Correlation analysis of lung cancer and urban spatial factor: based on survey in Shanghai

Abstract

Background: The density of particulate matter (PM) in mega-cities in China such as Beijing and Shanghai has exceeded basic standards for health in recent years. Human exposure to PMs has been identified as traceable and controllable factor among all complicated risk factors for lung cancer. While the improvement of air quality needs tremendous efforts and time, certain revision of PM's density might happen associated with the adjustment of built environment. It is also proved that urban built environment is directly relevant to respiratory disease. Studies have respectively explored the indoor and outdoor factors on respiratory diseases. More comprehensive spatial factors need to be analyzed to understand the cumulative effect of built environment upon respiratory system. This interdisciplinary study examines the impact of both indoor (including age of housing, interval after decoration, indoor humidity etc.) and outdoor spatial factors (including density, parking, green spaces etc.) on lung cancer. Methods: A survey of lung cancer patients and a control group has been conducted in 2014 and 2015. A total of 472 interviewees are randomly selected within a pool of local residents who have resided in Shanghai for more than 5 years. Data are collected including their socio-demographic factors, lifestyle factors, and external and internal residential area factors. Regression models are established based on collected data to analyze the associations between lung cancer and urban spatial factors. Results: Regression models illustrate that lung cancer presents significantly associated with a number of spatial factors. Significant outdoor spatial factors include external traffic volume (P=0.003), main plant type (P=0.035 for trees) of internal green space, internal water body (P=0.027) and land use of surrounding blocks (P=0.005 for residential areas of 7-9 floors, P=0.000 for residential areas of 4-6 floors, P=0.006 for business/ commercial areas over 10 floors, P=0.005 for business/commercial areas of 7-9 floors, P=0.043 for business/ commercial areas of 4-6 floors). Indoor spatial factors include age of housing (P=0.003) and indoor humidity (P=0.000). Conclusions: The findings support the hypothesis that both indoor and outdoor spatial factors are independently associated with lung cancer incidence. Certain principles based on the modeling results are proposed to revise the criteria for lung cancer screening of high-risk individuals. It also provides empirical evidence for urban planning and design to improve built environment with more thorough consideration of respiratory health.

Spatial Analysis of Built Environment Risk for Respiratory Health and Its Implication for Urban Planning: A Case Study of Shanghai

“…Epidemiological studies of lung cancer have identified risk factors for lung cancer such as smoking, passive smoking, familial inheritance, air pollution (outdoor and indoor air pollution), work environment exposure and diet [38]. Relevant studies have identified certain factors of urban built environment affecting outdoor air pollution, including land use, spatial form, transportation system, green space and public open space [39]. The scale and layout of specific types of land use may affect outdoor air pollution, thus affecting respiratory health, including industrial land [40,41,42,43,44], cultivated land [44], residential land [40,41,42,44] and waterbody [42,44].…”

Urban Trees and Human Health: A Scoping Review

“…In the cross-sectional studies, several positive outcomes and a few neutral findings were reported. Positive outcomes included: lower prevalence of lung cancer associated with green space covered with trees within residential areas [49]; lower prevalence of asthma among children associated with greater street tree density [50]; and reduced asthma hospitalization associated with tree density during periods with high ambient pollutant concentrations [51]. Neutral findings included: no significant association between street tree density and asthma hospitalization among children [50]; and no significant association between tree density and asthma hospitalization during periods with lower ambient pollutant concentrations [51].…”

Effects of neighborhood building density, height, greenspace, and cleanliness on indoor environment and health of building occupants

“…Various previous studies indicated that neighborhood greenspace affects building occupant health. Researchers tend to associate this result with the opportunity provided to occupants to walk and exercise (e.g., [44,66]. In current study, even though half of the buildings are located in areas surrounded by large greenspace, majority of these green areas are not accessible (fall outside the premises area) (refer to Fig.…”

“…In fact, the roles of greenspace have found to be especially significant in protecting building occupants from health hazards related to air pollution and extreme temperature (e.g. [11], and in promoting healthy behaviors amongst building occupants, such as physical activities (e.g., [44,66].…”