristics. A statistical analysis shows that the SHI is largest for neighbourhoods with scarce vegetation that have a high fraction of impervious surface, and a low albedo. Furthermore, NOAA-AVHHR satellite images were used to monitor the heat wave of July 2006 and retrieve the diurnal variation in the SHI of Rotterdam. Average surface temperature differences between the warmest and coolest districts are maximum 12 °C during day, and 9 °C during night. Districts with a large night-time SHI differ from districts with a large daytime SHI.

Knobeloch L, M Ziarnik, et al. 1994. Gastrointestinal upsets associated with ingestion of copper-contaminated water. Environmental Health Perspectives 102(11): 958-61.

During 1992 and 1993 the Wisconsin Division of Health investigated five cases in which copper-contaminated drinking water was suspected of causing gastrointestinal upsets. Each of these case studies was conducted after our office was notified of high copper levels in drinking water or notified of unexplained illnesses. Our findings suggest that drinking water that contains copper at levels above the federal action limit of 1.3 mg/l may be a relatively common cause of diarrhea, abdominal cramps, and nausea. These symptoms occurred most frequently in infants and young children and among residents of newly constructed or renovated homes.

Knowlton K, M Rotkin-Ellman, et al. 2009. The 2006 California heat wave: Impacts on hospitalizations and emergency department visits. Environmental Health Perspectives 117(1): 61 - 7.

Background: Climate models project that heat waves will increase in frequency and severity. Despite many studies of mortality from heat waves, few studies have examined morbidity.

Objectives: In this study we investigated whether any age or race/ethnicity groups experienced increased hospitalizations and emergency department (ED) visits overall or for selected illnesses during the 2006 California heat wave.

Methods: We aggregated county-level hospitalizations and ED visits for all causes and for 10 cause groups into six geographic regions of California. We calculated excess morbidity and rate ratios (RRs) during the heat wave (15 July to 1 August 2006) and compared these data with those of a reference period (8-14 July and 12-22 August 2006).

Results: During the heat wave, 16,166 excess ED visits and 1,182 excess hospitalizations occurred statewide. ED visits for heat-related causes increased across the state [RR = 6.30; 95% confidence interval (CI), 5.67-7.01], especially in the Central Coast region, which includes San Francisco. Children (0-4 years of age) and the elderly (= 65 years of age) were at greatest risk. ED visits also showed significant increases for acute renal failure, cardiovascular diseases, diabetes, electrolyte imbalance, and nephritis. We observed significantly elevated RRs for hospitalizations for heat-related illnesses (RR = 10.15; 95% CI, 7.79-13.43), acute renal failure, electrolyte imbalance, and nephritis.

Conclusions: The 2006 California heat wave had a substantial effect on morbidity, including regions with relatively modest temperatures. This suggests that population acclimatization and adaptive capacity influenced risk. By better understanding these impacts and population vulnerabilities, local communities can improve heat wave preparedness to cope with a globally warming future.

Kong F, H Yin, et al. 2014. A satellite image-based analysis of factors contributing to the green-space cool island intensity on a city scale. Urban Forestry & Urban Greening, 13(4): 846-53.

Urban green spaces provide cooler microclimates and create localized urban cool islands and, as part of an adaptation strategy to cope with future urban climate change, have been proposed as a means to mitigate the urban heat island effect. Numerous previous research papers have discussed green-space size, type, and vegetation density, as well as many other factors that might influence green-space cooling effects. However, little has been done with regard to exploring and quantifying the characteristics of the green-space cool island (UCI). It is also largely unknown whether or how the patterns of green space and land use, as well as the adjacent urban thermal environment, affect UCIs. In this paper, the land surface temperature (LST) was retrieved from satellite imagery. The UCI was identified, and one of the UCI characteristics, the UCI intensity, was defined. Multiple linear regression models were then used to explore and quantify the combined effects of factors related to the UCI intensity. The results show that the intensity differed between UCIs, and correlated significantly with the extent of and mean temperature reduction associated with an UCI. Multiple linear regression analysis found that UCI intensity was affected by areas of forest vegetation and its spatial arrangements, as well as by the composition of the cool island and its neighboring thermal environment. The study validated the suitability of using intensity as an indicator of the UCI. Identifying the UCI as a result of the green-space cooling effect, will help in the management and planning of the spatial arrangement of green spaces in cities to reduce the effects of the urban thermal environment and help cities adapt to climate change.

Koohsari MJ, S Mavoa, et al. 2015. Public open space, physical activity, urban design and public health: Concepts, methods and research agenda. Health & place, 33: 75-82.

Public open spaces such as parks and green spaces are key built environment elements within neighbourhoods for encouraging a variety of physical activity behaviours. Over the past decade, there has been a burgeoning number of active living research studies examining the influence of public open space on physical activity. However, the evidence shows mixed associations between different aspects of public open space (e.g., proximity, size, quality) and physical activity. These inconsistencies hinder the development of specific evidence-based guidelines for urban designers and policy-makers for (re)designing public open space to encourage physical activity. This paper aims to move this research agenda forward, by identifying key conceptual and methodological issues that may contribute to inconsistencies in research examining relations between public open space and physical activity.

Korpela KM, M Ylen, et al. 2010. Favorite green, waterside and urban environments, restorative experiences and perceived health in Finland. Health Promotion International 25(2): 200-209.

The study investigated restorative experiences in relation to respondents' everyday favorite places and analysed the associations between the use of favorite places, restorative experiences, their determinants and aspects of self-rated health. A simple random sample of 1273 inhabitants, aged between 15 and 75 years, of two major cities in Finland (Helsinki and Tampere) completed a postal questionnaire. A subsample of the answers from inhabitants with a self-reported distance from home to a favorite place of 15 km or less (n = 1089) was analysed. Restorative experiences in favorite exercise and activity outdoor areas, waterside environments and extensively managed natural settings (mainly urban woodlands) were stronger than in favorite places in built urban settings or green spaces in urban settings (mostly parks). The results revealed a link between the need for restoration (worries and stress), the use of environmental self-regulation strategies (favorite places) and restorative outcomes. The more worries about money and work (during the last month) a person had, the more stressed a person had felt during the last year, the less energetic s/he had felt, the lower was the number of visits to the favorite place (during the last 6 months) and the lower the typical level of restorative experiences. Inconsistently, the direct path suggested that the more worries about money and work, the higher the typical level of restorative experiences. The findings increase knowledge of health-enhancing environments and have implications for stress and work recovery research.

Kravchenko J, AP Abernethy, et al. 2013. Minimization of Heatwave Morbidity and Mortality. American Journal of Preventive Medicine 44(3): 274-282.

Global climate change is projected to increase the frequency and duration of periods of extremely high temperatures. Both the general populace and public health authorities often underestimate the impact of high temperatures on human health. To highlight the vulnerable populations and illustrate approaches to minimization of health impacts of extreme heat, the authors reviewed the studies of heat-related morbidity and mortality for high-risk populations in the U.S. and Europe from 1958 to 2012. Heat exposure not only can cause heat exhaustion and heat stroke but also can exacerbate a wide range of medical conditions. Vulnerable populations, such as older adults; children; outdoor laborers; some racial and ethnic subgroups (particularly those with low SES); people with chronic diseases; and those who are socially or geographically isolated, have increased morbidity and mortality during extreme heat. In addition to ambient temperature, heat-related health hazards are exacerbated by air pollution, high humidity, and lack of air-conditioning. Consequently, a comprehensive approach to minimize the health effects of extreme heat is required and must address educating the public of the risks and optimizing heatwave response plans, which include improving access to environmentally controlled public havens, adaptation of social services to address the challenges required during extreme heat, and consistent monitoring of morbidity and mortality during periods of extreme temperatures.

Kubesch NJ, A de Nazelle, et al. 2015. Respiratory and inflammatory responses to short-term exposure to traffic-related air pollution with and without moderate physical activity. Occupational and environmental medicine, 72(4): 284-93.

Objectives Exposure to traffic-related air pollution (TRAP) has been associated with adverse respiratory and systemic outcomes. Physical activity (PA) in polluted air may increase pollutant uptake and thereby health effects. The authors aimed to determine the short-term health effects of TRAP in healthy participants and any possible modifying effect of PA.

Methods Crossover real-world exposure study comparing in 28 healthy participants pulmonary and inflammatory responses to four different exposure scenarios: 2 h exposure in a high and low TRAP environment, each at rest and in combination with intermittent moderate PA, consisting of four 15 min rest and cycling intervals. Data were analysed using mixed effect models for repeated measures.

Results Intermittent PA compared to rest, irrespective of the TRAP exposure status, increased statistically significant (p<=0.05) pulmonary function (forced expiratory volume in 1 s (34 mL), forced vital capacity (29 mL), forced expiratory flow (FEF25-75%) (91 mL)), lung inflammation (fraction of exhaled nitric oxide, FeNO, (0.89 ppb)), and systemic inflammation markers interleukin-6 (52.3%), leucocytes (9.7%) and neutrophils count (18.8%). Interquartile increases in coarse particulate matter were statistically significantly associated with increased FeNO (0.80 ppb) and neutrophil count (5.7%), while PM2.5 and PM10 (particulate matter smaller than 2.5 and 10 µm in diameter, respectively) increased leucocytes (5.1% and 4.0%, respectively). We found no consistent evidence for an interaction between TRAP and PA for any of the outcomes of interest.

Conclusions In a healthy population, intermittent moderate PA has beneficial effects on pulmonary function even when performed in a highly polluted environment. This study also suggests that particulate air pollution is inducing pulmonary and systemic inflammatory responses.

Kubzansky LD, I Kawachi, D Sparrow. 1999. Socioeconomic status, hostility, and risk factor clustering in the normative aging study: Any help from the concept of allostatic load? Annals of Behavioral Medicine 21(4): 330-8.

Objective: To examine the relationships between socioeconomic status (SES), psychosocial vulnerability (hostility), and allostatic load. Allostatic load refers to the cumulative physiological cost of adaptation to stress.

Method: We examined the relationships, between SES (as measured by educational attainment), hostility, and allostatic load in the Normative Aging Study, a longitudinal study of community-dwelling men aged 21 to 80 years and free of known chronic medical conditions at entry in the 1960s. In 1986, the revised Minnesota Multiphasic Personality Inventory was administered by mail, from which a hostility measure was derived by summing the scores from three Cook-Medley subscales: Hostile Affect, Hostile Attribution, Aggressive Responding. An index of allostatic load was constructed from data collected during physical exams conducted between 1987 and 1990 (i.e. measures reflecting "wear and tear" on the cardiovascular, endocrine, and metabolic systems). Cross-sectional relationships between education, hostility, and allostatic load were examined in 818 men.

Results Separate linear regression analyses indicated that lower levels of educational attainment and greater hostility were both associated with higher allostatic load scores ( p <.05 and p <.01, respectively). Less education was also associated with higher hostility ( p <.001). When allostatic load was regressed simultaneously on education and hostility, the effect of education was attenuated, while hostility ( p <.05) maintained an independent affect.

Conclusions: Our findings suggest that lower levels of education and greater hostility are associated with greater "wear and tear" on the body. The effects of education on allostatic load may be mediated by hostility.

Kunst AE, CWN Looman, LP Mackenbach. 1993. Outdoor air temperature and mortality in the Netherlands: A time-series analysis. American Journal of Epidemiology 137(3): 331-41.

Death rates become progressively higher when outdoor air temperature rises above or falls below 20-25 C. This study addresses the question of whether this relation is largely attributable to the direct effects of exposure to heat and cold on the human body in general, and on the circulatory system in particular. The association between daily mortality and daily temperatures in the Nethetlands in the period 1979-1987 was examined by controlling for influenza incidence, air pollution, and season; distinguishing lag periods; examining effect modification by wind speed and relative humidity; and distinguishing causes of death. Important direct effects of exposure to cold and heat on mortality were suggested by the following findings: 1) control for influenza incidence reduced cold-related mortality by only 34% and reduced heat-related mortality by 23% (the role of air pollution and season was negligible); 2) 62% of the "unexplained" cold-related mortality, and all heat-related mortality, occurred within 1 week; and 3) effect modification by wind speed was in the expected direction. The finding that 57% of "unexplained" cold-related mortality and 26% of the "unexplained" heat-related mortality was attributable to cardiovascular diseases suggests that direct effects are only in part the result of increased stress on the circulatory system. For heat-related mortality, direct effects on the respiratory system are probably more important. For cold-related mortality, the analysis yielded evidence of an important indirect effect involving increased incidence of influenza and other respiratory infections.

Kuo FE and WC Sullivan. 2001. Aggression and Violence in the inner city - Effect of environment via mental Fatigue. Environment and Behavior 33(4): 543-71.

S. Kaplan suggested that one outcome of mental fatigue may be an increased propensity for outbursts of anger and even violence. If so, contact with nature, which appears to mitigate mental fatigue, may reduce aggression and violence. This study investigated that possibility in a setting and population with relatively high rates of aggression: inner-city urban public housing residents. Levels of aggression were compared for 145 urban public housing residents randomly assigned to buildings with varying levels of nearby nature (trees and grass). Attentional functioning was assessed as an index of mental fatigue. Residents living in relatively barren buildings reported more aggression and violence than did their counterparts in greener buildings. Moreover, levels of mental fatigue were higher in barren buildings, and aggression accompanied mental fatigue. Tests for the proposed mechanism and for alternative mechanisms indicated that the relationship between nearby nature and aggression was fully mediated through attentional functioning.

Kuo FE, WC Sullivan, et al. 1998. Fertile ground for community: Inner-city neighborhood common spaces. American Journal of Community Psychology 26(6): 823-51.Kuo, F. S., Williams (1998). "Fertile Ground for Community: Inner-City Neighborhood Common Spaces." American Journal of Community Psychology 26(6): 823-851.

Research suggests that the formation of neighborhood social ties (NSTs) may substantially depend on the informal social contact which occurs in neighborhood common spaces, and that in inner-city neighborhoods where common spaces are often barren no-man's lands, the presence of trees and grass supports common space use and informal social contact among neighbors. We found that for 145 urban public housing residents randomly assigned to 18 architecturally identical buildings, levels of vegetation in common spaces predict both use of common spaces and NSTs; further, use of common spaces mediated the relationship between vegetation and NSTS. In addition, vegetation and NSTs were significantly related to residents' senses of safety and adjustment. These findings suggest that the use and characteristics of common spaces may play a vital role in the natural growth of community, and that improving common spaces may be an especially productive focus for community organizing efforts in inner-city neighborhoods.

Kuo FE.and A FaberTaylor. 2004. A potential natural treatment for ADD/ADHD: evidence from a national study. American Journal of Public Health 94(9) 1580 -6.

Objectives. We examined the impact of relatively "green" or natural settings on attention-deficit/hyperactivity disorder (ADHD) symptoms across diverse subpopulations of children.

Methods. Parents nationwide rated the aftereffects of 49 common after-school and weekend activities on children's symptoms. Aftereffects were compared for activities conducted in green outdoor settings versus those conducted in both built outdoor and indoor settings.

Results. In this national, nonprobability sample, green outdoor activities reduced symptoms significantly more than did activities conducted in other settings,even when activities were matched across settings. Findings were consistent across age, gender, and income groups; community types; geographic regions; and diagnoses.

Conclusions. Green outdoor settings appear to reduce ADHD symptoms in children across a wide range of individual, residential, and case characteristics.

Kuprys-Lipinska I, P Kuna, & I Wagner. 2014. Water in the urban space and the health of residents. Water in the City, Sendzimir Foundation, Krakow, 47-55.

The processes of urbanization deprive cities of water and greenery and residents of a healthy living environment. Concrete-dominated space makes people more prone to cardiovascular diseases, obesity, depression, osteoarthritis, asthma and allergy. The lack of water and greenery in urban space is one of the significant causes of allergies which are currently the top health concern for Polish children and adults below the age of 30. The inclusion of bluegreen infrastructure in urban planning is one of the crucial preventive measures in the fight against the epidemic of lifestyle diseases. Blue-green infrastructure improves air temperature and humidity, reduces pollution, stimulates the human immune system, provides favourable conditions for outdoor activities, and consequently, helps maintain proper body weight, good physical endurance and optimum mental health. In this chapter we show how the inclusion of bluegreen infrastructure in the urban system helps to retain water and support the ecosystems' ability to provide services by creating healthy urban space, thus improving the living conditions of residents and helping the city move closer to sustainable development.

Kweon B-S, WC Sullivan, AR Wiley. 1998. Green common spaces and the social integration of inner-city older adults. Environment and Behavior 30(6): 832-58.

For older adults, social integration and the strength of social ties are profoundly important predictors of well-being and longevity. Can the physical environment be designed to promote older adults' social integration with their neighbors? We examined this possibility by testing the relationships between varying amount of exposure to green outdoor common spaces and the strength of ties among neighbors. Results of interviews with 91 older adults (between the ages of 64 and 91 years) from one inner-city neighborhood show that the use of green outdoor common spaces predicted both the strength of neighborhood social ties and sense of community. Although the strength of these relationships were modest, the findings suggest that the characteristics of outdoor common spaces can play a role in the formation and maintenance of social ties among older adult residents of inner-city neighborhoods. The results have implications for designers, managers, and residents of housing developments.


Laborde A, F Tomasina, et al. 2015. Children's health in Latin America: the influence of environmental exposures. Environmental health perspectives, 123(3): 201.

Background Chronic diseases are increasing among children in Latin America.

Objective and Methods To examine environmental risk factors for chronic disease in Latin American children and to develop a strategic initiative for control of these exposures, the World Health Organization (WHO) including the Pan American Health Organization (PAHO), the Collegium Ramazzini, and Latin American scientists reviewed regional and relevant global data.

Results Industrial development and urbanization are proceeding rapidly in Latin America, and environmental pollution has become widespread. Environmental threats to children's health include traditional hazards such as indoor air pollution and drinking-water contamination; the newer hazards of urban air pollution; toxic chemicals such as lead, asbestos, mercury, arsenic, and pesticides; hazardous and electronic waste; and climate change. The mix of traditional and modern hazards varies greatly across and within countries reflecting industrialization, urbanization, and socioeconomic forces.

Conclusions To control environmental threats to children's health in Latin America, WHO, including PAHO, will focus on the most highly prevalent and serious hazards-indoor and outdoor air pollution, water pollution, and toxic chemicals. Strategies for controlling these hazards include developing tracking data on regional trends in children's environmental health (CEH), building a network of Collaborating Centres, promoting biomedical research in CEH, building regional capacity, supporting development of evidence-based prevention policies, studying the economic costs of chronic diseases in children, and developing platforms for dialogue with relevant stakeholders.

Lachowycz K, and AP Jones. 2014. Does walking explain associations between access to greenspace and lower mortality? Social Science & Medicine, 107: 9-17.

Despite emerging evidence that access to greenspace is associated with longer life expectancy, little is understood about what causal mechanisms may explain this relationship. Based on social-ecological theories of health, greenspace has multifaceted potential to influence mortality but the potential alternative mediating pathways have not been empirically tested. This study evaluates relationships between access to greenspace, walking and mortality. Firstly, we test for an association between access to greenspace and self-reported levels of walking using a survey of 165,424 adults across England collected during 2007 and 2008. Negative binomial regression multilevel models were used to examine associations between greenspace access and self reported number of days walked in the last month, in total and for recreational and health purposes, after controlling for relevant confounders. Secondly we use an area level analysis of 6781 middle super output areas across England to examine if recreational walking mediates relationships between greenspace access and reduced premature mortality from circulatory disease. Results show clear evidence of better greenspace access being associated with higher reported recreational walking. There were between 13% and 18% more days of recreational walking in the greenest quintile compared with the least green after adjustment for confounders. Tests for mediation found no evidence that recreational walking explain the associations between greenspace and mortality. Futhermore, whilst the relationship between greenspace access and walking was observed for all areas, the relationship between greenspace access and reduced mortality was only apparent in the most deprived areas. These findings indicate that the association between greenspace and mortality, if causal, may be explained by mediators other than walking, such as psychosocial factors. Future research should concentrate on understanding the causal mechanisms underlying observed associations.

Lachowycz K, AP Jones, et al. 2010. What can global positioning systems tell us about the contribution of different types of urban greenspace to children's physical activity? Health & Place , Volume 18, Issue 3, May 2012, Pages 586-594.

Urban greenspace is hypothesised to be an important location for physical activity in children, but their actual use of the resource to be active is not well known. In this study, global positioning systems (GPS) and accelerometers were used to measure activity within green environments for 902 English children aged 11-12. We summarised activity intensities in different types of greenspace on weekday evenings, weekend days and by season. Around half of outdoor moderate-vigorous activity took place in greenspace at the weekend and use was consistent across seasons. The findings suggest the importance of certain types of greenspace to children's physical activity.

Lachowycz K, AP Jones. 2013. Towards a better understanding of the relationship between greenspace and health: Development of a theoretical framework. Landscape and Urban Planning 118(0): 62-69.

A growing body of evidence investigates whether access to greenspace, such as parks and woodland, is beneficial to well-being. Potential health benefits of greenspace exposure include opportunity for activities within the space and psychological benefits of viewing and interacting with nature. However, empirical research evidence on the effects of greenspace exposure shows mixed findings. Hence we suggest that the key questions of "if, why and how?" greenspace influences health remain largely unanswered. We argue that researchers have inadequately considered the causal pathways which drive the relationship. In particular, an improved understanding is needed of potential mediators and moderators. In this paper we draw on social-ecological theories and a review of the literature to develop a novel theoretical framework which summarises current knowledge about hypothetical causal pathways between access to greenspace and health outcomes. The framework highlights how mediators - such as use of greenspace and perceptions of the living environment - drive associations between access and both physical and psychological health outcomes. We propose key moderators based on evidence that associations between greenspace and health differ by demographic factors such as gender, ethnicity and socio-economic status, living context, greenspace type and climate. We discuss the evidence for how and why these factors act as moderators and consider the implications which arise from this improved understanding of the relationship between greenspace and health. In conclusion, we discuss how the framework can be used to inform planning of research studies, and how it may be developed in the future as more evidence emerges.

Lafortezza R, G Carrus, et al. 2009. Benefits and well-being perceived by people visiting green spaces in periods of heat stress. Urban Forestry & Urban Greening 8(2): 97-108.

In urban environments, green spaces have proven to act as ameliorating factors of some climatic features related to heat stress, reducing their effects and providing comfortable outdoor settings for people. In addition, green spaces have demonstrated greater capacity, compared with built-up areas, for promoting human health and well-being. In this paper, we present results of a study conducted in Italy and the UK with the general goal to contribute to the theoretical and empirical rationale for linking green spaces with well-being in urban environments. Specifically, the study focused on the physical and psychological benefits and the general well-being associated with the use of green spaces on people when heat stress episodes are more likely to occur. A questionnaire was set up and administered to users of selected green spaces in Italy and the UK (n=800). Results indicate that longer and frequent visits of green spaces generate significant improvements of the perceived benefits and well-being among users. These results are consistent with the idea that the use of green spaces could alleviate the perception of thermal discomfort during periods of heat stress.

Laino, Charlene. 2008. More Strokes in the U.S. than in Europe. WebMD Health News. February 22, 2008.

More Strokes in the U.S. than in Europe. -- -- Accessed February 2013.

Larson LR, JW Whiting, et al. 2014. Physical activity locations in Georgia: Frequency of use by socio-demographic group. Journal of Outdoor Recreation and Tourism, 5: 68-72.

Active outdoor recreation helps to mitigate health consequences associated with sedentary behavior. Enhanced understanding of socio-demographic differences in physical activity (PA) location preferences could therefore contribute to health promotion. This study examined frequency of use for various PA locations in Georgia, a state with historically high levels of physical inactivity and obesity. Data were collected via intercept surveys of visitors to state parks (n=761) and flea markets near the parks (n=234). According to these self-reports, homes and backyards were used most frequently for PA followed by neighborhood settings. State parks and gyms or recreation centers were used less frequently than other recreation settings. Latinos relied more on parks and less on homes/backyards for PA than others groups. African Americans and Asians used gyms or recreation centers more often than other groups. Development of built environments that promote active living should account for PA location choices across diverse communities.

Laurent O, W Jun, et al. 2013. Green spaces and pregnancy outcomes in Southern California. Health & Place 24(0): 190-195.

Little is known about the impacts of green spaces on pregnancy outcomes. The relationship between green space exposure and preeclampsia has never been studied. We used a hospital-based perinatal database including more than 80,000 births to study the relationships between greenness exposure and three pregnancy outcomes: birth weight in term born infants, preterm deliveries and preeclampsia. Greenness was characterized using the normalized difference vegetation index (NDVI) within circular buffers surrounding maternal homes. Analyses were conducted using generalized estimating equations, adjusted for potential confounders. We observed an increase in birth weight in term born infants and a reduced risk of preterm births associated with an increase in NDVI. No significant association was observed between greenness and preeclampsia. This study provides modest support for beneficial effects of greenness exposure on pregnancy outcomes and calls for confirmation in other study settings.

Lautenschlager NT, KL Cox, et al. 2008. Effect of physical activity on cognitive function in older adults at risk for Alzheimer Disease. The Journal of the American Medical Association 300(9): 1027-37.

Context: Many observational studies have shown that physical activity reduces the risk of cognitive decline; however, evidence from randomized trials is lacking.

Objective: To determine whether physical activity reduces the rate of cognitive decline among older adults at risk

Design and Setting: Randomized controlled trial of a 24-week physical activity intervention conducted between 2004 and 2007 in metropolitan Perth, Western Australia. Assessors of cognitive function were blinded to group membership.

Participants: We recruited volunteers who reported memory problems but did not meet criteria for dementia. Three hundred eleven individuals aged 50 years or older were screened for eligibility, 89 were not eligible, and 52 refused to participate. A total of 170 participants were randomized and 138 participants completed the 18-month assessment.Intervention Participants were randomly allocated to an education and usual care group or to a 24-week home-based program of physical activity

Main Outcome: Measure Change in Alzheimer Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores (possible range, 0-70) over 18 months.

Results: In an intent-to-treat analysis, participants in the intervention group improved 0.26 points (95% confidence interval,-0.89 to 0.54) and those in the usual care group deteriorated 1.04 points (95% confidence interval, 0.32 to 1.82) on the ADAS-Cog at the end of the intervention. The absolute difference of the outcome measure between the intervention and control groups was -1.3 points (95% confidence interval,-2.38 to -0.22) at the end of the intervention. At 18 months, participants in the intervention group improved 0.73 points (95% confidence interval, -1.27 to 0.03) on the ADAS-Cog, and those in the usual care group improved 0.04 points (95% confidence interval, -0.46 to 0.88). Word list delayed recall and Clinical Dementia Rating sum of boxes improved modestly as well, whereas word list total immediate recall, digit symbol coding, verbal fluency, Beck depression score, and Medical Outcomes 36-Item Short-Form physical and mental component summaries did not change significantly.

Conclusions: In this study of adults with subjective memory impairment, a 6-month program of physical activity provided a modest improvement in cognition over an 18-month follow-up period

Law BM. 2011. Top 10 Causes of Low Birth Weight Babies. Discovery fit and health.

Top 10 causes of low birth weight babies. -- -- Accessed February 2013.

Lazaro R and JL Mora. 2014. Sediment content and chemical properties of water runoff on biocrusts in drylands. Biologia, 69(11): 1539-54.

In drylands, water erosion can be a process with important economic and ecological implications, and is very dependent on the soil surface cover. There is broad agreement that biocrusts protect the soil from erosion in a wide range of circumstances. However, there is little information available on the effect of rain and biocrust types on this protective capacity and there is particularly very little knowledge on the erosive effects of runoff on biocrusts, which are expected to be larger in larger drainage areas, on the resistance of biocrusts to the combined effect of raindrops plus runoff flow and on the solute mobilisation by runoff in biocrusts. To answer these questions, we performed 96 rainfall-simulation in situ factorial experiments, including two biocrust types (cyanobacteria and lichens), three rain types (42, 63 and 77 mm h-1, always 20 min rain), four plot lengths (1, 2, 3 and 4 m long) and four replicates. In each experiment, runoff volume was measured and a runoff sample was taken to determine (i) the amount of dry matter in runoff, (ii) the amount of organic matter among the dry matter, (iii) the electrical conductivity, pH and alkalinity in runoff water. The main findings were: biocrusts strongly protected soil against water erosion, even under the most erosive conditions, and the protection increased with the successional development. Biocrusts were very resistant to the impact of raindrops and also to runoff flow, although an emergent hypothesis arose: under the most erosive conditions, a threshold of erodibility could be reached at the cyanobacterial biocrust. The lichen crust also protected the soil against the removal of soil soluble substances. The development of a biocrust could change the chemical composition of the solutes in runoff.

Lee A C K and R Maheswaran. 2011. The health benefits of urban green spaces: a review of the evidence. Journal of Public Health 33(2): 212-222

Background: Urban development projects can be costly and have health impacts. An evidence-based approach to urban planning is therefore essential. However, the evidence for physical and non-physical health benefits of urban green space is unclear.

Methods: A literature search of academic and grey literature was conducted for studies and reviews of the health effects of green space. Articles found were appraised for their relevance, critically reviewed and graded accordingly. Their findings were then thematically categorized.

Results: There is weak evidence for the links between physical, mental health and well-being, and urban green space. Environmental factors such as the quality and accessibility of green space affects its use for physical activity. User determinants, such as age, gender, ethnicity and the perception of safety, are also important. However, many studies were limited by poor study design, failure to exclude confounding, bias or reverse causality and weak statistical associations.

Conclusion: Most studies reported findings that generally supported the view that green space have a beneficial health effect. Establishing a causal relationship is difficult, as the relationship is complex. Simplistic urban interventions may therefore fail to address the underlying determinants of urban health that are not remediable by landscape redesign.

Lee J, BJ Park, et al. 2011. Effect of forest bathing on physiological and psychological responses in young Japanese male subjects. Public Health 125(2): 93-100.

Summary/Objective: To provide scientific evidence supporting the efficacy of forest bathing as a natural therapy by investigating its physiological benefits using biological indicators in outdoor settings.

Study design: Within-group comparisons were used to examine psychological and physiological responses to exposure to real forest and urban environments.

Methods: Young Japanese male adults participated in a 3-day, 2-night field experiment. Physiological responses as well as self-reported psychological responses to forest and urban environmental stimuli were measured in real settings. The results of each indicator were compared against each environmental stimulus.

Results: Heart rate variability analysis indicated that the forest environment significantly increased parasympathetic nervous activity and significantly suppressed sympathetic activity of participants compared with the urban environment. Salivary cortisol level and pulse rate decreased markedly in the forest setting compared with the urban setting. In psychological tests, forest bathing significantly increased scores of positive feelings and significantly decreased scores of negative feelings after stimuli compared with the urban stimuli.

Conclusion: Physiological data from this field experiment provide important scientific evidence on the health benefits of forest bathing. The results support the concept that forest bathing has positive effects on physical and mental health, indicating that it can be effective for health promotion. Despite the small sample size in this study, a very clear tendency towards positive physiological and psychological outcomes in forests was observed.

Lee J, BJ Park, et al. 2015. Acute effects of exposure to a traditional rural environment on urban dwellers: a crossover field study in terraced farmland. International journal of environmental research and public health, 12(2): 1874-93.

Despite an increasing attention and public preference for rural amenities, little evidence is available on the health benefits of a rural environment. In this study, we identified physiological and psychological benefits of exposure to a rural environment using multiparametric methods. Twelve young male adults participated in a 3-day field experiment (mean +- standard deviation age, 22.3 +- 1.3 years). Sleeping environment, diet program, physical activities, and other factors possibly affecting physiological responses were controlled during experiment period. For all participants, salivary cortisol concentration, heart rate variability, and blood pressure were measured at rural and urban field sites. Self-evaluation questionnaires were administered to analyze the psychological states in two different environments. Volatile compounds in the air were also analyzed to investigate air quality. The data were compared between rural and urban environments. The data showed that exposure to a rural environment reduced stress hormone secretion and sympathetic nervous activity and increased parasympathetic nervous activity. Short-term exposure to a rural environment also improved mood states. Our findings indicate that exposure to a rural environment effectively reduced physiological stress and enhanced psychological well-being.

Lee J, Y Tsunetsugu, et al. 2014. Influence of forest therapy on cardiovascular relaxation in young adults. Evidence-Based Complementary and Alternative Medicine.

Background. Despite increasing attention toward forest therapy as an alternative medicine, very little evidence continues to be available on its therapeutic effects. Therefore, this study was focused on elucidating the health benefits of forest walking on cardiovascular reactivity.

Methods. Within-group comparisons were used to examine the cardiovascular responses to walking in forest and urban environments. Forty-eight young adult males participated in the two-day field research. Changes in heart rate variability, heart rate, and blood pressure were measured to understand cardiovascular reactivity. Four different questionnaires were used to investigate the changes in psychological states after walking activities.

Results. Forest walking significantly increased the values of ln(HF) and significantly decreased the values of ln(LF/HF) compared with the urban walking. Heart rate during forest walking was significantly lower than that in the control. Questionnaire results showed that negative mood states and anxiety levels decreased significantly by forest walking compared with urban walking.

Conclusion. Walking in the forest environment may promote cardiovascular relaxation by facilitating the parasympathetic nervous system and by suppressing the sympathetic nervous system. In addition, forest therapy may be effective for reducing negative psychological symptoms.

Lee J-Y, L Duk-Chul. 2014. Cardiac and pulmonary benefits of forest walking versus city walking in elderly women: A randomised, controlled, open-label trial. European Journal of Integrative Medicine 6(1): 5-11.

Introduction: Interest increases in the role of the natural environment providing health benefits. This study compared forest and city walking on arterial stiffness and pulmonary function.

Methods: A single-centre, parallel, randomised, and controlled, open-label trial was conducted. Seventy women >60 years were recruited into the study. The forest-walking group walked around a forested area for 1 h. The city-walking group walked around an urban area for 1 h. Blood pressure, arterial stiffness (CAVI), and pulmonary function (FEV1, FEV6) were assessed before and 30 min after the walking activity.

Results: Of the 70 women randomly assigned to the forest walking (n=50) or city walking (n=20) groups. Eight participants were excluded from analysis due to early dropout leaving 43 participants in the forest-walking group and 19 in the city-walking group. One hour of forest walking significantly improved CAVI (p<0.01), FEV1 (p<0.01) and FEV6 (p<0.01). No significant change was observed in the city-walking group. There were significant differences in changes of CAVI (p<0.01), FEV1 (p=0.02), and FEV6 (p=0.04), between the city-walking and the forest-walking groups. No significant side effects were reported.

Conclusion: Our results showed that forestwalking improved arterial stiffness and pulmonary function in 61 elderly Korean women. Further large scale and long-term studies are needed to better understand the clinical significance of these findings. Clinical trial registered with (KCT0000631).

Lee KE, KJ Williams, et al. 2015. 40-second green roof views sustain attention: The role of micro-breaks in attention restoration. Journal of Environmental Psychology, 42: 182-9.

Based on attention restoration theory we proposed that micro-breaks spent viewing a city scene with a flowering meadow green roof would boost sustained attention. Sustained attention is crucial in daily life and underlies successful cognitive functioning. We compared the effects of 40-s views of two different city scenes on 150 university students' sustained attention. Participants completed the task at baseline, were randomly assigned to view a flowering meadow green roof or a bare concrete roof, and completed the task again at post-treatment. Participants who briefly viewed the green roof made significantly lower omission errors, and showed more consistent responding to the task compared to participants who viewed the concrete roof. We argue that this reflects boosts to sub-cortical arousal and cortical attention control. Our results extend attention restoration theory by providing direct experimental evidence for the benefits of micro-breaks and for city green roofs.

Lee KH, TM Isenhart & RC Schultz. 2003. Sediment and nutrient removal in an established multi-species riparian buffer. Journal of Soil and Water Conservation, 58(1), 1-8.

Riparian buffers are widely recommended as a tool for removing nonpoint source pollutants from agricultural areas especially those carried by surface runoff. A field plot study was conducted to determine the effectiveness of an established multi-species buffer in trapping sediment, nitrogen, and phosphorus from cropland runoff during natural rainfall events. Triplicate plots were installed in a previously established buffer with a 4.1 by 22.1 m (14 x 73 ft.) cropland source area paired with either no buffer, a 7.1 m (23 ft) switchgrass (Panicum virgatum L. cv. Cave-n-Rock) buffer, or a 16.3 m (53.5 ft) switchgrass/woody buffer (7.1 m swithgrass/9.2 m woody) located at the lower end of each plot. The switchgrass buffer removed 95% of the sediment, 80% of the total-nitrogen (N), 62% of the nitrate-nitrogen (NO3-N), 78% of the total-phosphorus (P), and 58% of the phosphate-phosphorus (PO4-P). The switchgrass/woody buffer removed 97% of the sediment, 94% of the total-N, 85% of the NO3-N, 91% of the total-P, and 80% of the PO4-P in the runoff. There was a significant negative correlation between the trapping effectiveness of the buffers and the intensity and total rainfall of individual storms. While the 7 m (23 ft) switchgrass buffer was effective in removing sediment and sediment-bound nutrients, the added width of the 16.3 m (53.5 ft) switchgrass/woody buffer increased the removal efficiency of soluble nutrients by over 20%. Similar or even greater reductions might have been found if the 16.3 m (53.5 ft) buffer had been planted completely to native warm-season grasses. In this buffer, combinations of the dense, stiff, native warm-season grass and woody vegetation improved the removal effectiveness for the nonpoint source pollutants from agricultural areas.

Lee KY, PH Lee, & D Macfarlane. 2014. Associations between moderate-to-vigorous physical activity and neighbourhood recreational facilities: the features of the facilities matter. International journal of environmental research and public health, 11(12): 12594-610.

Objectives: To examine the associations between objectively-assessed moderate-to-vigorous physical activity (MVPA) and perceived/objective measures of neighbourhood recreational facilities categorized into indoor or outdoor, public, residential or commercial facilities. The associations between facility perceptions and objectively-assessed numbers of recreational facilities were also examined.

Method: A questionnaire was used on 480 adults to measure local facility perceptions, with 154 participants wearing ActiGraph accelerometers for >=4 days. The objectively-assessed number of neighbourhood recreational facilities were examined using direct observations and Geographical Information System data.

Results: Both positive and negative associations were found between MVPA and perceived/objective measures of recreational facilities. Some associations depended on whether the recreational facilities were indoor or outdoor, public or residential facilities. The objectively-assessed number of most public recreational facilities was associated with the corresponding facility perceptions, but the size of effect was generally lower than for residential recreational facilities.

Conclusions: The objectively-assessed number of residential outdoor table tennis courts and public indoor swimming pools, the objectively-assessed presence of tennis courts and swimming pools, and the perceived presence of bike lanes and swimming pools were positive determinants of MVPA. It is suggested to categorize the recreational facilities into smaller divisions in order to identify unique associations with MVPA.

Lestan KA, I Erzen, & M Golobic. 2014. The role of open space in urban neighbourhoods for health-related lifestyle. International journal of environmental research and public health, 11(6): 6547-70.

The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in the early nineties. Compared to the older neighborhoods, these are typically single-use residential areas, with small open spaces and poor landscape design. The research is concerned with the quality of life in these areas, especially from the perspective of the vulnerable users, like the elderly and children. Both depend on easily accessible green areas in close proximity to their homes. The hypothesis is that the poor open space quality affects their health-related behavior and their perceived health status. The research has three methodological phases: (1) a comparison between urban residential areas by criteria describing their physical characteristics; (2) behavior observation and mapping and (3) a resident opinion survey. The results confirm differences between open spaces of the selected residential areas as well as their relation with outdoor activities: a lack of outdoor programs correlates with poor variety of outdoor activities, limited to transition type, less time spent outdoors and lower satisfaction with their home environment. The survey also disclosed a strong influence of a set of socio-economic variables such as education and economic status on physical activity and self-perceived health status of people. The results therefore confirm the hypothesis especially for less affluent and educated; i.e., vulnerable groups.

Li F, Y Liu, et al. 2014. Ambient air pollution in China poses a multifaceted health threat to outdoor physical activity. J Epidemiol Community Health.

No abstract provided.

Li GX, MG Zhou, et al. 2013. Seasonal effects of PM10 concentrations on mortality in Tianjin, China: a time-series analysis. Journal of Public Health 21(2): 35-144.

Aim: There are uncertainties regarding the modification effects of season and temperature on the relationship between air pollution and mortality. This study aims to examine the effects of season and temperature onmortality associated with particulate matter less than 10 mircom in diameter (PM10)in Tianjin, China.

Methods: Time-series analysis was used to explore the modification effects of season and temperature on the association between PM10 and cause-specificmortality in Tianjin between 2006 and 2009. The causes studied were overall non-accidental mortality and subcategories of cardiovascular, respiratory, cardiopulmonary, stroke, and ischemic heart diseases (IHD).

Results: The association between PM10 and mortality showed a strong seasonal pattern and the effects of PM10 on cause-specific mortalities were strongest for high temperature days. Generally, the adverse effects were stronger in summer than for other seasons, except for respiratory mortality. In the summer period, a 10 micro-m/m3 increase in PM10 at 0-1days was associated with an increase in mortality for non-accidental (0.95 %, 95 % confidence interval [CI]: 0.45, 1.45), cardiovascular (1.40 %, 95 %CI: 0.77, 2.03), cardio-pulmonary (1.37 %, 95 %CI: 0.77, 1.98), IHD (1.55 %,95 %CI: 0.73, 2.37), and stroke (1.27 %, 95 % CI: 0.37,2.12) causes. The overall increase in mortality per 10 micro-m/m3 increase in PM10 was 0.42 % (95 %CI: 0.26, 0.58) for non-accidental, 0.41 % (95 %CI: 0.21, 0.62) for cardiovascular, 0.46 % (95 %CI: 0.26,0.65) for cardiopulmonary, 0.57 % (95 %CI: 0.30, 0.84) for IHD, and 0.32 % (95 %CI: 0.03,0.61) for stroke. At high temperatures (>=23.8 °C), a 10 micro-m/m3 increase in PM10 at 0-1 days was associated with an increase in mortality of 0.90 % (95 %CI: 0.61,1.19) for non-accidental, 1.01 % for cardiovascular, 1.40 % (95 %CI: 0.55, 2.27) for respiratory, 1.06 % (95 %CI: 0.71, 1.41) for cardiopulmonary, 1.47 % (95 %CI: 1.00, 1.94) for IHD, and 0.75% (95 %CI: 0.24, 1.28) for stroke. In addition, the PM10 effects of high temperature days were stronger for those aged 65 years and over.

Conclusion: Season and temperature could modify the adverse effects of PM10. An increase in hot summer days caused by climate change may enhance the risks of air pollution on human health. More attention should be paid to older populations, especially in summer and days with high temperatures.

Li J, GS Okin, et al. 2007. Quantitative effects of vegetation cover on wind erosion and soil nutrient loss in a desert grassland of southern New Mexico, USA. Biogeochemistry, 85(3): 317-32.

Wind is a key abiotic factor that influences the dynamics of arid and semiarid systems. We investigated two basic relationships on vegetation manipulation (grass cover reduction) plots at the Jornada Experimental Range in southern New Mexico: (1) wind erosion rates (horizontal mass flux and dust emission) versus vegetative cover, and (2) nutrient loss versus vegetative cover. The results indicate that wind erosion rates and nutrient loss by dust emission are strongly affected by plant cover; however, the importance of shrubs and grasses in reducing dust flux may not be equal. The dramatic increase of wind erosion between 75% grass cover reduction and 100% grass cover reduction suggests that sparsely distributed mesquites are relatively ineffective at reducing wind erosion and nutrient loss compared to grasses. Comparisons of nutrients between surface soils and wind blown dust indicate that aeolian transport is a major cause for the loss of soil nutrients in susceptible environments. We found that increased aeolian flux over three windy seasons (March 2004-July 2006) removed up to 25% of total organic carbon (TOC) and total nitrogen (TN) from the top 5 cm of soil, and about 60% of TOC and TN loss occurred in the first windy season (March-July 2004). The balance between net loss of nutrients by aeolian processes and the addition of nutrients by biotic processes changed from negative (net loss) to positive (net accumulation) between 50% grass cover reduction and 25% grass cover reduction. The estimated lifetime of surface soil TOC and TN of about 10 years on the plot with 100% grass cover reduction indicates that impacts of wind erosion on soil resources can occur on very short timescales.

Li M, S Gu, et al. 2015. Heat waves and morbidity: current knowledge and further direction-a comprehensive literature review. International journal of environmental research and public health, 12(5): 5256-83.

In the past few decades, several devastating heat wave events have significantly challenged public health. As these events are projected to increase in both severity and frequency in the future, it is important to assess the relationship between heat waves and the health indicators that can be used in the early warning systems to guide the public health response. Yet there is a knowledge gap in the impact of heat waves on morbidity. In this study, a comprehensive review was conducted to assess the relationship between heat waves and different morbidity indicators, and to identify the vulnerable populations. The PubMed and ScienceDirect database were used to retrieve published literature in English from 1985 to 2014 on the relationship between heat waves and morbidity, and the following MeSH terms and keywords were used: heat wave, heat wave, morbidity, hospital admission, hospitalization, emergency call, emergency medical services, and outpatient visit. Thirty-three studies were included in the final analysis. Most studies found a short-term negative health impact of heat waves on morbidity. The elderly, children, and males were more vulnerable during heat waves, and the medical care demand increased for those with existing chronic diseases. Some social factors, such as lower socioeconomic status, can contribute to heat-susceptibility. In terms of study methods and heat wave definitions, there remain inconsistencies and uncertainties. Relevant policies and guidelines need to be developed to protect vulnerable populations. Morbidity indicators should be adopted in heat wave early warning systems in order to guide the effective implementation of public health actions.

Li Q. 2010. Effect of forest bathing trips on human immune function. Environmental Health and Preventive Medicine 15(1): 9-17.

In Japan, a forest bathing trip, called "Shinrinyoku" in Japanese, is a short, leisurely visit to a forest; it is regarded as being similar to natural aromatherapy. This review focuses on the effects of forest bathing trips on human immune function. Beginning in 2005, adult Japanese individuals, both male and female, participated in a series of studies aimed at investigating the effect of forest bathing trips on human immune function. The subjects experienced a 3-day/2-night trip to forest areas, and blood and urine were sampled on days 2 (the first sampling during each trip) and 3 (the second sampling during each trip), and on days 7 and 30 after the trips. Natural killer (NK) activity, the numbers of NK, granulysin-, perforin-, and granzymes A/B-expressing lymphocytes in the blood, and the concentration of urinary adrenaline were measured. The same measurements were made before the trips on a normal working day as a control. The mean values of NK activity and the numbers of NK, granulysin-, perforin-, and granzymes A/B-expressing cells on forest bathing days were significantly higher than those on the control days, whereas the mean values of the concentration of urinary adrenaline on forest bathing days were significantly lower than that on the control days in both male and female subjects. The increased NK activity lasted for more than 30 days after the trip, suggesting that a forest bathing trip once a month would enable individuals to maintain a higher level of NK activity. In contrast, a visit to the city as a tourist did not increase NK activity, the numbers of NK cells, or the level of intracellular granulysin, perforin, and granzymes A/B. These findings indicate that forest bathing trips resulted in an increase in NK activity, which was mediated by increases in the number of NK cells and the levels of intracellular granulysin, perforin, and granzymes A/B.

Li XJ, XR Li, et al. 2008. Effects of crust and shrub patches on runoff, sedimentation, and related nutrient (C, N) redistribution in the desertified steppe zone of the Tengger Desert, Northern China. Geomorphology, 96(1-2): 221-32.

Biological soil crusts (BSCs) are extensively developed and commonly regarded as a kind of vegetation in desertification areas around the world. The natural recovery process of BSCs after disturbance and their long-term impacts on the soil water conditions are important but not well understood. In order to provide more insights into this problem, we set up two treatments including BSCs (natural BSCs without disturbance) and disturbed BSCs (the top 30 mm of surface soil, including the BSC layer, was severely disturbed and completely removed) in a semi-arid environment on the Loess Plateau of China. Over the succeeding years, the natural recovery process of BSCs was qualitatively described and the soil water content at 0-90 cm depth of the two treatments was consecutively monitored. The results showed the following: (1) it is possible to recover natural moss-dominated BSCs after severe disturbance under natural conditions, and the recovery process to BSC full-coverage took approximately three years; (2) the BSC disturbance greatly decreased soil water content by up to 18% and the effects gradually weakened with time; (3) the BSC disturbance decreased surface soil water content (0-70 cm) by up to 24% but increased deep soil water content (80-90 cm) by up to 13%; and (4) the BSC disturbance decreased soil water storage at 0-90 cm by 7.8 mm, 4.4 mm, 8.0 mm, and 4.9 mm in the second, third, fourth, and seventh years, respectively. We concluded that the BSC disturbance degraded soil water conditions in the three to four years following the disturbance. Therefore, the artificial destruction of natural moss-dominated BSCs in a semi-arid region on the Loess Plateau of China should not be recommended as a land management practice for the improvement of soil water conditions.

Lilienfeld SO and H Arkowitz. 2010. Are Men the More Belligerent Sex? Scientific American; April 5, 2010.

Are Men the More Belligerent Sex? Accessed February 2013.

Lin BB, RA Fuller, et al. 2014. Opportunity or orientation? Who uses urban parks and why. PLoS one, 9(1): e87422.

There is growing recognition that interactions with nature provide many desirable human well-being outcomes, yet increasing urbanization is degrading the quality and quantity of nature experiences. Thus, it has become increasingly important to understand how and why urban dwellers interact with nature. Studies of urban green space use have largely focused on the availability and ease of access to green space, suggesting that greater opportunities to experience such space will lead to increased use. However, a growing literature emphasizes the potential for an individual's nature orientation to affect their interaction with green space. Here we measure the importance of both opportunity and orientation factors in explaining urban park use. An urban lifestyle survey was deployed across Brisbane, Australia in November 2012 to assess patterns of green space use. Participants (n = 1479) were asked to provide information on demographics, private yard use, park visitations in the past week, and their orientation toward nature. About 60% of those surveyed had visited a park in the past week, and while this park user population had significantly greater nearby park coverage (within a 250 m radius; p = 0.006), a much stronger determinant of visitation was their higher nature orientation (p < 0.00001), suggesting that while both opportunity and orientation are important drivers for park visitation, nature orientation is the primary effect. Park users also spent significantly more time in their yards than non-park users (p < 0.00001), suggesting that yard use does not necessarily compensate for lower park use. Park users with stronger nature orientation (i) spent more time in their yard, (ii) traveled further to green spaces, and (iii) made longer visits than park visitors with weaker nature orientation. Overall, our results suggest that measures to increase people's connection to nature could be more important than measures to increase urban green space availability if we want to encourage park visitation.

Lindal PJ and T Hartig. 2015. Effects of urban street vegetation on judgments of restoration likelihood. Urban Forestry & Urban Greening, 14(2): 200-9.

Knowledge of how to increase the restorative quality of residential streetscapes may help to offset problems entailed by urban densification. The present study considered the effects of trees, grass, and flower beds on ratings of restoration likelihood for streetscapes. We used digital-imaging techniques to systematically vary these natural elements in images of residential streets with different architectural characteristics. Using a web-based procedure, 103 images were rated by independent groups of Icelandic adults (N=188) on either restoration likelihood, preference, being away, or fascination. Group mean scores on the psychological variables were calculated for each image, and the images were then used as the units of analysis in regression analyses. Ratings of restoration likelihood increased with increase in the number of street trees and the presence of flower beds. These effects were apparently mediated by perceptions of being away and fascination. The architectural characteristics of buildings along the streets had a strong independent effect on restoration likelihood ratings, but they did not moderate the positive effects of vegetation on restoration likelihood ratings. The results provide guidance for the design of more psychologically sustainable urban residential environments.

Lindemann-Matthies P, X Junge, and D Matthies. 2010. The influence of plant diversity on people's perception and aesthetic appreciation of grassland vegetation. Biological Conservation, 143(1): 195-202.

The conservation of biodiversity critically depends on the value that humans attach to it. Apart from an ecological and economic value, an aesthetic value has often been assigned to biodiversity. However, it is not known whether lay people appreciate the diversity of species and not just certain individual species or nature as a whole. We studied in a series of experiments and field studies people's perception and appreciation of species diversity. We presented meadow-like arrays of different species richness and evenness but random species composition to lay people and asked them to estimate plant species richness and rank the arrays by attractiveness. The experiments were complemented by two larger-scale field studies using natural meadows. Both in the experiments and the field studies the mean perception of species richness by people increased with true species richness, but was slightly overestimated at low and increasingly underestimated at high diversity levels. Lay people's aesthetic appreciation of both the experimental grassland arrays and the natural meadows increased with true species richness. Communities consisting of the same number of species were perceived to be more species-rich and were appreciated more when their evenness was high. Our results demonstrate that plant diversity in itself is attractive to humans. The current reduction of the diversity of grasslands due to intensification of management may thus reduce the attractiveness of regions where grasslands are a dominant feature of the landscape. This could have negative consequences for tourism and may add an economic argument for the conservation of biodiversity in grasslands.

Lindern EV, Bauer N, et al. 2013. Occupational engagement as a constraint on restoration during leisure time in forest settings. Landscape and Urban Planning 118(0): 90-97.

Abundant evidence affirms that contact with nature can promote physical and mental health, but the relationship appears to be contingent on multiple factors. We address the possibility that having paid work related to a natural environment constrains the psychological restoration that can be realized in such environments. Using data from a cross-sectional survey administered to a national probability sample of Swiss adults (N=1678), we tested a multiple-mediator regression model in which having an occupational relationship to forests is assumed to affect the degree to which a person reports experiencing restoration with visits to forests, as mediated by experiences of being away and fascination and by familiarity with the forest. The results indicate that having a forest profession was associated with greater familiarity, which was in turn associated with greater reported restoration. At the same time, however, this positive indirect association was more than offset by a lower sense of being away during forest visits, which was itself a positive predictor of reported restoration. Fascination did predict reported restoration, but it was not associated with forest profession. The pattern of associations held after adjustment for different characteristics, like age, gender, level of employment, and intensity of forest visitation. The results illustrate that the restorative value of nature experience is contingent on occupational engagement with the natural environment, and they indicate some pathways through which occupational engagement can affect restoration. Landscape professionals can use these results to articulate more nuanced arguments regarding access to natural environments for restoration purposes.

Linos A, A Petralias, et al. 2011. Oral ingestion of hexavalent chromium through drinking water and cancer mortality in an industrial area of Greece - An ecological study. Environmental Health 10(1): 50.

BACKGROUND: Hexavalent chromium is a known carcinogen when inhaled, but its carcinogenic potential when orally ingested remains controversial. Water contaminated with hexavalent chromium is a worldwide problem, making this a question of significant public health importance.

METHODS: We conducted an ecological mortality study within the Oinofita region of Greece, where water has been contaminated with hexavalent chromium. We calculated gender, age, and period standardized mortality ratios (SMRs) for all deaths, cancer deaths, and specific cancer types of Oinofita residents over an 11-year period (1999 - 2009), using the greater prefecture of Voiotia as the standard population.

RESULTS: A total of 474 deaths were observed. The SMR for all cause mortality was 98 (95% CI 89-107) and for all cancer mortality 114 (95% CI 94-136). The SMR for primary liver cancer was 1104 (95% CI 405-2403, p-value <0.001). Furthermore, statistically significantly higher SMRs were identified for lung cancer (SMR=145, 95% CI 100-203, p-value=0.047) and cancer of the kidney and other genitourinary organs among women (SMR=368, 95% CI 119-858, p-value=0.025). Elevated SMRs for several other cancers were also noted (lip, oral cavity and pharynx 344, stomach 121, female breast 134, prostate 128, and leukaemias 168), but these did not reach statistical significance.

CONCLUSIONS: Elevated cancer mortality in the Oinofita area of Greece supports the hypothesis of hexavalent chromium carcinogenicity via the oral ingestion pathway of exposure. Further studies are needed to determine whether this association is causal, and to establish preventive guidelines and public health recommendations.

Lipton RB, WF Stewart, et al. 2001. Prevalence and burden of migraine in the United States: Data from the American Migraine Study II. Headache: The Journal of Head and Face Pain 41(7): 646-57.

Objective.-To describe the prevalence, sociodemographic profile, and the burden of migraine in the United States in 1999 and to compare results with the original American Migraine Study, a 1989 population-based study employing identical methods.

Methods.-A validated, self-administered questionnaire was mailed to a sample of 20 000 households in the United States. Each household member with severe headache was asked to respond to questions about symptoms, frequency, and severity of headaches and about headache-related disability. Diagnostic criteria for migraine were based on those of the International Headache Society. This report is restricted to individuals 12 years and older.

Results.-Of the 43 527 age-eligible individuals, 29 727 responded to the questionnaire for a 68.3% response rate. The prevalence of migraine was 18.2% among females and 6.5% among males. Approximately 23% of households contained at least one member suffering from migraine. Migraine prevalence was higher in whites than in blacks and was inversely related to household income. Prevalence increased from aged 12 years to about aged 40 years and declined thereafter in both sexes. Fifty-three percent of respondents reported that their severe headaches caused substantial impairment in activities or required bed rest. Approximately 31% missed at least 1 day of work or school in the previous 3 months because of migraine; 51% reported that work or school productivity was reduced by at least 50%.

Conclusions.-Two methodologically identical national surveys in the United States conducted 10 years apart show that the prevalence and distribution of migraine have remained stable over the last decade. Migraine-associated disability remains substantial and pervasive. The number of migraineurs has increased from 23.6 million in 1989 to 27.9 million in 1999 commensurate with the growth of the population. Migraine is an important target for public health interventions because it is highly prevalent and disabling.

Loder A. 2014. 'There's a meadow outside my workplace': A phenomenological exploration of aesthetics and green roofs in Chicago and Toronto. Landscape and urban planning, 126: 94-106.

Green roofs are an increasingly popular urban greening strategy in North American cities. Most green roofs have been sedum-based, but there has been a recent trend to mimic the native habitat of a region in prairie-style green roofs. While this supports ecological restoration goals, it also conflicts with ambiguous responses by urbanites to the aesthetics of 'wild' and 'messy' nature in the city. Though green roofs are transforming downtown central business districts, there has been little research on office workers' perceptions of green roofs, or on how they may influence their health, well-being, and experience of central business districts. Furthermore, while recent research has looked at aesthetic perceptions of green roofs, there is scant qualitative work that explains why urbanites may have these preferences, or cultural and contextual factors influencing these perceptions. While not uncontroversial, green roofs make an excellent lens through which to explore the human relationship to nature in cities due to their lack of existing symbolism, challenge of the nature/city divide, and mimicking of native habitat. This paper explores office workers' perceptions of green roofs in Toronto and Chicago, two cities known for their leadership in green roof implementation. Using a phenomenological analysis of fifty-five semi-structured interviews, this paper examines (a) office workers' perceptions of green roofs; (b) how their lived experience influences their perceptions of aesthetics and urban nature, and (c) design implications for a more sustainable city. Results show that while 'wilder' prairie-style green roofs are not always well-liked, they are more likely to be associated with fascination, creative thinking, and calm well-being than sedum green roofs. Green roofs were also linked to an ethic of care and restoration, and may provide 'loose fit' places for respite and better health for office workers.

Lottrup L, P Grahn, et al. 2012. Workplace greenery and perceived level of stress: Benefits of access to a green outdoor environment at the workplace. Landscape and Urban Planning (0). In press.

Dealing with stress and stress-related diseases is an increasing problem in both developed and developing countries and has an enormous cost for individuals, companies, and societies. A positive relationship between access to a green outdoor environment at work, and decreased stress has been found in previous studies, and this relationship is in line with a vast body of research in other contexts. The aim of this study is to investigate whether access to a green outdoor environment at work is related to employees' perceived level of stress and attitude toward the workplace. The study is based on data from a questionnaire answered by 439 randomly selected individuals in Sweden. The questionnaire addressed the respondents' level of stress and workplace attitude, and the characteristics and accessibility of the outdoor environment at the respondents' workplace. The results showed significant relationships between physical and visual access to workplace greenery, and a positive workplace attitude and decreased level of stress for male respondents. For female respondents, a significant relationship between physical and visual access to workplace greenery and a positive workplace attitude was found, but not between access to workplace greenery and level of stress. Furthermore, a positive workplace attitude was related to decreased levels of stress for female respondents, but not for male respondents. These findings support existing research which suggests that the workplace outdoor environment is an asset for employees' wellbeing and level of stress, and they indicate that gender plays a central role in realizing the benefits of such environments.

Lottrup L, P Grahn, UK Stigsdotter. 2013. Workplace greenery and perceived level of stress: Benefits of access to a green outdoor environment at the workplace. Landscape and Urban Planning 110(0): 5-11.

Dealing with stress and stress-related diseases is an increasing problem in both developed and developing countries and has an enormous cost for individuals, companies, and societies. A positive relationship between access to a green outdoor environment at work, and decreased stress has been found in previous studies, and this relationship is in line with a vast body of research in other contexts. The aim of this study is to investigate whether access to a green outdoor environment at work is related to employees' perceived level of stress and attitude toward the workplace. The study is based on data from a questionnaire answered by 439 randomly selected individuals in Sweden. The questionnaire addressed the respondents' level of stress and workplace attitude, and the characteristics and accessibility of the outdoor environment at the respondents' workplace. The results showed significant relationships between physical and visual access to workplace greenery, and a positive workplace attitude and decreased level of stress for male respondents. For female respondents, a significant relationship between physical and visual access to workplace greenery and a positive workplace attitude was found, but not between access to workplace greenery and level of stress. Furthermore, a positive workplace attitude was related to decreased levels of stress for female respondents, but not for male respondents. These findings support existing research which suggests that the workplace outdoor environment is an asset for employees' wellbeing and level of stress, and they indicate that gender plays a central role in realizing the benefits of such environments.

Louv R. 2005. Last child in the woods: Saving our children from nature-deficit disorder. Chapel Hill, NC: Algonquin Books.

No abstract provided.

Lovasi G S, M D M Bader, et al. 2012. Body Mass Index, Safety Hazards, and Neighborhood Attractiveness. American Journal of Preventive Medicine 43(4): 378-384.

Background: Neighborhood attractiveness and safety may encourage physical activity and help individuals maintain a healthy weight. However, these neighborhood characteristics may not be equally relevant to health across all settings and population subgroups.

Purpose: To evaluate whether potentially attractive neighborhood features are associated with lower BMI, whether safety hazards are associated with higher BMI, and whether environmentenvironment interactions are present such that associations for a particular characteristic are stronger in an otherwise supportive environment.

Methods: Survey data and measured height and weight were collected from a convenience sample of 13,102 adult New York City (NYC) residents in 2000-2002; data analyses were completed 20082012. Built-environment measures based on municipal GIS data sources were constructed within 1-km network buffers to assess walkable urban form (density, land-use mix, transit access); attractiveness (sidewalk cafs, landmark buildings, street trees, street cleanliness); and safety (homicide rate, pedestrianauto collision and fatality rate). Generalized linear models with cluster-robust SEs controlled for individual and area-based sociodemographic characteristics.

Results: The presence of sidewalk cafes, density of landmark buildings, and density of street trees were associated with lower BMI, whereas the proportion of streets rated as clean was associated with higher BMI. Interactions were observed for sidewalk cafs with neighborhood poverty, for street-tree density with walkability, and for street cleanliness with safety. Safety hazard indicators were not independently associated with BMI.

Conclusions: Potentially attractive community and natural features were associated with lower BMI among adults in NYC, and there was some evidence of effect modification.

Lovasi GS, JPM O'Neil-Dunne, et al. 2013. Urban tree canopy and asthma, wheeze, rhinitis, and allergic sensitization to tree pollen in a New York City birth cohort. Environ Health Perspect 121(4): 494-500, 500e1-6.

BACKGROUND: Urban landscape elements, particularly trees, have the potential to affect airflow, air quality, and production of aeroallergens. Several large-scale urban tree planting projects have sought to promote respiratory health, yet evidence linking tree cover to human health is limited.

OBJECTIVES: We sought to investigate the association of tree canopy cover with subsequent development of childhood asthma, wheeze, rhinitis, and allergic sensitization.

METHODS: Birth cohort study data were linked to detailed geographic information systems data characterizing 2001 tree canopy coverage based on LiDAR (light detection and ranging) and multispectral imagery within 0.25 km of the prenatal address. A total of 549 Dominican or African-American children born in 1998-2006 had outcome data assessed by validated questionnaire or based on IgE antibody response to specific allergens, including a tree pollen mix.

RESULTS: Tree canopy coverage did not significantly predict outcomes at 5 years of age, but was positively associated with asthma and allergic sensitization at 7 years. Adjusted risk ratios (RRs) per standard deviation of tree canopy coverage were 1.17 for asthma (95% CI: 1.02, 1.33), 1.20 for any specific allergic sensitization (95% CI: 1.05, 1.37), and 1.43 for tree pollen allergic sensitization (95% CI: 1.19, 1.72).

CONCLUSIONS: Results did not support the hypothesized protective association of urban tree canopy coverage with asthma or allergy-related outcomes. Tree canopy cover near the prenatal address was associated with higher prevalence of allergic sensitization to tree pollen. Information was not available on sensitization to specific tree species or individual pollen exposures, and results may not be generalizable to other populations or geographic areas.

Lovasi GS, JW Quinn, et al. 2008. Children living in areas with more street trees have lower asthma prevalence. Journal of Epidemiology and Community Health 62:647-9.

Introduction: Childhood asthma prevalence in the US increased by 50% from 1980 to 2000, with especially high prevalence in poor urban communities. Methods: Asthma prevalence among children ages 4-5 years old and asthma hospitalizations among children less than 15 years old were available for 42 health service catchment areas within New York City. Street tree counts were provided by the New York City Department of Parks and Recreation. We also measured proximity to pollution sources, socio-demographic characteristics, and population density for each area. Results: Controlling for potential confounders, an increase in tree density of one standard deviation (SD: 343 trees/km2) was associated with a lower asthma prevalence (relative risk [RR]: 0.71 per SD of tree density; 95% CI [confidence interval]: 0.64-0.79), but not asthma hospitalizations (RR: 0.89 per SD of tree density; 95% CI: 0.75-1.06). Conclusions: Street trees were associated with a lower prevalence of early childhood asthma. Our study does not permit inference that trees are causally related to asthma at the individual-level. The PlaNYC sustainability initiative, which includes a commitment to plant one million trees by the year 2017, offers an opportunity for a large prospective evaluation.

Lovasi GS, O Schwartz-Soicher, et al. 2013. Neighborhood safety and green space as predictors of obesity among preschool children from low-income families in New York City. Preventive Medicine 57(3): 189-193.

Background: Neighborhood safety, green space, walkability, and sociodemographics may influence physical activity and childhood obesity.

Methods: Data on measured height and weight, demographic characteristics, and home ZIP code were collected from year 2004 enrollees in a means-tested preschool program in New York City. Each ZIP code was surrounded by a 400-m buffer and characterized using data from the US census, local government departments, New York Times website, and Transportation Alternatives. Linear and Poisson models were constructed using cluster robust standard errors and adjusting for child's sex, race, ethnicity, age, and neighborhood characteristics.

Results: Analyses included 11,562 children ages 3-5 years living in 160 residential ZIP codes. A higher homicide rate (at the 75th vs 25th percentile) was associated with a 22% higher prevalence of obesity (95% CI for the prevalence ratio (PR): 1.05 to 1.41). A higher density of street trees (at the 75th vs 25th percentile) was associated with 12% lower prevalence of obesity (95% CI for the PR: 0.79 to 0.99). Other neighborhood characteristics did not have significant associations with childhood obesity.

Conclusions: Among preschool children from low-income families, neighborhood homicide rate was associated with more obesity and street tree density was associated with less obesity.

Luber G. and M McGeehin. 2008. Climate change and extreme heat events. American Journal of Preventive Medicine 35(5): 429-35

The association between climate change and the frequency and intensity of extreme heat events is now well established. General circulation models of climate change predict that heatwaves will become more frequent and intense, especially in the higher latitudes, affecting large metropolitan areas that are not well adapted to them. Exposure to extreme heat is already a significant public health problem and the primary cause of weather-related mortality in the U.S. This article reviews major epidemiologic risk factors associated with mortality from extreme heat exposure and discusses future drivers of heat-related mortality, including a warming climate, the urban heat island effect, and an aging population. In addition, it considers critical areas of an effective public health response including heat response plans, the use of remote sensing and GIS methodologies, and the importance of effective communications strategies.

Lucas, Richard E. "Happiness." Encyclopedia of Social Psychology. 2007. SAGE Publications. 10 Nov. 2011.

Happiness. -- -- Accessed February 2013.

Lundholm J, Tran S, Gebert L. 2015. Plant functional traits predict green roof ecosystem services. Environmental science & technology, 49(4): 2366-74.

Plants make important contributions to the services provided by engineered ecosystems such as green roofs. Ecologists use plant species traits as generic predictors of geographical distribution, interactions with other species, and ecosystem functioning, but this approach has been little used to optimize engineered ecosystems. Four plant species traits (height, individual leaf area, specific leaf area, and leaf dry matter content) were evaluated as predictors of ecosystem properties and services in a modular green roof system planted with 21 species. Six indicators of ecosystem services, incorporating thermal, hydrological, water quality, and carbon sequestration functions, were predicted by the four plant traits directly or indirectly via their effects on aggregate ecosystem properties, including canopy density and albedo. Species average height and specific leaf area were the most useful traits, predicting several services via effects on canopy density or growth rate. This study demonstrates that easily measured plant traits can be used to select species to optimize green roof performance across multiple key services.

Lung Function in COPD - Topic Overview Accessed May 2017.


Maas J, RA Verheij, et al. 2006. Green space, urbanity, and health: how strong is the relation? Journal of Epidemiology and Community Health 60 (7): 587-92.

Study objectives: To investigate the strength of the relation between the amount of green space in people's living environment and their perceived general health. This relation is analysed for different age and socioeconomic groups. Furthermore, it is analysed separately for urban and more rural areas, because the strength of the relation was expected to vary with urbanity.

Design: The study includes 250 782 people registered with 104 general practices who filled in a self administered form on sociodemographic background and perceived general health. The percentage of green space (urban green space, agricultural space, natural green space) within a one kilometre and three kilometre radius around the postal code coordinates was calculated for each household.

Methods: Multilevel logistic regression analyses were performed at three levels-that is, individual level, family level, and practice level-controlled for sociodemographic characteristics.

Main results: The percentage of green space inside a one kilometre and a three kilometre radius had a significant relation to perceived general health. The relation was generally present at all degrees of urbanity. The overall relation is somewhat stronger for lower socioeconomic groups. Elderly, youth, and secondary educated people in large cities seem to benefit more from presence of green areas in their living environment than other groups in large cities.

Conclusions: This research shows that the percentage of green space in people's living environment has a positive association with the perceived general health of residents. Green space seems to be more than just a luxury and consequently the development of green space should be allocated a more central position in spatial planning policy.

Maas J, RA Verheij, et al. 2008. Physical activity as a possible mechanism behind the relationship between green space and health: A multilevel analysis. BMC Public Health 8(1): 206.

Background: The aim of this study was to investigate whether physical activity (in general, and more specifically, walking and cycling during leisure time and for commuting purposes, sports and gardening) is an underlying mechanism in the relationship between the amount of green space in people's direct living environment and self-perceived health. To study this, we first investigated whether the amount of green space in the living environment is related to the level of physical activity. When an association between green space and physical activity was found, we analysed whether this could explain the relationship between green space and health.

Methods: The study includes 4.899 Dutch people who were interviewed about physical activity, self-perceived health and demographic and socioeconomic background. The amount of green space within a one-kilometre and a three-kilometre radius around the postal code coordinates was calculated for each individual. Multivariate multilevel analyses and multilevel logistic regression analyses were performed at two levels and with controls for socio-demographic characteristics and urbanicity.

Results: No relationship was found between the amount of green space in the living environment and whether or not people meet the Dutch public health recommendations for physical activity, sports and walking for commuting purposes. People with more green space in their living environment walked and cycled less often and fewer minutes during leisure time; people with more green space garden more often and spend more time on gardening. Furthermore, if people cycle for commuting purposes they spend more time on this if they live in a greener living environment. Whether or not people garden, the time spent on gardening and time spent on cycling for commuting purposes did not explain the relationship between green space and health.

Conclusion: Our study indicates that the amount of green space in the living environment is scarcely related to the level of physical activity. Furthermore, the amount of physical activity undertaken in greener living environments does not explain the relationship between green space and health.

Maas J, RA Verheij, et al. 2009. Morbidity is related to a green living environment. J Epidemiol Community Health 63: 967-973.

Background: As a result of increasing urbanisation, people face the prospect of living in environments with few green spaces. There is increasing evidence for a positive relation between green space in people's living environment and self-reported indicators of physical and mental health. This study investigates whether physicianassessed morbidity is also related to green space in people's living environment.

Methods: Morbidity data were derived from electronic medical records of 195 general practitioners in 96 Dutch practices, serving a population of 345 143 people. Morbidity was classified by the general practitioners according to the International Classification of PrimaryCare. The percentage of green space within a 1 km and 3 km radius around the postal code coordinates was derived from an existing database and was calculated for each household. Multilevel logistic regression analyses were performed, controlling for demographic and socioeconomic characteristics.

Results: The annual prevalence rate of 15 of the 24 disease clusters was lower in living environments with more green space in a 1 km radius. The relation was strongest for anxiety disorder and depression. The relation was stronger for children and people with a lower socioeconomic status. Furthermore, the relation was strongest in slightly urban areas and not apparent in very strongly urban areas.

Conclusion: This study indicates that the previously established relation between green space and a number of self-reported general indicators of physical and mental health can also be found for clusters of specific physician-assessed morbidity. The study stresses the importance of green space close to home for children and lower socioeconomic groups.

Maas J, S M E van Dillen, et al. 2009. Social contacts as a possible mechanism behind the relation between green space and health. Health & Place 15(2):586-95.

This study explored whether social contacts are an underlying mechanism behind the relationship between green space and health. We measured social contacts and health in 10,089 residents of the Netherlands and calculated the percentage of green within 1 and a 3km radius around the postal code coordinates for each individual's address. After adjustment for socio-economic and demographic characteristics, less green space in people's living environment coincided with feelings of loneliness and with perceived shortage of social support. Loneliness and perceived shortage of social support partly mediated the relation between green space and health.

MacIvor JS, MA Ranalli, and JT Lundholm. 2011. Performance of dryland and wetland plant species on extensive green roofs. Annals of botany, 107(4): 671-9.

Background and Aims

Green roofs are constructed ecosystems where plants perform valuable services, ameliorating the urban environment through roof temperature reductions and stormwater interception. Plant species differ in functional characteristics that alter ecosystem properties. Plant performance research on extensive green roofs has so far indicated that species adapted to dry conditions perform optimally. However, in moist, humid climates, species typical of wetter soils might have advantages over dryland species. In this study, survival, growth and the performance of thermal and stormwater capture functions of three pairs of dryland and wetland plant species were quantified using an extensive modular green roof system.


Seedlings of all six species were germinated in a greenhouse and planted into green roof modules with 6 cm of growing medium. There were 34 treatments consisting of each species in monoculture and all combinations of wet- and dryland species in a randomized block design. Performance measures were survival, vegetation cover and roof surface temperature recorded for each module over two growing seasons, water loss (an estimate of evapotranspiration) in 2007, and albedo and water capture in 2008.

Key Results

Over two seasons, dryland plants performed better than wetland plants, and increasing the number of dryland species in mixtures tended to improve functioning, although there was no clear effect of species or habitat group diversity. All species had survival rates >75 % after the first winter; however, dryland species had much greater cover, an important indicator of green roof performance. Sibbaldiopsis tridentata was the top performing species in monoculture, and was included in the best treatments.


Although dryland species outperformed wetland species, planting extensive green roofs with both groups decreased performance only slightly, while increasing diversity and possibly habitat value. This study provides further evidence that plant composition and diversity can influence green roof functions.

Mackay G J and J T Neill. 2010. The effect of "green exercise" on state anxiety and the role of exercise duration, intensity, and greenness: A quasi-experimental study. Psychology of Sport and Exercise 11(3): 238-245.

Objective The study aimed to explore the short-term effects of "green exercise" on state anxiety and to examine the influence of exercise type, intensity, duration, and degree of greenness.

Method A quasi-experimental design involved eight pre-existing outdoor exercise groups (N=101) who completed pre- and post-exercise questionnaires.

Results Results indicated a significant reduction in participants' state anxiety following green exercise experiences (d=-0.47). However, there was a significant interaction between anxiety changes and the type of green exercise, with effect sizes for the groups ranging between 0.14 and 1.02. The largest anxiety reductions were reported by the Road Cycling, Boxercise, and Mountain Biking groups. Exercise intensity and duration did not impact on state-anxiety changes, however higher degrees of perceived environmental greenness were associated with larger reductions in anxiety.

Conclusions Green exercise effected moderate short-term reductions in anxiety, with greater reductions evident for some exercise groups and for participants who perceived themselves to be exercising in morenatural environments. These findings support claims for mental health benefits of green exercise but they also highlight the need to better understand individual and group differences and the role of perceived environmental "greenness".

MacKerron G, S Mourato. 2013. Happiness is greater in natural environments. Global Environmental Change 23(5): 992-1000.

Links between wellbeing and environmental factors are of growing interest in psychology, health, conservation, economics, and more widely. There is limited evidence that green or natural environments are positive for physical and mental health and wellbeing. We present a new and unique primary research study exploring the relationship between momentary subjective wellbeing (SWB) and individuals' immediate environment within the UK. We developed and applied an innovative data collection tool: a smartphone app that signals participants at random moments, presenting a brief questionnaire while using satellite positioning (GPS) to determine geographical coordinates. We used this to collect over one million responses from more than 20,000 participants. Associating GPS response locations with objective spatial data, we estimate a model relating land cover to SWB using only the within-individual variation, while controlling for weather, daylight, activity, companionship, location type, time, day, and any response trend. On average, study participants are significantly and substantially happier outdoors in all green or natural habitat types than they are in urban environments. These findings are robust to a number of alternative models and model specifications. This study provides a new line of evidence on links between nature and wellbeing, strengthening existing evidence of a positive relationship between SWB and exposure to green or natural environments in daily life. Our results have informed the UK National Ecosystem Assessment (NEA), and the novel geo-located experience sampling methodology we describe has great potential to provide new insights in a range of areas of interest to policymakers.

Madlock, Annette D. "Self-Esteem." Encyclopedia of Identity. 2010. SAGE Publications. 8 Dec. 2011.

No abstract provided.

Madrigano J, K Ito, et al. 2015. A case-only study of vulnerability to heat wave-related mortality in New York City (2000-2011). Environmental health perspectives, 123(7): 672.

Background As a result of climate change, the frequency of extreme temperature events is expected to increase, and such events are associated with increased morbidity and mortality. Vulnerability patterns, and corresponding adaptation strategies, are most usefully conceptualized at a local level.

Methods We used a case-only analysis to examine subject and neighborhood characteristics that modified the association between heat waves and mortality. All deaths of New York City residents from 2000 through 2011 were included in this analysis. Meteorological data were obtained from the National Climatic Data Center. Modifying characteristics were obtained from the death record and geographic data sets.

Results A total of 234,042 adult deaths occurred during the warm season of our study period. Compared with other warm-season days, deaths during heat waves were more likely to occur in black (non-Hispanic) individuals than other race/ethnicities [odds ratio (OR) = 1.08; 95% CI: 1.03, 1.12], more likely to occur at home than in institutions and hospital settings (OR = 1.11; 95% CI: 1.06, 1.16), and more likely among those living in census tracts that received greater public assistance (OR = 1.05; 95% CI: 1.01, 1.09). Finally, deaths during heat waves were more likely among residents in areas of the city with higher relative daytime summer surface temperature and less likely among residents living in areas with more green space.

Conclusion Mortality during heat waves varies widely within a city. Understanding which individuals and neighborhoods are most vulnerable can help guide local preparedness efforts.

Madureira H, F Nunes, et al. 2015. Urban residents' beliefs concerning green space benefits in four cities in France and Portugal. Urban Forestry & Urban Greening, 14(1): 56-64.

Understanding how urban residents rate the benefits associated with urban green spaces is crucial in developing appropriate urban green infrastructure strategies. This study explores residents' beliefs concerning the benefits of urban green spaces and investigates whether similarities and differences can be highlighted in four different French and Portuguese urban areas (Paris, Angers, Lisbon and Porto) through a questionnaire survey (n=1000) based on the best-worst scaling (BWS) method. The results demonstrated that urban green space benefits are not equally valued among cities, suggesting that there is simultaneously a consensus among the most and least valued benefits across cities, as well as local variations in city residents' beliefs about some other benefits of urban green spaces. For example, the importance of urban green spaces for personal health and well-being and to facilitate contact with nature were noted by residents of all four urban areas; consensus also exists on the little support given to two microclimatic functions of green spaces, namely, air temperature reduction and noise reduction. On the other hand, some green space benefits, such as the promotion of biodiversity or the contribution to the city image, are differentially valued among the four cities. Overall, the study stresses the importance of developing local assessments of the beliefs surrounding the benefits of urban green spaces. Recognizing these multiple beliefs and communicating clearly about the benefits offered by green spaces may help to mitigate future conflicts between residents and urban planners and managers, and thus contribute to optimizing green infrastructure planning benefits.

Mahar MT, SK Murphy, et al. 2006. Effects of a classroom-based program on physical activity and on-task behavior. Medicine & Science in Sports & Exercise 38(12): 2086-94.

Purpose: This study evaluated the effects of a classroom-based physical activity program on children's in-school physical activity levels and on-task behavior during academic instruction.

Methods: Physical activity of 243 students was assessed during school hours. Intervention-group students (N = 135) received a classroom-based program (i.e., Energizers). The control group (N = 108) did not receive Energizers. On-task behavior during academic instruction time was observed for 62 third-grade (N = 37) and fourth-grade students (N = 25) before and after Energizers activities. An independent groups t-test compared in-school physical activity levels between intervention and control classes. A multiple-baseline across-classrooms design was used to evaluate the effectiveness of the Energizers on on-task behavior. Additionally, a two-way (time [pre- vs postobservation] x period [baseline vs intervention]) repeated-measures analysis of variance compared on-task behavior between observation periods. Magnitudes of mean differences were evaluated with Cohen's delta (ES).

Results: Students in the intervention group took significantly (P < 0.05) more in-school steps (5587 +/- 1633) than control-group students (4805 +/- 1543), and the size of this difference was moderate (ES = 0.49). The intervention was effective in improving on-task behavior; after the Energizers were systematically implemented, on-task behavior systematically improved. The improvement in on-task behavior of 8% between the pre-Energizers and post-Energizers observations was statistically significant (P < 0.017), and the difference was moderate (ES = 0.60). Likewise, the least on-task students improved on-task behavior by 20% after Energizers activities. This improvement was statistically significant (P < 0.001) and meaningful (ES = 2.20).

Conclusion: A classroom-based physical activity program was effective for increasing daily in-school physical activity and improving on-task behavior during academic instruction.

Maillard E, S Payraudeau, E Faivre, C Gregoire, SGangloff & G Imfeld. 2011. Removal of pesticide mixtures in a stormwater wetland collecting runoff from a vineyard catchment. Science of The Total Environment, May 1; 409(11):2317-24.

Wetlands can collect contaminated runoff from agricultural catchments and retain dissolved and particleladen pesticides. However, knowledge about the capacity and functioning of wetland systems with respect to the removal of pesticides is very limited. Here we show that stormwater wetlands can efficiently remove pesticides in runoff from vineyard catchments during the period of pesticide application, although flow and hydrochemical conditions of the wetland largely vary over time. During the entire agricultural season, the inflowing load of nine fungicides, six herbicides, one insecticide and four degradation products was 8.039 g whereas the outflowing load was 2.181 g. Removal rates of dissolved loads by the wetland ranged from 39% (simazine) to 100% (cymoxanil, gluphosinate, kresoxim methyl and terbuthylazine). Dimethomorph, diuron, glyphosate, metalaxyl and tetraconazole were more efficiently removed in spring than in summer. More than 88% of the input mass of suspended solids was retained, underscoring the capability of the wetland to trap pesticide-laden particles via sedimentation. Only the insecticide flufenoxuron was frequently detected in the wetland sediments. Our results demonstrate that stormwater wetlands can efficiently remove pesticide mixtures in agricultural runoff during critical periods of pesticide application, although fluctuations in the runoff regime and hydrochemical characteristics can affect the removal rates of individual pesticides.

Maimaitiyiming M, A Ghulam, et al. 2014. Effects of green space spatial pattern on land surface temperature: Implications for sustainable urban planning and climate change adaptation. ISPRS Journal of Photogrammetry and Remote Sensing, 89: 59-66.

The urban heat island (UHI) refers to the phenomenon of higher atmospheric and surface temperatures occurring in urban areas than in the surrounding rural areas. Mitigation of the UHI effects via the configuration of green spaces and sustainable design of urban environments has become an issue of increasing concern under changing climate. In this paper, the effects of the composition and configuration of green space on land surface temperatures (LST) were explored using landscape metrics including percentage of landscape (PLAND), edge density (ED) and patch density (PD). An oasis city of Aksu in Northwestern China was used as a case study. The metrics were calculated by moving window method based on a green space map derived from Landsat Thematic Mapper (TM) imagery, and LST data were retrieved from Landsat TM thermal band. A normalized mutual information measure was employed to investigate the relationship between LST and the spatial pattern of green space. The results showed that while the PLAND is the most important variable that elicits LST dynamics, spatial configuration of green space also has significant effect on LST. Though, the highest normalized mutual information measure was with the PLAND (0.71), it was found that the ED and PD combination is the most deterministic factors of LST than the unique effects of a single variable or the joint effects of PLAND and PD or PLAND and ED. Normalized mutual information measure estimations between LST and PLAND and ED, PLAND and PD and ED and PD were 0.7679, 0.7650 and 0.7832, respectively. A combination of the three factors PLAND, PD and ED explained much of the variance of LST with a normalized mutual information measure of 0.8694. Results from this study can expand our understanding of the relationship between LST and street trees and vegetation, and provide insights for sustainable urban planning and management under changing climate.

Maine MA, NL Sune, & SC Lagger. 2004. Chromium bioaccumulation: comparison of the capacity of two floating aquatic macrophytes. Water Research, 38(6), 1494-1501.

The capacity of Salvinia herzogii and Pistia stratiotes to remove Cr (III) from water and their behaviour at different Cr (III) concentrations were studied in outdoor experiments. Cr distribution in aerial parts and roots with time and the possible mechanisms of Cr uptake were analyzed. Both macrophytes efficiently removed Cr from water at concentrations of 1, 2, 4 and 6mg CrL-1. S. herzogii was the best adapted species. At a greater initial concentration, greater bioaccumulation rates were observed. Root Cr uptake was a rapid process that was completed within the first 24h. Cr uptake through direct contact between the leaves and the solution is the main cause of the increase of Cr in the aerial parts, Cr being poorly translocated from the roots to the aerial parts. Both mechanisms were fast processes. The Cr uptake mechanism involves two components: a fast component and a slow one. The former occurs mainly due to the roots and leaves adsorption and is similar for both species. The slow component is different for each species probably because in P. stratiotes a Cr precipitation occurs induced by the roots.

Manes F, G Incerti, et al. 2012. Urban ecosystem services: tree diversity and stability of tropospheric ozone removal. Ecological Applications 22(1): 349-360.

Urban forests provide important ecosystem services, such as urban air quality improvement by removing pollutants. While robust evidence exists that plant physiology, abundance, and distribution within cities are basic parameters affecting the magnitude and efficiency of air pollution removal, little is known about effects of plant diversity on the stability of this ecosystem service. Here, by means of a spatial analysis integrating system dynamic modeling and geostatistics, we assessed the effects of tree diversity on the removal of tropospheric ozone (O3) in Rome, Italy, in two years (2003 and 2004) that were very different for climatic conditions and ozone levels. Different tree functional groups showed complementary uptake patterns, related to tree physiology and phenology, maintaining a stable community function across different climatic conditions. Our results, although depending on the city-specific conditions of the studied area, suggest a higher function stability at increasing diversity levels in urban ecosystems. In Rome, such ecosystem services, based on published unitary costs of externalities and of mortality associated with O3, can be prudently valued to roughly US$2 and $3 million/year, respectively.

Manes F, V Silli, et al. 2014. Urban Ecosystem Services: tree diversity and stability of PM10 removal in the Metropolitan Area of Rome. Annali di Botanica, 4: 19-26.

Urban vegetation, and particularly urban forests, are known to provide important ecosystem services, such as urban air quality improvement by removing gaseous and particulate pollutants. The amount of PM10 removed by urban and periurban trees of the metropolitan area of Rome (evergreen broadleaves, deciduous broadleaves and conifers) was estimated by considering the minimum and maximum PM10 concentration values recorded in the Municipality of Rome during the years 2003 and 2004. The results of these simulations have been used to map the Ecosystem Service of PM10 removal by the three functional groups in the five Sanitary Districts of the Municipality. Given the spatial uniformity of PM10 levels in the urban area, the highest amount of PM10 deposition rates, during the whole period, are those of the Sanitary District with the largest vegetation cover (RMD). It is also interesting to highlight that the highest deposition fluxes, for the three functional groups, were estimated for the 2004 summer period, in concurrence with the highest mean values of Leaf Area Index. Our results confirm the crucial role of vegetation in supporting significant Ecosystem Services as air quality improvement, highlighting the importance of biodiversity and green infrastructures in sustain and enhance benefits provided by trees.

Mantler A and AC Logan. 2015. Natural environments and mental health. Advances in Integrative Medicine, 2(1): 5-12.

Ancestral experiences and evolutionary processes continue to influence the brain in ways that may escape conscious awareness by contemporary adults. It is becoming increasingly evident that the 2.2 million years our genus has spent in natural environments are consequential to modern mental health. This might be especially true in the context of rapid global urbanization, loss of biodiversity and environmental degradation. Here, we examine some of the emerging research related to natural environments (and specific elements within them) and mental health. Our synthesis includes research from various branches of science and medicine, e.g., epidemiology, psychology, physiology, anthropology, evolutionary biology, and microbiology. Significant knowledge gaps remain. However, the accumulating strength of research from multiple disciplines makes it difficult to dismiss the clinical relevancy of natural environments in 21st century mental health care.

Markevych I, E Fuertes, et al. 2014. Surrounding greenness and birth weight: results from the GINIplus and LISAplus birth cohorts in Munich. Health & place, 26: 39-46.

Aim We investigated the association between surrounding greenness at the mother's residential address at the time of delivery and birth weight in two German birth cohorts and explored potential underlying hypotheses.

Methods Complete data on 3203 newborns, recruited in Munich between 1996 and 1999, were available. Surrounding greenness was defined using the mean of the Normalized Difference Vegetation Index, which was derived from Landsat 5 TM satellite images.

Results An interquartile increase of surrounding greenness in a 500-m buffer was associated with an average birth weight increase of 17.6 g (95% CI=0.5 to 34.6). The effect strengthened after individual adjustment for NO2, PM2.5, distance to major road and population density. The strongest association was found for mothers with less than 10 years of school education. The results remained robust when additionally adjusted for noise or maternal stress during pregnancy. Neighbourhood green spaces were not associated with birth weight.

Conclusions Surrounding greenness at the birth address was positively associated with birth weight in two birth cohorts in Munich. The mechanisms driving this association remain unclear and warrant further investigation.

Markevych I, E Thiering, et al. 2014. A cross-sectional analysis of the effects of residential greenness on blood pressure in 10-year old children: results from the GINIplus and LISAplus studies. BMC public health, 14(1): 1.

Background According to Ulrich's psychoevolutionary theory, contact with green environments mitigates stress by activating the parasympathetic system, (specifically, by decreasing blood pressure (BP)). Experimental studies have confirmed this biological effect. However, greenness effects on BP have not yet been explored using an observational study design. We assessed whether surrounding residential greenness is associated with BP in 10 year-old German children.

Methods Systolic and diastolic BPs were assessed in 10 year-old children residing in the Munich and Wesel study areas of the German GINIplus and LISAplus birth cohorts. Complete exposure, outcome and covariate data were available for 2,078 children. Residential surrounding greenness was defined as the mean of Normalized Difference Vegetation Index (NDVI) values, derived from Landsat 5 TM satellite images, in circular 500-m buffers around current home addresses of participants. Generalized additive models assessed pooled and area-specific associations between BP and residential greenness categorized into area-specific tertiles.

Results In the pooled adjusted model, the systolic BP of children living at residences with low and moderate greenness was 0.90 +/- 0.50 mmHg (p-value = 0.073) and 1.23 +/- 0.50 mmHg (p-value = 0.014) higher, respectively, than the systolic BP of children living in areas of high greenness. Similarly, the diastolic BP of children living in areas with low and moderate greenness was 0.80 +/- 0.38 mmHg (p-value = 0.033) and 0.96 +/- 0.38 mmHg (p-value = 0.011) higher, respectively, than children living in areas with high greenness. These associations were not influenced by environmental stressors (temperature, air pollution, noise annoyance, altitude and urbanisation level). When stratified by study area, associations were significant among children residing in the urbanised Munich area but null for those in the rural Wesel area.

Conclusions Lower residential greenness was positively associated with higher BP in 10 year-old children living in an urbanised area. Further studies varying in participants' age, geographical area and urbanisation level are required.

Marselle MR, KN Irvine, et al. 2013. Walking for well-being: Are group walks in certain types of natural environments better for well-being than group walks in urban environments? International Journal of Environmental Research and Public Health 10(11): 5603-5628.

The benefits of walking in natural environments for well-being are increasingly understood. However, less well known are the impacts different types of natural environments have on psychological and emotional well-being. This cross-sectional study investigated whether group walks in specific types of natural environments were associated with greater psychological and emotional well-being compared to group walks in urban environments. Individuals who frequently attended a walking group once a week or more (n=708) were surveyed on mental well-being (Warwick Edinburgh Mental Well-being Scale), depression (Major Depressive Inventory), perceived stress (Perceived Stress Scale), and emotional well-being (Positive and Negative Affect Schedule). Compared to group walks in urban environments, group walks in farmland were significantly associated with less perceived stress and negative affect, and greater mental well-being. Group walks in green corridors were significantly associated with less perceived stress and negative affect. There were no significant differences between the effect of any environment types on depression or positive affect. Outdoor walking group programs could be endorsed through "green prescriptions" to improve psychological and emotional well-being, as well as physical activity.

Martensson F, C Boldemann, et al. 2009. Outdoor environmental assessment of attention promoting settings for preschool children. Health & Place, 15(4): 1149-57.

The restorative potential of green outdoor environments for children in preschool settings was investigated by measuring the attention of children playing in settings with different environmental features. Eleven preschools with outdoor environments typical for the Stockholm area were assessed using the outdoor play environment categories (OPEC) and the fraction of visible sky from play structures (sky view factor), and 198 children, aged 4.5-6.5 years, were rated by the staff for inattentive, hyperactive and impulsive behaviors with the ECADDES tool. Children playing in large and integrated outdoor areas containing large areas of trees, shrubbery and a hilly terrain showed less often behaviors of inattention (p<.05). The choice of tool for assessment of attention is discussed in relation to outdoor stay and play characteristics in Swedish preschool settings. The results indicate that the restorative potential of green outdoor environments applies also to preschool children and that environmental assessment tools as OPEC can be useful when to locate and develop health-promoting land adjacent to preschools.

Martensson F, M Jansson, et al. 2014. The role of greenery for physical activity play at school grounds. Urban Forestry & Urban Greening, 13(1): 103-13.

Greenery is assumed to promote physical activity at school grounds by facilitating open and flexible play situations that engage many children. The role of greenery for school ground activity was investigated at two schools, one of which contained a substantial amount of greenery and the other one little greenery. All in all 197 children from 4th (10-11 years) and 6th grade (12-13 years), were involved in a one week field study, documenting self-reported school ground use, their favourite places and favourite activities and counting their steps by pedometer. The most common school ground activities were related to the use of balls as part of different sports, games and other playful activity. The more extensive green areas belonged to children's favourite places, but were little used, whereas settings with a mix of green and built elements in proximity to buildings were well-used favourites. Physical activity in steps was similar at the two schools, but on average girls got less of the activity they need during recess. Greenery was found important by contributing to settings attractive to visit for girls as well as boys and for younger as well as older children, if located in ways that also supported peer interaction and various games.

Matsuoka R H. 2010. Student performance and high school landscapes: Examining the links. Landscape and Urban Planning 97(4): 273-282.

High school students today are experiencing unprecedented levels of school-related stress. At the same time, a growing body of research has linked views of nature with restoration from mental fatigue and stress reduction. How important are such views for students while they are at school? This study investigated 101 public high schools in southeastern Michigan to examine the role played by the availability of nearby nature in student academic achievement and behavior. The analyses revealed consistent and systematically positive relationships between nature exposure and student performance. Specifically, views with greater quantities of trees and shrubs from cafeteria as well as classroom windows are positively associated with standardized test scores, graduation rates, percentages of students planning to attend a four-year college, and fewer occurrences of criminal behavior. In addition, large expanses of landscape lacking natural features are negatively related to these same test scores and college plans. These featureless landscapes included large areas of campus lawns, athletic fields, and parking lots. All analyses accounted for student socio-economic status and racial/ethnic makeup, building age, and size of school enrollment.

Mayo Clinic - Heat Stroke. Accessed February 2013.

McConnell R, E Shen, et al. 2015. A longitudinal cohort study of body mass index and childhood exposure to secondhand tobacco smoke and air pollution: the Southern California Children's Health Study. Environmental health perspectives, 123(4): 360.

Background: Childhood body mass index (BMI) and obesity prevalence have been associated with exposure to secondhand smoke (SHS), maternal smoking during pregnancy, and vehicular air pollution. There has been little previous study of joint BMI effects of air pollution and tobacco smoke exposure.

Methods: Information on exposure to SHS and maternal smoking during pregnancy was collected on 3,318 participants at enrollment into the Southern California Children's Health Study. At study entry at average age of 10 years, residential near-roadway pollution exposure (NRP) was estimated based on a line source dispersion model accounting for traffic volume, proximity, and meteorology. Lifetime exposure to tobacco smoke was assessed by parent questionnaire. Associations with subsequent BMI growth trajectory based on annual measurements and attained BMI at 18 years of age were assessed using a multilevel modeling strategy.

Results: Maternal smoking during pregnancy was associated with estimated BMI growth over 8-year follow-up (0.72 kg/m2 higher; 95% CI: 0.14, 1.31) and attained BMI (1.14 kg/m2 higher; 95% CI: 0.66, 1.62). SHS exposure before enrollment was positively associated with BMI growth (0.81 kg/m2 higher; 95% CI: 0.36, 1.27) and attained BMI (1.23 kg/m2 higher; 95% CI: 0.86, 1.61). Growth and attained BMI increased with more smokers in the home. Compared with children without a history of SHS and NRP below the median, attained BMI was 0.80 kg/m2 higher (95% CI: 0.27, 1.32) with exposure to high NRP without SHS; 0.85 kg/m2 higher (95% CI: 0.43, 1.28) with low NRP and a history of SHS; and 2.15 kg/m2 higher (95% CI: 1.52, 2.77) with high NRP and a history of SHS (interaction p-value 0.007). These results suggest a synergistic effect.

Conclusions: Our findings strengthen emerging evidence that exposure to tobacco smoke and NRP contribute to development of childhood obesity and suggest that combined exposures may have synergistic effects.

McCunn LJ and R Gifford. 2014. Interrelations between sense of place, organizational commitment, and green neighborhoods. Cities, 41: 20-9.

Does the notion of organizational commitment apply to neighborhoods? Typically, sense of place is examined in relation to belonging and identification in communities, whereas organizational commitment is traditionally investigated in work settings. Based on apparent commonalities between the two constructs, we hypothesized that (a) neighborhood residents would experience them similarly, (b) the two constructs would be similarly associated with a physical variable ('greenness') and (c) individuals living in neighborhoods with more sustainable attributes would experience greater neighborhood (organizational) commitment, and a stronger sense of place. Neighborhood commitment and sense of place were significantly correlated, with moderate shared variance. Neighborhood commitment was significantly associated with the number of 'green' neighborhood attributes. Thus, neighborhood commitment and sense of place appear to be similar but not identical constructs, suggesting that neighborhood commitment has distinct value as an environmental construct in community research.

McEachan RR, SL Prady,et al. 2015. The association between green space and depressive symptoms in pregnant women: moderating roles of socioeconomic status and physical activity. Journal of epidemiology and community health.

Background The current study explored the association between green space and depression in a deprived, multiethnic sample of pregnant women, and examined moderating and mediating variables.

Method 7547 women recruited to the 'Born in Bradford' cohort completed a questionnaire during pregnancy. A binary measure of depressive symptoms was calculated using a validated survey. Two green space measures were used: quintiles of residential greenness calculated using the normalised difference vegetation index for three neighbourhood sizes (100, 300 and 500 m to green space buffer zones around participant addresses); access to major green spaces estimated as straight line distance between participant address and nearest green space (>0.5 hectares). Logistic regression analyses examined relationships between green space and depressive symptoms, controlling for ethnicity, demographics, socioeconomic status (SES) and health behaviours. Multiplicative interactions explored variations by ethnic group, SES or activity levels. Mediation analysis assessed indirect effects via physical activity.

Results Pregnant women in the greener quintiles were 18-23% less likely to report depressive symptoms than those in the least green quintile (for within 100 m of green space buffer zone). The green space-depressive symptoms association was significant for women with lower education or who were active. Physical activity partially mediated the association of green space, but explained only a small portion of the direct effect.

Conclusions Higher residential greenness was associated with a reduced likelihood of depressive symptoms. Associations may be stronger for more disadvantaged groups and for those who are already physically active. Improving green space is a promising intervention to reduce risk of depression in disadvantaged groups.

McElroy JA, A Trentham-Dietz, et al. 2008. Nitrogen-nitrate exposure from drinking water and colorectal cancer risk for rural women in Wisconsin, USA. Journal of Water and Health 6(3): 399-409.

One unintentional result of widespread adoption of nitrogen application to croplands over the past 50 years has been nitrate contamination of drinking water with few studies evaluating the risk of colorectal cancer. in our population-based case-control study of 475 women age 20-74 years with colorectal cancer and 1447 community controls living in rural Wisconsin, drinking water nitrate exposure were interpolated to subjects residences based on measurements which had been taken as part of a separate water quality survey in 1994. Individual level risk factor data was gathered in 1990--1992 and 1999-2001. Logistic regression models estimated the risk of colorectal cancer for the study period, separately and pooled. In the pooled analyses, an overall colorectal cancer risk was not observed for exposure to nitrate-nitrogen in the highest category (>= 10 ppm) compared to the lowest category (<0.5 ppm). However, a 2.9 fold increase risk was observed for proximal colon cancer cases in the highest compared to the lowest category. Statistically significant increased distal colon or rectal cancer risk was not observed. These results suggest that if an association exists with nitrate-nitrogen exposure from residential drinking water consumption, it may be limited to proximal colon cancer.

McMinn D, NM Oreskovic, et al. 2014. The physical environment and health-enhancing activity during the school commute: global positioning system, geographical information systems and accelerometry. Geospatial health, 8(2): 569-72.

Active school travel is in decline. An understanding of the potential determinants of health-enhancing physical activity during the school commute may help to inform interventions aimed at reversing these trends. The purpose of this study was to identify the physical environmental factors associated with health-enhancing physical activity during the school commute. Data were collected in 2009 on 166 children commuting home from school in Scotland. Data on location and physical activity were measured using global positioning systems (GPS) and accelerometers, and mapped using geographical information systems (GIS). Multi-level logistic regression models accounting for repeated observations within participants were used to test for associations between each land-use category (road/track/path, other man-made, greenspace, other natural) and moderate-to-vigorous physical activity (MVPA). Thirty-nine children provided 2,782 matched data points. Over one third (37.1%) of children's school commute time was spent in MVPA. Children commuted approximately equal amounts of time via natural and man-made land-uses (50.2% and 49.8% respectively). Commuting via road/track/path was associated with increased likelihood of MVPA (Exp(B)=1.23, P < 0.05), but this association was not seen for commuting via other manmade land-uses. No association was noted between greenspace use and MVPA, but travelling via other natural land-uses was associated with lower odds of MVPA (Exp(B)=0.32, P < 0.05). Children spend equal amounts of time commuting to school via man-made and natural land-uses, yet man-made transportation route infrastructure appears to provide greater opportunities for achieving health-enhancing physical activity levels.

McPherson E, J Simpson, et al. 1999. Benefit cost analysis of Modesto's municipal urban forest. Journal of Arboriculture 25(5): 235-248.

Abstract. This study answers the question: Do the accrued benefits from Modesto's urban forest justify an annual municipal budget that exceeds $2 million? Results indicate that the benefits residents obtain from Modesto's 91,179 public trees exceeded management costs by a factor of nearly 2.In fiscal year 1997-1998, Modesto spent $2.6 million for urban forestry ($14.36/resident, $28.77/tree), and 74% of this amount was for mature tree care. Total annual benefits from Modesto's urban forest were $4.95 million ($27.12/ resident, $54.33/tree). Net benefits for FY 1997-1998 were $2,329,900 ($12.76/resident, $25.55/tree). Annual air-pollutant uptake was 154 metric tonnes (3.7 lb/tree), with an implied value of $1.48 million ($16/ tree). Aesthetics and other benefits had an estimated value of $1.5 million ($17/tree). Building shade and cooler summer temperatures attributed to street and park trees saved 110,133 MBtu, valued at $870,000 (122 kWh/tree, $10/ tree). Smaller benefits resulted from reductions in stormwater runoff (292,000 m3 or 845 gal/tree, $616,000 or $7/tree) and atmospheric carbon dioxide (13,900 t or 336 lb/tree, $460,000 or $5/tree). Due to the population's relatively even-aged structure and heavy reliance on mature Modesto ash for benefits, management strategies are needed that may reduce net benefits but increase diversity and stability.

McPherson G, JR Simpson, et al. 2005. Municipal forest benefits and costs in five US cities. Journal of Forestry 103: 411-6.

Increasingly, city trees are viewed as a best management practice to control stormwater, an urban-heat-island mitigation measure for cleaner air, a CO2-reduction option to offset emissions, and an alternative to costly new electric power plants. Measuring benefits that accrue from the community forest is the first step to altering forest structure in ways that will enhance future benefits. This article describes the structure, function, and value of street and park tree populations in Fort Collins, Colorado; Cheyenne, Wyoming; Bismarck, North Dakota; Berkeley, California; and Glendale, Arizona. Although these cities spent $13-65 annually per tree, benefits ranged from $31 to $89 per tree. For every dollar invested in management, benefits returned annually ranged from $1.37 to $3.09. Strategies each city can take to increase net benefits are presented.

Mechler R, M Amann, W Schopp. 2002. A methodology to estimate changes in statistical life expectancy due to the control of particulate matter air pollution. International Institute for Applied Systems Analysis.

Studies in the United States have shown that those living in less polluted cities live longer than those living in more polluted cities. After adjustments for other factors, an association remained between ambient concentrations of fine particles and shorter life expectancy. This paper presents a methodology to apply the findings of these epidemiological studies to scenarios to control fine particulate matter in Europe and to estimate the resulting losses in statistical life expectancy that can be attributed to particulate matter pollution. Calculations are carried out for all of Europe with a 50*50 km resolution, distinguishing higher PM2.5 levels in urban areas. The methodology uses population statistics and projections from the United Nations, and applies changes in mortality risk identified by the epidemiological studies to the life tables for the individual countries. The preliminary implementation suggests that, for constant 1990 pollution levels, statistical life expectancy is reduced by approximately 500 days (95 percent confidence interval ranging from 168 - 888 days). By 2010, the control measures presently decided for emissions of primary particles and the precursors of secondary aerosols are expected to reduce these losses to about 280 days (94 - 497), while the theoretical maximum technically feasible emission reductions could bring reduced life expectancy below 200 (65 - 344) days. While the quantifications in this study must be considered as preliminary, the methodology will allow the introduction of health impacts from fine particulate matter into a multi-pollutant/multi-effect framework so that control measures can be explored taking full account of their ancillary benefits for acidification, eutrophication and ground-level ozone.

Medicinenet - Diabetes (Type 1 and Type 2).

Diabetes (Type 1 and Type 2). -- -- Accessed November 2016.

MedlinePlus - Chronic Obstructive Pulmonary Disease. (COPD) Accessed February 2013.

MedlinePlus - Confusion. Accessed February 2013.

MedlinePlus - Fatigue. Accessed February 2013.

MedlinePlus - Migraine. Accessed February 2013.

MedlinePlus - Thyroid Disease.

Thyroid Disease. -- -- Accessed February 2013.

Medlock JM and AG Vaux. 2015. Impacts of the creation, expansion and management of English wetlands on mosquito presence and abundance-developing strategies for future disease mitigation. Parasites & vectors, 8(1): 142.

The incidence of mosquito-borne diseases is increasing in Europe, partly due to the incursion of a number of invasive species known to be vectors of dengue and chikungunya viruses, but also due to the involvement of native species in the transmission of West Nile virus and malaria. For some of these pathogens, there is a risk of the re-emergence of vector-borne diseases that were once widespread in Europe, but declined partly due to large-scale land-drainage projects. Some mosquito species exploit container habitats as breeding sites in urban areas; an adaptation to human-made micro-habitats resulting from increased urbanisation. However, many species thrive in natural wetland ecosystems. Owing to the impacts of climate change there is an urgent need for environmental adaptation, such as the creation of new wetlands to mitigate coastal and inland flooding. In some cases, these initiatives can be coupled with environmental change strategies to protect a range of endangered flora and fauna species by enhancing and extending wetland landscapes, which may by driven by European legislation, particularly in urban areas. This paper reviews field studies conducted in England to assess the impact of newly created wetlands on mosquito colonisation in a) coastal, b) urban and c) arable reversion habitats. It also considers the impact of wetland management on mosquito populations and explores the implications of various water and vegetation management options on the range of British mosquito species. Understanding the impact of wetland creation and management strategies on mosquito prevalence and the potential risk of increasing the levels of nuisance or disease vector species will be crucial in informing health and well-being risk assessments, guiding targeted control, and anticipating the social effects of extreme weather and climate change. Although new wetlands will certainly extend aquatic habitats for mosquitoes, not all species will become a major nuisance or a vector concern as a result. Understanding how the design and management of wetlands might exacerbate mosquito densities is crucial if we are to manage nuisance mosquitoes and control vector species in the event of a disease outbreak. This entomological evidence-base will ensure that control strategies achieve optimal efficacy at minimal cost.

Meng Z and B Lu. 2007. Dust events as a risk factor for daily hospitalization for respiratory and cardiovascular diseases in Minqin, China. Atmospheric Environment, 41(33): 7048-58.

Dust events are common air pollution events in parts of the world with arid, semi-arid, or desert areas. There is little research on the association between respiratory and cardiovascular health and dust events in places which are close to the deserts. The aim of this study is to evaluate the health effects of dust events in a location where traffic and industry are underdeveloped and dust events are most frequent in China. The setting allows the opportunity to reduce confounding by anthropogenically derived particulate matter and to confirm the health effects of dust events. The present study was done using daily counts of hospitalizations in Minqin (1994-2003) for respiratory and cardiovascular diseases (International Classification of Diseases, Tenth revision) for males and females. Using a semi-parametric generalized additive model and controlling for long-term temporal trends, day of the week, meteorological factors, and seasonal influence, counts of hospitalization were analyzed for dust events in a Poisson regression.

Relative risks (RRs) were used to estimate the risk of dust events for respiratory and cardiovascular hospitalizations. In the year-round model, dust events with a lag of 3 days were significantly associated with total respiratory hospitalization for males and females, with RRs of 1.14 (95% confidence interval (CI) 1.01-1.29) and 1.18 (95% CI 1.00-1.41); dust events with a lag of 4 days were significantly associated with upper respiratory tract infection (URTI) in males (RR 1.28, 95% CI 1.04-1.59), and dust events with a lag of 6 days were significantly associated with pneumonia in males, with an RR of 1.17 (95% CI 1.00-1.38). A significant association between dust events with a lag of 3 days and hypertension in males was also found (RR 1.30, 95% CI 1.03,1.64). In the seasonal analysis model, the associations between the dust events and respiratory and cardiovascular hospitalizations were stronger in spring and in winter, respectively.

The results show the health effects of dust events on respiratory and cardiovascular hospitalizations, and the characteristic seasonal distribution of the health effects. In addition, the health effects of dust events are consistent with recent animal and human data showing the respiratory and cardiovascular effects of particulate matter.

Mentens J, D Raes, M Hermy. 2006. Green roofs as a tool for solving the rainwater runoff problem in the urbanized 21st century? Landscape and Urban Planning 77(3): 217-26.

During the last two decades, a large amount of research has been published in German on the reduction of rainwater runoff for different types of roof greening. This paper analyzes the original measurements reported in 18 publications. Rainfall-runoff relationships for an annual and seasonal time scale were obtained from the analysis of the available 628 data records. The derived empirical models allowed us to assess the surface runoff from various types of roofs, when roof characteristics and the annual or seasonal precipitation are given. The annual rainfall-runoff relationship for green roofs is strongly determined by the depth of the substrate layer. The retention of rainwater on green roofs is lower in winter than in summer. The application of the derived annual relationship for the region of Brussels showed that extensive roof greening on just 10% of the buildings would already results in a runoff reduction of 2.7% for the region and of 54% for the individual buildings. Green roofs can therefore be a useful tool for reducing urban rainfall runoff. Yet in order to provide a greater effect on overall runoff they should be accompanied by other means of runoff reduction and/or water retention.

Meuleman AF, R Van Logtestijn, et al. 2003. Water and mass budgets of a vertical-flow constructed wetland used for wastewater treatment. Ecological engineering, 20(1): 31-44.

To estimate the nutrient and organic matter (Biological Oxygen Demand (BOD5) and Chemical Oxygen Demand (COD)) removal capacity of a constructed vertical-flow wetland in The Netherlands, a water and nutrient budget study was conducted. Also bacterial water quality enhancement was measured. The system had a Phragmites australis vegetation and comprised four parallel compartments of 0.25 ha each, which were loaded sequentially with sewage from recreational facilities. Annual loading rates were moderate and were estimated to be 16 700 kg COD ha-1; 6700 kg BOD5 ha-1; 2400 kg N ha-1; and 335 kg P ha-1. The removal efficiencies for COD (81%) and BOD5 (96%) were high. Almost all Escherichia coli and F-specific RNA bacteriophages (>99%) were removed from the wastewater during transport. The removal efficiencies for nitrogen (30%) and phosphorus (24%) were much lower. Nutrient removal was the result of plant uptake and harvesting (15% of total N input, 10% of total P input), denitrification (8% of total N input), sedimentation and accumulation of organic matter in the soil (7% of N total input, 14% of total P input). Removal efficiencies for N and P could be increased by harvesting the Phragmites vegetation in October, rather than the current harvesting practice in December. This vertical-flow wetland appeared to be P-saturated after 15 years of operation. The use of sandy sediments with better P-adsorbing properties is advocated as a critical issue for the design of these systems. Further, the groundwater eutrophication resulting from the poor functioning of the drainage systems has shown that a good hydraulic separation of vertical-flow systems from the subsurface is an important prerequisite for their proper functioning.

Milandri SG, KJ Winter, et al. 2012. The performance of plant species in removing nutrients from stormwater in biofiltration systems in Cape Town, 38(5): 655-62.

In 2009, the City of Cape Town (CoCT) adopted a stormwater policy which mandates that new and existing developments should reduce the concentration of phosphorus and suspended solids in stormwater runoff by 45% and 80%, respectively, but offered no explicit guidance about how these water quality targets might be achieved. This study aims to contribute to the limited knowledge that exists about the performance of local plant species to treat stormwater. A large nursery-based study was conducted to investigate the performance of 9 locally-occurring plant species to remove orthophosphate (PO43), ammonia (NH3) and nitrate (NO3) found in urban stormwater. Synthetic stormwater was applied to each species as well as a control consisting only of soil (Malmesbury shale). The discharge was collected from a drainage pipe at the base of each of the 150 containers. The results show that all species (excluding Ficinia) reduced the average concentrations of PO43 by 81% and NH3 by 90%. By contrast, NO3" was reduced by an average of 69% (excluding by Elegia and Phragmites) with 8 of the 9 species removing significantly more than the control. The species that performed well for all three nutrients include Agapanthus and turf grasses, Stenotaphrum and Pennisetum. The results of the study highlight three important factors in the design of biofilters: that a substantial proportion of nutrients can be captured or absorbed by plants; that the soil medium is an important factor in the removal of PO4" 3 and NH3; and that plant choice is essential in the removal of NO3-. Future research should test plant species in both the laboratory and field settings, and should include additional contaminants such as household detergents, heavy metals and bacteria.

Millennium Ecosystem Assessment 2005 - Dryland Systems. Accessed February 2013.

Millennium Ecosystem Assessment 2005 - Ecosystems and Human Well-Being: Wetlands and Water. Accessed February 2013.

Miller KA, DS Siscovick, et al. 2007. Long-term exposure to air pollution and incidence of cardiovascular events in women. New England Journal of Medicine 356(5): 447-58.

Background: Fine particulate air pollution has been linked to cardiovascular disease, but previous studies have assessed only mortality and differences in exposure between cities. We examined the association of long-term exposure to particulate matter of less than 2.5 micro-m in aerodynamic diameter (PM2.5) with cardiovascular events.

Methods: We studied 65,893 postmenopausal women without previous cardiovascular disease in 36 U.S. metropolitan areas from 1994 to 1998, with a median follow-up of 6 years. We assessed the women's exposure to air pollutants using the monitor located nearest to each woman's residence. Hazard ratios were estimated for the first cardiovascular event, adjusting for age, race or ethnic group, smoking status, educational level, household income, body-mass index, and presence or absence of diabetes, hypertension, or hypercholesterolemia.

Results: A total of 1816 women had one or more fatal or nonfatal cardiovascular events, as confirmed by a review of medical records, including death from coronary heart disease or cerebrovascular disease, coronary revascularization, myocardial infarction, and stroke. In 2000, levels of PM2.5 exposure varied from 3.4 to 28.3 micro-g per cubic meter (mean, 13.5). Each increase of 10 micro-g per cubic meter was associated with a 24% increase in the risk of a cardiovascular event (hazard ratio, 1.24; 95% confidence interval [CI], 1.09 to 1.41) and a 76% increase in the risk of death from cardiovascular disease (hazard ratio, 1.76; 95% CI, 1.25 to 2.47). For cardiovascular events, the between-city effect appeared to be smaller than the within-city effect. The risk of cerebrovascular events was also associated with increased levels of PM2.5 (hazard ratio, 1.35; 95% CI, 1.08 to 1.68).

Conclusion: Long-term exposure to fine particulate air pollution is associated with the incidence of cardiovascular disease and death among postmenopausal women. Exposure differences within cities are associated with the risk of cardiovascular disease.

Ming J, L Xian-guo, et al. 2007. Flood mitigation benefit of wetland soil - A case study in Momoge National Nature Reserve in China. Ecological Economics 61(2-3): 217-23.

Wetlands have many important functions. To a wide range of wildlife species, they offer critically important habitats. They also act to mitigate flooding, regulate micro and macro climate changes, degrade pollutants and control erosion etc. Wetland benefits are these functions, which provide direct, indirect, and non-use values to humans. In this study, field soil data are used to calculate the flood mitigation benefits of wetland soils within the Momoge National Nature Reserve, Jilin Province, the People's Republic of China. Calculations are based upon environmental economic assessment methods and GIS techniques. The estimated flood mitigation capacity of wetland soils within the Momoge Reserve was 7.15 x 100,000 m3/hm2/yr. This translated into an economic benefit of 5700 $/hm2/yr due to flood mitigation. Spatial differences in the flood mitigation ability of soils were observed across the Momoge wetlands. Benefits associated with flood mitigation were highest within the middle reaches of the Momoge wetlands and least in the East. This quantitative analysis of flood mitigation benefit, with its investigation of wetland soils, will be a useful reference both for the assessment of wetland values in the local region and also for the greater understanding wetland function and value assessment methods.

Ming, Kuo FE. 2013. Nature-deficit disorder: evidence, dosage, and treatment. Journal of Policy Research in Tourism, Leisure and Events 5(2): 172-186.

Claims have long been made of the health-promoting effects of contact with 'nature', but these claims have only recently been subjected to rigorous scientific testing. A strong body of evidence is now in hand. An array of studies ranging from rigorous experiments to large-scale epidemiological work has tied nature to health for outcomes ranging from childhood obesity, to immune functioning and rates of physician-diagnosed disease in adults, to longevity in older adults. Moreover, enough evidence has accumulated to begin to answer key questions about the dosage of nature needed to promote health. Do all forms of nature seem to help? Do small bits of nature help, or is some minimum level required for an effect? Similarly, to what extent is an explicit focus on nature necessary - are effects limited to fishing, hiking, gardening, and the like? The evidence to date suggests, broadly, that total exposure is important; all forms and quantities of exposure are helpful; and the greener the better. From these insights into dosage, nine recommendations are drawn for addressing nature deficits at the population level: green everyday places and views; bring green spaces closer; bring green activities and events closer; make spaces and programs fit nearby users; make green spaces serve multiple activities and uses; support longer visits; reconsider barriers to use; help people start green activities; and help people continue green activities.

Mitchell R and F Popham. 2008. Effect of exposure to natural environment on health inequalities: an observational population study. Lancet 372(9650): 1655-60.

Background: Studies have shown that exposure to the natural environment, or so-called green space, has an independent effect on health and health-related behaviours. We postulated that income-related inequality in health would be less pronounced in populations with greater exposure to green space, since access to such areas can modify pathways through which low socio-economic position can lead to disease.

Methods: We classified the population of England at younger than retirement age (n=40 813 236) into groups on the basis of income deprivation and exposure to green space. We obtained individual mortality records (n=366 348) to establish whether the association between income deprivation, all-cause mortality, and cause-specific mortality (circulatory disease, lung cancer, and intentional self-harm) in 2001 - 05, varied by exposure to green space measured in 2001, with control for potential confounding factors. We used stratified models to identify the nature of this variation.

Findings: The association between income deprivation and mortality differed significantly across the groups of exposure to green space for mortality from all causes (p<0.0001) and circulatory disease (p= 0.0212), but not from lung cancer or intentional self-harm. Health inequalities related to income deprivation in all-cause mortality and mortality from circulatory diseases were lower in populations living in the greenest areas. The incidence rate ratio (IRR) for all-cause mortality for the most income deprived quartile compared with the least deprived was 1.93 (95% CI 1.86 - 2.01) in the least green areas, whereas it was 1.43 (1.34 - 1.53) in the most green. For circulatory diseases, the IRR was 2.19 (2.04 - 2.34) in the least green areas and 1.54 (1.38 - 1.73) in the most green. There was no effect for causes of death unlikely to be affected by green space, such as lung cancer and intentional self-harm. Interpretation: Populations that are exposed to the greenest environments also have lowest levels of health inequality related to income deprivation. Physical environments that promote good health might be important to reduce socio-economic health inequalities.

Mitchell R. 2013. Is physical activity in natural environments better for mental health than physical activity in other environments? Social Science & Medicine 2013(91): 130-134.

Experimental evidence suggests that there may be synergy between the psychological benefits of physical activity, and the restorative effects of contact with a natural environment; physical activity in a natural environment might produce greater mental health benefits than physical activity elsewhere. However, such experiments are typically short-term and, by definition, artificially control the participant types, physical activity and contact with nature. This observational study asked whether such effects can be detected in everyday settings at a population level. It used data from the Scottish Health Survey 2008, describing all environments in which respondents were physically active. Associations were sought between use of each environment, and then use of environments grouped as natural or non-natural, and the risk of poor mental health (measured by the General Health Questionnaire (GHQ)) and level of wellbeing (measured by the Warwick Edinburgh Mental health and Wellbeing Score (WEMWBS). Results showed an independent association between regular use of natural environments and a lower risk of poor mental health, but not for activity in other types of environment. For example, the odds of poor mental health (GHQ >= 4) among those regularly using woods or forests for physical activity were 0.557 (95% CI 0.323-0.962), compared to non-users. However, regular use of natural environments was not clearly associated with greater wellbeing, whilst regular use of non-natural environments was. The study concludes that physical activity in natural environments is associated with a reduction in the risk of poor mental health to a greater extent than physical activity in other environments, but also that activity in different types of environment may promote different kinds of positive psychological response. Access to natural environments for physical activity should be protected and promoted as a contribution to protecting and improving population mental health.

Mitchell RJ, EA Richardson, et al. 2015. Neighborhood environments and socioeconomic inequalities in mental well-being. American journal of preventive medicine, 49(1): 80-4.


It has been suggested that socioeconomic inequalities in health might be reduced among populations with good access to green space. However, the potential for other neighborhood characteristics to reduce socioeconomic health inequalities, or to confound the effects of green space, has not been well explored. Therefore, this study investigates which, if any, neighborhood characteristics are associated with narrower socioeconomic inequalities in mental well-being in a large, international sample of urban residents.


The 2012 European Quality of Life Survey provided data on 21,294 urban residents from 34 European nations. Associations between mental well-being (captured by the WHO-5 scale) and level of financial strain were assessed for interaction with five different neighborhood characteristics, including reported access to recreational/green areas, financial services, transport, and cultural facilities. Multilevel regression models allowed for clustering of individuals within region and country in this cross-sectional, observational study. Data were analyzed in 2014.


Socioeconomic inequality in mental well-being was 40% (8.1 WHO-5 points) narrower among respondents reporting good access to green/recreational areas, compared with those with poorer access. None of the other neighborhood characteristics or services were associated with narrower inequality.


If societies cannot, or will not, narrow socioeconomic inequality, research should explore the so-called equigenic environments-those that can disrupt the usual conversion of socioeconomic inequality to health inequality. This large, international, observational study suggests that access to recreational/green areas may offer such a disruption.

Mitsch WJ and JG Gosselink. 2007. Wetlands. 4th ed. John Wiley and Sons, New Jersey.


Mohammadi MJ, H Godini, et al. 2015. An association between air quality and COPD in Ahvaz, Iran. Jundishapur Journal of Chronic Disease Care, 4(1).

Context: Ahvaz, capital city of Khuzestan province, with a population of more than 1 million people is very famous in standpoint of air pollution. Nitrogen dioxide is emitted from vehicles and industries which can have short and long term effects on citizens.

Evidence Acquisition: Data were taken from Ahvaz Department of Environment (ADoE). Stations were Naderi, Behdasht Ghadim, Havashenasi, and Mohitzist. The COPD attributed to nitrogen dioxide in Ahvaz city, Iran, in 2011 were calculated by utilizing relative risk and baseline incidence related to health end point nitrogen dioxide. Data were analyzed by SPSS ver 16.

Results: The highest and lowest annually average nitrogen dioxide concentrations during 2011 were 70 and 21 µg/m³, respectively. The Bureau of Meteorology "Havashenasi" and head office of ADoE "Mohitzist" had the highest and the lowest nitrogen dioxide concentrations during 2011, respectively. Approximately 4% of the hospital admission for COPD happened when the nitrogen dioxide concentration was > 10 µg/m³. Low percentage of the observed health endpoints was associated with low concentration of measured nitrogen dioxide.

Conclusions: Using alternative energy sources, such as solar cooking and electrical heating is effective, as is using fuels such as kerosene or coal rather than biomass. Higher relative risk value can depict mismanagement in urban air quality. The lower level of relative risk value may be achieved if some control strategies for reducing nitrogen dioxide emission are used.

Monteiro A, V Carvalho, et al. 2013. Excess mortality and morbidity during the July 2006 heat wave in Porto, Portugal. International Journal of Biometeorology 57(1): 155-167.

The purpose of this study was to understand the effects of the July 2006 heat wave through the use of the heat index, in mortality (all causes) and morbidity (all causes, respiratory and circulatory diseases) in general, and in people over 74 years and by gender, in Porto. In this paper, the Poisson generalized additive regression model was used to estimate the impact of apparent temperature (heat index) and daily mortality and morbidity during the July 2006 heat wave. Daily mortality, morbidity and heat index were correlated with lags of apparent temperature up to 7 days using Pearson correlation. For a 1°C increase in mean apparent temperature we observed a 2.7 % (95 % CI: 1.7-3.6 %) increase in mortality (all cause), a 1.7 % (95 % CI: 0.6-2.9 %) increase in respiratory morbidity, a 2.2 % (95 % CI: 0.4-4.1 %) increase in respiratory morbidity in women, a 5.4 % (95%CI: 1.1-6.6 %) increase in chronic obstructive pulmonary morbidity, and a 7.5 % (95 % CI: 1.3-14.1 %) increase in chronic obstructive pulmonary.

Morales E, R Garcia-Esteban, et al. 2015. Intrauterine and early postnatal exposure to outdoor air pollution and lung function at preschool age. Thorax, 70(1): 64-73.

Background Effects of prenatal and postnatal exposure to air pollution on lung function at preschool age remain unexplored. We examined the association of exposure to air pollution during specific trimesters of pregnancy and postnatal life with lung function in preschoolers.

Methods Lung function was assessed with spirometry in preschoolers aged 4.5 years (n=620) participating in the INfancia y Medio Ambiente (INMA) cohort. Temporally adjusted land use regression (LUR) models were applied to estimate individual residential exposures to benzene and nitrogen dioxide (NO2) during specific trimesters of pregnancy and early postnatal life (the first year of life). Recent and current (1 year and 1 week before lung function testing, respectively) exposures to NO2 and nitrogen oxides (NOx) were also assessed.

Results Exposure to higher levels of benzene and NO2 during pregnancy was associated with reduced lung function. FEV1 estimates for an IQR increase in exposures during the second trimester of pregnancy were -18.4 mL, 95% CI -34.8 to -2.1 for benzene and -28.0 mL, 95% CI -52.9 to -3.2 for NO2. Relative risk (RR) of low lung function (<80% of predicted FEV1) for an IQR increase in benzene and NO2 during the second trimester of pregnancy were 1.22, 95% CI 1.02 to 1.46 and 1.30, 95% CI 0.97 to 1.76, respectively. Associations for early postnatal, recent and current exposures were not statistically significant. Stronger associations appeared among allergic children and those of lower social class.

Conclusions Prenatal exposure to residential traffic-related air pollution may result in long-term lung function deficits at preschool age.

Moreno D, C Pedrocchi, et al. 2007. Creating wetlands for the improvement of water quality and landscape restoration in semi-arid zones degraded by intensive agricultural use. ecological engineering, 30(2): 103-11.

Increasing interest in restoring wetlands within a multipurpose approach is observed in degraded lands submitted to intensive human uses. This study evaluates the effectiveness of constructed and natural wetlands in removing nutrients from agricultural wastewater and their potential contribution to landscape heterogeneity in semiarid Monegros area, NE Spain. To achieve the first aim, wetland plots of differing sizes (50, 200, 800 m2) were constructed upon fields abandoned four years earlier. Water has been sampled at the inflow and outflow of the plots for two years. Results show a 24-43% rate of total nitrogen removal and no clear trend for phosphorus in constructed wetlands. Slight effectiveness improvements took place in the second working year and in large-size plots. For the second goal, a number of catchments with wetlands that originated as a consequence of irrigation were selected. These wetlands do not contribute significantly to improving the landscape diversity of agricultural catchments. Based on this experimental work, it is estimated that it should be necessary to restore wetlands in 3.25 and 5.60% of total watershed areas to remove most nitrogen from wastewater. Their restoration should be implemented also with the objective of increasing the landscape diversity of zones extensively transformed and homogenized by agricultural practices.

Mori J, A Sabo, HM Hanslin, et al. 2015. Deposition of traffic-related air pollutants on leaves of six evergreen shrub species during a Mediterranean summer season. Urban Forestry & Urban Greening, 14(2): 264-73.

Six evergreen broad-leaved shrub species (Viburnum tinus subsp. lucidum L., Arbutus unedo L., Photinia x fraseri Dress., Laurus nobilis L., Elaeagnus x ebbingei L., Ligustrum japonicum Thunb.) were tested for their capacity to accumulate pollutants on the surface of their current season leaves in a Mediterranean environment. Plants were planted along a road in 2010 and exposed to traffic pollution. Leaf element deposition (Al, As, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Ni, Pb, Sb, Se, Tl, V, Zn) was analyzed six times from early summer to early autumn 2012. Particulate matter on leaves, element concentration of particulate matter in the air and meteorological parameters were measured. Elements on leaves were related to meteorological conditions to study the inter-relations. E. x ebbingei, P. x fraseri and V. lucidum were found to accumulate more pollutants, while L. nobilis and A. unedo were the lowest accumulators. A common trend of element depositions was found. Generally, elements increased from the first to the second sampling (28 June to 19 July) and, thereafter, decreased until the early autumn. Element depositions depended on species and meteorological parameters. Rain decreased the element accumulation on leaves, whilst an increase in wind velocity and element concentrations (in the air) tended to increase the presence of elements on leaves. Meteorological conditions were confirmed to be important factors modifying the dynamics of pollution deposition and their removal from leaves during a season.

Morishita M, RL Bard, et al. 2015. The characteristics of coarse particulate matter air pollution associated with alterations in blood pressure and heart rate during controlled exposures. Journal of Exposure Science and Environmental Epidemiology, 25(2): 153-9.

Although fine particulate matter (PM) air pollution <2.5 µm in aerodynamic diameter (PM2.5) is a leading cause of global morbidity and mortality, the potential health effects of coarse PM (2.5-10 µm in aerodynamic diameter; PM10-2.5) remain less clearly understood. We aimed to elucidate the components within coarse PM most likely responsible for mediating these hemodynamic alterations. Thirty-two healthy adults (25.9+-6.6 years) were exposed to concentrated ambient coarse PM (CAP) (76.2+-51.5 µg/m(3)) and filtered air (FA) for 2 h in a rural location in a randomized double-blind crossover study. The particle constituents (24 individual elements, organic and elemental carbon) were analyzed from filter samples and associated with the blood pressure (BP) and heart rate (HR) changes occurring throughout CAP and FA exposures in mixed model analyses. Total coarse PM mass along with most of the measured elements were positively associated with similar degrees of elevations in both systolic BP and HR. Conversely, total PM mass was unrelated, whereas only two elements (Cu and Mo) were positively associated with and Zn was inversely related to diastolic BP changes during exposures. Inhalation of coarse PM from a rural location rapidly elevates systolic BP and HR in a concentration-responsive manner, whereas the particulate composition does not appear to be an important determinant of these responses. Conversely, exposure to certain PM elements may be necessary to trigger a concomitant increase in diastolic BP. These findings suggest that particulate mass may be an adequate metric of exposure to predict some, but not all, hemodynamic alterations induced by coarse PM mass.

Morita E, M Imai, et al. 2011. A before and after comparison of the effects of forest walking on the sleep of a community-based sample of people with sleep complaints. BioPsychoSocial Medicine 5(1): 1-7.

Background: Sleep disturbance is a major health issue in Japan. This before-after study aimed to evaluate the immediate effects of forest walking in a community-based population with sleep complaints.

Methods: Participants were 71 healthy volunteers (43 men and 28 women). Two-hour forest-walking sessions were conducted on 8 different weekend days from September through December 2005. Sleep conditions were compared between the nights before and after walking in a forest by self-administered questionnaire and actigraphy data.

Results: Two hours of forest walking improved sleep characteristics; impacting actual sleep time, immobile minutes, self-rated depth of sleep, and sleep quality. Mean actual sleep time estimated by actigraphy on the night after forest walking was 419.8 +- 128.7 (S.D.) minutes whereas that the night before was 365.9 +- 89.4 minutes (n = 42). Forest walking in the afternoon improved actual sleep time and immobile minutes compared with forest walking in the forenoon. Mean actual sleep times did not increase after forenoon walks (n = 26) (the night before and after forenoon walks, 380.0 +- 99.6 and 385.6 +- 101.7 minutes, respectively), whereas afternoon walks (n = 16) increased mean actual sleep times from 342.9 +- 66.2 to 475.4 +-150.5 minutes. The trend of mean immobile minutes was similar to the abovementioned trend of mean actual sleep times.

Conclusions: Forest walking improved nocturnal sleep conditions for individuals with sleep complaints, possibly as a result of exercise and emotional improvement. Furthermore, extension of sleep duration was greater after an afternoon walk compared to a forenoon walk. Further study of a forest-walking program in a randomized controlled trial is warranted to clarify its effect on people with insomnia.

Morita E, S Fukuda, et al. 2007. Psychological effects of forest environments on healthy adults: Shinrin-yoku (forest-air bathing, walking) as a possible method of stress reduction. Public Health 121(1): 54-63.

Objectives Shinrin-yoku (walking and/or staying in forests in order to promote health) is a major form of relaxation in Japan; however, its effects have yet to be completely clarified. The aims of this study were: (1) to evaluate the psychological effects of shinrin-yoku in a large number of participants; and (2) to identify the factors related to these effects.

Methods Four hundred and ninety-eight healthy volunteers took part in the study. Surveys were conducted twice in a forest on the same day (forest day) and twice on a control day. Outcome measures were evaluated using the Multiple Mood Scale-Short Form (hostility, depression, boredom, friendliness, wellbeing and liveliness) and the State-Trait Anxiety Inventory A-State Scale. Statistical analyses were conducted using analysis of variance and multiple regression analyses.

Results Hostility (P<0.001) and depression (P<0.001) scores decreased significantly, and liveliness (P=0.001) scores increased significantly on the forest day compared with the control day. The main effect of environment was also observed with all outcomes except for hostility, and the forest environment was advantageous. Stress levels were shown to be related to the magnitude of the shinrin-yoku effect; the higher the stress level, the greater the effect.

Conclusions This study revealed that forest environments are advantageous with respect to acute emotions, especially among those experiencing chronic stress. Accordingly, shinrin-yoku may be employed as a stress reduction method, and forest environments can be viewed as therapeutic landscapes. Therefore, customary shinrin-yoku may help to decrease the risk of psychosocial stress-related diseases, and evaluation of the long-term effects of shinrin-yoku is warranted.

Mowafi M, Z Khadr, et al. 2012. Is access to neighborhood green space associated with BMI among Egyptians? A multilevel study of Cairo neighborhoods. Health & Place 18(2): 385-390.

Evidence of a link between green space and obesity has increased in the developed world, but few studies have been conducted in the developing world. Our study tests whether availability of neighborhood green space is associated with BMI among adults in Cairo, Egypt. Using data from the 2007 Cairo Urban Inequity Study, we conducted multilevel analyses and found no significant green space-BMI association, leading us to conclude that this intervention may not be as promising in this developing world context as it has been in some western urban contexts. Other aspects of the urban environment should be evaluated to better understand neighborhood variations in obesity in Cairo.

Mowen A, E Orsega-Smith, et al. 2007. The role of park proximity and social support in shaping park visitation, physical activity, and perceived health among older adults. Journal of physical activity & health, 4(2): 167.

BACKGROUND: Health scholars purport that park proximity and social support promotes physical activity and health. However, few studies examine the combined contributions of these constructs in shaping physical activity and health.

PURPOSE: In this study, the contributions of environmental and social characteristics in shaping park use, physical activity, and health are examined.

METHODS: A survey was distributed to 1515 older adults in Cleveland, Ohio.

RESULTS: Path analysis indicated that social support was directly related to health. Perceived park walking proximity was related to physical activity and health through park use frequency. Park proximity was directly related to park use duration.

CONCLUSIONS: Results suggest that environmental and social characteristics contribute to physical activity and health, but perceptions may also be a prerequisite to park use, daily physical activity, and health.

Mu H, B Battsetseg, et al. 2010. Effects of Asian Dust Storm on Health-related Quality of Life: A Survey Immediately after an Asian Dust Storm Event in Mongolia. International Journal of Health Research, 3(2): 87-92.

Purpose: In spring, Asian dust storm events occur frequently in the deserts of Mongolia and northwestern China. Epidemiological studies have shown that particulate matter during a dust event can cause the deterioration of subjective symptoms concerning the eye and the respiratory. The objective of this study was to assess the possible effects of dust events on health-related quality of life (HRQoL) in the general population. Methods: A survey of the HRQoL and subjective symptoms related to eye and respiratory systems was carried out for inhabitants in Mongolia after a dust storm event. HRQoL was assessed based on the SF-36. The study participant were 87 nomads. Results: The scores of SF-36 subscales for group with symptoms were significantly lower than group without symptoms. In the results of the multiple regression analysis, the scores of SF-36 subscales were significantly related to the subjective symptoms. Conclusion: This result suggested that a decreased HRQoL of people with symptoms, corroborated by subjective symptoms, may be the result of damage from a dust storm event. Measurement of HRQoL in the general population may thus be an index of the effect from the dust storm.

Murray CJL and AD Lopez. 1997. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. The Lancet 349(9063): 1436-42.

Summary/Background: Prevention and control of disease and injury require information about the leading medical causes of illness and exposures or risk factors. The assessment of the public-health importance of these has been hampered by the lack of common methods to investigate the overall, worldwide burden. The Global Burden of Disease Study (GBD) provides a standardised approach to epidemiological assessment and uses a standard unit, the disability-adjusted life year (DALY), to aid comparisons.Methods DALYs for each age-sex group in each GBD region for 107 disorders were calculated, based on the estimates of mortality by cause, incidence, average age of onset, duration, and disability severity. Estimates of the burden and prevalence of exposure in different regions of disorders attributable to malnutrition, poor water supply, sanitation and personal and domestic hygiene, unsafe sex, tobacco use, alcohol, occupation, hypertension, physical inactivity, use of illicit drugs, and air pollution were developed.

Findings Developed regions account for 11.6% of the worldwide burden from all causes of death and disability, and account for 90.2% of health expenditure worldwide. Communicable, maternal, perinatal, and nutritional disorders explain 43.9%; non-communicable causes 40.9%; injuries 15.1%; malignant neoplasms 5.1%; neuropsychiatric conditions 10.5%; and cardiovascular conditions 9.7% of DALYs worldwide. The ten leading specific causes of global DALYs are, in descending order, lower respiratory infections, diarrhoeal diseases, perinatal disorders, unipolar major depression, ischaemic heart disease, cerebrovascular disease, tuberculosis, measles, road-traffic accidents, and congenital anomalies. 15.9% of DALYs worldwide are attributable to childhood malnutrition and 6.8% to poor water, and sanitation and personal and domestic hygiene

Interpretation: The three leading contributors to the burden of disease are communicable and perinatal disorders affecting children. The substantial burdens of neuropsychiatric disorders and injuries are under-recognised. The epidemiological transition in terms of DALYs has progressed substantially in China, Latin America and the Caribbean, other Asia and islands, and the middle eastern crescent. If the burdens of disability and death are taken into account, our list differs substantially from other lists of the leading causes of death. DALYs provide a common metric to aid meaningful comparison of the burden of risk factors, diseases, and injuries.

Mustapa ND, NZ Maliki, and A Hamzah. 2015. Repositioning Children's Developmental Needs in Space Planning: A Review of Connection to Nature. Procedia-Social and Behavioral Sciences, 170: 330-9.

The past few decades have shown that the opportunity for children to have a direct connection with nature and outdoor environment declined due to rapid urbanization. Children are facing various physical and health problems as consequences from this phenomenon. This paper presents a review on benefits of nature on children's developmental needs. The review also highlights children's experiences in nature and effects of disconnection from the nature. In summary, it is crucial to understand children's view towards nature and environment in creating spaces that reconnect them with nature. Designing for children today is indeed designing for the future, as well.

Myers SS, G Lynne, et al. 2013. Human health impacts of ecosystem alteration. Proceedings of the National Academy of Sciences 110(47): 18753-18760.

Human activity is rapidly transforming most of Earth's natural systems. How this transformation is impacting human health, whose health is at greatest risk, and the magnitude of the associated disease burden are relatively new subjects within the field of environmental health. We discuss what is known about the human health implications of changes in the structure and function of natural systems and propose that these changes are affecting human health in a variety of important ways. We identify several gaps and limitations in the research that has been done to date and propose a more systematic and comprehensive approach to applied research in this field. Such efforts could lead to a more robust understanding of the human health impacts of accelerating environmental change and inform decision making in the land-use planning, environmental conservation, and public health policy realms.

Mytton O T, N Townsend, et al. 2012. Green space and physical activity: An observational study using Health Survey for England data. Health & Place 18(5): 1034-1041.

Past studies have suggested that a link between health outcomes and green space is due to increased levels of physical activity of individuals living in areas with more green space. We found a positive association between green space and physical activity levels. The odds of achieving the recommended amount of physical activity was 1.27 (95% CI: 1.13-1.44) for people living in the greenest quintile in England compared to those living in the least green quintile, after controlling for individual and environmental factors. However, no association was found between green space and types of physical activity normally associated with green space. An association was found with other types of physical activity (gardening and do-it-yourself, and occupational physical activity). These findings suggest that although there is a positive association between physical activity and green space it may not be explained by individuals using green space for recreation.


Nakau M, J Imanishi, et al. 2013. Spiritual care of cancer patients by integrated medicine in urban green space: A pilot study. EXPLORE: The Journal of Science and Healing 9(2): 87-90.

Background: Psycho-oncological care, including spiritual care, is essential for cancer patients. Integrated medicine, a therapy combining modern western medicine with various kinds of complementary and alternative medicine, can be appropriate for the spiritual care of cancer because of the multidimensional characteristics of the spirituality. In particular, therapies that enable patients to establish a deeper contact with nature, inspire feelings of life and growth of plants, and involve meditation may be useful for spiritual care as well as related aspects such as emotion. The purpose of the present study was to examine the effect of spiritual care of cancer patients by integrated medicine in a green environment.

Methods: The present study involved 22 cancer patients. Integrated medicine consisted of forest therapy, horticultural therapy, yoga meditation, and support group therapy, and sessions were conducted once a week for 12 weeks. The spirituality (the Functional Assessment of Chronic Illness Therapy-Spiritual well-being), quality of life (Short Form-36 Health Survey Questionnaire), fatigue (Cancer Fatigue Scale), psychological state (Profile of Mood States, short form, and State-Trait Anxiety Inventory) and natural killer cell activity were assessed before and after intervention.

Results: In Functional Assessment of Chronic Illness Therapy-Spiritual well-being, there were significant differences in functional well-being and spiritual well-being pre- and postintervention. This program improved quality of life and reduced cancer-associated fatigue. Furthermore, some aspects of psychological state were improved and natural killer cell activity was increased.

Conclusions: It is indicated that integrated medicine performed in a green environment is potentially useful for the emotional and spiritual well-being of cancer patients.

Naragon K, and D Watson D. 2009. "Positive affectivity". In S. Lopez (Ed.), The Encyclopedia of Positive Psychology(pp. 707-711). Hoboken, NJ: Wiley-Blackwell.

No abstract provided.

Nardini A, S Andri, and M Crasso. 2012. Influence of substrate depth and vegetation type on temperature and water runoff mitigation by extensive green roofs: shrubs versus herbaceous plants. Urban Ecosystems, 15(3): 697-708.

The relative contribution of substrate depth and vegetation type on temperature mitigation and stormwater runoff reduction was studied in an experimental green roof in North eastern Italy. Two substrate depths (120 and 200 mm) and two vegetation types (herbaceous plants and shrubs, respectively) were used, and compared to control modules with similar substrate depths but left bare of vegetation. Experimental observations showed that: a) green roofs substantially reduce thermal load over the rooftop, with significant effects of substrate depth and no apparent impact of vegetation type; b) thermal effects are strongly influenced by substrate water content; c) green roofs strongly reduce water runoff with significant substrate x vegetation effects. Our data suggest that green roof design addressed to optimization of the thermal functions should take into account adequate planning of substrate depth. Moreover, our data show that vegetated modules out-competed medium-only ones in terms of runoff reduction capacity, in accordance with some previous studies. Both shrub-vegetated and herbaceous modules intercepted and stored more than 90% rainfall during intense precipitation events, with no significant difference between the two vegetation types despite different substrate depths.

Nassauer J I. Ed. 1997. Placing nature: culture and landscape ecology. Island Press.

No abstract provided.

National Alliance on Mental Illness - Mental Illness. Accessed February 2013.

National Center for Health Statistics. Accessed November 2016.

National Heart Lung and Blood Institute - High Blood Pressure. Accessed February 2013.

National Heart Lung and Blood Institute - Pneumonia. Accessed February 2013.

National Institute of Mental Health: Prevalence of Serious Mental Illness Among U.S. Adults by Age, Sex, and Race. Accessed February 2013.

Neave, M and Abrahams, AD. 2002. Vegetation influences on water yields from grassland and shrubland ecosystems in the Chihuahuan Desert. Earth Surface Processes and Landforms 27: 1011-1020.

This study examines runoff generated under simulated rainfall on Summerford bajada in the Jornada Basin, New Mexico, USA. Forty‐five simulation experiments were conducted on 1 m2 and 2 m2 runoff plots on grassland, degraded grassland, shrub and intershrub environments located in grassland and shrubland communities. Average hydrographs generated for each environment show that runoff originates earlier on the vegetated plots than on the unvegetated plots. This early generation of runoff is attributed to soil infiltration rates being overwhelmed by the rapid concentration of water at the base of plants by stemflow. Hydrographs from the degraded grassland and intershrub plots rise continuously throughout the 30 min simulation events indicating that these plots do not achieve equilibrium runoff. This continuously rising form is attributed to the progressive development of raindrop‐induced surface seals. Most grassland and shrub plots level out after the initial early rise indicating equilibrium runoff is achieved. Some shrub plots, however, display a decline in discharge after the early rise. The delayed infiltration of water into macropores beneath shrubs with vegetation in their understories is proposed to explain this declining form. Water yields predicted at the community level indicate that the shrubland sheds 150 per cent more water for a given storm event than the grassland.

Netz Y, M-J Wu, BJ Becker, G Tenenbaum. 2005. Physical activity and psychological well-being in advanced age: A meta-analysis of intervention studies. Psychology and Aging 20(2): 272-84.

A meta-analysis examined data from 36 studies linking physical activity to well-being in older adults without clinical disorders. The weighted mean-change effect size for treatment groups (dC. = 0.24) was almost 3 times the mean for control groups (dC. = 0.09). Aerobic training was most beneficial (dC. = 0.29), and moderate intensity activity was the most beneficial activity level (dC. = 0.34). Longer exercise duration was less beneficial for several types of well-being, though findings are inconclusive. Physical activity had the strongest effects on self-efficacy (dC. = 0.38), and improvements in cardiovascular status, strength, and functional capacity were linked to well-being improvement overall. Social cognitive theory is used to explain the effect of physical activity on well-being.

Nguyen T, X Yu, et al. 2015. Relationship between types of urban forest and PM 2.5 capture at three growth stages of leaves. Journal of Environmental Sciences, 27: 33-41.

Particulate matter diameter <=2.5 µm (PM2.5) causes direct harm to human health. Finding forms of urban forest systems that with the ability to reduce the amount of particulate matter in air effectively is the aim of this study. Five commonly cultivated kinds of urban forest types were studied in Beijing city at three stages of leaf growth. Results show that the urban forest system is capable of storing and capturing dust from the air. The types of shrubs and broadleaf trees that have the ability to capture PM2.5 from the air are most effective when leaves have fully developed. In the leafless season, the conifer and mixed tree types are the most effective in removing dust from the air. For all kinds of forest types and stages of leaf growth, the PM2.5 concentration is highest in the morning but lower in the afternoon and evening. Grassland cannot control particles suspended in the air, but can reduce dust pollution caused by dust from the ground blown by the wind back into the air.

Nielsen TS and KB Hansen. 2007. Do green areas affect health? Results from a Danish survey on the use of green areas and health indicators. Health & Place 13(4): 839-50.

The article presents the result from a Danish survey on access and use of green areas and the impact on experienced stress and obesity. The statistical results indicate that access to a garden or short distances to green areas from the dwelling are associated with less stress and a lower likelihood of obesity. The number of visits cannot explain the effects of green areas on the health indicators. It is suggested that the significance of distance to green areas is mainly derived from its correlation with the character of the neighbourhood and its conduciveness to outdoor activities and "healthy" modes of travel.

Nisbet E and M Lem. 2015. Prescribing a dose of nature: modern medicine is rediscovering the simple healing power of being outdoors. Alternatives Journal, 41(2): 36-40.

Psychologist Elizabeth Nisbet explains why greenery takes away the blues. Much or our discourse around environmental issues involves hazards like air and water pollution, deforestation, species extinction or the looming consequences of global climate change. Rarely do we ponder the importance of protecting the natural environment as a mental health resource. Yet, increasingly, scientists from varied disciplines are investigating how interaction with the natural world can improve both physical and psychological health. For those feeling discouraged about the seemingly overwhelming environmental problems we face and the many barriers to changing destructive behaviour, the notion of nature as a source of health, healing and even happiness is exciting. A growing body of evidence points to the importance of green space for mitigating the health hazards associated with urbanization, such as heart disease, respiratory illness, low birth weight, poor immune functioning and higher mortality. Several decades of research in Japan, Korea and Finland have demonstrated that natural and urban environments affect the human stress response differently. People immersed in nature show benefits on a variety of physiological indicators, such as heart rate variability, levels of cortisol (the "fight or flight" hormone), the presence of anti-cancer proteins and the natural killer-ceil activity important for immune functioning. Contact with nature improves mental health as well. People suffering from clinical depression ruminate less and have more positive emotions after walking through an arboretum than after walking in an urban core. Beyond simply reducing stress and ill-being, natural environments can enhance problem solving, concentration and social cohesion. Not surprisingly, in greener communities neighbours interact more with each other and people feel safer and better adjusted. Even brief contact with unspectacular urbanized nature can increase happiness more than we realize. Researchers who asked people to predict in advance what their mood would be like after.

NLM - Cough Accessed April 2016.

Nowak D J, D E Crane, et al. 2006. Air pollution removal by urban trees and shrubs in the United States. Urban Forestry & Urban Greening 4(3-4): 115-123.

A modeling study using hourly meteorological and pollution concentration data from across the coterminous United States demonstrates that urban trees remove large amounts of air pollution that consequently improve urban air quality. Pollution removal (O3, PM10, NO2, SO2, CO) varied among cities with total annual air pollution removal by US urban trees estimated at 711,000 metric tons ($3.8 billion value). Pollution removal is only one of various ways that urban trees affect air quality. Integrated studies of tree effects on air pollution reveal that management of urban tree canopy cover could be a viable strategy to improve air quality and help meet clean air standards.

Nowak D J. 1994. Air Pollution Removal by Chicago's Urban Forest. In McPherson, E. Gregory; Nowak, David J.; Rowntree, Rowan A. eds. 1994. Chicago's urban forest ecosystem: results of the Chicago Urban Forest Climate Project. Gen. Tech. Rep. NE-186. Radnor, PA: U.S. Department of Agriculture, Forest Service, Northeastern Forest Experiment Station: 201 p.

In 1991, trees in the City of Chicago (11 percent tree cover) removed an estimated 15 metric tons (t) (17 tons) of carbon monoxide (CO), 84 t (93 tons) of sulfur dioxide (SO2), 89 t (98 tons) of nitrogen dioxide (NO2), 191 t (210 tons) of ozone (03) , and 212 t (234 tons) of particulate matter less than 10 microns (PMI 0). Across the study region of Cook and DuPage Counties, trees (in-leaf season) removed an average of 1.2 t/day (1.3 tons/day) of CO, 3.7 t/day (4.0 tons/day) of SO2, 4.2 t/day (4.6 tons/day) of NO2, 8.9 t/day (9.8 tons/day) of PM10 and 10.8 t/day (11.9 tons/day) of 03. The value of pollution removal in 1991 was estimated at $1 million for trees in Chicago and $9.2 million for trees across the study area. Average hourly improvement (in-leaf season) in air quality due to all trees in the study area ranged from 0.002 percent for CO to 0.4 percent for PM10. Maximum hourly improvement was estimated at 1.3 percent for SO2, though localized improvements in air quality can reach 5 to 10 percent or greater in areas of relatively high tree cover, particularly under stable atmospheric conditions during the daytime (in-leaf season). Large, healthy trees remove an estimated 60 to 70 times more pollution than small trees. This paper discusses the ways in which urban trees affect air quality, limitations to estimates of pollution removal by trees in the Chicago area, and management considerations for improving air quality with urban trees.

Nowak DJ and DE Crane. 2002. Carbon storage and sequestration by urban trees in the USA. Environmental Pollution 116(3): 381-389.

Based on field data from 10 USA cities and national urban tree cover data, it is estimated that urban trees in the coterminous USA currently store 700 million tonnes of carbon ($14,300 million value) with a gross carbon sequestration rate of 22.8 million tC/yr ($460 million/year). Carbon storage within cities ranges from 1.2 million tC in New York, NY, to 19,300 tC in Jersey City, NJ. Regions with the greatest proportion of urban land are the Northeast (8.5%) and the southeast (7.1%). Urban forests in the north central, northeast, south central and southeast regions of the USA store and sequester the most carbon, with average carbon storage per hectare greatest in southeast, north central, northeast and Pacific northwest regions, respectively. The national average urban forest carbon storage density is 25.1 tC/ha, compared with 53.5 tC/ha in forest stands. These data can be used to help assess the actual and potential role of urban forests in reducing atmospheric carbon dioxide, a dominant greenhouse gas.

Nowak DJ, S Hirabayashi, et al. 2013. Modeled PM2.5 removal by trees in ten U.S. cities and associated health effects. Environmental Pollution 178(0): 395-402.

Urban particulate air pollution is a serious health issue. Trees within cities can remove fine particles from the atmosphere and consequently improve air quality and human health. Tree effects on PM2.5 concentrations and human health are modeled for 10 U.S. cities. The total amount of PM2.5 removed annually by trees varied from 4.7 tonnes in Syracuse to 64.5 tonnes in Atlanta, with annual values varying from $1.1 million in Syracuse to $60.1 million in New York City. Most of these values were from the effects of reducing human mortality. Mortality reductions were typically around 1 person yr-1 per city, but were as high as 7.6 people yr-1 in New York City. Average annual percent air quality improvement ranged between 0.05% in San Francisco and 0.24% in Atlanta. Understanding the impact of urban trees on air quality can lead to improved urban forest management strategies to sustain human health in cities.

Nutsford D, AL Pearson, S Kingham. 2013. An ecological study investigating the association between access to urban green space and mental health. Public Health 127(11): 1005-1011.

Objectives: This study aims to find whether proximity to urban green spaces is associated with human mental health. Study design: A cross-sectional examination of the relationship between access to urban green spaces and counts of anxiety/mood disorder treatments amongst residents (aged 15 years and over) in Auckland City, New Zealand.

Methods: Anxiety/mood disorder treatment counts by three age groups were aggregated to 3149 small area units in Auckland. Six measures of green space access were derived using GIS techniques involving total green spaces and useable green spaces. Negative binomial regression models have been fitted to test the relationship between access to green space and area-level anxiety/mood disorder treatment counts, adjusted for age and area-level deprivation.

Results: Anxiety/mood disorder treatment counts were associated with three green space measures. The proportion of both total and useable green space within 3 km and distance to nearest useable green space all indicated a protective effect of increased access to green space against anxiety/mood disorder treatment counts. Access to total and useable green space within 300 m did not exhibit significant associations.

Conclusion: This study found that decreased distance to useable green space and increased proportion of green space within the larger neighbourhood were associated with decreased anxiety/mood disorder treatment counts in an urban environment. This suggests the benefits of green space on mental health may relate both to active participation in useable green spaces near to the home and observable green space in the neighbourhood environment.

Nuvolone D, D Balzi, et al. 2013. Ozone short-term exposure and acute coronary events: A multicities study in Tuscany (Italy). Environmental Research 126(0): 17-23.

Objective: Many studies have investigated the potential role of ozone exposure in cardiovascular mortality and morbidity. The effects on specific cardiovascular outcome and the role of individual susceptibility are less studied. This paper focuses on the short-term effects of ozone on acute coronary events and it investigates comorbidities as indicators of personal susceptibility.

Setting and patients: This study was conducted in five urban areas of the Tuscany region (Italy) covering the period January 2002-December 2005. Air quality and meteorological data from urban background monitoring sites were collected. Hospital admissions for acute myocardial infarction and out-of-hospital coronary deaths were extracted from administrative database.

Design: Both time series and case-crossover designs were applied. The confounding effects of some time-dependent variables, such as temperature, were taken into account. Some potential susceptibility factors were investigated. Pooled estimates were derived from random-effect meta-analysis.

Results: During the warm season 4555 hospitalized acute myocardial infarctions and 1931 out-of-hospital coronary deaths occurred. Authors estimated a 6.3% (95% confidence interval, 1.2%, 11.7%) increase in out-of-hospital coronary deaths for a 10 micro-g/m3 increase in ozone (lag 0-5). Results also suggested higher risks for females, elderly, and patients previously hospitalized for cerebrovascular and artery diseases.

Conclusions: This study adds further evidence to the relation between cardiovascular diseases and ozone exposure, showing an adverse effect on out-of-hospital coronary deaths, but not on hospitalized acute myocardial infarctions. Some susceptible subgroups, such as females, elderly, and patients affected by some chronic diseases, are likely to be at major risk.


O'Brien L and J Morris. 2014. Well-being for all? The social distribution of benefits gained from woodlands and forests in Britain. Local Environment, 19(4): 356-83.

Well-being is a positive physical, mental and social state and has increasingly become an area of interest to researchers and policy-makers internationally. This paper presents results from research that analyses the well-being benefits gained by different sections of society through viewing, engaging with, and accessing woodlands and forests in Britain. We draw on 31 studies undertaken since 2001 and present a meta-analysis of quantitative data and a meta-synthesis of qualitative data to explore the range of benefits and associated activities in woodlands, and their social distribution. We also present a state-of-the-art typology of well-being benefits for woodlands in Britain. The findings illustrate the wide range of well-being benefits gained by different social groups through various forms of engagement with and activities undertaken in woodlands. We illustrate the wide range of meanings and values attached to trees and woodlands across different social groups. The evidence also illustrates how carefully designed and targeted interventions can be particularly effective in enabling and encouraging people to visit woodland sites, to participate or get involved in new activities and, therefore, to realise a range of well-being benefits.

O'Brien L, J Morris, & A Stewart. 2014. Engaging with peri-urban woodlands in england: The contribution to people's health and well-being and implications for future management. International journal of environmental research and public health, 11(6): 6171-92.

In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin's ideas of co-construction and Gibson's theory of affordances. We focus on peri-urban woodlands in England as important places where people can interact with nature for health and well-being. Qualitative data were collected in situ via walks in the woods, focus group discussions and photo elicitation, with a sample of 49 people. These methods provide rich data on the wide range of meanings associated with woodlands that can have a perceived impact on people's health and well-being. The findings link to contemporary debates about health, well-being and ecosystem services. We explore the inter-play between attributes of the physical environment and the range of facilities provided to enable access, social interactions and the benefits people attribute to their woodland experiences. We conclude that peri-urban woodlands can clearly contribute to self-reported health and well-being in multiple ways, and that organized activities can be important for those who face barriers to accessing woodlands. A strong message emerging from the research is the opportunity afforded by woodlands for social connections with others, as well as the provision of a range of sensory benefits and opportunities to observe and enjoy seasonal change in woodlands. Mental restoration via connection with nature also emerged as important, confirming previous research.

Olmos-Marquez MA, Alarcon-Herrera MT, and IR Martin-Dominguez. 2012. Performance of Eleocharis macrostachya and its importance for arsenic retention in constructed wetlands. Environmental Science and Pollution Research, 19(3): 763-71.


Arsenic (As) can be removed from water via rhizofiltration using phytostabilizing plants. The aim of this study was to investigate the performance of Eleocharis macrostachya in constructed wetland prototypes, as well as the plant's arsenic mass retention and the distribution of As along the wetland flow gradient and the soil in the wetland mesocosmos.

Materials and methods

Experiments were carried out in laboratory-scale wetland prototypes, two planted with E. macrostachya and one without plants. Samples of water were taken at the inlet and outlet of the wetlands during the 33-week test period. At the end of the experiment, plants and soil (silty-sand) from each prototype were divided in three equal segments (entrance, middle and exit) and analyzed for their arsenic content. Results revealed that the planted wetlands have a higher As-mass retention capacity (87-90% of the total As inflow) than prototypes without plants (27%).


As mass balance in the planted wetlands revealed that 78% of the total inflowing As was retained in the soil bed. Nearly 2% was absorbed in the plant roots, 11% was flushed as outflow, and the fate of the remaining 9% is unknown. In the prototype without plants, the soil retained 16% of As mass, 72% of the arsenic was accounted for in the outflow, and 12% was considered unknown. Although E. macrostachya retained only 2% of the total arsenic mass in their roots, its presence was a determining factor for arsenic retention in the wetland soil medium.


Hence, planted wetlands might be a suitable option for treating As-contaminated water.

Orlovsky L, G Tolkacheva, et al. 2004. Dust storms as a factor of atmospheric air pollution in the Aral Sea basin. WIT Transactions on Ecology and the Environment, 74: 353-62

The Aral Sea Basin is considered as a region with increased rates of atmospheric air pollution by aerosols of arid origin. It is conditioned by the aridity of the climate and the presence of a great number of natural sources of aerosols emission to the atmosphere. The average annual number of days with dust storms varies from 20 to 67, while the maximum reaches up to 108-146 days with dust storms in separate years. The dusty and salty aerosol is the indispensable component and satellite of the dust storms in the region. The solonchaks (salty pans), secondary salinized irrigated lands and exposed bottom of the Aral Sea serve as natural sources of such kind of atmospheric pollution. Solonchaks, occupying the area of about 150 thousand km2 of the Aral Basin, create the powerful basis for development of aeolian processes, and, consequently, saltydust emission.

This paper presents the climatic characteristics of the dust storms in the Aral Sea region, and quantitative assessment of salty-dust emission from the Aral Sea surface, its dried off bottom and surrounding solonchaks. Distribution of components of aerosols by the height and remoteness from the sources of emission, routes and distance of transportation of atmospheric aerosols from the dried bottom of the Aral Sea to the adjacent areas are studied.

Ostro BD. 1990. Associations between morbidity and alternative measures of particulate matter. Risk Analysis 10(3): 421-7.

This paper explores the association between acute respiratory morbidity and different measures of exposure to airborne particulate matter, including sulfates, total suspended particulates, and fine and inhalable particulates. Regression analysis was used to test for the impacts of these alternative measures of particulate matter on respiratory morbidity using the 1979 -1981 annual Health Interview Surveys and EPA's Inhalable Particle Monitoring Network. The general results indicate that, of the surrogate measures for particulate matter, sulfates appear to have the greatest association with morbidity. To the extent that sulfuric acid aerosols are correlated with airborne sulfates, the results suggest that respiratory impairment sufficient to lead to days of reduced activity may be related to the existence of acidity in the air. These findings are consistent with the results of ecological studies reporting an association between mortality and exposures to fine particles and sulfates.

Ostro BD. 1994. Estimating health effects of air pollution: a method with an application to Jakarta. P. R. Department. Washington, DC. Working Paper 1301.

To develop efficient strategies for pollution control, it is essential to assess both the costs of control and the benefits that may result. These benefits will often included improvements in public health, including reductions in both morbidity and premature mortality. Until recently, there has been little guidance about how to calculate the benefits of air pollution controls and how to use those estimates to assign priorities to different air pollution control strategies. The author describes a method for quantifying the benefits of reduced ambient concentrations of pollutants (such as ozone and particulate matter) typically found in urban areas worldwide. The author then applies the method to data on Jakarta, Indonesia, an area characterized by little wind, high population concentration (8 million people), congested roads, and ambient air pollution. The magnitude of the benefits of pollution control depend on the level of air pollution, the expected effects on health of the pollutants (dose-response), the size of the population affected and the economic value of these effects. The results for Jakarta suggest that significant benefits result from reducing exposure to both outdoor and indoor air pollutants. For example, if annual concentrations of particulate matter were reduced to the midpoint of the World Health Organization guideline (and former U.S. ambient standard), the estimates indicate a reduction per year of 1,400 premature deaths (with a range of 900 to 1,900), 49,000 emergency room visits, 600,000 asthma attacks, 7.6 million restricted activity days (including work loss), 124,000 cases of bronchitis in children, and 37 million minor respiratory symptoms. In the case of Jakarta, the methodology suggests that reducing exposure to lead and nitrogen dioxide should also be a high priority. An important consequence of ambient lead pollution is a reduction in learning abilities for children, measured as I.Q loss. Apart from that, reducing the proportion of respirable particles can reduce the amount of illness and premature mortality. Clearly, air pollution represents a significant public health hazard to residents of Jakarta and other cities consistently exposed to high levels of air pollution, such as Bangkok, Mexico City, and Santiago, Chile.

Osungbade KO and OK Ige. 2011. Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening. Journal of Pregnancy 2011.

Objectives. Review of public health perspectives of preeclampsia in developing countries and implications for health system strengthening.

Methods. Literature from Pubmed (MEDLINE), AJOL, Google Scholar, and Cochrane database were reviewed.

Results. The prevalence of preeclampsia in developing countries ranges from 1.8% to 16.7%. Many challenges exist in the prediction, prevention, and management of preeclampsia. Promising prophylactic measures like low-dose aspirin and calcium supplementation need further evidence before recommendation for use in developing countries. Treatment remains prenatal care, timely diagnosis, proper management, and timely delivery. Prevailing household, community, and health system factors limiting effective control of preeclampsia in these countries were identified, and strategies to strengthen health systems were highlighted.

Conclusion. Overcoming the prevailing challenges in the control of preeclampsia in developing countries hinges on the ability of health care systems to identify and manage women at high risk.


Paffenbarger RS, R Hyde, et al. 1986. Physical activity, all-cause mortality, and longevity of college alumni. New England Journal of Medicine 314(10): 605-13.

We examined the physical activity and other life-style characteristics of 16,936 Harvard alumni, aged 35 to 74, for relations to rates of mortality from all causes and for influences on length of life. A total of 1413 alumni died during 12 to 16 years of follow-up (1962 to 1978). Exercise reported as walking, stair climbing, and sports play related inversely to total mortality, primarily to death due to cardiovascular or respiratory causes. Death rates declined steadily as energy expended on such activity increased from less than 500 to 3500 kcal per week, beyond which rates increased slightly. Rates were one quarter to one third lower among alumni expending 2000 or more kcal during exercise per week than among less active men. With or without consideration of hypertension, cigarette smoking, extremes or gains in body weight, or early parental death, alumni mortality rates were significantly lower among the physically active. Relative risks of death for individuals were highest among cigarette smokers and men with hypertension, and attributable risks in the community were highest among smokers and sedentary men. By the age of 80, the amount of additional life attributable to adequate exercise, as compared with sedentariness, was one to more than two years.

Pandey AK, M Pandey, et al. 2015. Air pollution tolerance index and anticipated performance index of some plant species for development of urban forest. Urban Forestry & Urban Greening, 14(4): 866-71.

Urban forest is a collection of trees growing in urban area. Green plants are well known for their abilities to reduce air and noise pollution. It is important that plants used for the development of urban forest must be tolerant to air pollutants. There must be some criteria to select tolerant plants for urban forest and for that two indices viz. air pollution tolerance index (APTI) and anticipated performance index (API) can be a good tool. In the present study, 29 plant species commonly found in urban area of Varanasi, India, has been evaluated for their APTI and API. Based on these two indices, the most suitable plant species were identified and recommended for development of urban forest in Varanasi for long-term air pollution abatement. It was revealed that Ficus benghalensis L. and Ficus religiosa would be excellent performers. Similarly Polyalthia longifolia, Ficus glomerata (Roxb.), Anthocephalus indicus and Mangifera indica were estimated to be very good performers. In the similar fashion Cassia fistula L., Drypetes roxburghii, Terminalia arjuna, Psidium guajava L., Millingtonia hortensis and Dalbergia sissoo were estimated to be good performers with respect to anticipated performance index.

Papanastasiou DK, D Melas, & HD Kambezidis. 2015. Air quality and thermal comfort levels under extreme hot weather. Atmospheric Research, 152: 4-13.

Meteorological (T and RH values) and air pollution data (PM10, NO2 and O3 concentrations) observed in Athens, Thessaloniki and Volos were analyzed to assess the air quality and the thermal comfort conditions and to study their synergy, when extreme hot weather prevailed in Greece during the period 2001-2010. The identification of a heat wave day was based on the suggestion made by the IPCC to define an extreme weather event. According to it, a heat wave day is detected when the daily maximum hourly temperature value exceeds its 90th percentile. This temperature criterion was applied to the data recorded at the cities center. Air quality was assessed at three sites in Athens (city center, near the city center, suburb), at two sites in Thessaloniki (city center, suburb) and at one site in Volos (city center), while thermal comfort conditions were assessed at the cities center. Mean pollution levels during the heat wave days and the non-heat wave days were calculated in order to examine the impact of the extreme hot weather on air quality. For this purpose, the distributions of the common air quality index and the exceedances of the air quality standards in force during the heat wave days and the non-heat wave days were also studied. Additionally, the variation of the daily maximum hourly value of Thom's discomfort index was studied in order to investigate the effect of extreme hot weather on people's thermal comfort. Moreover, the values of the common air quality index and Thom's discomfort index were comparatively assessed so as to investigate their synergy under extreme hot weather.

Paquet C, TP Orschulok, et al. 2013. Are accessibility and characteristics of public open spaces associated with a better cardiometabolic health? Landscape and Urban Planning 118(0): 70-78.

This study investigated the associations between the accessibility, greenness, size, and type (active vs. passive) of public open spaces (POS) and clinical risk markers for cardiometabolic diseases and whether such associations could be explained (mediated) by physical activity and psychological well-being. Adult participants (n=3754) provided clinical, self-reported, and residential location data. Cardiometabolic risk was defined as the sum of six anthropometric and biochemical risk markers. POS accessibility was defined as the number and proportion of POS within a 1000-m road distance from participants' residences. Greenness, size and type were respectively defined as the median Normalised Difference Vegetation Index, median size, and proportion of POS with a sporting land use for all accessible POS. Physical activity and psychological well-being were self-reported. Associations were tested using Poisson regression models accounting for spatial clustering of observations and participants' age, gender, education, income and area-level socioeconomic disadvantage. The number and proportion of POS were not found to be statistically significantly related to cardiometabolic health; however, greenness, size, and type (active) of available POS were inversely related to cardiometabolic risk. The association between POS and cardiometabolic health was partially mediated by physical activity. Psychological well-being was not implicated in the associations tested. These results suggest that the characteristics, not the number or proportion, of locally accessible POS are related to cardiometabolic health and, to some degree, physical activity. Maintaining or improving the quality of locally available POS might be a more effective urban design strategy to support cardiometabolic health than efforts to increase the accessibility of POS.

Park B-J., Y Tsunetsugu, et al. 2008. Physiological effects of Shinrin-yoku (taking in the atmosphere of the forest) in a mixed forest in Shinano Town, Japan. Scandinavian Journal of Forest Research 23(3): 278-283.

Abstract The purpose of this study was to examine the physiological effects of Shinrin-yoku (taking in the atmosphere of the forest). The subjects were 12 male university students. On the first day of the experiments, six subjects went to the forest area, and the other six went to a city area as a control. On the second day, subjects went to the opposite areas as a cross-check. In the afternoon, they were seated on chairs watching the landscapes of their given area for 15 min. Heart rate variability (HRV), salivary cortisol and pulse rate were measured as physiological indices in the morning and in the evening at the place of accommodation, before and after watching the landscapes in the field areas. The high-frequency power of HRV of subjects in the forest area was significantly higher than that of subjects in the city area. The pulse rate of subjects in the forest area was significantly lower than that of subjects in the city area. The salivary cortisol concentration of the subjects in the forest area was significantly lower than that of subjects in the city area. The results of physiological measurements show that Shinrin-yoku was an effective form of relaxation.

Passmore HA and AJ Howell. 2014. Eco-existential positive psychology: Experiences in nature, existential anxieties, and well-being. The Humanistic Psychologist, 42(4): 370-88.

Numerous scholars have explored the notion that our relationship with nature is essential to our well-being, and some have suggested that we have an evolved inclination to affiliate with nature. A substantial body of research supports these hypotheses, and demonstrates both the restorative and additive capacity of affiliating with nature. This article posits that experiences with the natural environment play a fundamentally important role in addressing the 6 existential anxieties of identity, happiness, isolation, meaning in life, freedom, and death--a perspective that we call Eco-Existential Positive Psychology. Moreover, we propose that affiliating with nature affords us the opportunity to be fully flourishing human beings. This article provides supporting evidence for Eco-Existential Positive Psychology via an interdisciplinary literature review.

Pataki et al. 2011. Coupling biogeochemical cycles in urban environments: ecosystem services, green solutions, and misconceptions. Front Ecol Environ 2011; 9(1): 27-36.

Urban green space is purported to offset greenhouse-gas (GHG) emissions, remove air and water pollutants, cool local climate, and improve public health. To use these services, municipalities have focused efforts on designing and implementing ecosystem-services-based "green infrastructure" in urban environments. In some cases the environmental benefits of this infrastructure have been well documented, but they are often unclear, unquantified, and/or outweighed by potential costs. Quantifying biogeochemical processes in urban green infrastructure can improve our understanding of urban ecosystem services and disservices (negative or unintended consequences) resulting from designed urban green spaces. Here we propose a framework to integrate biogeochemical processes into designing, implementing, and evaluating the net effectiveness of green infrastructure, and provide examples for GHG mitigation, stormwater runoff mitigation, and improvements in air quality and health.

Peacock J, R Hine, J Pretty. 2007. Got the blues, then find some greenspace: The mental health benefits of green exercise activities and green care. Wivenhoe Park, Colchester, Centre for Environment and Society, Department of Biological Sciences, University of Essex.

No abstract provided.

Penna MLF and MP Duchiade. 1991. Air pollution and infant mortality from pneumonia in the Rio de Janeiro metropolitan area. Bulletin of the Pan American Health Organization (United States); (WHO); 25(1): 47-54.

The authors report the results of an investigation into the possible association between air pollution and infant mortality from pneumonia in the Rio de Janeiro Metropolitan Area. This investigation employed multiple linear regression analysis (stepwise method) for infant mortality from pneumonia in 1980, including the study population's areas of residence, incomes, and pollution exposure as independent variables. With the income variable included in the regression, a statistically significant association was observed between the average annual level of particulates and infant mortality from pneumonia. While this finding should be accepted with caution, it does suggest a biological association between these variables. The authors' conclusion is that air quality indicators should be included in studies of acute respiratory infections in developing countries.

Pereira G, H Christian, et al. 2013. The association between neighborhood greenness and weight status: an observational study in Perth Western Australia. Environ Health 12(49): 1-9.

BACKGROUND: Few studies have examined the relationship between weight status and objectively measured neighborhood greenness and no study has examined this relationship across the different stages of adulthood): This research was an investigation of weight status and neighborhood greenness using objectively measured satellite remote sensing for a large population representative sample.

METHOD: Cross-sectional study of 10,208 young adults (16-24 years), mid-age adults (25-64 years) and older adults (65+ years) from a population representative sample for the period 2004-2009 in Perth, Western Australia. Neighborhood greenness was ascertained for a 1600m road network service area around each participant's address using the mean and standard deviation of the Normalized Difference Vegetation Index (NDVI) obtained from remote sensing. Multiple logistic regression was used to assess associations with weight status (overweight-or-obese, obese) adjusted for socio-demographics and health-related behaviors.

RESULTS: The adjusted odds ratio (OR) comparing obesity in the highest to the lowest tertile of mean greenness was 0.78 (95% CI 0.69-0.89). For the same comparison, the OR for overweight-or-obese was similar, 0.84 (95% CI 0.76-0.92). The OR comparing obesity in the highest to lowest tertile of variation in greenness was 0.75 (95% CI 0.66-0.85). For the same comparison, the OR for overweight-or-obese was similar, 0.75 (95% CI 0.68-0.82).,

CONCLUSION: Higher levels and greater variation of neighborhood greenness are associated with lower odds of obesity among adults of all ages. Research examining neighborhood characteristics correlated with variability in greenness will help better understand these relationships.

Pereira G, S Foster, et al. 2012. The association between neighborhood greenness and cardiovascular disease: an observational study. BMC Public Health 12(1): 466.

BACKGROUND:Previous studies have demonstrated links between cardiovascular disease and physical inactivity and poor air quality, which are both associated with neighborhood greenness. However, no studies have directly investigated neighborhood greenness in relation to coronary heart disease risk. We investigated the effect of neighborhood greenness on both self-reported and hospital admissions of coronary heart disease or stroke, accounting for ambient air quality, socio-demographic, behavioral and biological factors.

METHOD:Cross-sectional study of 11,404 adults obtained from a population representative sample for the period 2003-2009 in Perth, Western Australia. Neighborhood greenness was ascertained for a 1600m service area surrounding the residential address using the mean and standard deviation of the Normalized Difference Vegetation Index (NDVI) obtained from remote sensing. Logistic regression was used to assess associations with medically diagnosed and hospitalization for coronary heart disease or stroke.

RESULTS:The odds of hospitalization for heart disease or stroke was 37% (95% CI: 8%, 57%) lower among adults in neighborhoods with highly variable greenness (highest tertile) compared to those in predominantly green, or predominantly non-green neighborhoods (lowest tertile). This effect was independent of the absolute levels of neighborhood greenness. There was weaker evidence for associations with the mean level of neighborhood greenness.

CONCLUSION:Variability in neighborhood greenness is a single metric that encapsulates two potential promoters of physical activity - an aesthetically pleasing natural environment and access to urban destinations. Variability in greenness within a neighborhood was negatively associated with coronary heart disease and stroke.

Peschardt KK, UK Stigsdotter, & J Schipperrijn. 2016. Identifying features of pocket parks that may be related to health promoting use. Landscape Research, 41(1): 79-94.

Urban green spaces have been shown to promote health and well-being and recent research indicates that the two primary potentially health promoting uses of pocket parks are 'rest and restitution' and 'socialising'. The aim of this study is to identify features in pocket parks that may support these uses. The relationship between the two types of use and the shape, size, noise level, greenness, as well as 'elements' (paved and unpaved trails, cafe, historical feature, table, other seating than benches, flowerbeds, view outside park, playground) in nine pocket parks in Copenhagen were analysed. The results show that 'green features' do not seem to be of crucial importance for 'socialising' whereas, as expected, features promoting gathering should be prioritised. For 'rest and restitution', the main results show that 'green ground cover' and 'enclosed green niches' are important, while 'disturbing features' (playground, view outside park) should be avoided. The results add knowledge about the features which support the health promoting use of pocket parks to the existing body of research.

Peschardt, K., & Stigsdotter, U. (2014). Evidence for Designing Health Promoting Pocket Parks. International Journal of Architectural Research: ArchNet-IJAR, 8(3), 149-164.

The use of urban green environments has repeatedly been associated with improved health and well-being for people living in cities. This study focuses on the health promoting potential of pocket parks in the dense city area of Copenhagen. A natural experiment was conducted, which evaluated one pocket park, Dantes Plads, before and after a redesign. Six people were interviewed about their perception of the change. First of all, the results show that Dantes Plads is primarily used for 'rest and restitution'. Furthermore, the interviewees prefer to have the presence of sun, shade and planting in relation to rest and restitution, while varied 'terrain' may create fascination thereby providing the opportunity for restoration. 'Noise level' is perceived differently from subject to subject, while 'benches' as well as 'visual angels' should not be oriented directly towards disturbing surroundings. The findings add to existing knowledge on the design of health promoting pocket parks for 'rest and restitution' in dense city areas.

Pickett STA, ML Cadenasso, AM Grove, CH Nilon, RV Pouyat, WC Zipper & R Costanza. 2001. Urban Ecological Systems: Linking Terrestrial, Ecological, Physical, and Socioeconomic Components of Urban Areas. Annu. Rev. Ecol. Syst. 2001. 32:127-57.

Ecological studies of terrestrial urban systems have been approached along several kinds of contrasts: ecology in as opposed to ecology of cities; biogeochemical compared to organismal perspectives, land use planning versus biological, and disciplinary versus interdisciplinary. In order to point out how urban ecological studies are poised for significant integration, we review key aspects of these disparate literatures. We emphasize an open definition of urban systems that accounts for the exchanges of material and influence between cities and surrounding landscapes. Research on ecology in urban systems highlights the nature of the physical environment, including urban climate, hydrology, and soils. Biotic research has studied flora, fauna, and vegetation, including trophic effects of wildlife and pets. Unexpected interactions among soil chemistry, leaf litter quality, and exotic invertebrates exemplify the novel kinds of interactions that can occur in urban systems. Vegetation and faunal responses suggest that the configuration of spatial heterogeneity is especially important in urban systems. This insight parallels the concern in the literature on the ecological dimensions of land use planning. The contrasting approach of ecology of cities has used a strategy of biogeochemical budgets, ecological footprints, and summaries of citywide species richness. Contemporary ecosystem approaches have begun to integrate organismal, nutrient, and energetic approaches, and to show the need for understanding the social dimensions of urban ecology. Social structure and the social allocation of natural and institutional resources are subjects that are well understood within social sciences, and that can be readily accommodated in ecosystem models of metropolitan areas. Likewise, the sophisticated understanding of spatial dimensions of social differentiation has parallels with concepts and data on patch dynamics in ecology and sets the stage for comprehensive understanding of urban ecosystems. The linkages are captured in the human ecosystem framework.

Pilotti M, E Klein, et al. 2015. Is viewing a nature video after work restorative? Effects on blood pressure, task performance, and long-term memory. Environment and Behavior, 47(9): 947-69.

Can a brief exposure to nature at the end of a workday enhance sustained attention and long-term memory? Student advisors viewed a video of either a natural environment or a busy city street after work. Then they performed a tone-detection task that was intended to mimic a key feature of their job (being on the telephone). After the nature video, systolic blood pressure increased and response latencies remained stable across time. After the city video, systolic blood pressure remained unchanged from baseline, whereas response latencies increased over time. Self-reports of arousal and emotional state did not differ significantly between videos, whereas memory of the experimental setting was better after viewing the nature video. In sum, a brief contact with nature at the end of a workday may give an individual vigor to complete additional tasks but not improve his or her affect.

Pisello AL, C Piselli, and F Cotana. 2015. Thermal-physics and energy performance of an innovative green roof system: The Cool-Green Roof. Solar Energy, 116: 337-56.

Given the large amount of worldwide energy use associated to buildings' life cycle, in recent years various energy efficient strategies have been proposed to reduce buildings' environmental impact, e.g. green and cool roofs. The purpose of this work is to analyze an innovative type of green roof, named Cool-Green Roof combining the features of both green and cool roofs. In fact, it is characterized by a specific vegetative layer able to optimize the quote of short-wave radiation reflected by the selected vegetation. After the analytical dissertation of the system, the developed solution is studied when applied in a case study building represented by a multifamily XVI century building in central Italy, characterized by cement based roof ceiling needing to be retrofitted. Both in-lab and in-field experimental analyses were carried out for evaluating the building thermal-physics and the solar reflectance and thermal emittance of the selected plant compared to other flat roof materials and greeneries. Additionally, the year-round performance of Cool-Green Roof is assessed through calibrated and validated dynamic thermal-energy simulation. Main findings of the study show how the Cool-Green Roof is able to reduce the number of indoor overheating hours in summer by 98.2%, with negligible penalties in winter, given its high insulation capability, typical of green roof solutions. Therefore, the Cool-Green Roof could be considered as (i) a strategy for roof retrofitting in existing (even historic) buildings, and (ii) a solution for improving urban environment quality. Finally, the Cool-Green Roof could represent a promising mitigation strategy against urban heat island phenomenon, suitable for application even in those dense historical cities where other invasive mitigation techniques are unlikely applicable.

Pitts SBJ, MB Edwards, et al. 2013. Obesity is inversely associated with natural amenities and recreation facilities per capita. Journal of physical activity & health 10(7): 1032-1038.

Background: Little is known about the associations between natural amenities, recreation facility density, and obesity, at a national level. Therefore, the purpose of this paper was to examine associations between county-level natural amenities, density of recreation facilities, and obesity prevalence among United States counties.

Methods: Data were obtained from a compilation of sources within the United States Department of Agriculture Economic Research Service Food Environment Atlas. Independent variables of interest were the natural amenities scale and recreation facilities per capita. The dependent variable was county-level obesity prevalence. Potential covariates included a measure of county-level percent Black residents, percent Hispanic residents, median age, and median household income. All models were stratified by population loss, persistent poverty, and metro status. Multilevel linear regression models were used to examine the association between obesity and natural amenities and recreation facilities, with "state" as a random effects second level variable.

Results: There were statistically significant negative associations between percent obesity and 1) natural amenities and 2) recreation facilities per capita. Conclusions: Future research should examine environmental and policy changes to increase recreation facilities and enhance accessible natural amenities to decrease obesity rates.

Plane J, F Klodawsky. 2013. Neighbourhood amenities and health: Examining the significance of a local park. Social Science & Medicine 99(0): 1-8.

This paper reports the results of a qualitative study that examines the links between neighbourhood spaces and quality of life for nine formerly homeless women who live in a supportive housing development in Ottawa, Ontario. It explores a local park that participants subjectively identified as the most meaningful place influencing their health and quality of life. Looking at the neighbourhood from the participants' perspectives, this paper discusses the links between access to nearby urban green space, feelings of well-being, and having a sense of belonging to the broader community. The primary methods used in our study were photovoice, whereby participants were asked to take pictures of both healthy and unhealthy aspects of their neighbourhood, and participant observation of the women's interactions with their immediate and neighbourhood living environments. The participants used photographs as a tool to help describe their experiences of the park as not only a therapeutic or health-promoting place, but also an un-therapeutic or health-denying place. Participant observation helped fill the gaps that women were unable to articulate in the interviews. The results reveal that participants placed more emphasis on inclusive (free of charge) social events and the ability to interact with others at the park than on its aesthetics. This finding supports the notion that while beautification certainly has value, resources to support free community events in public spaces are at least equally important for establishing feelings of inclusion in the community among marginalized populations.

Plante TG, C Cage, et al. 2006. Psychological benefits of exercise paired with virtual reality: outdoor exercise energizes whereas indoor virtual exercise relaxes. International Journal of Stress Management 13(1): 108-17.

In the present study the authors sought to evaluate the psychological effects of exercise when paired with virtual reality. One-hundred and twelve introductory psychology students (47 male and 65 female) were randomly assigned to one of three 20-min experimental conditions including (a) taking a brisk outdoor walk around a college campus, (b) walking on a laboratory treadmill combined with a virtual reality video presentation of the same college campus walk, or (c) viewing the virtual reality walk without participating in any actual exercise. Several standardized mood and enjoyment measures were administered immediately before and after the experimental conditions. Results suggest that greater energy was experienced while walking outside whereas less energy was reported when viewing the virtual reality walk with no actual exercise. These findings were most pronounced for female participants. Both female and male participants walking in the laboratory with the virtual reality were more relaxed and experienced the least tension of the three conditions.

Pliakas T, P Wilkinson, & C Tonne. 2014. Contribution of the physical environment to socioeconomic gradients in walking in the Whitehall II study. Health & place, 27: 186-93.

Socioeconomic gradients in walking are well documented but the underlying reasons remain unclear. We examined the contribution of objective measures of the physical environment at residence to socioeconomic gradients in walking in 3363 participants (50-74 years) from the Whitehall II study (2002-2004). Individual-level socioeconomic position was measured as most recent employment grade. The contribution of multiple measures of the physical environment to socioeconomic position gradients in self-reported log transformed minutes walking/week was examined by linear regression. Objective measures of the physical environment contributed only to a small extent to socioeconomic gradients in walking in middle-aged and older adults living in Greater London, UK. Of these, only the number of killed and seriously injured road traffic casualties per km of road was predictive of walking. More walking in areas with high rates of road traffic casualties per km of road may signal an effect not of injury risk but of more central locations with multiple destinations within short distances ('compact neighbourhoods'). This has potential implications for urban planning to promote physical activity.

Poloniecki JD, RW Atkinson, et al. 1997. Daily time series for cardiovascular hospital admissions and previous day's air pollution in London, UK. Occupational and Environmental Medicine 54(8): 535-40.

OBJECTIVE: To test for a significant association between air pollution and emergency hospital admissions for circulatory diseases (international classification of diseases-9 390-459) in London, England, that would be consistent with a causal effect of pollution on the previous day.

METHODS: Long term concurrent trends, temperature, humidity, day of the week, influenza epidemic of 1989, and cyclical covariations with periodicity < 20 days in daily measures of pollution and admissions for 1987-94 were allowed for.

RESULTS: There were 373556 admissions. No association was found between O3 and circulatory diseases. Four other pollutants were associated with acute myocardial infarction and circulatory diseases combined. P values and attributable cases (95% confidence intervals) for acute myocardial infarction were: black smoke P = 0.003, 2.5% (0.8% to 4.3%); NO2 P = 0.002, 2.7% (0.8% to 4.6%); CO P = 0.001, 2.1% (0.7% to 3.5%); and SO2 P = 0.0006, 1.7% (0.7% to 2.6%). There were also associations between black smoke and angina (P = 0.02), NO2 and arrhythmia (P = 0.04), and CO and other circulatory diseases (P = 0.004), but none with heart failure. Acute myocardial infarction was the only diagnosis for which there were significant associations with and without adjustment for cyclical terms. The associations with acute myocardial infarction were significant only in the cool season.

CONCLUSION: Population data were consistent with 1 in 50 heart attacks currently presenting at London hospitals being triggered by outdoor air pollution. Further research is now needed to investigate whether background concentrations of black smoke, NO2, CO, and SO2 are a preventable cause of myocardial infarction. These results, if applied to all myocardial infarctions in the United Kingdom, indicate a potential saving of 6000 heart attacks a year.

Ponka A and M Virtanen. 1994. Chronic bronchitis, emphysema, and low-level air pollution in Helsinki, 1987-1989. Environmental Research 65(2): 207-217.

The effects of low levels of air pollution and weather conditions on the number of patients admitted to hospitals for exacerbation of chronic bronchitis or emphysema (n = 2807) was studied in Helsinki during a 3-year period, 1987-1989. The daily number of admissions via the emergency room was significantly associated with prevailing levels of sulfur dioxide (SO2) and nitrogen dioxide (NO2) in Poisson regressions controlled for weather, season, time trends, and day of the week, whereas the total number of admissions (via the emergency room and otherwise) was not significantly associated with these pollutants. The effect of SO, was observed only among those under 65 years old; a significant peak of admissions was seen during the same day (RR, 1.31 for a 2.7-fold increase in SO2; 95% CI, 1.01-1.70; P = 0.039), and another after a 3-day lag (RR, 1.39; 95% CI, 1.05-1.86; P = 0.021). The effect of NO2 was strongest after a 6-day lag and was significant only among those over 64 years old (RR, 1.31;95% CI, 1.03-1.66; P = 0.022). The average of mean 24-hr concentrations of NO, was 39 micro-g/m3 (0.021 ppm) and that for SO2 was 19 micro-g/m3 (0.0067 ppm). No relationship was found between admissions and the concentrations of total suspended particulates (TSP) or ozone (O3), the temperature, or the relative humidity. However, the number of admissions among those over 64 years of age was significantly lower, irrespective of temperature, during the summer than during other seasons. The mean daily concentration of O3 was fairly low (22 micro-g/m3 or 0.011 ppm), but that of TSP was high, 76 micro-g/m3. The mean temperature was low, +4.7C. These results suggest that SO2 and NO2 concentrations lower than those given as guidelines in many countries, and lower than previously shown, may increase the incidence of symptoms in some patients with chronic bronchitis or emphysema.

Pope 3rd CA, MJ Thun, et al. 1995. Particulate air pollution as a predictor of mortality in a prospective study of U.S. adults. Am. J. Respir. Crit. Care Med. 151(3): 669-74.

Time-series, cross-sectional, and prospective cohort studies have observed associations between mortality and particulate air pollution but have been limited by ecologic design or small number of subjects or study areas. The present study evaluates effects of particulate air pollution on mortality using data from a large cohort drawn from many study areas. We linked ambient air pollution data from 151 U.S. metropolitan areas in 1980 with individual risk factor on 552,138 adults who resided in these areas when enrolled in a prospective study in 1982. Deaths were ascertained through December, 1989. Exposure to sulfate and fine particulate air pollution, which is primarily from fossil fuel combustion, was estimated from national data bases. The relationships of air pollution to all-cause, lung cancer, and cardiopulmonary mortality was examined using multivariate analysis which controlled for smoking, education, and other risk factors. Although small compared with cigarette smoking, an association between mortality and particulate air pollution was observed. Adjusted relative risk ratios (and 95% confidence intervals) of all-cause mortality for the most polluted areas compared with the least polluted equaled 1.15 (1.09 to 1.22) and 1.17 (1.09 to 1.26) when using sulfate and fine particulate measures respectively. Particulate air pollution was associated with cardiopulmonary and lung cancer mortality but not with mortality due to other causes. Increased mortality is associated with sulfate and fine particulate air pollution at levels commonly found in U.S. cities. The increase in risk is not attributable to tobacco smoking, although other unmeasured correlates of pollution cannot be excluded with certainty.

Pope 3rd, CA, RT Burnett, et al. 2002. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. Journal of the American Medical Association 287(9): 1132-41.

Context: Associations have been found between day-to-day particulate air pollution and increased risk of various adverse health outcomes, including cardiopulmonary mortality. However, studies of health effects of long-term particulate air pollution have been less conclusive.

Objective: To assess the relationship between long-term exposure to fine particulate air pollution and all-cause, lung cancer, and cardiopulmonary mortality.

Design, Setting, and Participants: Vital status and cause of death data were collected by the American Cancer Society as part of the Cancer Prevention II study, an ongoing prospective mortality study, which enrolled approximately 1.2 million adults in 1982. Participants completed a questionnaire detailing individual risk factor data (age, sex, race, weight, height, smoking history, education, marital status, diet, alcohol consumption, and occupational exposures). The risk factor data for approximately 500 000 adults were linked with air pollution data for metropolitan areas throughout the United States and combined with vital status and cause of death data through December 31, 1998.

Main Outcome Measure: All-cause, lung cancer, and cardiopulmonary mortality.

Results: Fine particulate and sulfur oxiderelated pollution were associated with all-cause, lung cancer, and cardiopulmonary mortality. Each 10-g/m3 elevation in fine particulate air pollution was associated with approximately a 4%, 6%, and 8% increased risk of all-cause, cardiopulmonary, and lung cancer mortality, respectively. Measures of coarse particle fraction and total suspended particles were not consistently associated with mortality.

Conclusion: Long-term exposure to combustion-related fine particulate air pollution is an important environmental risk factor for cardiopulmonary and lung cancer mortality.

Popek R, H Gawronska, et al. 2013. Particulate matter on foliage of 13 woody species: Deposition on surfaces and phytostabilisation in waxes - a 3-year study. International Journal of Phytoremediation 15(3): 245-256.

Particulate matter (PM) as an air pollutant can be harmful for human health through allergic, mutagenic and carcinogenic effects. Although the main focus is on decreasing air pollution, after PM has been emitted to the atmosphere, one of the realistic options to decrease it's concentrations in urbanized area will be phytoremediation. This study compared the capacity to capture PM from air of seven tree species commonly cultivated in Poland (Catalpa bignonioides Walter, Corylus colurna L., Fraxinus pennsylvanica Marsh., Ginkgo biloba L., Platanus x hispanica Mill. ex Muenchh., Quercus rubra L., Tilia tomentosa Moench 'Brabant') and six shrub species (Acer tataricum subsp. ginnala (Maxim.) Wesm., Sambucus nigra L., Sorbaria sorbifolia (L.) A.Br., Spiraea japonica L.f., Syringa meyeri C.K. Schneid. 'Palibin', Viburnum lantana L.). Significant differences were found between species in mass of total PM accumulation for two PM categories and three size fractions determined and in amount of waxes. A positive correlation was found between in-wax PM of diameter 2.5-10 micro-m and amount of waxes, but not between amount of waxes and amount of total PM or of any size fraction.

Potchter O and HI Ben-Shalom. 2013. Urban warming and global warming: Combined effect on thermal discomfort in the desert city of Beer Sheva, Israel. Journal of arid environments, 98: 113-22.

The effect of climatic changes on human comfort levels was investigated through examination and statistical analysis of long-term trends in human discomfort during summer months in the desert city of Beer Sheva, Israel and in the adjacent rural area of Wadi Hatzerim. In an era of global warming, the urban warming effect is likely to be amplified and as a result increase human discomfort, especially during summer.

Climate data for the city of Beer Sheva over the last 40 years shows an increase of temperature and air humidity in comparison to the surrounding rural area. Wind velocity data for Wadi Hatzerim show that changes are inconstant and not significant, while in Beer Sheva, wind velocity is significantly reduced. Two indices - the Discomfort Index (DI) and Physiological Equivalent Air temperature (PET) - were used to evaluate the effect of these climatic changes on human discomfort. Although the bio-meteorological indices showed the same tendency of increasing heat stress values and duration, in Beer Sheva they were more pronounced and more significant than in the desert environment. The study concludes that these combined climatic effects negatively impact human comfort and are more noticeable in desert cities at peak daytime hours during summer.

Poulsen DV, UK Stigsdotter & AD Refshage. 2015. Whatever happened to the soldiers? Nature-assisted therapies for veterans diagnosed with post-traumatic stress disorder: A literature review. Urban Forestry & Urban Greening, 14(2): 438-45.

Nature-assisted therapy (NAT) has become more common and recognized in both practice and research. The literature often describes how NAT gradually emerged in the UK and the US offering rehabilitation of soldiers suffering from traumatic experiences after active service in WW I and WW II. The main question of this review is to investigate what happened to this patient group? Consequently the aim is to systematically review: The literature; the evidence level; the health outcomes; and the transmissibility of the therapy programmes and results for practitioners. The review describes the development and status of practice and research concerning NAT for veterans with post-traumatic stress disorder (PTSD).

The systematic review included a seven-step literature search. Relevant data sources were scrutinized in order to retrieve literature meeting the predefined inclusion criteria. Due to the limited amount of peer-reviewed literature, non-peer-reviewed literature was also included in the review.

The final selection yielded eleven peer reviewed and nine non-peer-reviewed publications. Three can be characterized as RCT studies, while the remainder is qualitative case studies. Eight themes emerged from the systematic analysis of the qualitative case studies. This review found that a large amount of projects offering NAT to veterans suffering from PTSD exist in many parts of the world and they present no adverse negative results.

Recommendations for future practice and research are posed.

Powell H, JR Krall, et al. 2015. Ambient coarse particulate matter and hospital admissions in the medicare cohort air pollution study, 1999-2010. Environmental health perspectives, 123(11): 1152.

Background In recent years a number of studies have examined the short-term association between coarse particulate matter (PM10-2.5) and mortality and morbidity outcomes. These studies, however, have produced inconsistent conclusions.

Objectives We estimated both the national- and regional-level associations between PM10-2.5 and emergency hospitalizations for both cardiovascular and respiratory disease among Medicare enrollees >=65 years of age during the 12-year period 1999 through 2010.

Methods Using air pollution data obtained from the U.S. Environmental Protection Agency air quality monitoring network and daily emergency hospitalizations for 110 large urban U.S. counties assembled from the Medicare Cohort Air Pollution Study (MCAPS), we estimated the association between short-term exposure to PM10-2.5 and hospitalizations using a two-stage Bayesian hierarchical model and Poisson log-linear regression models.

Results A 10-µg/m³ increase in PM10-2.5 was associated with a significant increase in same-day cardiovascular hospitalizations [0.69%; 95% posterior interval (PI): 0.45, 0.92]. After adjusting for PM2.5, this association remained significant (0.63%; 95% PI: 0.38, 0.88). A 10-µg/m³ increase in PM10-2.5 was not associated with a significant increase in respiratory-related hospitalizations.

ConclusionsWe found statistically significant evidence that daily variation in PM10-2.5 is associated with emergency hospitalizations for cardiovascular diseases among Medicare enrollees >=65 years of age. This association was robust to adjustment for concentrations of PM2.5.

Power MC, MA Kioumourtzoglou, et al. 2015. The relation between past exposure to fine particulate air pollution and prevalent anxiety: observational cohort study, 350.

Objective To determine whether higher past exposure to particulate air pollution is associated with prevalent high symptoms of anxiety.

Design Observational cohort study.

Setting Nurses' Health Study.

Participants 71,271 women enrolled in the Nurses' Health Study residing throughout the contiguous United States who had valid estimates on exposure to particulate matter for at least one exposure period of interest and data on anxiety symptoms.

Main outcome measures Meaningfully high symptoms of anxiety, defined as a score of 6 points or greater on the phobic anxiety subscale of the Crown-Crisp index, administered in 2004.

Results The 71,271 eligible women were aged between 57 and 85 years (mean 70 years) at the time of assessment of anxiety symptoms, with a prevalence of high anxiety symptoms of 15%. Exposure to particulate matter was characterized using estimated average exposure to particulate matter <2.5 µm in diameter (PM2.5) and 2.5 to 10 µm in diameter (PM2.5-10) in the one month, three months, six months, one year, and 15 years prior to assessment of anxiety symptoms, and residential distance to the nearest major road two years prior to assessment. Significantly increased odds of high anxiety symptoms were observed with higher exposure to PM2.5 for multiple averaging periods (for example, odds ratio per 10 µg/m³ increase in prior one month average PM2.5: 1.12, 95% confidence interval 1.06 to 1.19; in prior 12 month average PM2.5: 1.15, 1.06 to 1.26). Models including multiple exposure windows suggested short term averaging periods were more relevant than long term averaging periods. There was no association between anxiety and exposure to PM2.5-10. Residential proximity to major roads was not related to anxiety symptoms in a dose dependent manner.

Conclusions Exposure to fine particulate matter (PM2.5) was associated with high symptoms of anxiety, with more recent exposures potentially more relevant than more distant exposures. Research evaluating whether reductions in exposure to ambient PM2.5would reduce the population level burden of clinically relevant symptoms of anxiety is warranted.

Power MC, MG Weisskopf, et al. 2010. Traffic-related air pollution and cognitive function in a cohort of older men. Environmental Health Perspectives 119(5):682-7.

Background: Traffic-related particles induce oxidative stress and may exert adverse effects on central nervous system function, which could manifest as cognitive impairment. Objective: To assess the association between black carbon (BC), a marker of traffic-related air pollution, and cognition in older men.

Methods: 680 men (mean age (SD): 71 (7)) from the VA Normative Aging Study completed a battery of 7 cognitive tests at least once between 1996 and 2007. We assessed long-term exposure to traffic-related air pollution using a validated spatiotemporal land-use regression model for BC.

Results: The association between BC and cognition was non-linear and BC estimates were logtransformed for all analyses (ln(BC)). In a multivariable-adjusted model, for each doubling in BC on the natural scale, the odds of having an MMSE score at or below 25 was 1.3 times higher (95% confidence interval (95%CI): 1.1, 1.6). In a multivariable-adjusted model for global cognitive function, which combined scores from the remaining 6 tests, a doubling of BC was associated with a 0.054 standard deviation lower test score (95%CI: -0.103, -0.006), an effect size similar to that observed with a difference in age of 1.9 years in our data. There was no evidence of heterogeneity by cognitive test. In sensitivity analyses adjusting for past lead exposure, the association with MMSE scores was similar (OR: 1.3, 95%CI: 1.1, 1.7) but the association with global cognition was somewhat attenuated (-0.038 per doubling in BC, 95%CI: -0.089, 0.012).

Conclusions: Ambient traffic-related air pollution was associated with decreased cognitive function in older men.

Prendez M, V Carvajal, et al. 2013. Biogenic volatile organic compounds from the urban forest of the Metropolitan Region, Chile. Environmental Pollution 183(0): 143-150.

Tropospheric ozone is a secondary pollutant whose primary sources are volatile organic compounds and nitrogen oxides. The national standard is exceeded on a third of summer days in some areas of the Chilean Metropolitan Region (MR). This study reports normalized springtime experimental emissions factors (EF) for biogenic volatile organic compounds from tree species corresponding to approximately 31% of urban trees in the MR. A Photochemical Ozone Creation Index (POCI) was calculated using Photochemical Ozone Creation Potential of quantified terpenes. Ten species, natives and exotics, were analysed using static enclosure technique. Terpene quantification was performed using GC-FID, thermal desorption, cryogenic concentration and automatic injection. Observed EF and POCI values for terpenes from exotic species were 78 times greater than native values; within the same family, exotic EF and POCI values were 28 and 26 times greater than natives. These results support reforestation with native species for improved urban pollution management.

Prescott GJ, GR Cohen, et al. 1998. Urban air pollution and cardiopulmonary ill health: a 14.5 year time series study. Occupational and Environmental Medicine 55(10): 697-4.

OBJECTIVES: To examine possible associations between daily concentrations of urban air pollutants and hospital emergency admissions and mortality due to cardiac and pulmonary disease.

METHODS: A time series study was conducted in the City of Edinburgh, which has a population of about 450,000. Poisson log linear regression models were used to investigate the relation of the daily event rate with daily air pollution concentrations of sulphur dioxide (SO2) and black smoke from 1981 to 1995, and of nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO), and particulate matter (PM10) from 1992 to 1995. Adjustments were made for seasonal and weekday variation, daily temperature, and wind speed.

RESULTS: The most significant findings were positive associations over the period 1981-95 between black smoke as a mean of the previous three days and daily all cause mortality in people aged < or = 65, and respiratory mortality also in this age group (3.9% increase in mortality for a 10 micro-grams/m3 increment in black smoke). For hospital emergency admissions between 1992 and 1995 the two most significant findings (p > 0.05) were for cardiovascular admissions of people aged < or = 65 which showed a positive association with PM10 as a mean of the 3 previous days, and a negative association with O3 as a mean of the previous three days. Analyses of outcomes based on linkage with previous cardiorespiratory emergency admissions did not show substantially different results.

CONCLUSION: These data suggest that in the City of Edinburgh, after correction for confounders, there was a small but significant association between concentrations of black smoke and respiratory mortality in the older age group, probably attributable to higher pollution levels in the early part of the study period. There were also generally weak and variable associations between day to day changes in concentrations of urban air pollutants at a single central point and emergency hospital admission rates from cardiac and respiratory disease.

Pretty J, J Peacock, et al. 2005. The mental and physical health outcomes of green exercise. International Journal of Environmental Health Research 15(5): 319-7. (n=100)

Both physical activity and exposure to nature are known separately to have positive effects on physical and mental health. We have investigated whether there is a synergistic benefit in adopting physical activities whilst being directly exposed to nature ('green exercise'). Five groups of 20 subjects were exposed to a sequence of 30 scenes projected on a wall whilst exercising on a treadmill. Four categories of scenes were tested: rural pleasant, rural unpleasant, urban pleasant and urban unpleasant. The control was running without exposure to images. Blood pressure and two psychological measures (self esteem and mood) were measured before and after the intervention. There was a clear effect of both exercise and different scenes on blood pressure, self-esteem and mood. Exercise alone significantly reduced blood pressure, increased self-esteem, and had a positive significant effect on 4 of 6 mood measures. Both rural and urban pleasant scenes produced a significantly greater positive effect on self esteem than the exercise-only control. This shows the synergistic effect of green exercise in both rural and urban environments. By contrast, both rural and urban unpleasant scenes reduced the positive effects of exercise on self-esteem. The rural unpleasant scenes had the most dramatic effect, depressing the beneficial effects of exercise on three different measures of mood. It appears that threats to the countryside depicted in rural unpleasant scenes have a greater negative effect on mood than already urban unpleasant scenes. We conclude that green exercise has important public and environmental health consequences.

Pretty, J. G., Murray; Peacock, Jo; Hine, Rachel; Sellens, Martin; South, Nigel (2005) A Countryside for Health and Well-Being: The Physical and Mental Health Benefits of Green Exercise. (n=263)

No abstract provided.

Pryor A, M Townsend, et al. 2006. Health and well-being naturally:'contact with nature'in health promotion for targeted individuals, communities and populations. Health Promotion Journal of Australia, 17(2): 114-23.

Issue addressed: The increase in mental health disorders worldwide makes it important to recognise health promotion interventions that are effective, accessible and affordable. Although natural spaces are coming to be recognised as health-promoting settings for general populations, little is understood about the use of nature-contact in treatment and care for individuals experiencing ill-health.

PTSD: National Center for PTSD

PTSD. -- -- Accessed February 2016.

Pullman, Marcie. 2009. Conifer PM2.5 Deposition and Re-Suspension in Wind and Rain Events. Plant Science - Thomas Whitlow Ithaca, NY, Cornell University. MS.

Recent EPA rulings allow State Implementation Plans (SIP) to include new urban tree plantings as a measure of air pollution abatement, creating an urgent need for accurate estimates of pollution removal by trees. Deposition velocities (Vd) of particulates to trees have been reported for a number of species without explicitly recognizing that observed deposition is a net process, the sum of particle deposition and re-suspension. This has implications for atmospheric models that include a separate re-suspension term to estimate PM loading to trees. Wind tunnel tests at 5 m/s wind speed report 2.5% resuspension with a conifer species over a half day (Ould-Dada). However, in the native environment higher wind speeds are suspected to be responsible for the majority of resuspension of PM2.5. In the present study, three conifer species were dosed with KNO3 Dp 2.5 micro-m particulates and exposed in a wind tunnel to winds of 6.5, 10, and 13 m/s for 5, 10, or 20 minutes, to determine PM2.5 resuspension rates. Deposition velocities were also determined over a range of PM concentrations. Though the removal of particles from the air is small, re-suspension from Pinus strobus increased from 0% at 6.5 m/s to 20% of the original dose removed at 10 m/s and 50% of the original dose removed at 13 m/s. Taxus cuspidata had low rates of resuspension (20% of the original dose) at all three wind speeds, while Tsuga canadensis had no resuspension. Vd are 0.02 cm/s for Tsuga, 0.01 cm/s for Pinus, and 0.005 for Taxus. Deposition velocity was found to be related to complexity of needle and branch arrangement, and not of total needle surface area as hypothesized. Re-suspension is likely to result from mechanical jarring of needles at high wind speeds rather than direct scouring by the wind. An analysis of wind conditions in upstate New York revealed that wind events of a magnitude sufficient to cause resuspension in Pinus occur 1.25% of the time in January and 0.07% of the time in July. The implications of these findings are: models of pollution removal by urban trees (ie, The Urban Forest Effects Model, UFORE) underestimate the amount of PM2.5 retained by leaves by 50%.

Putnam RD, 2000. Bowling Alone: The Collapse and Revival of American Community. New York: Simon and Schuster.

No abstract provided



Raanaas R K, G G Patil, et al. 2012. Health benefits of a view of nature through the window: a quasi-experimental study of patients in a residential rehabilitation center. Clinical Rehabilitation 26(1): 21-32.

OBJECTIVE: To examine the health benefits of a bedroom window view to natural surroundings for patients undergoing a residential rehabilitation programme.

DESIGN: Longitudinal quasi-experiment.

SETTING: A residential rehabilitation centre.

SUBJECTS: Two-hundred and seventy-eight coronary and pulmonary patients provided data at all measurement points during the programme.

INTERVENTION: Blind, quasi-random allocation to a private bedroom with a panoramic view to natural surroundings or with a view either partially or entirely blocked by buildings.

MAIN MEASURES: Self-reported physical and mental health (SF-12), subjective well-being, emotional states, use of the private bedroom and leisure activities.

CONCLUSION: For women, a blocked view appeared to negatively influence change in physical health (time x view x gender interaction, F(4,504)=2.51, P=0.04), whereas for men, a blocked view appeared to negatively influence change in mental health (time x view x gender interaction, F(4,504)=5.67, P< 0.01). Pulmonary patients with a panoramic view showed greater improvement in mental health than coronary patients with such a view (time x view x diagnostic group interaction, F(4,504)=2.76, P=0.03). Those with a panoramic view to nature more often chose to stay in their bedroom when they wanted to be alone than those with a blocked view (odds ratio (OR)=2.32, 95% confidence interval (CI) 1.08-5.01). An unobstructed bedroom view to natural surroundings appears to have better supported improvement in self-reported physical and mental health during a residential rehabilitation programme, although the degree of change varied with gender and diagnostic group.

Raglin JS and WP Morgan. 1987. Influence of exercise and quiet rest on state anxiety and blood pressure. Medicine & Science in Sports & Exercise 19(5): 456-63.

A series of investigations was performed in which Ss rested quietly for 40-min and performed aerobic exercise on separate occasions. Blood pressure (BP) and state anxiety were assessed prior to and following the conditions. In the first experiment, 15 normotensive Ss were assessed during the 3-h following the treatments. The results revealed that state anxiety and BP were reduced following both conditions. The exercise-induced BP reductions remained significant for 2 to 3 h (P < 0.05), whereas the BP reductions returned to baseline within 20-min following cessation of quiet rest. The second experiment involved an evaluation of the effects of exercise and quiet rest on 15 pharmacologically controlled hypertensive Ss. A significant reduction in systolic BP (P < 0.05) was observed following exercise and quiet rest. State anxiety was reduced following quiet rest and exercise (P < 0.05). It is concluded that exercise and quiet rest have similar effects on state anxiety, and both conditions are followed by a transitory reduction in blood pressure. These anti-anxiety effects, however, are sustained for a longer period following exercise.

Rai U N, S Sinha, R D Tripathi & P Chandra. 1995. Wastewater treatability potential of some aquatic macrophytes: Removal of heavy metals. Ecological Engineering, 5(1), 5-12.

Free-floating, submerged and emergent plants (Hydrodictyon reticulatum, Spirodela polyrrhiza, Chara corallina, Ceratophyllum demersum, Vallisneria spiralis, Bacopa monnieri, Alternanthera sessilis and Hygrorrhiza aristata) were evaluated for their heavy metal (Cu, Cr, Fe, Mn, Cd, Ph) removal potential under laboratory conditions. Treatability study was carried out using pond water contaminated with the effluents from various industrial sources. Plants differ in the extent of metal accumulation; however, metals present in relatively high concentrations were accumulated more. Results showed a decrease in Cr level from 4.866 M to below maximum permissible limit by C. demersum, H. reticulatum and S. polyrrhiza within 15 d. Similarly, elevated levels of Fe were reduced to below permissible limit by C. demersum and H. reticulatum after 15 d. Manganese concentration (6.63 M) were reduced to 1.63 p M by C. demersum and H. reticulatum in 7 d. Bacopa monnieri and H. aristata decreased Cd levels from 0.155 M to 0.009 M whereas S. polyrrhiza and H. reticulatum reduced levels to 0.036 M after 15 d of treatment. More than 70% Pb was removed by C. demersum, H. aristata and H. reticulatum within 15 d. Results suggest the use of these plants for metal abatement in dilute wastewaters.

Rasanen JV, T Holopainen, et al. 2013. Effects of species-specific leaf characteristics and reduced water availability on fine particle capture efficiency of trees. Environmental Pollution 183(0): 64-70.

Trees can improve air quality by capturing particles in their foliage. We determined the particle capture efficiencies of coniferous Pinus sylvestris and three broadleaved species: Betula pendula, Betula pubescens and Tilia vulgaris in a wind tunnel using NaCl particles. The importance of leaf surface structure, physiology and moderate soil drought on the particle capture efficiencies of the trees were determined. The results confirm earlier findings of more efficient particle capture by conifers compared to broadleaved plants. The particle capture efficiency of P. sylvestris (0.21%) was significantly higher than those of B. pubescens, T. vulgaris and B. pendula (0.083%, 0.047%, 0.043%, respectively). The small leaf size of P. sylvestris was the major characteristic that increased particle capture. Among the broadleaved species, low leaf wettability, low stomatal density and leaf hairiness increased particle capture. Moderate soil drought tended to increase particle capture efficiency of P. sylvestris.

Rashki A, DG Kaskaoutis, et al. 2012. Dust storms and their horizontal dust loading in the Sistan region, Iran. Aeolian Research, 5: 51-62.

The Sistan region in southeast Iran is considered as one of the most active dust source regions in South west Asia. The strong "Levar" winds in summer favor the uplift of large quantities of dust from the Hamoun basin, which is located in the northern part of Sistan. After a dry period at the end of the 1999s, and due to land-use change and desiccation of the Hamoun lakes, the frequency and severity of dust storms have been significantly increased. Within this framework, this study analyses the aerosol characteristics, dust loading and air quality over the Sistan region. The dust loading was measured using dust traps up to four and eight meters height (with a one meter distance between the traps) at two locations near the Hamoun basin during the period August 2009 to July 2010. The results show large quantities of transported dust that strongly dependent on the duration of the dust events, and secondarily, on the wind speed and distance from the source region. The grain size distribution of the dusts reveals that the coarser calibers are found at the station nearer to Hamoun, while the large differences in the grain-size distribution found between the two stations indicate significant spatio-temporal variation in dust characteristics. Furthermore, to assess the air quality, Particulate Matter (PM10) concentrations were measured over Zabol city during September 2010 to July 2011, and the Air Quality Index (AQI) was obtained. Daily PM10 levels during intense dust storms rise up to 2000 micro-g m-3, even reaching to 3094 micro-g m-3, while the monthly mean PM10 variation shows extreme values (>500 micro-g m-3) for the period June to October. Analysis of the AQI shows that 61% of the days are associated with a high health risk, while 30.1% are even identified as hazardous.

Rea CL, MS Bisesi, et al. 2015. Human health-related ecosystem services of avian-dense coastal wetlands adjacent to a Western Lake Erie swimming beach. EcoHealth, 12(1): 77-87.

Wetlands provide many valuable ecosystem services, including water quality improvement to protect downstream aquatic ecosystems such as lakes, rivers, and estuaries. However, their ability to improve water quality to safe levels for direct human exposure while largely surrounded by agricultural lands and hosting large wildlife populations remains unknown. Our aim was to examine the ecosystem service capabilities of an avian-dense coastal wetland surrounded by agricultural lands along the southwestern shore of Lake Erie in Ohio by assessing the quality of water as it flows through the wetland (Ottawa National Wildlife Refuge (ONWR)) and into Lake Erie beach waters. Our study used total phosphorus and fecal indicator (Escherichia coli) concentrations as water quality metrics across the wetland and at an adjacent Lake Erie swimming beach during the 2012 summer swim season. E. coli and total P levels were consistently highest at the site, where water enters the ONWR (mean E. coli=507 CFU/100 mL; mean total P=535 µg/L), and steadily decreased as water flowed through the wetland and into the adjacent beach (mean E. coli=10 CFU/100 mL; mean total P=41 µg/L). E. coli and total P showed statistically significant (a=0.01) correlations with phycocyanin, chlorophyll-a, turbidity, specific conductivity, dissolved oxygen, and pH; total P was also significantly correlated with total N. The results suggest that this wetland may be contributing to improving water quality, which is beneficial for human health as well as to downstream ecosystem health (e.g., limiting eutrophication promoting conditions, etc.).

Reacher M, K McKenzie, C Lane, T Nichols, et al. 2004. Health impacts of flooding in Lewes: a comparison of reported gastrointestinal and other illness and mental health in flooded and non-flooded households. Communicable Disease and Public Health 7(1): 39 - 46.

Severe flooding may become more frequent due to global warming. A historical cohort study was conducted by telephone interview for new episodes of illness in all age groups, and for psychological distress in adults, following severe river flooding on 12 October 2000 in the town of Lewes in Southern England. Two hundred and twenty-seven residents of 103 flooded households and 240 residents of 104 non-flooded households in the same postal district were recruited by random selection of addresses from a post flooding survey and a commercial database respectively. Having been flooded was associated with earache (RR 2.2 [1.1,4.1] p = 0.02), and a significant increase in risk of gastroenteritis with depth of flooding (RR 1.7 [0.9,3.0] p = 0.09, p for trend by flood depth = 0.04). Adults had a four-times higher risk of psychological distress defined as a score of < 4 in response to the 12- item General Health Questionnaire (GHQ-12) (RR 4.1 [2.6, 6.4] p > 0.0005, p for trend by flood depth = 0.01). Associations between flooding and new episodes of physical illness in adults diminished after adjustment for psychological distress. Flooding remained highly significantly associated with psychological distress after adjustment for physical illnesses. Psychological distress may explain some of the excess physical illness reported by flooded adults and possibly by children as well. Policies to promote population resilience to flooding where flood prevention has failed must include practical support for flood victims and provision of appropriate psychological support. Associations with physical illnesses affirm the need for advice and assistance with individual, household and environmental hygiene and access to medical services.

Reed K, W Carly, et al. 2013. A repeated measures experiment of green exercise to improve self-esteem in UK school children. PLoS One 8(7): e69176.

Exercising in natural, green environments creates greater improvements in adult's self-esteem than exercise undertaken in urban or indoor settings. No comparable data are available for children. The aim of this study was to determine whether so called 'green exercise' affected changes in self-esteem; enjoyment and perceived exertion in children differently to urban exercise. We assessed cardiorespiratory fitness (20 m shuttle-run) and self-reported physical activity (PAQ-A) in 11 and 12 year olds (n=75). Each pupil completed two 1.5 mile timed runs, one in an urban and another in a rural environment. Trials were completed one week apart during scheduled physical education lessons allocated using a repeated measures design. Self-esteem was measured before and after each trial, ratings of perceived exertion (RPE) and enjoyment were assessed after completing each trial. We found a significant main effect (F (1,74),=12.2, p<0.001), for the increase in self-esteem following exercise but there was no condition by exercise interaction (F (1,74),=0.13, p= 0.72). There were no significant differences in perceived exertion or enjoyment between conditions. There was a negative correlation (r=-0.26, p=0.04) between habitual physical activity and RPE during the control condition, which was not evident in the green exercise condition (r=-0.07, p=0.55). Contrary to previous studies in adults, green exercise did not produce significantly greater increases in self-esteem than the urban exercise condition. Green exercise was enjoyed more equally by children with differing levels of habitual physical activity and has the potential to engage less active children in exercise.

Regan L and R Rai. 2000. Epidemiology and the medical causes of miscarriage. Best Practice & Research Clinical Obstetrics & Gynaecology 14(5): 839-854.

Human reproduction is extraordinarily wasteful. The reasons for this have taxed all of the contributors to this book. As we move into the 21st century it is sobering to reflect on the fact that we have failed to harness the power of the evolving revolution in molecular medical biology to answer the fundamental question: why is the fate of a fertilized egg so hazardous and so unsuccessful? The following account summarizes our limited knowledge of the epidemiology of miscarriage and then moves on to consider some of the medical causes of miscarriage. The contribution of genetic abnormalities to the problem of pregnancy wastage is discussed elsewhere in this volume.

Reid C E, M S O'Neill, et al. 2009. Mapping community determinants of heat vulnerability. Environmental Health Perspectives 117(11): 1730-6.

Background: The evidence that heat waves can result in both increased deaths and illness is substantial, and concern over this issue is rising because of climate change. Adverse health impacts from heat waves can be avoided, and epidemiologic studies have identified specific population and community characteristics that mark vulnerability to heat waves.

Objectives: We situated vulnerability to heat in geographic space and identified potential areas for intervention and further research.

Methods: We mapped and analyzed 10 vulnerability factors for heat-related morbidity/mortality in the United States: six demographic characteristics and two household air conditioning variables from the U.S. Census Bureau, vegetation cover from satellite images, and diabetes prevalence from a national survey. We performed a factor analysis of these 10 variables and assigned values of increasing vulnerability for the four resulting factors to each of 39,794 census tracts. We added the four factor scores to obtain a cumulative heat vulnerability index value.

Results: Four factors explained 75% of the total variance in the original 10 vulnerability variables: social/environmental vulnerability (combined education/poverty/race/green space), social isolation, air conditioning prevalence, and proportion elderly/diabetes. We found substantial spatial variability of heat vulnerability nationally, with generally higher vulnerability in the Northeast and Pacific Coast and the lowest in the Southeast. In urban areas, inner cities showed the highest vulnerability to heat.

Conclusions: These methods provide a template for making local and regional heat vulnerability maps. After validation using health outcome data, interventions can be targeted at the most vulnerable populations.

Reklaitiene R, R Grazuleviciene,et al. 2014. The relationship of green space, depressive symptoms and perceived general health in urban population. Scandinavian journal of public health, 42(7): 669-76.

Aims:To assess the relationship between green space proximity, use of green space and depressive symptoms and perceived general health among a random sample men and women.

Methods: Cross-sectional study of a population-based sample of 6,944 45-72 year old Kaunas city residents. Self-reported questionnaires provided information on sociodemographic variables, health behaviours, depressive symptoms and poor and very poor perceived general health. Residential proximity to green spaces was defined as living less than 300 m, within interval of 300-999 m, and equal or more than 1 km from a park. The use of the park was divided into two categories: no park use or use <4hrs/week and use of the park >=4 h/week. The study received approval from the Kaunas Regional Research Ethics Committee. Multiple logistic regression assessed the associations controlling for confounding variables.

Results: The prevalence of depressive symptoms and poor and or very poor perceived general health was higher in women than in men. The association between the use of the park and residential proximity to the park revealed that women living >300 m from a green space and who used the space >=4 h/week showed higher odds 1.92 (1.11-3.3) and 1.68 (0.81-3.48) of depressive symptoms and poor and very poor perceived general health as compared to those who used the park <4 hrs/week and residential proximity was >300 m.

Conclusions: The results of our study confirmed an association between use of the green space, residential proximity, and depressive symptoms and poor and very poor perceived general health among women only.

Remick R A. 2002. Diagnosis and management of depression in primary care: a clinical update and review. CMAJ 167 (11): 1253-60.

No abstract provided.

Richardson E A and R Mitchell. 2010. Gender differences in relationships between urban green space and health in the United Kingdom. Social Science & Medicine 71(3): 568-575.

Natural environments, or 'green spaces', have been associated with a wide range of health benefits. Gender differences in neighbourhood effects on health have been found in a number of studies, although these have not been explored in relation to green space. We conducted the first UK-wide study of the relationship between urban green space and health, and the first such study to investigate gender differences in this relationship. An ecological approach was used. Two land use datasets were used to create a proportional green space measure (% by area) at the UK Census Area Statistic ward scale. Our sample consisted of 6432 urban wards, with a total population of 28.6 million adults aged 1664 years in 2001. We selected health outcomes that were plausibly related to green space (cardiovascular disease mortality, respiratory disease mortality and self-reported limiting long-term illness) and another that was expected to be unrelated (lung cancer mortality). Negative binomial regression models examined associations between urban green space and these health outcomes, after controlling for relevant confounders. Gender differences in these associations were observed and tested. Male cardiovascular disease and respiratory disease mortality rates decreased with increasing green space, but no significant associations were found for women. No protective associations were observed between green space and lung cancer mortality or self-reported limiting long-term illness for either men or women. Possible explanations for the observed gender differences in the green space and health relationship are gender differences in perceptions and usage of urban green spaces. We conclude that it is important not to assume uniform health benefits of urban green space for all population subgroups. Additionally, urban green space measures that capture quality as well as quantity could be more suited to studying green space and health relationships for women.

Richardson E A, J Pearce, et al. 2010. The association between green space and cause-specific mortality in urban New Zealand: an ecological analysis of green space utility. BMC Public Health (10).

BACKGROUND: There is mounting international evidence that exposure to green environments is associated with health benefits, including lower mortality rates. Consequently, it has been suggested that the uneven distribution of such environments may contribute to health inequalities. Possible causative mechanisms behind the green space and health relationship include the provision of physical activity opportunities, facilitation of social contact and the restorative effects of nature. In the New Zealand context we investigated whether there was a socioeconomic gradient in green space exposure and whether green space exposure was associated with cause-specific mortality (cardiovascular disease and lung cancer). We subsequently asked what is the mechanism(s) by which green space availability may influence mortality outcomes, by contrasting health associations for different types of green space.

METHODS: This was an observational study on a population of 1,546,405 living in 1009 small urban areas in New Zealand. A neighbourhood-level classification was developed to distinguish between usable (i.e., visitable) and non-usable green space (i.e., visible but not visitable) in the urban areas. Negative binomial regression models were fitted to examine the association between quartiles of area-level green space availability and risk of mortality from cardiovascular disease (n = 9,484; 1996 - 2005) and from lung cancer (n = 2,603; 1996 - 2005), after control for age, sex, socio-economic deprivation, smoking, air pollution and population density.

RESULTS: Deprived neighbourhoods were relatively disadvantaged in total green space availability (11% less total green space for a one standard deviation increase in NZDep2001 deprivation score, p > 0.001), but had marginally more usable green space (2% more for a one standard deviation increase in deprivation score, p = 0.002). No significant associations between usable or total green space and mortality were observed after adjustment for confounders.

CONCLUSION: Contrary to expectations we found no evidence that green space influenced cardiovascular disease mortality in New Zealand, suggesting that green space and health relationships may vary according to national, societal or environmental context. Hence we were unable to infer the mechanism in the relationship. Our inability to adjust for individual-level factors with a significant influence on cardiovascular disease and lung cancer mortality risk (e.g., diet and alcohol consumption) will have limited the ability of the analyses to detect green space effects, if present. Additionally, green space variation may have lesser relevance for health in New Zealand because green space is generally more abundant and there is less social and spatial variation in its availability than found in other contexts.

Richardson E A, R Mitchell, et al. 2012. Green cities and health: a question of scale? Journal of Epidemiology and Community Health 66(2): 160-165.

Background: Cities are expanding and accommodating an increasing proportion of the world's population. It is important to identify features of urban form that promote the health of city dwellers. Access to green space has been associated with health benefits at both individual and neighbourhood level. We investigated whether a relationship between green space coverage and selected mortality rates exists at the city level in the USA.

Methods: An ecological cross-sectional study. A detailed land use data set was used to quantify green space for the largest US cities (n=49, combined population of 43 million). Linear regression models were used to examine the association between city-level 'greenness' and city-level standardised rates of mortality from heart disease, diabetes, lung cancer, motor vehicle fatalities and all causes, after adjustment for confounders.

Results: There was no association between greenness and mortality from heart disease, diabetes, lung cancer or automobile accidents. Mortality from all causes was significantly higher in greener cities.

Conclusions: While considerable evidence suggests that access to green space yields health benefits, we found no such evidence at the scale of the American city. In the USA, greener cities tend also to be more sprawling and have higher levels of car dependency. Any benefits that the green space might offer seem easily eclipsed by these other conditions and the lifestyles that accompany them. The result merits further investigation as it has important implications for how we increase green space access in our cities.

Richardson EA, J Pearce, et al. 2013. Role of physical activity in the relationship between urban green space and health. Public Health 127(4): 318-324.

Objectives: Local availability of green space has been associated with a wide range of health benefits. Possible causative mechanisms underpinning the green space and health relationship include the provision of physical activity opportunities, the stress-relieving effects of nature and the facilitation of social contacts. This study sought to investigate whether urban green space was related to individual-level health outcomes, and whether levels of physical activity were likely to be a mediating factor in any relationships found. Study design: Cross-sectional analysis of anonymized individual health survey responses.

Methods: Neighbourhood-level green space availability was linked to 8157 respondents to the New Zealand Health Survey 2006/07 on the basis of their place of residence. Adjusted multilevel models were constructed for four health outcomes which are plausibly related to green space via physical activity: cardiovascular disease; overweight; poor general health; and poor mental health (Short Form 36).

Results: The greenest neighbourhoods had the lowest risks of poor mental health [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.66-1.00]. Cardiovascular disease risk was reduced in all neighbourhoods with >15% green space availability (e.g. OR 0.80, 95% CI 0.64-0.99 for those with 33-70% green space), However, a dose-response relationship was not found. Green space availability was not related to overweight or poor general health. Overall, levels of physical activity were higher in greener neighbourhoods, but adjustment for this only slightly attenuated the green space and health relationships.

Conclusions: Neighbourhood green space was related to better cardiovascular and mental health in a New Zealand Health Survey, independent of individual risk factors. Although physical activity was higher in greener neighbourhoods, it did not fully explain the green space and health relationship.

Ritz B, F Yu, et al 2002. Ambient air pollution and risk of birth defects in Southern California. American Journal of Epidemiology 155(1): 17-25.

The authors evaluated the effect of air pollution on the occurrence of birth defects ascertained by the California Birth Defects Monitoring Program in neonates and fetuses delivered in southern California in 1987-1993. By using measurements from ambient monitoring stations of carbon monoxide (CO), nitrogen dioxide, ozone, and particulate matter <10 micro-m in aerodynamic diameter, they calculated average monthly exposure estimates for each pregnancy. Conventional, polytomous, and hierarchical logistic regression was used to estimate odds ratios for subgroups of cardiac and orofacial defects. Odds ratios for cardiac ventricular septal defects increased in a dose-response fashion with increasing second-month CO exposure (odds ratio (OR)2nd quartile CO = 1.62, 95% confidence interval (CI): 1.05, 2.48; OR3rd quartile CO = 2.09, 95% CI: 1.19, 3.67; OR4th quartile CO = 2.95, 95% CI: 1.44, 6.05). Similarly, risks for aortic artery and valve defects, pulmonary artery and valve anomalies, and conotruncal defects increased with second-month ozone exposure. The study was inconclusive for other air pollutants. The authors' results are supported by the specificity of the timing of the effect and some evidence from animal data; however, this is the first known study to link ambient air pollution during a vulnerable window of development to human malformations. Confirmation by further studies is needed.

Rodriguez D A, G-H Cho, et al. 2012. Out and about: Association of the built environment with physical activity behaviors of adolescent females. Health & Place 18(1): 55-62.

Locational data, logged on portable GPS units and matched with accelerometer data, was used to examine associations of the built environment with physical activity and sedentary behaviors of adolescent females. In a sample of 293 adolescent females aged 15 to 18 years old in Minneapolis and San Diego, the built environment around each GPS point and its corresponding sedentary, light, and moderate-to-vigorous intensity physical activity was examined using random intercept multinomial logistic regression models. The odds of higher physical activity intensity (3-level outcome: sedentary, light, MVPA) were higher in places with parks, schools, and high population density, during weekdays, and lower in places with more roads and food outlets. Understanding the places where physical activity and sedentary behaviors occur appears to be a promising strategy to clarify relationships and inform policy aimed at increasing physical activity and reducing sedentary behaviors.

Roe J and P Aspinall. 2011. The emotional affordances of forest settings: An investigation in boys with extreme behavioural problems. Landscape Research, 36(5): 535-52.

The physical and social participatory properties of landscapes have been explored using affordance theory but, as yet, the affective dimension of affordances is ill-defined. This paper sets out a framework for integrating affect within the affordance perceptual model. In doing so, it draws on two established models of emotion that identify 'valence' (pleasure-displeasure) and 'arousal' (inactive-active) as basic dimensions underlying an emotional response. Ethnographic methods were employed over a six-month period to observe the emotional responses to a forest setting in boys (aged 10-12) with extreme behaviour problems and confined to a specialist residential school in central Scotland. Over time, changes in affective responses to the setting were mapped and located both within the physical setting and within the circumplex emotion model. Results show an increase in positive affective responses to the forest setting over time, accompanied by increased trust, exploratory activity and social cohesion, dimensions linked in the literature with well-being. The significance of this paper is two-fold: first, it extends research in restorative health by showing how forest settings can, in a rehabilitation context over time, offer opportunities for long-term 'instoration' in boys suffering from extreme mental trauma. Second, it is a first attempt at integrating affect within the affordance perception framework providing a conceptual model which can be expanded upon by future researchers.

Roe J and P Aspinall. 2011. The restorative benefits of walking in urban and rural settings in adults with good and poor mental health. Health & Place 17(1): 103-113.

People differ in their potential for psychological restoration but there is little evidence on the role of varying mental health state or settings in the process. This paper reports two quasi-experiments which compare the restorative benefits of walking in urban and rural settings in two groups of adults with good and poor mental health. Two aspects of restoration are examined, firstly mood, the other using personal project techniques (Little, 1983) to capture an under-explored aspect of cognitive restoration through reflection on everyday life tasks. Results are consistent with a restorative effect of landscape: the rural walk was advantageous to affective and cognitive restoration in both health groups when compared to an urban walk. However, beneficial change took place to a greater extent in the poor health group. Differential outcomes between health groups were found in the urban setting, which was most advantageous to restoration in the poor mental health group. This study extends restorative environments research by showing that the amount of change and context for restoration can differ amongst adults with variable mental health.

Roe J and P Aspinall. 2011. The restorative outcomes of forest school and conventional school in young people with good and poor behaviour. Urban forestry & urban greening, 10(3): 205-12.

Research has shown that the context for psychological restoration and the amount of change can vary amongst adults with different mental health states. There is, however, little evidence of this process in young people. This paper reports on a study which compares the restorative outcomes for adolescents (aged 11) when spending time in an outdoor education setting (forest school) versus a conventional indoor school setting. The adolescents differed across a behavioural spectrum from 'good' to 'poor' behaviour (n = 18). Two aspects of restoration are examined, firstly mood (measuring energy, stress, anger and hedonic tone), the other, reflection on personal goals using personal project techniques (Little, 1983) to capture this. Results from repeated measures analysis of variance (ANOVA) on each of the emotional variables showed a number of significant effects with - in each case - greater positive change in the forest setting. There were additional significant behavioural effects with those with poor behaviour benefiting most from the forest school experience. This study extends restorative environments research by showing the amount of change and context for restoration can vary amongst young people with different behaviour states.

Roe JJ, CW Thompson, et al. 2013. Green space and stress: evidence from cortisol measures in deprived urban communities. International Journal of Environmental Research and Public Health 10(9): 4086-4103.

Contact with green space in the environment has been associated with mental health benefits, but the mechanism underpinning this association is not clear. This study extends an earlier exploratory study showing that more green space in deprived urban neighbourhoods in Scotland is linked to lower levels of perceived stress and improved physiological stress as measured by diurnal patterns of cortisol secretion. Salivary cortisol concentrations were measured at 3, 6 and 9 h post awakening over two consecutive weekdays, together with measures of perceived stress. Participants (n=106) were men and women not in work aged between 35-55 years, resident in socially disadvantaged districts from the same Scottish, UK, urban context as the earlier study. Results from linear regression analyses showed a significant and negative relationship between higher green space levels and stress levels, indicating living in areas with a higher percentage of green space is associated with lower stress, confirming the earlier study findings. This study further extends the findings by showing significant gender differences in stress patterns by levels of green space, with women in lower green space areas showing higher levels of stress. A significant interaction effect between gender and percentage green space on mean cortisol concentrations showed a positive effect of higher green space in relation to cortisol, measures in women, but not in men. Higher levels of neighbourhood green space were associated with healthier mean cortisol levels in women whilst also attenuating higher cortisol levels in men. We conclude that higher levels of green space in residential neighbourhoods, for this deprived urban population of middle-aged men and women not in work, are linked with lower perceived stress and a steeper (healthier) diurnal cortisol decline. However, overall patterns and levels of cortisol secretion in men and women were differentially related to neighbourhood green space and warrant further investigation.

Rogerson M, Dk Brown, et al. 2015. A comparison of four typical green exercise environments and prediction of psychological health outcomes. Perspectives in public health, 136(3): 171-80.


'Green exercise' (GE) is physical activity while simultaneously being exposed to nature. GE comprises three physical components: the individual, the exercise and the environment, and one processes component encompassing a range of psychological and physiological processes. Previous research has consistently shown affective benefits of GE compared to equivalent non-GE. Investigating the possibility of optimum GE environments may help maximise health benefits. The aim of this study was to compare affective outcomes of GE participation between four different typical GE environments (beach, grasslands, riverside, heritage), and further examine influences of several physical component-related variables and one processes component-related variable, on these outcomes.


Participants (N = 331) completed questionnaires before and after a 5km run, at one of four parkrun event locations.



GE offers accessible provision for improving acute psychological wellbeing. Although nature-based exercise environments can facilitate affective outcomes, the overall type of nature may be less critical. Other characteristics of the individual, exercise and environment can significantly influence attainment of psychological GE benefits. However, the results support a greater importance of the processes component in attaining previously reported affective outcomes.

Rook GA 2013. Regulation of the immune system by biodiversity from the natural environment: An ecosystem service essential to health. Proceedings of the National Academy of Sciences 110(46): 18360-18367.

Epidemiological studies suggest that living close to the natural environment is associated with long-term health benefits including reduced death rates, reduced cardiovascular disease, and reduced psychiatric problems. This is often attributed to psychological mechanisms, boosted by exercise, social interactions, and sunlight. Compared with urban environments, exposure to green spaces does indeed trigger rapid psychological, physiological, and endocrinological effects. However, there is little evidence that these rapid transient effects cause long-term health benefits or even that they are a specific property of natural environments. Meanwhile, the illnesses that are increasing in high-income countries are associated with failing immunoregulation and poorly regulated inflammatory responses, manifested as chronically raised C-reactive protein and proinflammatory cytokines. This failure of immunoregulation is partly attributable to a lack of exposure to organisms ("Old Friends") from mankind's evolutionary past that needed to be tolerated and therefore evolved roles in driving immunoregulatory mechanisms. Some Old Friends (such as helminths and infections picked up at birth that established carrier states) are almost eliminated from the urban environment. This increases our dependence on Old Friends derived from our mothers, other people, animals, and the environment. It is suggested that the requirement for microbial input from the environment to drive immunoregulation is a major component of the beneficial effect of green space, and a neglected ecosystem service that is essential for our well-being. This insight will allow green spaces to be designed to optimize health benefits and will provide impetus from health systems for the preservation of ecosystem biodiversity.

Rosenthal JK, PL Kinney, & KB Metzger. 2014. Intra-urban vulnerability to heat-related mortality in New York City, 1997-2006. Health & place, 30: 45-60.

The health impacts of exposure to summertime heat are a significant problem in New York City (NYC) and for many cities and are expected to increase with a warming climate. Most studies on heat-related mortality have examined risk factors at the municipal or regional scale and may have missed the intra-urban variation of vulnerability that might inform prevention strategies. We evaluated whether place-based characteristics (socioeconomic/demographic and health factors, as well as the built and biophysical environment) may be associated with greater risk of heat-related mortality for seniors during heat events in NYC. As a measure of relative vulnerability to heat, we used the natural cause mortality rate ratio among those aged 65 and over (MRR65+), comparing extremely hot days (maximum heat index 100 °F+) to all warm season days, across 1997-2006 for NYC's 59 Community Districts and 42 United Hospital Fund neighborhoods. Significant positive associations were found between the MRR65+ and neighborhood-level characteristics: poverty, poor housing conditions, lower rates of access to air-conditioning, impervious land cover, surface temperatures aggregated to the area-level, and seniors' hypertension. Percent Black/African American and household poverty were strong negative predictors of seniors' air conditioning access in multivariate regression analysis.

Rotem-Mindali O, Y Michael, et al. 2015. The role of local land-use on the urban heat island effect of Tel Aviv as assessed from satellite remote sensing. Applied Geography, 56: 145-53.

Climate change in cities has received much focus in the past few decades. Heat stress in urban areas has an adverse effect on human health and is expected to worsen in the future due to the global warming. Vegetation has been shown to mitigate this effect, but introducing 'green' areas into the metropolitan space is a challenging task. We assessed the thermal load in terms of surface temperature in Tel Aviv, the biggest metropolitan area of Israel. The thermal effect of four different urban land uses was estimated. Specifically, we compared the cooling effect of residential areas with high vegetation cover (referred here as 'green' residential) to that of small to medium size (2-40 ha) public parks. To this end, we used satellite data of land surface temperature (LST) and the Normalized Difference Vegetation Index (NDVI), as a surrogate for vegetation cover. High-temporal data were combined with high spatial resolutions data to produce 10-year average LST and NDVI maps at high spatial resolution over Tel Aviv. As expected, industrial areas had the highest LST due to lowest ratio of vegetation to free space area (1%), while 'green' areas displayed the lowest LST. Green residential and small-medium public parks had comparable thermal loads, with green residential having slightly lower LST (by 0.5 °C). In general, small-medium public parks displayed higher LST than expected. Inefficient use of free spaces for vegetation, i.e., relatively low vegetation cover to free space ratio, was probably the main cause for this. Public parks had a higher local cooling effect, but a less continuous one on the proximate surrounding (30-90 m from the park), probably due to their relative location in the urban fabric. Our results suggest that 'greening' areas within the private urban space should be encouraged at the expense of building new small-medium parks in metropolitan areas that lack the sufficient free space for larger parks. The outcome of this study may have key implications for urban planners seeking to mitigate urban heat island effects under the limitation of existing dense urban layout.

Rowe D. 2011. Green roofs as a means of pollution abatement. Environmental Pollution 159(8-9): 2100-2110.

Green roofs involve growing vegetation on rooftops and are one tool that can help mitigate the negative effects of pollution. This review encompasses published research to date on how green roofs can help mitigate pollution, how green roof materials influence the magnitude of these benefits, and suggests future research directions. The discussion concentrates on how green roofs influence air pollution, carbon dioxide emissions, carbon sequestration, longevity of roofing membranes that result in fewer roofing materials in landfills, water quality of stormwater runoff, and noise pollution. Suggestions for future directions for research include plant selection, development of improved growing substrates, urban rooftop agriculture, water quality of runoff, supplemental irrigation, the use of grey water, air pollution, carbon sequestration, effects on human health, combining green roofs with complementary related technologies, and economics and policy issues.

Russell R, AD Guerry, et al. 2013. Humans and Nature: How Knowing and Experiencing Nature Affect Well-Being. Annual Review of Environment and Resources 38(1): 473-502.

Ecosystems provide many of the material building blocks for human well-being. Although quantification and appreciation of such contributions have rapidly grown, our dependence upon cultural connections to nature deserves more attention. We synthesize multidisciplinary peer-reviewed research on contributions of nature or ecosystems to human well-being mediated through nontangible connections (such as culture). We characterize these connections on the basis of the channels through which such connections arise (i.e., knowing, perceiving, interacting with, and living within) and the components of human well-being they affect (e.g., physical, mental and spiritual health, inspiration, identity). We found enormous variation in the methods used, quantity of research, and generalizability of the literature. The effects of nature on mental and physical health have been rigorously demonstrated, whereas other effects (e.g., on learning) are theorized but seldom demonstrated. The balance of evidence indicates conclusively that knowing and experiencing nature makes us generally happier, healthier people. More fully characterizing our intangible connections with nature will help shape decisions that benefit people and the ecosystems on which we depend.

Ryan R M, N Weinstein, et al. 2010. Vitalizing effects of being outdoors and in nature. Journal of Environmental Psychology 30(2): 159-68.

Five studies utilizing survey, experimental, and diary methods assessed the effects of being outdoors on subjective vitality. In Study 1, we used a vignette method to examine whether being outdoors was associated with vitality, above and beyond the influences of physical activity and social interactions. Study 2 explored the effects of being outdoors on vitality through an experimental design contrasting indoor and outdoor walks. In Study 3, participants were exposed to photographic scenes of either nature or buildings. Results showed that only the nature scenes enhanced subjective vitality. Studies 4 and 5 used a diary methodology to examine within-person variations in subjective energy as a function of being outdoors, again controlling for physical and social activity. Being outdoors was associated with greater vitality, a relation that was mediated by the presence of natural elements. Limitations of these studies are discussed, as well as their implications for research on energy and vitalization.


Sadeghian MM amd Z Vardanyan. 2013. The Benefits of urban parks, a review of urban research. Journal of Novel Applied Sciences 2(8): 231-237.

Urban parks are one of the most important components of cities and they have had an evolving role in the life of city residence. This role has ranged from relief the city to the mediator between humans and nature. This report presents the findings of a major literature review relating to benefits of urban parks. The review considers material from sources that include peer-reviewed literature, library and internet. The results of the study revealed the benefits of urban parks in four categories. Environmental Benefits including Ecological Benefits, Pollution Control, Biodiversity and Nature Conservation. Economic Benefits including Energy Savings, Urban parks and water management, Property Value. Social and Psychological Benefits including Recreation and Wellbeing, Human Health and Tourism actually Reducing Crime. Planning and design, including perceptions of green space, aesthetic values, the planning and design of green space.

Sadock BJ, HI Kaplan & VA Sadock. 2007. Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry (10th ed.). Philadelphia, PA, Lippincott, Williams & Wilkins.

No abstract provided.

Sahlin E, G Ahlborg, et al. 2015. Using nature-based rehabilitation to restart a stalled process of rehabilitation in individuals with stress-related mental illness. International journal of environmental research and public health, 12(2): 1928-51.

After a period of decrease, sick leave in Sweden due to psychiatric diagnoses is on the increase. The lack of established rehabilitation programmes for patients with stress-related mental disorders (SRMD) has opened up for the use of garden/nature in a multimodal rehabilitation context (Nature-Based Rehabilitation, NBR). Region Vastra Gotaland (VGR) started an NBR to offer additional rehabilitation for its employees on long-term sick leave due to SRMD, where initial care had not been sufficient. The aim was to explore whether the mental health and well-being of NBR participants had improved at the end of the NBR and at three follow-ups, and to explore the development of sick leave and health care utilization according to the NBR model (n=57) and an occupational health service (OHS) model (n=45). Self-assessment instruments for measuring burnout, depression, anxiety and wellbeing, and data from regional and national registers were used. Results showed decreased scores on burnout, depression and anxiety, and increased well-being scores and significantly reduced health care utilization in the NBR group. A large movement from ordinary sickness benefit to rehabilitation benefit was observed, which was not observed in the OHS group. The two groups were in different rehabilitation phases, which limited comparisons. The results point to beneficial effects of using NBR for this patient group and for enhancing a stalled rehabilitation process.

Samet J M, F Dominici, et al. 2000. Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994." The New England Journal of Medicine 343(24): 1742-9.

Background: Air pollution in cities has been linked to increased rates of mortality and morbidity in developed and developing countries. Although these findings have helped lead to a tightening of air-quality standards, their validity with respect to public health has been questioned.

Methods: We assessed the effects of five major outdoor-air pollutants on daily mortality rates in 20 of the largest cities and metropolitan areas in the United States from 1987 to 1994. The pollutants were particulate matter that is less than 10 um in aerodynamic diameter (PM 10), ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide. We used a two-stage analytic approach that pooled data from multiple locations.

Results: After taking into account potential confounding by other pollutants, we found consistent evidence that the level of PM 10 is associated with the rate of death from all causes and from cardiovascular and respiratory illnesses. The estimated increase in the relative rate of death from all causes was 0.51 percent (95 percent posterior interval, 0.07 to 0.93 percent) for each increase in the PM 10 level of 10 micro-g per cubic meter. The estimated increase in the relative rate of death from cardiovascular and respiratory causes was 0.68 percent (95 percent posterior interval, 0.20 to 1.16 percent) for each increase in the PM 10 level of 10 micro-g per cubic meter. There was weaker evidence that increases in ozone levels increased the relative rates of death during the summer, when ozone levels are highest, but not during the winter. Levels of the other pollutants were not significantly related to the mortality rate.

Conclusions: There is consistent evidence that the levels of fine particulate matter in the air are associated with the risk of death from all causes and from cardiovascular and respiratory illnesses. These findings strengthen the rationale for controlling the levels of respirable particles in outdoor air.

Sanders R A. 1986. Urban vegetation impacts on the hydrology of Dayton, Ohio. Urban Ecology 9(3-4): 361-76.

Both the amount of stormwater runoff and its rate of discharge are greatly influenced by urban development. But one of the many benefits afforded by urban vegetation is its amelioration of extremes in urban runoff regimes. Using data for a 6-h, 1-year storm event on surface cover types for the city of Dayton, OH, the specific role of vegetation in lessening urban impacts on runoff is assessed. Estimates of runoff are obtained for 77 of Dayton's 79 neighborhoods for three scenarios: one for existing cover types (artificial surfaces, exposed soil, herbaceous cover, and tree canopy cover); one in which trees are hypothetically removed; and a third that places exposed soil in vegetation and increases tree canopy cover to achievably greater amounts. For this intensive storm in which the role of vegetation is less readily apparent than for gentler storms, existing tree canopies alone work to lower potential runoff by about 7%. This could be increased to nearly 12% by modestly increasing canopy coverage of the land surface. Effects on potential peak runoff rates are found throughout the city. Results suggest that when these hydrologic impacts are coupled with tree and other vegetation impacts in the city, a city can justify increasing attention to planning and managing its urban vegetation resource.

Sandifer PA, AE Sutton-Grier, & BP Ward. 2015. Exploring connections among nature, biodiversity, ecosystem services, and human health and well-being: Opportunities to enhance health and biodiversity conservation. Ecosystem Services, 12: 1-5.

We are at a key juncture in history where biodiversity loss is occurring daily and accelerating in the face of population growth, climate change, and rampant development. Simultaneously, we are just beginning to appreciate the wealth of human health benefits that stem from experiencing nature and biodiversity. Here we assessed the state of knowledge on relationships between human health and nature and biodiversity, and prepared a comprehensive listing of reported health effects. We found strong evidence linking biodiversity with production of ecosystem services and between nature exposure and human health, but many of these studies were limited in rigor and often only correlative. Much less information is available to link biodiversity and health. However, some robust studies indicate that exposure to microbial biodiversity can improve health, specifically in reducing certain allergic and respiratory diseases. Overall, much more research is needed on mechanisms of causation. Also needed are a re-envisioning of land-use planning that places human well-being at the center and a new coalition of ecologists, health and social scientists and planners to conduct research and develop policies that promote human interaction with nature and biodiversity. Improvements in these areas should enhance human health and ecosystem, community, as well as human resilience.

Santamouris M and D Kolokotsa. 2015. On the impact of urban overheating and extreme climatic conditions on housing, energy, comfort and environmental quality of vulnerable population in Europe. Energy and Buildings, 98: 125-33.

Extreme weather conditions in urban areas have a serious impact on the quality of life, energy consumption and health of urban citizens. In addition energy poverty has a serious impact on the quality of life of low income households. The aim of the present paper is review the actual housing status of low income population in Europe and discuss issues related to the impact of urban overheating and extreme weather phenomena on the specific energy consumption, indoor environmental conditions and health. Finally advanced low cost mitigation and adaptation technologies developed during the last years that offer a serious potential for energy and environmental improvements which can contribute to improve the quality of life of low income population are presented.

Santamouris M. 2014. Cooling the cities - a review of reflective and green roof mitigation technologies to fight heat island and improve comfort in urban environments. Solar energy, 103: 682-703.

The temperature of cities continues to increase because of the heat island phenomenon and the undeniable climatic change. The observed high ambient temperatures intensify the energy problem of cities, deteriorates comfort conditions, put in danger the vulnerable population and amplify the pollution problems. To counterbalance the phenomenon, important mitigation technologies have been developed and proposed. Among them, technologies aiming to increase the albedo of cities and the use of vegetative - green roofs appear to be very promising, presenting a relatively high heat island mitigation potential. This paper aims to present the state of the art on both the above technologies, when applied in the city scale. Tenths of published studies have been analysed. Most of the available data are based on simulation studies using mesoscale modeling techniques while important data are available from the existing experimental studies. When a global increase of the city's albedo is considered, the expected mean decrease of the average ambient temperature is close to 0.3 K per 0.1 rise of the albedo, while the corresponding average decrease of the peak ambient temperature is close to 0.9 K. When only cool roofs are considered, the analysis of the existing data shows that the expected depression rate of the average urban ambient temperature varies between 0.1 and 0.33 K per 0.1 increase of the roofs albedo with a mean value close to 0.2 K. As it concerns green roofs, existing simulation studies show that when applied on a city scale, they may reduce the average ambient temperature between 0.3 and 3 K. Detailed analysis of many studies reporting a comparison of the mitigation potential of both technologies has permitted the definition of the limits, the boundaries and the conditions under which the considered technologies reach their better performance, in a synthetic way.

Santillan-Soto N, R Garcia-Cueto, et al. 2015. Radiation balance of urban materials and their thermal impact in semi-desert region: Mexicali, Mexico study case. Atmosphere, 6(10): 1578-89.

Net radiation is an essential forcing of climate in the lower layers of Earth's atmosphere. In this paper, radiation balance is measured in clay soil and green grass, and is compared with three urban materials. These materials: asphalt, concrete and white painted elastomeric polystyrene roofing sheet are widely used in Mexicali, Baja California, Mexico. This study was carried out during August of 2011, the hottest time of the year. The 24-hour average values of net radiation found were: 137.2 W m-2 for asphalt, 119.1 for concrete, 104.6 for clay soil, 152 for green grass and 29.2 for the polystyrene insulation. The latter two types of materials are likely to be the most effective in reducing urban heat island effects. This variation in the radiation balance has widespread implications for human living conditions, as land cover change tends to be towards surfaces that have higher levels of net radiation.

Sarkar C, C Webster, et al. 2015. Exploring associations between urban green, street design and walking: Results from the Greater London boroughs. Landscape and Urban Planning, 143: 112-25.

In recent years, a series of studies have highlighted the positive effects of urban green on individual activity behaviour and health. In this paper, we examine salutogenic environment effects of urban green upon walking behaviour and how such effects are mediated by built environment configuration and street-level physical accessibility. The dwelling locations of N=15,354 respondents of the London Travel Demand Survey were geocoded and individual walking behaviour was extracted from the travel diary. A 0.5-m resolution normalized difference vegetation (NDVI) index derived from spectral reflectance measurements in remotely sensed colour infrared data was employed as an objective measure of greenness, while density of street trees acted as proxy of perceived environmental quality in street corridors. A network model of street-level physical accessibility was developed using spatial Design Network Analysis (sDNA). Logistic regression models reported a significant association of odds of walking with density of street trees and street-level betweenness (a measure of street network connectivity), while sensitivity analyses with continuous regression models for participants doing some walking indicated beneficial associations of distance walked with NDVI greenness and street trees. The results illustrate the necessity for targeted intervention strategies in activity-friendly planning via greening and optimized physical design of urban built environments.

Schandl H, S Boyden, et al. 2012. 'Biosensitive' cities-a conceptual framework for integrative understanding of the health of people and planetary ecosystems. Current Opinion in Environmental Sustainability 4(4): 378-384.

Urban sustainability research, despite rapid growth in research activity in recent years, still lacks integrative conceptual and methodological approaches that account for the full spectrum of urban processes and variables that determine human and ecosystem health and natural resource use. Once developed, such approaches would allow assessment of cities and urban policy and planning options in terms of the extent to which they satisfy the biologically determined health needs of people and maintain the integrity of the ecosystems on which cities depend. Integrated analysis and assessment of cities with regard to human health, ecosystem integrity and resource use would build on evolutionary and historical perspectives, and assist in understanding current environmental and health impacts of urbanism and options for the future.

Scholz M, R Harrington, et al. 2007. The integrated constructed wetlands (ICW) concept. Wetlands, 27(2): 337-54.

The free surface flow Integrated Constructed Wetlands (ICW) concept explicitly combines the objectives of cleansing and managing water flow from farmyards with that of integrating the wetland infrastructure into the landscape and enhancing its biological diversity. This leads to system robustness and sustainability. Hydraulic dissipation, vegetation interception, and evapotranspiration create an additional freeboard at the outlet of each wetland segment and at the point of discharge, thus enhancing hydraulic residence time and cleansing capacity during hydraulic fluxes. The principal design criteria leading to adequate effluent water quality (i.e., molybdate reactive phosphorus less than 1 mg/l) from ICW are that the wetland area needs to be sized by a factor of at least 1.3 times the farmyard area and the aspect ratio for the individual wetland segments (i.e., approximately four cells) needs to be less than 1:2.2 (width to length). Within a year of ICW commissioning, approximately 75% of farmyard runoff was intercepted, leading to improvements in the receiving surface waters of the catchment. Most of the recorded phosphate concentrations after ICW treatment agreed with the Irish Urban Wastewater Treatment Regulation 2001, which can be used as a benchmark to assess ICW treatment performance and which is usually applied unofficially to ICW even if it may appear to be too stringent. A case study of 13 ICW systems suggested that phosphorus exported from an ICW system was similar to the typical background concentrations of phosphorus export rates from land to water.

Schoonover J, K Williard, J Zaczek, J Mangun & A Carver. 2005. Nutrient attenuation in agricultural surface runoff by riparian buffer zones in Southern Illinois, USA. Agroforestry Systems, 64(2), 169-180.

Nutrients in overland flow from agricultural areas are a common cause of stream and lake water quality impairment. One method of reducing excess nutrient runoff from non-point sources is to restore or enhance existing riparian areas as vegetative buffers. A field scale study was conducted to assess the ability of remnant giant cane (Arundinaria gigantea (Walt.) Muhl.) and forest riparian buffer zones to attenuate nutrients in agricultural surface runoff from natural precipitation events. Two adjacent, 10.0 m wide riparian buffers were instrumented with 16 overland flow collectors to monitor surface runoff for nitrate, ammonium, and orthophosphate. Measurements were taken at 3.3 m increments within each buffer. The forest buffer significantly reduced incoming dissolved nitrate-N, dissolved ammonium-N, total ammonium-N, and total orthophosphate masses in surface runoff by 97, 74, 68, and 78 , respectively within the 10.0 m riparian buffer. Nutrient reductions within the cane buffer were 100 for all three nutrients due to relatively high infiltration rates. Significant reductions of total ammonium- N and total orthophosphate were detected by 3.3 m in the cane buffer and at 6.6 m in the forest buffer. Results suggest that both giant cane and forest vegetation are good candidates to incorporate into riparian buffer restoration designs for southern Illinois as well as in other regions within their native range with similar climatic and physiographic conditions.

Schulz R & SKC Peall. 2000. Effectiveness of a constructed wetland for retention of nonpoint-source pesticide pollution in the Lourens River Catchment, South Africa. Environmental Science & Technology, 35(2), 422-426.

Constructed wetlands have been widely used to control both point- and nonpoint-source pollution in surface waters. However, our knowledge about their effectiveness in retaining agricultural pesticide pollution is limited. A 0.44-ha vegetated wetland built along a tributary of the Lourens River, Western Cape, South Africa, was studied to ascertain retention of runoff-related agricultural pollution. Total suspended solids, orthophosphate, and nitrate were retained in the wetland in the proportions 15, 54, and 70%, respectively, during dry weather conditions (with rainfall less than 2 mm/d) and 78, 75, and 84% during wet conditions (with rainfall between 2 and 35 mm/d). Retention of water-diluted azinphos-methyl introduced via runoff at a level of 0.85 g/L was between 77 and 93%. Chlorpyrifos and endosulfan were measured during runoff in inlet water at 0.02 and 0.2 g/L, respectively. However, both pesticides were undetectable in the outlet water samples. During a period of 5 months, an increased concentration of various insecticides was detected in the suspended particles at the wetland inlet: azinphos-methyl, 43 g/kg; chlorpyrifos, 31 g/kg; and prothiofos, 6 g/kg. No organophosphorus pesticides were found in the outlet suspended-particle samples, highlighting the retention capability of the wetland. A toxicological evaluation employing a Chironomus bioassay in situ at the wetland inlet and outlet revealed an 89% reduction in toxicity below the wetland during runoff.

Schutte AR, JC Torquati, & HL Beattie. 2017. Impact of urban nature on executive functioning in early and middle childhood. Environment and Behavior, 49(1): 3-0.

According to attention restoration theory, directed attention can become fatigued and then be restored by spending time in a restorative environment. This study examined the restorative effects of nature on children's executive functioning. Seven- to 8-year-olds (school aged, n=34) and 4- to 5-year-olds (preschool, n=33) participated in two sessions in which they completed an activity to fatigue attention, then walked along urban streets (urban walk) in one session and in a park-like area (nature walk) in another session, and finally completed assessments of working memory, inhibitory control, and attention. Children responded faster on the attention task after a nature walk than an urban walk. School-aged children performed significantly better on the attention task than preschoolers following the nature walk, but not urban walk. Walk type did not affect inhibitory control or verbal working memory. However, preschoolers' spatial working memory remained more stable following the nature walk than the urban walk.

Schwartz J. 1999. Air pollution and hospital admissions for heart disease in eight U.S. counties. Epidemiology 10(1): 17-22.

This study examines the consistency of the association between particulate matter less than 10 [mu]m in aerodynamic diameter (PM10), carbon monoxide (CO), and hospital admissions for cardiovascular disease across eight urban counties with different levels of correlation between pollutants and between the pollutants and weather. I fit Poisson regression models controlling for day-of-week effects and using nonparametric smoothing to control for season and weather. Daily variation in PM10 was associated with hospital admissions for heart disease in the elderly (2.48% increase, for an interquartile range increase in exposure; 95% confidence limits = 1.82%, 3.15%). Daily variation in CO was also associated with admissions (2.79% increase, for an interquartile range (1.75 parts per million) increase in exposure; 95% confidence limits = 1.89%, 3.68%). These associations held in both humid and dry locations and were independent of the correlation between the pollutants and weather or other pollutants. The effect size estimates for PM10 and CO likewise showed no association with their correlation in each location, as one would expect if one pollutant were merely a proxy for the other. The PM10 effects are consistent with recent animal data showing cardiovascular effects and with preliminary human data showing effects on heart rate variability and plasma viscosity. The CO results are consistent with literature on angina exacerbations.

Scott K, E McPherson, et al. 1998. Air pollutant uptake by Sacramento's urban forest. Journal of Arboriculture 24(4): 224 - 234.

No abstract provided.

Seeland K, S Dubendorfer, et al. 2009. Making friends in Zurich's urban forests and parks: The role of public green space for social inclusion of youths from different cultures. Forest Policy and Economics 11(1): 10-17.

Integrating the distinct cultures of foreign resident youths is a challenge for Swiss political and educational institutions. An empirical survey of pupils (n=437) and teachers in selected schools of the city and metropolitan area of Zurich investigated leisure activities in urban forests and public green spaces for their potential to facilitate social interaction between Swiss and immigrant young people. Patterns of socialising and making friends in these outdoor locations were found to differ depending on age, school level, gender and the percentage of immigrants in each residential area. Public urban green spaces were found to play an important role for children and youths in making contacts and friends across cultures, which is considered a prerequisite for social inclusion.

Seeman T E. 1996. Social ties and health: The benefits of social integration. Annals of epidemiology, 6(5): 442-451.

This article explores the relationship between level of social integration and various aspects of health. A search of the literature published since the mid-1970s (under the MEDLINE key words, social ties, social network, social isolation, social environment) presented strong evidence that social integration leads to reduced mortality risks, and to a better state of mental health. The evidence on physical health outcomes is less conclusive. There is no consistent evidence that social integration affects the incidence of disease (at least for cardiovascular outcomes). However, social integration does appear to have a highly beneficial effect on post-myocardial infarction prognosis (functioning and longevity). A physiologic basis for these effects on health outcomes is also indicated by research demonstrating that both social isolation and nonsupportive social interactions can result in lower immune function and higher neuroendocrine and cardiovascular activity while socially supportive interactions have the opposite effects. In conclusion, available data suggest that, although social integration is generally associated with better health outcomes, the quality of existing ties also appears to influence the extent of such health benefits. Clearly, individuals' networks of social relationships represent dynamic and complex social systems that affect health outcomes.

Segala C, B Fauroux, et al. 1998. Short-term effect of winter air pollution on respiratory health of asthmatic children in Paris. European Respiratory Journal 11(3): 677-85.

There is controversy as to whether low levels of air pollution affect the symptoms and lung function in asthma. We addressed this by examining the short-term effects of winter air pollution on childhood asthma in Paris. We performed a 6 month follow-up of 84 medically diagnosed asthmatic children classified into two groups of severity. The outcomes included incidence and prevalence of asthma attacks, symptoms and use of supplementary beta2-agonists, peak expiratory flow (PEF) value and its variability. The statistical analysis controlled the lack of independence between daily health outcomes, trends and meteorology. Air pollution was associated with an increase in reports and duration of asthma attacks and asthma-like symptoms in mild asthmatic children. The strongest association was the risk of asthma attack for an increase of 50 micro-g x m(-3) of sulphur dioxide (SO2) on the same day (odds ratio (OR)=2.86). Maximum reduction in morning peak expiratory flow (PEF) (5%) and maximum increase in PEF variability (2%) were observed at a lag of 3 days for an increase of 50 micro-g x m(-3) of SO2 in the subgroup of mild asthmatics receiving no regular inhaled medication. In moderate asthmatic children, the duration of supplementary beta2-agonist use was strongly associated with air pollution. The general pattern of our results provides evidence of the effect of the low levels of air pollution encountered in Western Europe on symptoms and lung function in childhood asthma.

Seltenrich N. 2015. Between extremes: health effects of heat and cold. Environmental health perspectives, 123(11): A275.

No abstract provided.

Seltenrich N. 2015. Just what the doctor ordered: using parks to improve children's health. Environ Health Perspect, 123(10): A254-9.

No abstract provided.

Semenza JC, JE McCullough, et al. 1999. Excess hospital admissions during the July 1995 heat wave in Chicago. American Journal of Preventive Medicine 16(4): 269-77.

Introduction: This study describes medical conditions treated in all 47 non-VA hospitals in Cook County, IL during the 1995 heat wave. We characterize the underlying diseases of the susceptible population, with the goal of tailoring prevention efforts.

Methods: Primary and secondary discharge diagnoses made during the heat wave and comparison periods were obtained from computerized inpatient hospital discharge data to determine reasons for hospitalization, and comorbid conditions, respectively.

Results: During the week of the heat wave, there were 1072 (11%) more hospital admissions than average for comparison weeks and 838 (35%) more than expected among patients aged 65 years and older. The majority of this excess (59%) were treatments for dehydration, heat stroke, and heat exhaustion; with the exception of acute renal failure no other primary discharge diagnoses were significantly elevated. In contrast, analysis of comorbid conditions revealed 23% (p = 0.019) excess admissions of underlying cardiovascular diseases, 30% (p = 0.033) of diabetes, 52% (p = 0.011) of renal diseases, and 20% (p = 0.027) of nervous system disorders. Patient admissions for emphysema (p = 0.007) and epilepsy (p = 0.009) were also significantly elevated during the heat wave week.

Conclusions: The majority of excess hospital admissions were due to dehydration, heat stroke, and heat exhaustion, among people with underlying medical conditions. Short-term public health interventions to reduce heat-related morbidity should be directed toward these individuals to assure access to air conditioning and adequate fluid intake. Long-term prevention efforts should aim to improve the general health condition of people at risk through, among other things, regular physician-approved exercise.

Setala H, V Viippola, et al. 2013. Does urban vegetation mitigate air pollution in northern conditions? Environmental Pollution 183(0): 104-112.

It is generally accepted that urban vegetation improves air quality and thereby enhances the well-being of citizens. However, empirical evidence on the potential of urban trees to mitigate air pollution is meager, particularly in northern climates with a short growing season. We studied the ability of urban park/forest vegetation to remove air pollutants (NO2, anthropogenic VOCs and particle deposition) using passive samplers in two Finnish cities. Concentrations of each pollutant in August (summer; leaf-period) and March (winter, leaf-free period) were slightly but often insignificantly lower under tree canopies than in adjacent open areas, suggesting that the role of foliage in removing air pollutants is insignificant. Furthermore, vegetation-related environmental variables (canopy closure, number and size of trees, density of understorey vegetation) did not explain the variation in pollution concentrations. Our results suggest that the ability of urban vegetation to remove air pollutants is minor in northern climates.

Seybold K S and P C Hill. 2001. The Role of Religion and Spirituality in Mental and Physical Health. Current Directions in Psychological Science 10(1): 21-24.

An increased interest in the effects of religion and spirituality on health is apparent in the psychological and medical literature. Although religion in particular was thought, in the past, to have a predominantly negative influence on health, recent research suggests this relationship is more complex. This article reviews the literature on the impact of religion and spirituality on physical and mental health, concluding that the influence is largely beneficial. Mechanisms for the positive effect of religion and spirituality are proposed.

Shah AS, KK Lee, et al. 2015. Short term exposure to air pollution and stroke: systematic review and meta-analysis, 350: h1295.

Objective To review the evidence for the short term association between air pollution and stroke.

Design Systematic review and meta-analysis of observational studies

Data sources Medline, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science searched to January 2014 with no language restrictions.

Eligibility criteria Studies investigating the short term associations (up to lag of seven days) between daily increases in gaseous pollutants (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate matter (<2.5 µm or <10 µm diameter (PM2.5 and PM10)), and admission to hospital for stroke or mortality.

Main outcome measures Admission to hospital and mortality from stroke.

Results From 2748 articles, 238 were reviewed in depth with 103 satisfying our inclusion criteria and 94 contributing to our meta-estimates. This provided a total of 6.2 million events across 28 countries. Admission to hospital for stroke or mortality from stroke was associated with an increase in concentrations of carbon monoxide (relative risk 1.015 per 1 ppm, 95% confidence interval 1.004 to 1.026), sulphur dioxide (1.019 per 10 ppb, 1.011 to 1.027), and nitrogen dioxide (1.014 per 10 ppb, 1.009 to 1.019). Increases in PM2.5 and PM10concentration were also associated with admission and mortality (1.011 per 10 µg/m3 (1.011 to 1.012) and 1.003 per 10 µg/m3 (1.002 to 1.004), respectively). The weakest association was seen with ozone (1.001 per 10 ppb, 1.000 to 1.002). Strongest associations were observed on the day of exposure with more persistent effects observed for PM2.5.

Results From 2748 articles, 238 were reviewed in depth with 103 satisfying our inclusion criteria and 94 contributing to our meta-estimates. This provided a total of 6.2 million events across 28 countries. Admission to hospital for stroke or mortality from stroke was associated with an increase in concentrations of carbon monoxide (relative risk 1.015 per 1 ppm, 95% confidence interval 1.004 to 1.026), sulphur dioxide (1.019 per 10 ppb, 1.011 to 1.027), and nitrogen dioxide (1.014 per 10 ppb, 1.009 to 1.019). Increases in PM2.5 and PM10concentration were also associated with admission and mortality (1.011 per 10 µg/m³ (1.011 to 1.012) and 1.003 per 10 µg/m³ (1.002 to 1.004), respectively). The weakest association was seen with ozone (1.001 per 10 ppb, 1.000 to 1.002). Strongest associations were observed on the day of exposure with more persistent effects observed for PM2.5.

Conclusion Gaseous and particulate air pollutants have a marked and close temporal association with admissions to hospital for stroke or mortality from stroke. Public and environmental health policies to reduce air pollution could reduce the burden of stroke.

Shanahan DF, RA Fuller, et al. 2015. The health benefits of urban nature: how much do we need? BioScience, 65(5): 476-485.

Over 30 years of research has shown that urban nature is a promising tool for enhancing the physical, psychological, and social well-being of the world's growing urban population. However, little is known about the type and amount of nature people require in order to receive different health benefits, preventing the development of recommendations for minimum levels of exposure and targeted city planning guidelines for public health outcomes. Dose-response modelling, when a dose of nature is modeled against a health response, could provide a key method for addressing this knowledge gap. In this overview, we explore how "nature dose" and health response have been conceptualized and examine the evidence for different shapes of dose-response curves. We highlight the crucial need to move beyond simplistic measures of nature dose to understand how urban nature can be manipulated to enhance human health.

Shapiro K, P A Conrad, et al. 2010. Effect of Estuarine Wetland Degradation on Transport of Toxoplasma gondii Surrogates from Land to Sea. Applied and Environmental Microbiology 76(20): 6821-6828.

The flux of terrestrially derived pathogens to coastal waters presents a significant health risk to marine wildlife, as well as to humans who utilize the nearshore for recreation and seafood harvest. Anthropogenic changes in natural habitats may result in increased transmission of zoonotic pathogens to coastal waters. The objective of our work was to evaluate how human-caused alterations of coastal landscapes in California affect the transport of Toxoplasma gondii to estuarine waters. Toxoplasma gondii is a protozoan parasite that is excreted in the feces of infected felids and is thought to reach coastal waters in contaminated runoff. This zoonotic pathogen causes waterborne toxoplasmosis in humans and is a significant cause of death in threatened California sea otters. Surrogate particles that mimic the behavior of T. gondii oocysts in water were released in transport studies to evaluate if the loss of estuarine wetlands is contributing to an increased flux of oocysts into coastal waters. Compared to vegetated sites, more surrogates were recovered from unvegetated mudflat habitats, which represent degraded wetlands. Specifically, in Elkhorn Slough, where a large proportion of otters are infected with T. gondii, erosion of 36% of vegetated wetlands to mudflats may increase the flux of oocysts by more than 2 orders of magnitude. Total degradation of wetlands may result in increased Toxoplasma transport of 6 orders of magnitude or more. Destruction of wetland habitats along central coastal California may thus facilitate pathogen pollution in coastal waters with detrimental health impacts to wildlife and humans.

Shashua-Bar L, D Pearlmutter, & E Erell. 2011. The influence of trees and grass on outdoor thermal comfort in a hot-arid environment. International Journal of Climatology, 31(10): 1498-506.

The effects of vegetation on human thermal stress in a hot-arid region were tested in two semi-enclosed urban spaces with various combinations of mature trees, grass, overhead shading mesh and paving. The index of thermal stress was calculated hourly from measured meteorological data in the studied sites to evaluate thermal comfort in the different spaces based on radiative and convective pedestrian-environment energy exchanges and sweat efficiency, and expressed on a thermal sensation scale ranging from 'comfortable' to 'very hot'. The efficiency of water use in providing improved comfort was gauged for each of the vegetative landscaping treatments by comparing the total evapotranspiration with the reduction in thermal stress, both expressed in terms of their values in equivalent energy. While conditions in a paved, unshaded courtyard were found to be uncomfortable throughout the daytime hours (with half of these hours defined by severe discomfort), each of the landscape treatments made a clear contribution to improved thermal comfort. With shading, either by trees or mesh, discomfort was reduced in duration by over half and limited in maximum severity when the shading was placed above paving. When combined with grass, both shading mechanisms yielded comfortable conditions at all hours. In both cases, the effect of trees was more pronounced than that of the mesh, but by a small margin. With unshaded grass, 'hot' conditions in the courtyard were restricted to a short period in mid-afternoon, a considerable improvement over unshaded paving, attributable mainly to the lower radiant surface temperatures.

Shashua-Bar L, D Pearlmutter, and E Erell. 2009. The cooling efficiency of urban landscape strategies in a hot dry climate. Landscape and Urban Planning, 92(3-4): 179-86.

This paper describes a climatic analysis of landscape strategies for outdoor cooling in a hot-arid region, considering the efficiency of water use. Six landscape strategies were studied, using different combinations of trees, lawn, and an overhead shade mesh. The effects of these treatments were tested during the summer season in two semi-enclosed courtyards located at an urban settlement in the arid Negev Highlands of southern Israel. Compared to a non-vegetated exposed courtyard, which on average reached a maximum air temperature of 34 °C in mid-afternoon, a similar courtyard treated with shade trees and grass yielded a daytime temperature depression of up to 2.5 K, while shading the courtyard with a fabric shading mesh, counter-intuitively, caused a relative increase of nearly 1 K. Unshaded grass was found to cause only a small air temperature depression and had the highest water requirement. However when the grass was shaded, either by the trees or by the shade mesh, a synergic effect produced greater cooling as well as a reduction of more than 50% in total water use. The "cooling efficiency" of these strategies was calculated as the ratio between the sensible heat removed from the space and the latent heat of evaporation, with the latter representing the amount of water required for landscape irrigation. This measure is proposed as a criterion for evaluating landscape strategies in arid regions, where water resources are scarce.

Sheldon Cohen & Denise Janicki-Deverts. 2012. Who's Stressed? Distributions of Psychological Stress in the United States in Probability Samples from 1983, 2006, and 2009. Journal of Applied Social Psychology 42 (6): 1320 - 34.

Psychological stress was assessed in 3 national surveys administered in 1983, 2006, and 2009. In all 3 surveys, stress was higher among women than men; and increased with decreasing age, education, and income. Unemployed persons reported high levels of stress, while the retired reported low levels. All associations were independent of one another and of race/ethnicity. Although minorities generally reported more stress than Whites, these differences lost significance when adjusted for the other demographics. Stress increased little in response to the 2008-2009 economic downturn, except among middle-aged, college-educated White men with full-time employment. These data suggest greater stress-related health risks among women, younger adults, those of lower socioeconomic status, and men potentially subject to substantial losses of income and wealth.

Shelef O, A Gross, and S Rachmilevitch. 2012. The use of Bassia indica for salt phytoremediation in constructed wetlands. water research, 46(13): 3967-76.

The treatment and reuse of wastewater in constructed wetlands offers a low-cost, environmentally-friendly alternative for common engineered systems. Salinity in treated wastewater is often increased, especially in arid and semi-arid areas, and may harm crops irrigated from wetlands. We have strong evidence that halophyte plants are able to reduce the salinity of wastewater by accumulating salts in their tissues. Bassia indica is an annual halophyte with unique adaptations for salt tolerance. We performed three experiments to evaluate the capability of B. indica for salt phytoremediation as follows: a hydroponic system with mixed salt solutions, a recirculated vertical flow constructed wetland (RVFCW) with domestic wastewater, and a vertical flow constructed wetland (VFCW) for treating goat farm effluents. B. Indica plants developed successfully in all three systems and reduced the effluent salinity by 20-60% in comparison with unplanted systems or systems planted with other wetland plants. Salinity reduction was attributed to the accumulation of salts, mainly Na and K, in the leaves. Our experiments were carried out on an operative scale, suggesting a novel treatment for green desalination in constructed wetlands by salt phytoremediation in desert regions and other ecosystems.

Shelef O, A Gross, and S Rachmilevitch. 2013. Role of plants in a constructed wetland: current and new perspectives. Water, 5(2): 405-19.

The role of plants in the treatment of effluents by constructed wetland (CW) systems is under debate. Here, we review ways in which plants can affect CW processes and suggest two novel functions for plants in CWs. The first is salt phytoremediation by halophytes. We have strong evidence that halophytic plants can reduce wastewater salinity by accumulating salts in their tissues. Our studies have shown that Bassia indica, a halophytic annual, is capable of salt phytoremediation, accumulating sodium to up to 10% of its dry weight. The second novel use of plants in CWs is as phytoindicators of water quality. We demonstrate that accumulation of H2O2, a marker for plant stress, is reduced in the in successive treatment stages, where water quality is improved. It is recommended that monitoring and management of CWs consider the potential of plants as phytoremediators and phytoindicators.

Shin Y-K, DJ Kim, et al. 2013. Differences of psychological effects between meditative and athletic walking in a forest and gymnasium. Scandinavian Journal of Forest Research 28(1): 64-72.

Several studies have reported that exercise and meditative activities in a forest are more effective than the same activities performed in an urban area. However, few studies have compared the direct effects of exercise to those of meditative activity in a forest and indoors. This study aimed to identify how the effects of the same activity might differ when performed in a forest as opposed to indoors, as well as how the effects of meditative and athletic activities in the same environment might differ. We recruited 139 females between 18 and 25 years of age and distributed the subjects into four groups by random allocation: athletic walking in the gymnasium (AG), athletic walking in the forest (AF), meditative walking in the gymnasium (MG), and meditative walking in the forest (MF). We evaluated the subjects before and after walking, using the State-Trait Anxiety Inventory-X, Rosenberg Self-Esteem Scale, and Happiness Index for Koreans. Meditative walking had greater effectiveness on the psychological aspects than athletic walking did in the same environment. Also, walking in the forest increased happiness to a greater degree than walking in the gymnasium at the same pace. Especially meditative walking in the forest was the most effective at increasing happiness.

Shutes RB. 2001. Artificial wetlands and water quality improvement. Environment international, 26(5-6): 441-7.

This paper illustrates the role of plants to assist the treatment of water pollution in man-made wetlands in tropical and temperate climates. It also considers the potential for environmental education of these wetland systems. The management and natural treatment of pollution is described in the Mai Po Marshes, Hong Kong and a wetland in London which is also an important site for birds. The design of the Putrajaya Lake and Wetland system in Malaysia is compared with a constructed wetland and lake for the treatment of urban surface runoff in a new residential development in the United Kingdom. The benefits of these natural systems are discussed in the context of the global trend for introducing sustainable methods of environmental management and low cost pollution treatment systems.

Si W, W Ji, et al. 2011. The function of constructed wetland in reducing the risk of heavy metals on human health. Environmental Monitoring and Assessment 181(1): 531-537.

Irrigation with polluted water from the upper Yellow River (YR) channel of Northwest China has resulted in agricultural soil being contaminated by heavy metals (HMs). This causes major concerns due to the potential health risk to the residents in this area. The present study aims to assess the efficiency of constructed wetland (CW) in reducing the heavy metal contamination in irrigation water and food crops, thus in reduction of potential health risk to the residents. The associated risk was assessed using hazard quotient (HQ) and hazard index (HI). The results showed a potential health risk to inhabitants via consumption of wheat grain irrigated with untreated water from YR. However CW could greatly reduce the human health risk of HMs contamination to local residents through significantly decreasing the concentrations of HMs in wheat grain. In theory, the reduction rate of this risk reached 35.19% for different exposure populations. Therefore, CW can be used as a system to pre-treat irrigation water and protect the residents from the potential HMs toxicity.

Singer A, T Zobeck, et al. 2003. The PM10 and PM2.5 dust generation potential of soils/sediments in the Southern Aral Sea Basin, Uzbekistan. Journal of Arid Environments, 54(4): 705-28.

The objective of this study was to assess the contribution of the major soil/sediment surfaces in the Southern Aral Sea Basin to the dust generation potential of this region. Eight crusts and soils/sediments from seven sites, representative of these surfaces, were sampled in the field and their major characteristics (particle size distribution, organic carbon content, carbonate content, salt content and composition) that are related to dust generation, were determined. The PM10 and PM2.5 dust generation potential of the materials was determined in the laboratory using the Lubbock Dust Generation, Analysis and Sampling System (LDGASS). The highest amount of PM10 dust (579.3 mg.m-3) was generated from the Takyr crust material. The lowest by one Solonchak salt crust material (39 6 mg.m-3). Salt crusts from the desiccated Aral Sea bottom generated intermediate amounts of dust.

The experimental results indicate that the Takyrs and Takyr-like soils, that occupy over 1 million ha in the Southern Aral Sea Basin, constitute the surfaces with the highest potential for being the source for the severe dust storms of the area. Second to the Takyr soils, the Solonchaks and Solonchak-like soils, also with an extent of over 1 million ha, contribute highly saline dust. To these must be added a large, as yet uncharted, proportion of the approximately 4 million ha of exposed sea bed, that exhibit Solonchak-like characteristics.

Soderstrom M, C Boldemann, et al. 2013. The quality of the outdoor environment influences childrens health - a cross-sectional study of preschools. Acta Paediatrica. 102(1): 83-91.

Aim: To test how the quality of the outdoor environment of child day care centres (DCCs) influences children's health.

Methods: The environment was assessed using the Outdoor Play Environmental Categories (OPEC) tool, time spent outdoors and physical activity as measured by pedometer. 172/253 (68%) of children aged 3.0-5.9 from nine DCCs participated in Southern Sweden. Health data collected were body mass index, waist circumference, saliva cortisol, length of night sleep during study, and symptoms and well-being which were scored (1-week diary - 121 parent responders). Also, parent-rated well-being and health of their child were scored (questionnaire, 132 parent responders). MANOVA, ANOVA and principal component analyses were performed to identify impacts of the outdoor environment on health.

Results: High-quality outdoor environment at DCCs is associated with several health aspects in children such as leaner body, longer night sleep, better well-being and higher mid-morning saliva cortisol levels.

Conclusion: The quality of the outdoor environment at DCCs influenced the health and well-being of preschool children and should be given more attention among health care professionals and community planners.

Solecki WD, C Rosenzweig, et al. 2005. Mitigation of the heat island effect in urban New Jersey. Global Environmental Change Part B: Environmental Hazards 6(1): 39-49.

Implementation of urban heat island (UHI) mitigation strategies such as increased vegetative cover and higher-albedo surface materials can reduce the impacts of biophysical hazards in cities, including heat stress related to elevated temperatures, air pollution and associated public health effects. Such strategies also can lower the demand for air-conditioning-related energy production. Since local impacts of global climate change may be intensified in areas with UHIs, mitigation strategies could play an increasingly important role as individuals and communities adapt to climate change. We use CITYgreen, a GIS-based modeling application, to estimate the potential benefits of urban vegetation and reflective roofs as UHI mitigation strategies for case study sites in and around Newark and Camden, New Jersey. The analysis showed that urban vegetation can reduce health hazards associated with the UHI effect by removing pollutants from the air. Less affluent, inner-city neighborhoods are the ones in which the hazard potential of the UHI effect is shown to be greatest. However, these neighborhoods have less available open space for tree planting and therefore a lower maximum potential benefit. As the climate warms, these neighborhoods may face greater consequences due to interactions between the UHI effect and global climate change. Results also show that urban vegetation is an effective and economically efficient way to reduce energy consumption and costs at the sites.

Song C, D Joung, et al. 2013. Physiological and psychological effects of walking on young males in urban parks in winter. Journal of Physiological Anthropology 32(18): 1-5.

Background: Interaction with nature has a relaxing effect on humans. Increasing attention has been focused on the therapeutic effects of urban green space; however, there is a lack of evidence-based field research. This study provided scientific evidence supporting the physiological and psychological effects of walking on young males in urban parks in winter.

Findings: Subjects (13 males aged 22.:5 +/- 3.1 years) were instructed to walk predetermined 15-minute courses in an urban park (test) and in the city area (control) Heart rate and heart rate variability (HRV) were measured to assess physiological responses. The semantic differential (SD) method, Profile of Mood States (POMS), and State-Trait Anxiety Inventory (STAI) were used to determine psychological responses. Heart rate was significantly lower and the natural logarithm of the high frequency component of HRV was significantly higher when walking through the urban park than through the city area. The results of three questionnaires indicated that walking in the urban park improved mood and decreased negative feelings and anxiety.

Conclusions: Physiological and psychological data from this field experiment provide important scientific evidence regarding the health benefits of walking in an urban park. The results support the premise that walking in an urban park has relaxing effects even in winter.

Song C, H Ikei, et al. 2013. Physiological and psychological impacts of walking stress in an urban environment on young males. Journal of Geography & Natural Disasters 3(2): 1-5.

Rapid urbanization and artificialization have caused environmental changes that threaten human health and quality of life. However, there is a lack of evidence-based research focused on the physiological and psychological impacts of urban environments. The aim of this study was to clarify the physiological and psychological impacts of urban environments using a field experiment. Thirty-six Japanese male university students (mean age 22.1 +/- 1.8 years) participated in the study, each was instructed to walk a predetermined 13-min course in an urban area (test) and forested area (control). Heart rate and heart rate variability were measured to assess physiological responses to the environment. The semantic differential method for assessing emotions and reports of feeling "refreshed" were used to determine psychological responses. Heart rate was significantly higher and the high-frequency component of heart rate variability, which is an index of parasympathetic nervous activity that is enhanced in relaxing situations, was significantly lower when the subjects walked through urban than through forested areas. Moreover, the psychological indices showed that the subjects felt more artificial and less "refreshed" when walking in the urban areas. In conclusion, these findings provide important scientific evidence of physiological and psychological impacts of walking stress in urban environments.

Song C, H Ikei, et al. 2014. Physiological and psychological responses of young males during spring-time walks in urban parks. Journal of physiological anthropology, 33(1): 1.

Background It is widely believed that contact with the natural environment can improve physical and mental health. Urban green spaces may provide city residents with these benefits; however, there is a lack of empirical field research on the health benefits of urban parks.

Methods This field experiment was performed in May. Seventeen males aged 21.2 +/- 1.7 years (mean +/- standard deviation) were instructed to walk predetermined 15-minute courses in an urban park and a nearby city area (control). Heart rate and heart rate variability (HRV) were measured to assess physiological responses. The semantic differential (SD) method, Profile of Mood States (POMS), and State-Trait Anxiety Inventory (STAI) were used to measure psychological responses.

Results Heart rate was significantly lower while walking in the urban park than while walking in the city street. Furthermore, the urban park walk led to higher parasympathetic nervous activity and lower sympathetic nervous activity compared with the walk through the city street. Subjective evaluations were generally in accordance with physiological reactions, and significantly higher scores were observed for the 'comfortable', 'natural', and 'relaxed' parameters following the urban park walk. After the urban park walk, the score for the 'vigor' subscale of the POMS was significantly higher, whereas that for negative feelings such as 'tension-anxiety' and 'fatigue' was significantly lower. The score for the anxiety dimension of the STAI was also significantly lower after the urban park walk.

Conclusions Physiological and psychological results from this field experiment provide evidence for the physiological and psychological benefits of urban green spaces. A brief spring-time walk in an urban park shifted sympathetic/parasympathetic balance and improved mood state.

Song J and ZH Wang. 2015. Impacts of mesic and xeric urban vegetation on outdoor thermal comfort and microclimate in Phoenix, AZ. Building and Environment, 94: 558-68.

Urban vegetation is an effective way in mitigating excessive heat and improving the outdoor thermal environment for residents in cities via evaporative cooling. Different urban vegetation forms (mesic or xeric) alter surface energy and water budgets in different ways, which is further complicated by interactions with buildings and anthropogenic controls. Mesic vegetation such as lawns reduces urban temperatures by evaporative cooling but requires large amounts of water for continuous irrigation. On the other hand, xeric vegetation such as shade trees reduces urban temperatures mainly through shading and has low water demand. The objective of this study is to investigate the impacts of different vegetation forms on microclimate in a hot desert city - Phoenix, AZ. We applied an advanced urban canopy model coupled with a single-column atmospheric model to simulate urban boundary layer dynamics over different landscaping scenarios with different combinations of mesic and xeric vegetation forms. We subsequently compared the urban land surface temperatures, near-surface air temperatures, outdoor thermal comfort in the urban canopy layer, as well as atmospheric dynamics (temperature, humidity) in the overlying boundary layer for a set of different scenarios.

Sonntag-Ostrom E, M Nordin, et al. 2014. Restorative effects of visits to urban and forest environments in patients with exhaustion disorder. Urban forestry & urban greening, 13(2): 344-54.

This experimental study investigated differences in perceived restorativeness, mood, attention capacity and physiological reactions when visiting city and forest environments. Twenty female patients diagnosed with exhaustion disorder visited three different forest environments and one city environment in randomized order. They performed a standardized 90-min test procedure in each of these environments. Evaluation of the environments and psychological effects in mood were studied with self-administered questionnaires. Attention capacity was studied with Necker Cube Pattern Control task. Physiological responses were measured with regularly scheduled controls of heart rate and blood pressure, and a single test of heart rate recovery. Visits to the forest environments were perceived as significantly more restorative, enhancing mood and attention capacity compared to the city. This also applies to the results of heart rate and to some extent to the results of the diastolic blood pressure. The results from this experimental study support our hypothesis that short visits to forest environments enhance both psychological and physiological recovery and that visits to forest environments are likely to be beneficial when suffering from exhaustion disorder.

Sonntag-Ostrom E, T Stenlund, et al. 2015. "Nature's effect on my mind"-Patients' qualitative experiences of a forest-based rehabilitation programme. Urban Forestry & Urban Greening, 14(3): 607-14.


The aim of this study was to investigate the personal experiences and perceived effects on mind from visits to forest environments in a subset of patients with severe exhaustion disorder (ED), who participated in a randomised controlled trial for evaluation of forest-based rehabilitation.


A subsample of 19 patients with diagnosed ED, who completed the three-month forest-based rehabilitation in the ForRest project, was interviewed.


The forest-based rehabilitation consisted of repeated forest visits with the main objective of spending time in rest and solitude in a chosen forest setting. Semi-structured interviews were carried out and analysed using Grounded Theory.


A core category and five subcategories were set up to describe the patients' experiences and development during the forest-based rehabilitation. As patients mostly reported that they strove to achieve peace of mind during the forest visits, Striving for serenity was chosen to be the core category. At first the patients were frustrated when left alone with their own thoughts in an unfamiliar forest environment. They gradually became familiar with the forest environments and also found their favourite places where they experienced peace of mind. They were then able to rest and begin reflective thinking about their life situation, which led to ambitions to change it. The preferred forest environments were characterised by openness, light and a good view, and were felt to be undemanding, peaceful and stimulating.


Visits to the forest provided favourite places for rest, were experienced as restorative, seemed to improve reflection and may have contributed to starting the coping process for these patients. However, forest visits, as the only treatment option, are not sufficient as rehabilitation from severe and long-term ED. We suggest that forest visits should be integrated with cognitive behavioural therapy to further improve the recovery and enhance coping in daily life for these patients.

Speldewinde PC, A Cook, et al. 2009. A relationship between environmental degradation and mental health in rural Western Australia. Health & place, 15(3): 880-7.

Australia is currently experiencing a process of escalating ecosystem degradation. This landscape degradation is associated with many outcomes that may directly or indirectly impact on human health. This study used a Bayesian spatial method to examine the effects of environmental degradation (measured as dryland salinity) on the mental health of the resident rural population. An association was detected between dryland salinity and depression, indicating that environmental processes may be driving the degree of psychological ill-health in these populations.

Sreetheran M and CC van den Bosch. 2014. A socio-ecological exploration of fear of crime in urban green spaces-A systematic review. Urban Forestry & Urban Greening, 13(1): 1-8.

Studies have pointed at the negative side of urban green spaces in terms of evoking fear of crime. However research on fear-provoking attributes suggests that there usually is no single attribute that influences fear but that rather a combination of attributes prevails. The aim of the paper is to systematically review those attributes that evoke fear of crime in urban green spaces and to highlight their complex interaction by adopting a social-ecological framework. Results include an overview of the reviewed literature with regard to authorship, journal, geographical distribution of the studies, types of urban green spaces studies, types of landscape stimulus used, applied methods, types of respondents involved and main study findings. Forty-eight studies met the authors' inclusion criteria. The majority of the studies highlighted that individual factors (such as gender and past experience) were more influential than social and physical factors in evoking fear of crime. A proposed socio-ecological framework highlights the attributes which evoke fear of crime in urban green spaces and its interactions and can help guide future research.

Stanke C, M Kerac, et al. 2013. Health effects of drought: a systematic review of the evidence. PLoS currents, 5.

Introduction. Climate change projections indicate that droughts will become more intense in the 21 century in some areas of the world. The El Nino Southern Oscillation is associated with drought in some countries, and forecasts can provide advance warning of the increased risk of adverse climate conditions. The most recent available data from EMDAT estimates that over 50 million people globally were affected by drought in 2011. Documentation of the health effects of drought is difficult, given the complexity in assigning a beginning/end and because effects tend to accumulate over time. Most health impacts are indirect because of its link to other mediating circumstances like loss of livelihoods. Methods. The following databases were searched: MEDLINE; CINAHL; Embase; PsychINFO, Cochrane Collection. Key references from extracted papers were hand-searched, and advice from experts was sought for further sources of literature. Inclusion criteria for papers summarised in tables include: explicit link made between drought as exposure and human health outcomes; all study designs/methods; all countries/contexts; any year of publication. Exclusion criteria include: drought meaning shortage unrelated to climate; papers not published in English; studies on dry/arid climates unless drought was noted as an abnormal climatological event. No formal quality evaluation was used on papers meeting inclusion criteria. Results. 87 papers meeting the inclusion criteria are summarised in tables. Additionally, 59 papers not strictly meeting the inclusion criteria are used as supporting text in relevant parts of the results section. Main categories of findings include: nutrition-related effects (including general malnutrition and mortality, micronutrient malnutrition, and anti-nutrient consumption); water-related disease (including E coli, cholera and algal bloom); airborne and dust-related disease (including silo gas exposure and coccidioidomycosis); vector borne disease (including malaria, dengue and West Nile Virus); mental health effects (including distress and other emotional consequences); and other health effects (including wildfire, effects of migration, and damage to infrastructure). Conclusions. The probability of drought-related health impacts varies widely and largely depends upon drought severity, baseline population vulnerability, existing health and sanitation infrastructure, and available resources with which to mitigate impacts as they occur. The socio-economic environment in which drought occurs influences the resilience of the affected population. Forecasting can be used to provide advance warning of the increased risk of adverse climate conditions and can support the disaster risk reduction process. Despite the complexities involved in documentation, research should continue and results should be shared widely in an effort to strengthen drought preparedness and response activities

Sterk G, MJ Riksen, and D Goossens. 2001. Dryland degradation by wind erosion and its control. Annals of arid Zone, 40(3): 351-68.

Global population growth is expected to impose an increasing pressure on agricultural production in the world's drylands, which cover approximately 41% of the continental area. The land resources in drylands are severely threatened by soil degradation, with wind erosion being one of the major degradation processes. It causes sedimentation at undesired places, crop damage by sand blasting and burial, deterioration of soil structure, a loss of soil fertility, and it affects the water economy in the topsoil. On drylands in developing countries, adequate wind erosion control is currently not achieved due to poor socio-economic conditions, low crop biomass production, crop competition and management constraints. A potential solution is to make use of the natural dryland vegetation of scattered trees and shrubs. But, more research is needed to better understand the effects of scattered vegetation on wind speed and erosion, as well as on particle deposition and accumulation. This ultimately should lead to models that can help develop location-specific wind erosion control strategies.

Sternat T and MA Katzman. 2016. Neurobiology of hedonic tone: the relationship between treatment-resistant depression, attention-deficit hyperactivity disorder, and substance abuse. Neuropsychiatric disease and treatment, 12: 2149.

Anhedonia, defined as the state of reduced ability to experience feelings of pleasure, is one of the hallmarks of depression. Hedonic tone is the trait underlying one's characteristic ability to feel pleasure. Low hedonic tone represents a reduced capacity to experience pleasure, thus increasing the likelihood of experiencing anhedonia. Low hedonic tone has been associated with several psychopathologies, including major depressive disorder (MDD), substance use, and attention-deficit hyperactivity disorder (ADHD). The main neural pathway that modulates emotional affect comprises the limbic-cortical-striatal-pallidal-thalamic circuits. The activity of various components of the limbic-cortical-striatal-pallidal-thalamic pathway is correlated with hedonic tone in healthy individuals and is altered in MDD. Dysfunction of these circuits has also been implicated in the relative ineffectiveness of selective serotonin reuptake inhibitors used to treat anxiety and depression in patients with low hedonic tone. Mood disorders such as MDD, ADHD, and substance abuse share low hedonic tone as well as altered activation of brain regions involved in reward processing and monoamine signaling as their features. Given the common features of these disorders, it is not surprising that they have high levels of comorbidities. The purpose of this article is to review the neurobiology of hedonic tone as it pertains to depression, ADHD, and the potential for substance abuse. We propose that, since low hedonic tone is a shared feature of MDD, ADHD, and substance abuse, evaluation of hedonic tone may become a diagnostic feature used to predict subtypes of MDD, such as treatment-resistant depression, as well as comorbidities of these disorders.

Stevenson B and J Wolfers. 2008. Happiness Inequality in the United States. NBER Working Paper Series, # 14220. Journal of Legal Studies, University of Chicago Press, vol. 37(S2), pages S33-S79, 06.

National Bureau of Economic Research: Happiness Inequality in the United States. -- -- Accessed February 2013.

Stokes B. 2007. Happiness is increasing in many countries -- but why? Pew Research Center.

Happiness is increasing in many countries -- but why? -- -- Accessed February 2013.

Sturm R and D Cohen. 2014. Proximity to urban parks and mental health. The journal of mental health policy and economics, 17(1): 19.

Background Urban parks have received attention in recent years as a possible environmental factor that could encourage physical activity, prevent obesity, and reduce the incidence of chronic conditions. Despite long hypothesized benefits of parks for mental health, few park studies incorporate mental health measures.

Aims of the Study To test the association between proximity to urban parks and psychological distress.

Methods Cross-sectional analysis of individual health survey responses. Data were collected for a study of capital improvements of neighborhood parks in Los Angeles. A survey was fielded on a sample of residential addresses, stratified by distance from the park (within 400m, 800m, 1.6 km, and 3.2km; N=1070). We used multiple regression to estimate the relationship between the psychological distress as measured by the MHI-5 (outcome variable) and distance to parks (main explanatory variable), controlling for observed individual characteristics.

Results Mental health is significantly related to residential distance from parks, with the highest MHI-5 scores among residents within short walking distance from the park (400m) and decreasing significantly over the next distances. The number of visits and physical activity minutes are significantly and independently related to distance, although controlling for them does not reduce the association between distance and mental health.

Discussion and Limitations This paper provides a new data point for an arguably very old question, but for which empirical data are sparse for the US. A nearby urban park is associated with the same mental health benefits as decreasing local unemployment rates by 2 percentage points, suggesting at least the potential of environmental interventions to improve mental health. The analysis is cross-sectional, making it impossible to control for important confounders, including residential selection.

Implications for Health Policy Mental health policy has traditionally focused on individual-centered interventions. Just as health policy for preventable chronic illnesses has shifted attention to modifiable environmental determinants, population mental health may benefit substantially from environmental interventions.

Implications for Future Research Policy evaluations should incorporate mental health measures when assessing neighborhood improvement programs and physical environments. Many recent and ongoing studies have excluded mental health measure in the belief that they are too burdensome for respondents or irrelevant. If a causal relationship is confirmed, then ameliorating neighborhood conditions and physical environments could represent a scalable way to improve mental health issues for large populations.

Su W, C Gu, and G Yang. 2010. Assessing the impact of land use/land cover on urban heat island pattern in Nanjing City, China. Journal of Urban Planning and Development, 136(4): 365-72.

Land use/land cover (LULC) change with urbanization affects urban heat island (UHI). We selected the Landsat Enhanced Thematic Mapper images for year 2005 to retrieve land surface temperature (LST) and LULC types and assess the correlation between LULC and LST pattern in Nanjing, China. Daytime mean LST of LULC types in the metropolitan area decreases from industrial, high-density residential commercial, pavement roads, low-density residential commercial, and rural residential to water. UHI centers (over 20.18°C) are located in two big stations, Zhonghua-Men Old City and main industrial zones. LULC pattern generally accords with UHI pattern and affects UHI pattern by artificial heat sources and thermal-biological variations of surface materials. The LST-NDVI index of pavement roads, high-density residential-commercial, rural residential, industrial, low-density residential commercial, forest grass, cultivated, and water body are 0.01, 0.101, 0.151, 0.262, 0.324, 0.987, 1.647, and 0.765, respectively. The LSTfd of profiles varies with landscape diversity and spatial difference. The LSTSstdev of LULC types varies with different spatial scales and selected profiles. Results enlighten us on designing open space in local scale to mitigate the UHI effect.

Sugiyama T, E Cerin, et al. 2014. Perceived neighbourhood environmental attributes associated with adults' recreational walking: IPEN Adult study in 12 countries. Health & place, 28: 22-30.

This study examined the strength and shape of associations between perceived environmental attributes and adults' recreational walking, using data collected from 13,745 adult participants in 12 countries. Perceived residential density, land use mix, street connectivity, aesthetics, safety from crime, and proximity to parks were linearly associated with recreational walking, while curvilinear associations were found for residential density, land use mix, and aesthetics. The observed associations were consistent across countries, except for aesthetics. Using data collected from environmentally diverse countries, this study confirmed findings from prior single-country studies. Present findings suggest that similar environmental attributes are associated with recreational walking internationally.

Sugiyama T, E Leslie, B Giles-Corti and N Owen. 2008. Associations of neighbourhood greenness with physical and mental health: do walking, social coherence and local social interaction explain the relationships? Journal of Epidemiology and Community Health, 62(5).

Background: Studies have shown associations between health indices and access to "green" environments but the underlying mechanisms of this association are not clear.

Objectives: To examine associations of perceived neighbourhood "greenness" with perceived physical and mental health and to investigate whether walking and social factors account for the relationships.

Methods: A mailed survey collected the following data from adults (n = 1895) in Adelaide, Australia: physical and mental health scores (12-item short-form health survey); perceived neighbourhood greenness; walking for recreation and for transport; social coherence; local social interaction and sociodemographic variables.

Results: After adjusting for sociodemographic variables, those who perceived their neighbourhood as highly green had 1.37 and 1.60 times higher odds of better physical and mental health, respectively, compared with those who perceived the lowest greenness. Perceived greenness was also correlated with recreational walking and social factors. When walking for recreation and social factors were added to the regression models, recreational walking was a significant predictor of physical health; however, the association between greenness and physical health became non-significant. Recreational walking and social coherence were associated with mental health and the relationship between greenness and mental health remained significant.

Conclusions: Perceived neighbourhood greenness was more strongly associated with mental health than it was with physical health. Recreational walking seemed to explain the link between greenness and physical health, whereas the relationship between greenness and mental health was only partly accounted for by recreational walking and social coherence. The restorative effects of natural environments may be involved in the residual association of this latter relationship.

Sullivan SM, MM Brashear, et al. 2014. Neighborhood environments and obesity among Afro-Caribbean, African American, and Non-Hispanic white adults in the United States: results from the National Survey of American Life. Preventive medicine, 61: 1-5.

Objective To examine possible associations between perceived neighborhood environments and obesity among a U.S. nationally representative sample of Afro-Caribbean, African American, and Non-Hispanic white adults.

Methods Data was used from the 2001-2003 National Survey of American Life (NSAL). All measures including neighborhood characteristics, height, and weight were self-reported. Multivariate logistic regression was used to compute odds ratios (ORs) of obesity (body mass index (BMI) >= 30 kg/m2) based on perceived neighborhood physical and social characteristics.

Results The odds of obesity were significantly lower for adults who reported involvement in clubs, associations, or help groups (odds ratio (OR): 0.62; 95% confidence interval (CI): 0.44, 0.85) and perceived that they had a park, playground, or open space in their neighborhood (odds ratio (OR): 0.68; 95% confidence interval (CI): 0.47, 0.98). These associations remained significant after adjusting for leisure-time physical activity. Race/ethnicity appeared to modify the association between involvement in clubs, associations, or help groups and obesity.

Conclusions Providing parks, playgrounds, or open space or increasing the perception of those amenities may assist in the prevention of obesity, especially in ethnically diverse neighborhoods in the United States. More research is needed to investigate how perceptions of the neighborhood environment influence obesity and whether perceptions of the neighborhood environment differ between individuals within the same neighborhoods.

Sung CY. 2013. Mitigating surface urban heat island by a tree protection policy: A case study of The Woodland, Texas, USA. Urban forestry & urban greening, 12(4): 474-80.

The Woodlands Township, TX, has a tree protection policy that consists of tree removal permits and minimum tree and shrub cover regulations. This paper examined the effect of The Woodlands' tree protection policy on surface urban heat island (SUHI) at the neighborhood scale by comparing the mean land surface temperatures (LSTs) derived from 37 thermal infrared bands of Landsat TM images between The Woodlands' neighborhoods and nearby control neighborhoods without such a policy. To rule out the effect of confounding factors that may influence LSTs, the control neighborhoods were selected to be similar in physical and socioeconomic status to The Woodlands' neighborhoods. LSTs of The Woodlands' neighborhoods were, on average, 1.5-3.9 °C lower than those of the control neighborhoods. The cooling effect of The Woodlands' tree protection policy was more prominent in summer when SUHI mitigation was mostly needed. Based on these findings, it can be concluded that a local tree protection policy is effective in mitigating SUHI at the neighborhood scale.

Sunyer J, M Esnaola, et al. 2015. Association between traffic-related air pollution in schools and cognitive development in primary school children: a prospective cohort study. PLoS Med, 12(3).


Air pollution is a suspected developmental neurotoxicant. Many schools are located in close proximity to busy roads, and traffic air pollution peaks when children are at school. We aimed to assess whether exposure of children in primary school to traffic-related air pollutants is associated with impaired cognitive development.

Methods and Findings

We conducted a prospective study of children (n=2,715, aged 7 to 10 y) from 39 schools in Barcelona (Catalonia, Spain) exposed to high and low traffic-related air pollution, paired by school socioeconomic index; children were tested four times (i.e., to assess the 12-mo developmental trajectories) via computerized tests (n=10,112). Chronic traffic air pollution (elemental carbon [EC], nitrogen dioxide [NO2], and ultrafine particle number [UFP; 10-700 nm]) was measured twice during 1-wk campaigns both in the courtyard (outdoor) and inside the classroom (indoor) simultaneously in each school pair. Cognitive development was assessed with the n-back and the attentional network tests, in particular, working memory (two-back detectability), superior working memory (three-back detectability), and inattentiveness (hit reaction time standard error). Linear mixed effects models were adjusted for age, sex, maternal education, socioeconomic status, and air pollution exposure at home.


Children attending schools with higher traffic-related air pollution had a smaller improvement in cognitive development.

Swinton S M, F Lupi, et al. 2007. Ecosystem services and agriculture: Cultivating agricultural ecosystems for diverse benefits. Ecological Economics 64(2): 245-252.

Crop and rangelands are over 25% of the Earth's land area, and they are expanding. Agricultural ecosystems rely on a suite of supporting ecosystem services to provide food, fiber and fuel as well as a range of accompanying but non-marketed ecosystem services (ES). Ecosystem services from agriculture include regulation of water and climate systems, aesthetic and cultural services, as well as enhanced supporting services (such as soil fertility). Many of these ES are appreciated by people, but they lack markets, so they lack the incentives for provision that come with prices. For public policy decisions to take them into account, non-market valuation techniques are needed, such as travel cost, contingent valuation, hedonic valuation, and cost-based or factor-income approaches. This article offers an overview of ES from agriculture and non-market valuation methods as it introduces the articles in this special section on Ecosystem Services and Agriculture. Understanding how ecological functions generate ES is fundamental to management, but so too is understanding how humans perceive and value those services. Research is required both to design cost-effective incentives to provide ES and to measure which kinds of ES could provide the greatest overall welfare benefits to society. Agricultural ecosystems offer newly recognized potential to deliver more diverse ecosystem services and mitigate the level of past ecosystem disservices. This special section of Ecological Economics conveys both how these are becoming possible and the challenges to science and public policy design of turning that potential into reality.

Syversen N. 2005. Effect and design of buffer zones in the Nordic climate: The influence of width, amount of surface runoff, seasonal variation and vegetation type on retention efficiency for nutrient and particle runoff. Ecological Engineering, 24(5), 483-490.

Loss of nutrients and sediments from agricultural runoff causes eutrophication in surface water. Vegetated buffer zones adjacent to a stream can effectively remove and retain nutrients and sediments. It is, therefore, important to study design criteria which optimise the effect of buffer zones (BZ). This paper describes the influence of four criteria: (i) buffer zone width, (ii) amount of surface runoff water entering the BZ, (iii) seasonal variation and (iv) vegetation type. These parameters were studied after simulated and natural runoff at four different sites in Southern Norway with cold temperate climate. Surface runoff was collected before entering and after passing the BZs. The simulation experiments were short-term experiments carried out over a few days in 1992 and 1993. In the natural runoff experiments, volume proportional mixed samples were collected after each runoff period during 1992-1999. The results show significantly higher removal efficiency (in %) from 10m wide BZs compared to 5m widths, however, the specific retention (per m2) is higher in 5m BZ. Buffer zones can receive particle runoff over several days without a significant decrease in their removal level. Retention efficiency between summer and autumn varied depending on the measured parameter (phosphorus, particles and nitrogen), and there were no significant differences in removal efficiency between summer and winter. The results show no significant differences between forest buffer zones (FBZ) and grass buffer zones (GBZ) regarding their retention efficiency for nitrogen and phosphorus. There was significantly higher retention efficiency in FBZ for particles. Average removal efficiencies from both simulated and natural runoff experiments varied from 60-89%, 37-81% and 81-91% for phosphorus, nitrogen and particles, respectively.

Szyszkowicz M, GG Kaplan, et al. 2009. Emergency department visits for migraine and headache: a multi-city study. International Journal of Occupational Medicine and Environmental Health 22(3): 235-42.

Objectives: We set out to examine associations between ambient air pollution concentrations and emergency department (ED) visits for migraine/headache in a multi-city study.

Materials and Methods: We designed a time-series study of 64 839 ED visits for migraine (ICD-9: 346) and of 68 495 ED visits for headache (ICD-9: 784) recorded at hospitals in five different cities in Canada. The data (days) were clustered according to the hierarchical structure (location, year, month, day of week). The generalised linear mixed models technique was applied to fit the logarithm of clustered daily counts of ED visits for migraine, and separately for headache, on the levels of air pollutants, after adjusting for meteorological conditions. The analysis was performed by sex (all, male, female) and for three different seasonal periods: whole (JanuaryDecember), warm (AprilSeptember), and cold (OctoberMarch).

Results: For female ED visits for migraine, positive associations were observed during the warm season for sulphur dioxide (SO2), and in the cold season for particulate matter (PM2.5) exposures lagged by 2-days. The percentage increase in daily visits was 4.0% (95% CI: 0.8-7.3) for SO2 mean level change of 4.6 ppb, and 4.6% (95% CI: 1.2,-8.1) for PM2.5 mean level change of 8.3 micro-g/m3. For male ED visits for headache, the largest association was obtained during the warm season for nitrogen dioxide (NO2), which was 13.5% (95% CI: 6.7-20.7) for same day exposure.

Conclusions: Our findings support the associations between air pollutants and the number of ED visits for headache.


Takano T, K Nakamura, M Watanabe. 2002. Urban residential environments and senior citizens' longevity in megacity areas: the importance of walkable green spaces. J Epidemiol Community Health (56): 913-8.

Study objectives: To study the association between greenery filled public areas that are nearby a residence and easy to walk in and the longevity of senior citizens in a densely populated, developed megacity.

Design: Cohort study.

Methods: The authors analysed the five year survival of 3144 people born in 1903, 1908, 1913, or 1918 who consented to a follow up survey from the records of registered Tokyo citizens in relation to baseline residential environment characteristics in 1992.

Main results: The survival of 2211 and the death of 897 (98.9% follow up) were confirmed. The probability of five year survival of the senior citizens studied increased in accordance with the space for taking a stroll near the residence (p< 0.01), parks and tree lined streets near the residence (p< 0.05), and their preference to continue to live in their current community (p< 0.01). The principal component analysis from the baseline residential environment characteristics identified two environment related factors: the factor of walkable green streets and spaces near the residence and the factor of a positive attitude to a person's own community. After controlling the effects of the residents' age, sex, marital status, and socioeconomic status, the factor of walkable green streets and spaces near the residence showed significant predictive value for the survival of the urban senior citizens over the following five years (p< 0.01).

Conclusions: Living in areas with walkable green spaces positively influenced the longevity of urban senior citizens independent of their age, sex, marital status, baseline functional status, and socioeconomic status. Greenery filled public areas that are nearby and easy to walk in should be further emphasised in urban planning for the development and re-development of densely populated areas in a megacity. Close collaboration should be undertaken among the health, construction, civil engineering, planning, and other concerned sectors in the context of the healthy urban policy, so as to promote the health of senior citizens.

Takayama N, K Korpela, et al. 2014. Emotional, restorative and vitalizing effects of forest and urban environments at four sites in Japan. International journal of environmental research and public health, 11(7): 7207-30.

The present study investigated the well-being effects of short-term forest walking and viewing ("forest bathing"). The hypothesis in our study was that both environment (forest vs. urban) and activity (walking and viewing) would influence psychological outcomes. An additional aim was to enhance basic research using several psychological methods. We conducted the experiments using 45 respondents in four areas of Japan from August to September, 2011. The hypothesis in our study was supported, because significant interaction terms between the environment and activity were confirmed regarding the Profile of Mood States (POMS) indexes, Restorative Outcome Scale (ROS) and Subjective Vitality Scale (SVS). No statistical differences between the two experimental groups in any of the ten scales were found before the experiment. However, feelings of vigor and positive effects, as well as feelings of subjective recovery and vitality were stronger in the forest environment than in the urban environment.

Tallis et al. 2011. Estimating the removal of atmospheric particulate pollution by the urban tree canopy of London, under current and future environments. Landscape and Urban Planning 103: 129-138.

Urban green space and particularly the tree canopy have been highlighted as offering a mitigation potential against atmospheric particulate pollution. In this paper current and future particulate (PM(10)) deposition to the urban tree canopy of the Greater London Authority (GLA) was estimated. A modelling approach was used based on the Urban Forest Effects Model (UFORE) and a modified version. Here we give evidence showing that these deposition models can be adapted to run from annual mean meteorological and PM(10) concentration data, thus providing a methodology to examine future scenarios. Depending on the modelling approach, the urban canopy of the GLA is currently estimated to remove between 852 and 2121 tonnes of PM(10) annually: representing between 0.7% and 1.4% of PM(10) from the urban boundary layer. Estimates of PM(10) removal which take into account a planned increased in tree cover, from the current 20% to 30% of the GLA land area, suggest deposition of 1109-2379 tonnes (1.1-2.6% removal) by the year 2050. The evidence provided here suggests that the targeting of tree planting in the most polluted areas of the GLA and particularly the use of street trees which have the greatest exposure to PM(10), would have the greatest benefit to future air quality. The increased deposition would be greatest if a larger proportion of coniferous to broadleaved trees were used at such sites.

Tamosiunas A, R Grazuleviciene, et al. 2014. Accessibility and use of urban green spaces, and cardiovascular health: findings from a Kaunas cohort study. Environmental Health, 13(1): 1.

Background The aims of this study were to explore associations of the distance and use of urban green spaces with the prevalence of cardiovascular diseases (CVD) and its risk factors, and to evaluate the impact of the accessibility and use of green spaces on the incidence of CVD among the population of Kaunas city (Lithuania).

Methods We present the results from a Kaunas cohort study on the access to and use of green spaces, the association with cardiovascular risk factors and other health-related variables, and the risk of cardiovascular mortality and morbidity. A random sample of 5,112 individuals aged 45-72 years was screened in 2006-2008. During the mean 4.41 years follow-up, there were 83 deaths from CVD and 364 non-fatal cases of CVD among persons free from CHD and stroke at the baseline survey. Multivariate Cox proportional hazards regression models were used for data analysis.

Results We found that the distance from people's residence to green spaces was not related to the prevalence of health-related variables. However, the prevalence of cardiovascular risk factors and the prevalence of diabetes mellitus were significantly lower among park users than among non-users. During the follow up, an increased risk of non-fatal and fatal CVD combined was observed for those who lived >=629.61 m from green spaces (3rd tertile of distance to green space) (hazard ratio (HR) = 1.36), and the risk for non-fatal CVD-for those who lived >=347.81 m (2nd and 3rd tertile) and were not park users (HR = 1.66) as compared to men and women who lived 347.8 m or less (1st tertile) from green space. Men living further away from parks (3rd tertile) had a higher risk of non-fatal and fatal CVD combined, compared to those living nearby (1st tertile) (HR = 1.51). Compared to park users living nearby (1st tertile), a statistically significantly increased risk of non-fatal CVD was observed for women who were not park users and living farther away from parks (2nd and 3rd tertile) (HR = 2.78).

Conclusion Our analysis suggests public health policies aimed at promoting healthy lifestyles in urban settings could produce cardiovascular benefits.

Tan J, Y Zheng, et al. 2007 Heat wave impacts on mortality in Shanghai, 1998 and 2003. International Journal of Biometerology 51(3): 193-200.

A variety of research has linked extreme heat to heightened levels of daily mortality and, not surprisingly, heat waves both in 1998 and in 2003 all led to elevated mortality in Shanghai, China. While the heat waves in the two years were similar in meteorological character, elevated mortality was much more pronounced during the 1998 event, but it remains unclear why the human response was so varied. In order to explain the differences in human mortality between the two years' heat waves, and to better understand how heat impacts human health, we examine a wide range of meteorological, pollution, and social variables in Shanghai during the summers (15 June to 15 September) of 1998 and 2003. Thus, the goal of this study is to determine what was responsible for the varying human health response during the two heat events. A multivariate analysis is used to investigate the relationships between mortality and heat wave intensity, duration, and timing within the summer season, along with levels of air pollution. It was found that for heat waves in both summers, mortality was strongly associated with the duration of the heat wave. In addition, while slightly higher than average, the air pollution levels for the two heat waves were similar and cannot fully explain the observed differences in human mortality. Finally, since the meteorological conditions and pollution levels for the two heat waves were alike, we conclude that improvements in living conditions in Shanghai, such as increased use of air conditioning, larger living areas, and increased urban green space, along with higher levels of heat awareness and the implementation of a heat warning system, were responsible for the lower levels of human mortality in 2003 compared to 1998.

Tang IC, WC Sullivan, & CY Chang. 2015. Perceptual evaluation of natural landscapes the role of the individual connection to nature. Environment and Behavior, 47(6): 595-617.

Many people do not seem to have interesting perceptual experiences while in contact with nature. To identify potential antecedents of positive perceptual experiences in natural settings, we investigated the role of a personal connection to nature on perceptual evaluation of preference-related environmental information in varying natural settings. The participants (N = 77) rated three different types of images of rural forest landscapes in terms of perceived environmental information, including sense of safety, coherence, complexity, legibility, mystery, attentional restorativeness, familiarity, and preference. They also reported their personal connection to nature. The results showed that deeper personal connections to nature are associated with greater perceptual evaluations of sense of safety, legibility, mystery, and attentional restorativeness after accounting for landscape type and familiarity. A personal connection to nature is likely to enhance a person's perceptual experiences of natural landscapes.

Tanner CC, ML Nguyen, and JP Sukias. 2005. Nutrient removal by a constructed wetland treating subsurface drainage from grazed dairy pasture. Agriculture, ecosystems & environment, 105(1-2): 145-62.

Nitrogen and phosphorus budgets over two annual periods are presented for an establishing surface-flow constructed wetland treating subsurface drainage from rain-fed, dairy cattle grazed pasture in the North Island of New Zealand. Drainage flows to the wetland (occupying approximately 1% of the catchment area) were highly pulsed, associated with rainfall and soil water status, and differed between years (305 and 197 mm drainage). Flow-proportional sampling of inflow and outflow concentrations were combined with continuous flow records to calculate mass balances for the wetlands. Influent nitrate concentrations were high (median 11 g m-3) in both years, but transient loads of organic N were also an important form of N in the first year. Mass removal of total nitrogen (TN) and its main constituent forms nitrate/nitrite and organic N was recorded for all seasons over both annual periods studied. TN mass removal efficiency of 79% (841 g m-2 per year) in the first year, declined to 21% (40 g m-2 per year) in the second year, associated with changes in the magnitude, speciation and seasonal pattern of N export from the catchment. Ammoniacal N (NH4-N), which comprised <0.5% of TN loadings to the wetland, was generated in small amounts during passage through the wetland in both years. Total phosphorus (TP) in the drainage waters occurred at median concentrations of 0.1-0.2 g m-3, mainly in dissolved reactive forms (DRP 92% by mass). TP export rose by 101% (5.0 g m-2 per year) after passage through the wetland in the first year, but decreased by 12% (0.2 g m-2 per year) in the second year. The results show that constructed wetlands comprising approximately 1% of catchment area can markedly reduce N export via pastoral drainage, but may be net sources of NH4-N, DRP and TP during establishment. Performance of the wetland appeared to be affected by both establishment/maturation factors and year-to-year climatic variations. Longer-term studies, supplemented by process-based laboratory and mesocosm investigations, are required to evaluate sustainable nutrient removal rates over a range of climatic conditions, and identify the key factors regulating performance.

Tasian GE, JE Pulido, et al, Urologic Diseases in America Project. 2014. Daily mean temperature and clinical kidney stone presentation in five US metropolitan areas: a time-series analysis. Environmental health perspectives, 22(10): 1081.

Background: High ambient temperatures are a risk factor for nephrolithiasis, but the precise relationship between temperature and kidney stone presentation is unknown.

Objectives: Our objective was to estimate associations between mean daily temperature and kidney stone presentation according to lag time and temperatures.

Methods: Using a time-series design and distributed lag nonlinear models, we estimated the relative risk (RR) of kidney stone presentation associated with mean daily temperatures, including cumulative RR for a 20-day period, and RR for individual daily lags through 20 days. Our analysis used data from the MarketScan Commercial Claims database for 60,433 patients who sought medical evaluation or treatment of kidney stones from 2005-2011 in the U.S. cities of Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Los Angeles, California; and Philadelphia, Pennsylvania.

Results: Associations between mean daily temperature and kidney stone presentation were not monotonic, and there was variation in the exposure-response curve shapes and the strength of associations at different temperatures. However, in most cases RRs increased for temperatures above the reference value of 10°C. The cumulative RR for a daily mean temperature of 30°C versus 10°C was 1.38 in Atlanta (95% CI: 1.07, 1.79), 1.37 in Chicago (95% CI: 1.07, 1.76), 1.36 in Dallas (95% CI: 1.10, 1.69), 1.11 in Los Angeles (95% CI: 0.73, 1.68), and 1.47 in Philadelphia (95% CI: 1.00, 2.17). Kidney stone presentations also were positively associated with temperatures < 2°C in Atlanta, and < 10°C in Chicago and Philadelphia. In four cities, the strongest association between kidney stone presentation and a daily mean temperature of 30°C versus 10°C was estimated for lags of <=3 days.

Conclusions: In general, kidney stone presentations increased with higher daily mean temperatures, with the strongest associations estimated for lags of only a few days. These findings further support an adverse effect of high temperatures on nephrolithiasis.

Tate KW, ER Atwill, et al. 2006. Significant Escherichia coli attenuation by vegetative buffers on annual grasslands. Journal of environmental quality, 35(3): 795-805.

A study was conducted to estimate the retention efficiency of vegetative buffers for Escherichia coli deposited on grasslands in cattle fecal deposits and subject to natural rainfall-runoff conditions. The study was conducted on annual grasslands in California's northern Sierra Nevada foothills, a region with a distinct wet-dry season Mediterranean climate. We used 48, 2.0- by 3.0-m runoff plots to examine the efficacy of 0.1-, 1.1-, and 2.1-m buffers at three land slopes (5, 20, and 35%) and four dry vegetation matter levels (225, 560, 900, and 4500 kg/ha) across 27 rainfall-runoff events during two rainfall seasons. Buffer width treatments were implemented by placement of cattle fecal material containing known loads of E. coli 0.1, 1.1, or 2.1 m upslope of the plot runoff collector. Mean total runoff to total rainfall ratio per plot ranged from 0.014:1 to 0.019:1 and reflected the high infiltration capacity of these soils. Approximately 94.8 to 99.995% of total E. coli load applied to each plot appears to be either retained in the fecal pat and/or attenuated within 0.1 m downslope of the fecal pat, irrespective of the presence of a wider vegetated buffer. Relative to a 0.1-m buffer, we found 0.3 to 3.1 log10 reduction in E. coli discharge per additional meter of vegetative buffer across the range of residual dry vegetation matter levels, land slope, and rainfall and runoff conditions experienced during this project. Buffer efficiency was significantly reduced as runoff increased. These results support the assertion that grassland buffers are an effective method for reducing animal agricultural inputs of waterborne E. coli into surface waters.

Taylor L and DF Hochuli. 2015. Creating better cities: how biodiversity and ecosystem functioning enhance urban residents' wellbeing. Urban Ecosystems, 18(3): 747-62.

Cities concentrate risks and the adverse effects of dense populations, such as outdoor air pollution, chronic disease and the impact of extreme weather events. Governments and planning bodies struggle to heed and apply the abundance of unintegrated research that links aspects of the urban environment with urban residents' wellbeing. In order to promote human wellbeing in cities, a number of key features of the urban environment should be promoted. The medical science, urban ecology and urban design research already recognises the importance of some aspects, including providing walkable spaces, community space and greenspace. We argue that in practice, the provision of these three features is insufficient for human wellbeing. Emerging research demonstrates the importance of biodiversity and ecosystem functions to wellbeing. This paper outlines the concept of wellbeing and provides a summary of the three established features of urban environments that enhance residents' lives: the provision of walkable, community and greenspace. We then outline the importance of two vital but often overlooked links in the discussion of how urban planning contributes to wellbeing: biodiversity and ecosystem functioning. Until governments and policies recognise the importance of these two elements, urban design and management for wellbeing is at best simplistic. It is important for biodiversity and ecosystem function to be considered during the design decision process. Urban designers and ecologists should recognise that their work has the potential to contribute to human wellbeing by integrating biodiversity and ecosystem functioning in their research.

Teas J, T Hurley, et al. 2007. Walking outside improves mood for healthy menopausal women. Clinical Medicine: Oncology 1: 35-43.

Background: Exercise has been shown to decrease breast cancer risk and slow the progression of breast cancer. Physician recommendations and clinical research data most often are for gym-based exercise programs. However, the importance of exercise location on mood and stress hormones that may infl uence adherence to exercise has not been addressed.

Methods: Women first walked for an hour outdoors along a university path, and then a week later, for an hour indoors on a treadmill in a typical gym environment. Pre and post outdoor and indoor exercise moods (happy, pleased, sad, frustrated, worried, angry, delighted, and joy) were assessed by a 6 point Likert questionnaire, and saliva samples were collected for analysis of cortisol, and alpha amylase (a surrogate for serum norepinephrine).

Results: Nineteen healthy, non-smoking, postmenopausal women (average age 58 4) participated. Compared with scores after walking outdoors, walking indoors was associated with higher scores of worry (p = 0.02; mean difference 0.9; 95% CI (0.17, 1.6) and frustration (p = 0.03; mean difference 0.9; 95% CI (0.12, 1.6), and lower scores for feelings of being pleased (p = 0.03; mean difference -0.8; 95% CI: -1.7, 0.1) and delighted (p = 0.05; mean difference -0.9; 95% CI: -1.75, -0.02). Changes in salivary hormone levels did not vary signifi cantly between the two environments.

Conclusion: Walking outdoors was associated with improved mood, but walking indoors was not. Improved mood may reduce breast cancer risk indirectly by promoting regular exercise. Physician recommendations for exercise should include gym and non-gym based exercise options.

Tennessen C M & B Cimprich. 1995. Views to nature: Effects on attention. Journal of Environmental Psychology 15(1): 77-85.

This study is based on a theoretical view which suggests that under increased demands for attention, individuals' capacity to direct attention may become fatigued. Once fatigued, attentional restoration must occur in order to return to an effectively functioning state. An attention-restoring experience can be as simple as looking at nature. The purpose of this study was to explore whether university dormitory residents with more natural views from their windows would score better than those with less natural views on tests of directed attention. Views from dormitory windows of 72 undergraduate students were categorized into four groups ranging from all natural to all built. The capacity to direct attention was measured using a battery of objective and subjective measures. Natural views were associated with better performance on attentional measures, providing support for the proposed theoretical view.

Terrado M, R Tauler, & EM Bennett. 2015. Landscape and local factors influence water purification in the Monteregian agroecosystem in Quebec, Canada. Regional Environmental Change, 15(8): 1743-55.

The management of riparian areas in agricultural regions is important for the protection of water quality. In Quebec, a buffer strip of at least three meters width is required for riparian buffers adjacent to agricultural areas. However, other qualities of the riparian area and the surrounding landscape may affect the ability of a system to deliver a water purification ecosystem service. This study, located in a tile-drained agroecosystem in the Monteregie (Quebec, Canada), aims to unravel the importance of local factors (the environment adjacent to the stream) and landscape factors (the environment in the whole drainage basin) in water purification through sediment and nutrient retention. We assessed riparian and water quality in twenty-one sites distributed among four headwater streams. A regression analysis indicates that both landscape and local variables influence the provision of water purification. We therefore suggest that the effect of riparian buffers might be mediated by other factors such as subsurface drainage or local land management. Landscape configuration (the geometry and location of various land uses) was identified as playing a key role in the level of ecosystem services provided. We suggest that management of water quality in agroecosystems should focus both on buffer strips and on management of larger source areas in the basin. Interventions should not be only limited to recommendations for buffer width, but should also consider interactions between other local and landscape factors.

Thomas F. The role of natural environments within women's everyday health and wellbeing in Copenhagen, Denmark. Health & place, 35: 187-95.

Urbanisation has been linked with sedentary lifestyles and poor mental health outcomes amongst women. The potential for natural environments to enhance physical activity and mental wellbeing in urban areas is now well recognised. However, little is known about the ways that women use natural spaces for health and wellbeing within the context of their everyday lives. This paper draws on ideas developed in the therapeutic landscapes literature to examine how experiences in different types of green and blue space provide important health and wellbeing benefits for women in Copenhagen, Denmark. As well as facilitating physical exercise, such spaces were found to enable a range of more subtle benefits that helped to restore mental wellbeing through stress and anxiety alleviation, the facilitation of emotional perspective, clarity and reassurance, and through the maintenance of positive family dynamics. However, amongst some women who were overweight, the socio-political associations they made with natural environments deterred use of such spaces. Such findings challenge dominant planning and policy assumptions that equate open public access to natural spaces with universal benefit.

Thompson Coon J, K Boddy, et al. 2011. Does Participating in Physical Activity in Outdoor Natural Environments Have a Greater Effect on Physical and Mental Wellbeing than Physical Activity Indoors? A Systematic Review. Environmental Science & Technology 45(5): 1761-1772.

Our objective was to compare the effects on mental and physical wellbeing, health related quality of life and long-term adherence to physical activity, of participation in physical activity in natural environments compared with physical activity indoors. We conducted a systematic review using the following data sources: Medline, Embase, Psychinfo, GreenFILE, SportDISCUS, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, Arts and Humanities Citation Index, Conference Proceedings Citation Index Science and BIOSIS from inception to June 2010. Internet searches of relevant Web sites, hand searches of relevant journals, and the reference lists of included papers and other review papers identified in the search were also searched for relevant information. Controlled trials (randomized and nonrandomized) were included. To be eligible trials had to compare the effects of outdoor exercise initiatives with those conducted indoors and report on at least one physical or mental wellbeing outcome in adults or children. Screening of articles for inclusion, data extraction, and quality appraisal were performed by one reviewer and checked by a second with discrepancies resolved by discussion with a third if necessary. Due to the heterogeneity of identified studies a narrative synthesis was performed. Eleven trials (833 adults) were included. Most participants (6 trials; 523 adults) were young students. Study entry criteria and methods were sparsely reported. All interventions consisted of a single episode of walking or running indoors with the same activity at a similar level conducted outdoors on a separate occasion. A total of 13 different outcome measures were used to evaluate the effects of exercise on mental wellbeing, and 4 outcome measures were used to assess attitude to exercise. Most trials (n = 9) showed some improvement in mental wellbeing on one or other of the outcome measures. Compared with exercising indoors, exercising in natural environments was associated with greater feelings of revitalization and positive engagement, decreases in tension, confusion, anger, and depression, and increased energy. However, the results suggested that feelings of calmness may be decreased following outdoor exercise. Participants reported greater enjoyment and satisfaction with outdoor activity and declared a greater intent to repeat the activity at a later date. None of the identified studies measured the effects of physical activity on physical wellbeing or the effect of natural environments on exercise adherence. The hypothesis that there are added beneficial effects to be gained from performing physical activity outdoors in natural environments is very appealing and has generated considerable interest. This review has shown some promising effects on self-reported mental wellbeing immediately following exercise in nature which are not seen following the same exercise indoors. However, the interpretation and extrapolation of these findings is hampered by the poor methodological quality of the available evidence and the heterogeneity of outcome measures employed. The review demonstrates the paucity of high quality evidence on which to base recommendations and reveals an undoubted need for further research in this area. Large, well designed, longer term trials in populations who might benefit most from the potential advantages of outdoor exercise are needed to fully elucidate the effects on mental and physical wellbeing. The influence of these effects on the sustainability of physical activity initiatives also awaits investigation.

Thompson CW, P Aspinall, & J Roe. 2014. Access to green space in disadvantaged urban communities: evidence of salutogenic effects based on biomarker and self-report measures of wellbeing. Procedia-Social and Behavioral Sciences, 153: 10-22.

This paper describes two case studies from Scotland, UK, exploring links between access to green space, perceptions of and activities in green space, and health and quality of life. One study involved a natural experiment to study the effects of improvements to woodlands near a disadvantaged urban community, compared with a similar community without such interventions. The second study, a recent, innovative study for the Scottish Government, demonstrated use of a biomarker as a method for measuring the salutogenic effects of environmental settings such as green space, offering evidence of environment-body interactions within a real-world context of people's everyday lives.

Thorndike, Edward. 1900. "Mental fatigue. I." Psychological Review 7(5): 466-482.

This paper is intended to be the first of a series of reports of a study of the nature of mental fatigue, some of the conditions affecting it, and especially its phenomena in school life. I hope also to discuss the methods and results of the many workers in this field in the light of some of the conclusions apparently justified by this study. It seemed wise not to undertake any statistical investigation of fatigue in school children until the fact of mental fatigue had been carefully studied at some length in a few cases. The present section deals, therefore, entirely with the results attained by a study of subjects whose mental history during the experiments the investigator knew, whose method of work he could control and whose phenomena he could therefore interpret with some degree of assurance. It will also be wise to reserve any references to the work of others (of whom Professor Kraepelin is the most important) until these new data are presented. The present paper may best be introduced by a quotation from a preliminary notice printed in Science. "Mental fatigue" may mean either the fact of incompetency to do certain mental work, or a feeling of incompetency which parallels the fact, or the feeling or feelings denoted by our common expressions mentally tired and mentally exhausted.

Timpone, R J. 1998. Ties that bind: Measurement, demographics, and social connectedness. Political Behavior, 20(1), 53-77.

In this article I develop a taxonomy of how demographic variables are used in political science models. The functions of demographicsfor description, as controls in statistical models, or as proxies for external societal cleavages or underlying individual attributesraise questions about validity and responsible usage. To illustrate the more general problem, the construct of social connectedness is examined in regard to its relationship with various demographic variables and its impact on voter turnout. Using data from the 1992 National Election Study, the analyses indicate that marital status, church attendance, owning a home, formal group membership, education, and income are all related to social connectedness, but the impact of education and income on electoral participation does not appear to be mediated by social connectedness. The results illustrate that careful consideration of measurement issues can clarify the relationships in our substantive models and that substantive models can illuminate measurement issues as well.

Tiwary A, Refi, J Colls. 2008. Collection of ambient particulate matter by porous vegetation barriers: sampling and characterization methods. Aerosol Science 39(1): 40-7.

Sampling and characterization methods for assessing the effect of vegetative barriers on particulate matter (PM10) concentrations and functional group composition were developed and applied in a case study. Ambient PM10 was concurrently sampled upwind and downwind of a hawthorn hedge at a rural location in the UK. Fourier transform infrared (FTIR) spectra of PM10 samples were collected to characterize the functional group composition. Absorbances associated with sulfate, nitrate, ammonium, aliphatic carbon-hydrogen, and carbonyl functional groups were observed in the FTIR spectra. Calculations with gravimetric measurements show that the hedge collects PM10 mass with a collection efficiency of 34% on average. FTIR results suggest that individual functional groups might exhibit different behavior in the hedge, but further method development and sampling is necessary to calculate functional group results with more confidence. Current results show the potential of using hedges to mitigate ambient concentrations of airborne PM10, and applying these methods to a more statistically robust sample size is anticipated to aid in elucidating physico-chemical mechanisms driving collection of PM10 by hedge elements.

Townsend M. 2006. Feel blue? Touch green! Participation in forest/woodland management as a treatment for depression. Urban Forestry & Urban Greening 5(3): 111-120.

Recent research by a team from Deakin University explored the health and wellbeing benefits of civic environmentalism - voluntary communal actions undertaken to promote ecosystem sustainability, typified by membership of a "friends of parks" group. The research confirmed what was known intuitively: that belonging to such a group and undertaking the activities associated with such a group exposes people not only to the benefits of the natural environment, but also to other people and to opportunities to make a contribution which is socially valued. On the basis of those findings, a pilot project involving intentional engagement of people suffering depression and related disorders in supported nature-based activities in a woodland environment is being implemented and evaluated. This article reports on that project and discusses the implications of its findings to date, and the findings of the three earlier projects, both for urban woodland/forest managers and for the health sector. As this contribution indicates, there appears to be potential for the use of civic environmentalism to promote health, wellbeing and social connectedness for individuals and the wider population, as well as for groups with identified health vulnerabilities. However, the realization of the benefits of such an approach will be dependent on co-operation between the environment and health sectors to create and promote opportunities for increased civic environmentalism, and to identify and address the barriers to their effective use.

Triguero-Mas M, P Dadvand, et al. 2015. Natural outdoor environments and mental and physical health: relationships and mechanisms. Environment international, 77: 35-41.


Evidence is growing for the beneficial impacts of natural outdoor environments on health. However, most of the evidence has focused on green spaces and little evidence is available on health benefits of blue spaces and about possible mediators and modifiers of such impacts. We investigated the association between natural outdoor environments (separately for green and blue spaces) and health (general and mental) and its possible mediators and modifiers.


Cross-sectional data from adults interviewed in Catalonia (Spain) between 2010 and 2012 as part of the Catalonia Health Survey were used. The collected data included sociodemographic characteristics, self-perceived general health, mental health, physical activity and social support. Indicators of surrounding greenness and access to natural outdoor environments within 300 m of the residence and degree of urbanization were derived for residential addresses. Associations were estimated using logistic regression and negative binominal models.


Green spaces were associated with better self-perceived general health and better mental health, independent of degree of urbanization. The associations were more consistent for surrounding greenness than for access to green spaces. The results were consistent for different buffers, and when stratifying for socioeconomic status. Slightly stronger associations were found for women and residents of non-densely populated areas. No association was found between green spaces and social contacts and physical activity. The results for blue spaces were not conclusive.


Green spaces are associated with better general and mental health across strata of urbanization, socioeconomic status, and genders. Mechanisms other than physical activity or social support may explain these associations.

Tsunetsugu Y, J Lee, et al. 2013. Physiological and psychological effects of viewing urban forest landscapes assessed by multiple measurements. Landscape and Urban Planning 113(0): 90-93.

The present study investigated the physiological and psychological effects of viewing urban forest landscapes on 48 young male urban residents. Four forested areas and four urban areas located in central and western Japan were used as the test sites. We found that in the forested areas, the subjects exhibited (i) significantly lower diastolic blood pressure, (ii) significantly higher parasympathetic nervous activity, but significantly lower sympathetic nervous activity, and (iii) significantly lower heart rate. The forest landscapes (iv) obtained better scores in subjective ratings, and (v) induced significantly less negative and more vigorous moods. Taken as whole, these findings suggest that even a short-term viewing of forests has relaxing effects. We have thus concluded that the approach taken in this study is useful in exploring the influences of urban green space on humans, as well as contributing to the planning and design of a healthy environment for urban residents.

Tudor-Locke C, MM Brashear, et al. 2010. Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women. International Journal of Behavioral Nutrition and Physical Activity 7(60): 1-11.

Background: The 2005-2006 National Health and Nutrition Examination Survey (NHANES) is used to describe an accelerometer-derived physical activity/inactivity profile in normal weight (BMI < 25 kg/m2), overweight (25 > BMI > 30 kg/m2), and obese (BMI > 30 kg/m2) U.S. adults.

Methods: We computed physical activity volume indicators (activity counts/day, uncensored and censored steps/day), rate indicators (e.g., steps/minute), time indicators (employing NHANES activity counts/minute cut points to infer time in non-wear, sedentary, low, light, moderate, and vigorous intensities), the number of breaks in sedentary time (occasions when activity counts rose from < 100 activity/counts in one minute to > 100 activity counts in the subsequent minute), achievement of public health guidelines, and classification by step-defined physical activity levels. Data were examined for evidence of consistent and significant gradients across BMI-defined categories.

Results: In 2005-2006, U.S adults averaged 6,564 +- SE 107 censored steps/day, and after considering non-wear time, they spent approximately 56.8% of the rest of the waking day in sedentary time, 23.7% in low intensity, 16.7% in light intensity, 2.6% in moderate intensity, and 0.2% in vigorous intensity. Overall, approximately 3.2% of U.S. adults achieved public health guidelines. The normal weight category took 7,190 +- SE 157 steps/day, and spent 25.7 +- 0.9 minutes/day in moderate intensity and 7.3 +- 0.4 minutes/day in vigorous intensity physical activity. The corresponding numbers for the overweight category were 6,879 +- 140 steps/day, 25.3 +- 0.9 minutes/day, and 5.3 +- 0.5 minutes/day and for the obese category 5,784 +- 124 steps/day, 17.3 +- 0.7 minutes/day and 3.2 +- 0.4 minutes/day. Across BMI categories, increasing gradients and significant trends were apparent in males for sedentary time and decreasing gradients and significant trends were evident in time spent in light intensity, moderate intensity, and vigorous intensity. For females, there were only consistent gradients and significant trends apparent for decreasing amounts of time spent in moderate and vigorous intensity.

Conclusions: Simple indicators of physical activity volume (i.e., steps/day) and time in light, moderate or vigorous intensity physical activity differ across BMI categories for both sexes, suggesting that these should continue to be targets for surveillance.

Tyrvainen L, A Ojala, et al. 2014. The influence of urban green environments on stress relief measures: A field experiment. Journal of Environmental Psychology, 38: 1-9.

This study investigated the psychological (perceived restorativeness, subjective vitality, mood, creativity) and physiological (salivary cortisol concentration) effects of short-term visits to urban nature environments. Seventy-seven participants visited three different types of urban areas; a built-up city centre (as a control environment), an urban park, and urban woodland located in Helsinki, the capital of Finland. Our results show that the large urban park and extensively managed urban woodland had almost the same positive influence, but the overall perceived restorativeness was higher in the woodland after the experiment. The findings suggest that even short-term visits to nature areas have positive effects on perceived stress relief compared to built-up environment. The salivary cortisol level decreased in a similar fashion in all three urban environments during the experiment. The relations between psychological measures and physiological measures, as well as the influence of nature exposure on different groups of people, need to be studied further.

Tzivian L, A Winkler, et al. 2015. Effect of long-term outdoor air pollution and noise on cognitive and psychological functions in adults. International journal of hygiene and environmental health, 218(1): 1-1.

It has been hypothesized that air pollution and ambient noise might impact neurocognitive function. Early studies mostly investigated the associations of air pollution and ambient noise exposure with cognitive development in children. More recently, several studies investigating associations with neurocognitive function, mood disorders, and neurodegenerative disease in adult populations were published, yielding inconsistent results. The purpose of th