In het project ‘Boeren voor Drinkwater’ werken melkveehouders sinds 2010 samen met onder andere de provincie Overijssel en drinkwaterbedrijf Vitens aan het verminderen van de milieubelasting op het grondwater in de meest kwetsbare zandgebieden. Hoewel nog niet overal de doelstelling voor nitraatuitspoeling gehaald wordt, is bij de deelnemers al een aanzienlijke vermindering bereikt. Het project laat zien dat een efficientere mineralenkringloop leidt tot minder milieubelasting en hand in hand gaat met een verbeterd economisch rendement. Om de drinkwaterwinning veilig te stellen is het echter nodig de mineralenbenutting in (vrijwel) het gehele intrekgebied te optimaliseren.
In epidemiological studies, exposure to green space is inconsistently associated with being overweight and physical activity, possibly because studies differ widely in their definition of green space exposure, inclusion of important confounders, study population and data analysis.We evaluated whether the association of green space with being overweight and physical activity depended upon definition of greenspace.We conducted a cross-sectional study using data from a Dutch national health survey of 387,195 adults. Distance to the nearest park entrance and surrounding green space, based on the Normalized Difference Vegetation Index (NDVI) or a detailed Dutch land-use database (TOP10NL), was calculated for each residential address. We used logistic regression analyses to study the association of green space exposure with being overweight and being moderately or vigorously physically active outdoors at least 150min/week (self-reported). To study the shape of the association, we specified natural splines and quintiles.The distance to the nearest park entrance was not associated with being overweight or outdoor physical activity. Associations of surrounding green space with being overweight or outdoor physical activity were highly non-linear. For NDVI surrounding greenness, we observed significantly decreased odds of being overweight [300m buffer, odds ratio (OR) = 0.88; 95% CI: 0.86, 0.91] and increased odds for outdoor physical activity [300m buffer, OR = 1.14; 95% CI: 1.10, 1.17] in the highest quintile compared to the lowest quintile. For TOP10NL surrounding green space, associations were mostly non-significant. Associations were generally stronger for subjects living in less urban areas and for the smaller buffers.Associations of green space with being overweight and outdoor physical activity differed considerably between different green space definitions. Associations were strongest for NDVI surrounding greenness.
Introduction World Health Organization estimates 1.5 million deaths worldwide to be directly caused by diabetes, making it the 7th leading cause of death in 2030. Lifestyle is considered an important factor in the onset of disease. In recent years, a number of epidemiological and toxicological studies linked long-term air pollution exposure with diabetes prevalence and incidence, with systemic inflammation being one of the hypothesized mechanisms. Methods Using the 2012 Dutch national health survey of 387,195 adults we investigated the associations between the annual average concentrations of a range of air pollutants from ESCAPE land use regression models and diabetes prevalence (self-reported doctors diagnosis). We adjusted for a range of potential confounders, including neighborhood- and individual background characteristics, and lifestyle-related risk factors (smoking habits, alcohol consumption, physical activity and BMI). Results Exposure to PM10, PM2.5, PM2.5-10, absorbance, OPDTT, OPESR and NO2 was associated with increased odds ratio (OR) of diabetes prevalence. After adjustment for a number of potential confounders, most of the associations (except PM2.5) remained significant. When correcting for other co-pollutants in two-pollutant models, NO2 [OR 1.06 (95% CI: 1.04, 1.08)] and OPDTT [1.08 (95% CI 1.06, 1.11)] were most robustly associated with increased diabetes prevalence, rendering the associations observed with other air pollution components insignificant. Stratified analysis showed no consistent effect modification by any of the included known diabetes risk factors. Conclusions Long-term residential exposure to OPDTT and NO2 was associated with increased diabetes prevalence in a large Dutch national health survey.
Most previous studies that investigated associations of surrounding green, air pollution or traffic noise with mortality focused on single exposures. The aim of this study was to evaluate combined associations of long-term residential exposure to surrounding green, air pollution and traffic noise with total non-accidental and cause-specific mortality. We linked a national health survey (Public Health Monitor, PHM) conducted in 2012 to the Dutch longitudinal mortality database. Subjects of the survey who were 30 years or older on 1 January 2013 (n = 339,633) were followed from 1 January 2013 till 31 December 2017. We used Cox proportional hazard models to evaluate associations of residential surrounding green (including the average Normalized Difference Vegetation Index (NDVI) in buffers of 300 m and 1000 m), annual average air pollutant concentrations (including particulate matter (PM10, PM2.5), nitrogen dioxide (NO2)) and traffic noise with non-accidental, circulatory disease, respiratory disease, lung cancer and neurodegenerative disease mortality. We observed 26,886 non-accidental deaths over 1.627.365 person-years of follow-up. Surrounding green, air pollution and traffic noise exposure were not significantly associated with non-accidental or cause-specific mortality. For non-accidental mortality, we found a hazard ratio (HR) of 0.99 (0.98, 1.01) per IQR increase in NDVI 300 m, a HR of 0.99 (95% CI: 0.97, 1.01) per IQR increase in NO2, a HR of 0.98 (0.97, 1.00) per IQR increase in PM2.5 and a HR of 0.99 (95% CI: 0.97, 1.01) per IQR increase in road-traffic noise. Analyses restricted to non-movers or excluding subjects aged 85+ years did not change the findings. We found no evidence for associations of long-term residential exposures to surrounding green, air pollution and traffic noise with non-accidental or cause-specific mortality in a large population based survey in the Netherlands, possibly related to the relatively short follow-up period.
We examined if the assessment of the health impact of a national Dutch regeneration programme depends on using either a repeated cross-sectional or longitudinal study design. This is important as only the latter design can incorporate migration patterns. For both designs, we compared trends in medication use between target and control districts. We found differences in medication use trends to be modest under the longitudinal design, and not demonstrable under the repeated cross-sectional design. The observed differences were hardly influenced by migration patterns. We conclude that in the Netherlands migration patterns had little effect on the health impact assessment of this national urban regeneration programme, so either the cross-sectional or longitudinal evaluation study design will do.
