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Complex interplay between greenness and air pollution in respiratory health
  1. Elaine Fuertes1,
  2. Debbie Jarvis1,2
  1. 1 National Heart and Lung Institute, Imperial College London, London, UK
  2. 2 MRC Centre for Environment & Health, Imperial College London, London, UK
  1. Correspondence to Elaine Fuertes, National Heart and Lung Institute, Imperial College London, London SW3 6LR, UK; e.fuertes{at}

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For many, it seems self-evident that a greener city improves the quality of life and health for its citizens. Epidemiological studies are providing increasing evidence that the presence and amount of vegetation around locations where one spends a lot of time (home, work and school) have numerous beneficial effects on physical and mental health, including increased longevity.1 Interestingly, the evidence supporting a positive role of vegetation on allergic and respiratory health is much weaker, possibly because of the complex role played by air pollution. Beneficial effects attributed to vegetation may be due to less air pollution, as levels tend to be lower in vegetated areas. Some vegetation types may also actively reduce air pollution levels, although the scientific consensus is that this occurs only to a limited extent.2 Air pollutants may also interact with vegetation, such as pollen,3 to influence associations with health. These mechanisms are relevant in urban settings where air pollution levels can be high.

Various metrics are used to estimate ‘vegetation exposure’ in epidemiological studies. The Normalised Difference Vegetation Index (NDVI) is common and assesses surrounding levels of green vegetation, often termed ‘greenness’. The NDVI is calculated from satellite data giving the ratio of visible and near-infrared light reflection and ranges from −1 (water), 0 (barren rock) to +1 (dense green vegetation). It provides a measure …

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  • Contributors EF and DJ both drafted the work, substantively revised it, have approved the submitted version, agree to be personally accountable for their contribution and will ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated, resolved, and the resolution documented in the literature.

  • Funding EF is a recipient of the Imperial College Research Fellowship (2019–2023, grant number: not applicable).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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