Biodiversity and human health: mechanisms and evidence of the positive health effects of diversity in nature and green spaces.

&lt;p&gt;&lt;b&gt;Introduction: &lt;/b&gt;Natural environments and green spaces provide ecosystem services that enhance human health and well-being. They improve mental health, mitigate allergies and reduce all-cause, respiratory, cardiovascular and cancer mortality. The presence, accessibility, proximity and greenness of green spaces determine the magnitude of their positive health effects, but the role of biodiversity (including species and ecosystem diversity) within green spaces remains underexplored. This review describes mechanisms and evidence of effects of biodiversity in nature and green spaces on human health.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Sources of data: &lt;/b&gt;We identified studies listed in PubMed and Web of Science using combinations of keywords including &#039;biodiversity&#039;, &#039;diversity&#039;, &#039;species richness&#039;, &#039;human health&#039;, &#039;mental health&#039; and &#039;well-being&#039; with no restrictions on the year of publication. Papers were considered for detailed evaluation if they were written in English and reported data on levels of biodiversity and health outcomes.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Areas of agreement: &lt;/b&gt;There is evidence for positive associations between species diversity and well-being (psychological and physical) and between ecosystem diversity and immune system regulation.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Areas of concern: &lt;/b&gt;There is a very limited number of studies that relate measured biodiversity to human health. There is more evidence for self-reported psychological well-being than for well-defined clinical outcomes. High species diversity has been associated with both reduced and increased vector-borne disease risk.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Growing points: &lt;/b&gt;Biodiversity supports ecosystem services mitigating heat, noise and air pollution, which all mediate the positive health effects of green spaces, but direct and long-term health outcomes of species diversity have been insufficiently studied so far.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Areas timely for research: &lt;/b&gt;Additional research and newly developed methods are needed to quantify short- and long-term health effects of exposure to perceived and objectively measured species diversity, including health effects of nature-based solutions and exposure to microbiota.&lt;/p&gt;</p

Simultaneous determination of parabens, bisphenols and alkylphenols in human placenta by ultra-high performance liquid chromatography - tandem mass spectrometry

&lt;p&gt;This study presents de development and validation of an ultra- high performance liquid chromatography – tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous determination of four parabens (methyl-, ethyl-, propyl-, and butyl-paraben (MeP, EtP, PrP, BuP), four bisphenols (BP) (BPA, BPB, BPF, and BPS) and two&amp;nbsp; alkylphenols (nonyl phenol (NP) and tert-octylphenol (OP) in human placenta samples.&amp;nbsp; After a short sample preparation time the extracts are analysed by UHPLC-MS/MS using negative electrospray ionization.&amp;nbsp; Labeled internal standards and matrix-matched calibration are used for quantification of the compounds. The method was validated according FDA guideline for bio analytical methods using spiked samples at three concentration levels (0.5-5 and 25 ng g−1). The parameters accuracy and precision fulfill the criteria. Calibration curves are linear between 0.5 and 50 ng −1. The limits of detection and quantification are in the range of 0.1-0.3 ng g−1 and 0.2 -0.7 ng g−1, respectively. The applicability of the method was demonstrated on&amp;nbsp; 71 human placenta samples from a Belgian cohort. The detection frequency was highest for OP (95%), EtP (86%), BPA (49%) and BPS (44%). Among the quantified compounds the highest quantification frequency was observed for OP (85%), EtP (65%) and BPA (25%). The concentrations of parabens ranged from 0.5-7.1 ng g−1 for MeP, from 0.5-4.5 ng g−1 for EtP and from 0.5-9.1 ng g−1 for PrP. The levels of bisphenols ranged from 0.5-3.9 ng g−1 for BPA, from 0.6-2.1 ng g−1 for BPF and from 0.8-1.3 ng g−1 for BPS. BPB and NP were not detected and OP levels ranged from 0.5-3.7 ng g−1. The results demonstrate that the developed analytical method is very sensitive and that levels of several compounds with known /suspected endocrine disrupting properties could be detected or quantified in human placenta samples. The results therefore suggest that fetal exposure to these compounds occurs. The method will be useful for studies to evaluate the health effects associated with this prenatal exposure.&lt;/p&gt;</p

Simultaneous determination of parabens, bisphenols and alkylphenols in human placenta by ultra-high performance liquid chromatography - tandem mass spectrometry

This study presents de development and validation of an ultra- high performance liquid chromatography – tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous determination of four parabens (methyl-, ethyl-, propyl-, and butyl-paraben (MeP, EtP, PrP, BuP), four bisphenols (BP) (BPA, BPB, BPF, and BPS) and two alkylphenols (nonyl phenol (NP) and tert-octylphenol (OP) in human placenta samples. After a short sample preparation time the extracts are analysed by UHPLC-MS/MS using negative electrospray ionization. Labeled internal standards and matrix-matched calibration are used for quantification of the compounds. The method was validated according FDA guideline for bio analytical methods using spiked samples at three concentration levels (0.5–5 and 25 ng g−1). The parameters accuracy and precision fulfill the criteria. Calibration curves are linear between 0.5 and 50 ng −1. The limits of detection and quantification are in the range of 0.1–0.3 ng g−1 and 0.2–0.7 ng g−1, respectively. The applicability of the method was demonstrated on 71 human placenta samples from a Belgian cohort. The detection frequency was highest for OP (95%), EtP (86%), BPA (49%) and BPS (44%). Among the quantified compounds the highest quantification frequency was observed for OP (85%), EtP (65%) and BPA (25%). The concentrations of parabens ranged from 0.5 to 7.1 ng g−1 for MeP, from 0.5 to 4.5 ng g−1 for EtP and from 0.5 to 9.1 ng g−1 for PrP. The levels of bisphenols ranged from 0.5 to 3.9 ng g−1 for BPA, from 0.6 to 2.1 ng g−1 for BPF and from 0.8 to 1.3 ng g−1 for BPS. BPB and NP were not detected and OP levels ranged from 0.5 to 3.7 ng g g−1. The results demonstrate that the developed analytical method is very sensitive and that levels of several compounds with known /suspected endocrine disrupting properties could be detected or quantified in human placenta samples. The results therefore suggest that fetal exposure to these compounds occurs. The method will be useful for studies to evaluate the health effects associated with this prenatal exposure.</p

Personal exposure to traffic-related air pollutants and relationships with respiratory symptoms and oxidative stress: A pilot cross-sectional study among urban green space workers.

&lt;p&gt;Exposure to ambient air pollution has been associated with various adverse health effects including respiratory, cardiovascular and neurological diseases. Exposure data for some specific pollutants and settings are however still insufficient and mechanisms underlying negative health outcomes are not fully elucidated. This pilot study aimed to assess individual exposure to three traffic-related air pollutants, black carbon (BC), polycyclic aromatic hydrocarbons (PAHs) and benzene, and the relationship with respiratory and oxidative stress outcomes in a cross-sectional sample of 48 green space workers in Brussels, Belgium. Participants were followed during four consecutive working days in 2016-2017 during which their individual exposure to BC, PAHs, benzene and more generally air pollution was measured using aethalometers, urinary biomarkers (1-hydroxypyrene, 1-naphthol, 2-naphthol, S-phenylmercapturic acid) and questionnaires. Data on respiratory health and oxidative stress were collected using questionnaires and respiratory/urinary biomarkers (exhaled nitric oxide [NO], 8-hydroxydeoxyguanosine [8-OHdG]). Associations between exposure and health outcomes were investigated using comparison tests and linear regression models, after stratification by present-day smoking status. Spatial variation in BC exposure was high, with concentrations varying between 0.26 and 5.69 μg/m. The highest levels were recorded during transport and, to a lesser extent, in green spaces located in the vicinity of roads with high traffic intensity. Concentrations of PAHs and benzene biomarkers did not systematically exceed the limits of detection. Among smokers, respiratory inflammation increased linearly with exposure to BC measured over the four days of follow-up (β = 8.73, 95% CI: 4.04, 13.41). Among non-smokers, oxidative stress increased linearly with BC measured on the fourth day (β = 2.88, 95% CI: 1.52, 4.24). Despite some limitations, this work supports the hypothesis that BC induces respiratory inflammation and oxidative stress. It also highlights the value of this compound as well as exhaled NO and urinary 8-OHdG biomarkers to detect early/mild effects of air pollution.&lt;/p&gt;</p

Residential green space, air pollution, socioeconomic deprivation and cardiovascular medication sales in Belgium: A nationwide ecological study

Green space may improve cardiovascular (CV) health, for example by promoting physical activity and by reducing air pollution, noise and heat.&nbsp; Socioeconomic and environmental factors may modify the health effects of green space. We examined the association between residential green space and reimbursed CV medication sales in Belgium between 2006 and 2014, adjusting for socioeconomic deprivation and air pollution.&nbsp; We analyzed data for 11,575 census tracts using structural equation models for the entire country and for the administrative regions.&nbsp; Latent variables for green space, air pollution and socioeconomic deprivation were used as predictors of CV medication sales and were estimated from the number of patches of forest, census tract relative forest cover and relative forest cover within a 600 m buffer around the census tract; annual mean concentrations of PM2.5, BC and NO2; and percentages of inhabitants that were foreign-born from lower- and mid-income countries, unemployed or had no higher education. A direct association between socioeconomic deprivation and CV medication sales [parameter estimate (95% CI): 0.26 (0.25; 0.28)] and inverse associations between CV medication sales and green space [–0.71 (–0.80; –0.61)] and air pollution [–1.62 (–1.69; –0.61)] were observed.&nbsp; In the regional models, the association between green space and CV medication sales was stronger in the region with relatively low green space cover (Flemish Region, standardized estimate –0.16) than in the region with high green space cover (Walloon Region, –0.10).&nbsp; In the highly urbanized Brussels Capital Region the association tended towards the null. In all regions, the associations between CV medication sales and socioeconomic deprivation were direct and more prominent. Our results suggest that there may be an inverse association between green space and CV medication sales, but socioeconomic deprivation was always the strongest predictor of CV medication&nbsp;sales.</p

Thyroid cancer incidence near nuclear sites in Belgium: An ecological study at small geographical level

In Belgium, variations in thyroid cancer incidence were observed around the major nuclear sites. The present ecological study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the four nuclear sites at the smallest Belgian geographical level. Rate ratios were obtained from a Bayesian hierarchical model for areas of varying sizes around the nuclear sites. Focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. No evidence was found for more incident cases of thyroid cancer near the two nuclear power plants. Regarding the two industrial and research nuclear sites, no evidence for a higher incidence in the vicinity of Mol‐Dessel was observed, whereas a slightly nonsignificant higher incidence was found in the close vicinity of Fleurus. In addition, significant gradients for thyroid cancer incidence were observed with the different types of surrogate exposure considered in the 20 km area around the site of Fleurus (decreasing distance, increasing wind direction frequency and increasing exposure to estimated hypothetical radioactive discharges of iodine‐131). In the investigation at the smallest Belgian geographical level, variations in thyroid cancer incidence were found around the Belgian nuclear sites. Significant exposure–response relationships were also observed for the site of Fleurus. Further investigations into these findings could be useful to allow inferring causal relationships on the origin of variations in incidence and to provide information at the individual&nbsp;level.</p

Thyroid Cancer Incidence around the Belgian Nuclear Sites, 2000-2014.

&lt;p&gt;The present study investigates whether there is an excess incidence of thyroid cancer among people living in the vicinity of the nuclear sites in Belgium. Adjusted Rate Ratios were obtained from Poisson regressions for proximity areas of varying sizes. In addition, focused hypothesis tests and generalized additive models were performed to test the hypothesis of a gradient in thyroid cancer incidence with increasing levels of surrogate exposures. Residential proximity to the nuclear site, prevailing dominant winds frequency from the site, and simulated radioactive discharges were used as surrogate exposures. No excess incidence of thyroid cancer was observed around the nuclear power plants of Doel or Tihange. In contrast, increases in thyroid cancer incidence were found around the nuclear sites of Mol-Dessel and Fleurus; risk ratios were borderline not significant. For Mol-Dessel, there was evidence for a gradient in thyroid cancer incidence with increased proximity, prevailing winds, and simulated radioactive discharges. For Fleurus, a gradient was observed with increasing prevailing winds and, to a lesser extent, with increasing simulated radioactive discharges. This study strengthens earlier findings and suggests increased incidences in thyroid cancer around two of the four Belgian nuclear sites. Further analyses will be performed at a more detailed geographical level.&lt;/p&gt;</p

An evaluation of species distribution models to estimate tree diversity at genus level in a heterogeneous urban-rural landscape

Trees provide ecosystem services that improve the environment and human health. The magnitude of these improvements may be related to tree diversity within green spaces, yet spatially explicit diversity data necessary to investigate such associations are often missing. Here, we evaluate two methods to model tree diversity at genus level based on environmental covariates and presence point data. We aimed to identify the drivers and suitable methods for urban and rural tree diversity models in the heterogeneous region of Flanders,&nbsp;Belgium. We stratified our research area into dominantly rural and dominantly urban areas and developed distribution models for 13 tree genera for both strata as well as for the area as a whole. Occurrence data were obtained from an open-access presence-only database of validated observations of vascular plants. These occurrence data were combined with environmental covariates in MaxEnt models. Tree diversity was modelled by adding up the individual species distribution&nbsp;models. Models in the dominantly rural areas were driven by soil characteristics (soil texture and drainage class). Models in the dominantly urban areas were driven by environmental covariates explaining urban heterogeneity. Nevertheless, the stratification into urban and rural did not contribute to a higher model quality. Generic tree diversity estimates were better when presences derived from distribution models were simply added up (binary stacking, True Positive Rate of 0.903). The application of macro-ecological constraints resulted in an underestimation of generic tree diversity (probability stacking, True Positive Rate of 0.533). We conclude that summing presences derived from species distribution models (binary stacking) is a suitable approach to increase knowledge on regional&nbsp;diversity.</p

Childhood leukemia near nuclear sites in Belgium: An ecological study at small geographical level.

BACKGROUND: A previous investigation of the occurrence of childhood acute leukemia around the Belgian nuclear sites has shown positive associations around one nuclear site (Mol-Dessel). In the following years, the Belgian Cancer Registry has made data available at the smallest administrative unit for which demographic information exists in Belgium, i.e. the statistical sector. This offers the advantage to reduce the potential misclassification due to large geographical&nbsp;scales. METHODS: The current study performed for the period 2006-2016 uses Poisson models to investigate (i) the incidence of childhood acute leukemia within 20 km around the four Belgian nuclear sites, (ii) exposure-response relationships between cancer incidence and surrogate exposures from the nuclear sites (distance, wind direction frequency and exposure by hypothetical radioactive discharges taking into account historical meteorological conditions). All analyses are carried out at statistical sector&nbsp;level. RESULTS: Higher incidence rate ratios were found for children &lt;15 years (7 cases, RR = 3.01, 95% CI: 1.43;6.35) and children &lt;5 years (&lt; 5 cases, RR = 3.62, 95% CI: 1.35;9.74) living less than 5 km from the site of Mol-Dessel. In addition, there was an indication for positive exposure-response relationships with the different types of surrogate&nbsp;exposures. CONCLUSION: Results confirm an increased incidence of acute childhood leukemia around Mol-Dessel, but the number of cases remains very small. Random variation cannot be excluded and the ecological design does not allow concluding on causality. These findings emphasize the need for more in-depth research into the risk factors of childhood leukemia, for a better understanding of the etiology of this&nbsp;disease.</p

Heat related mortality in the two largest Belgian urban areas: A time series analysis

Background Summer temperatures are expected to increase and heat waves will occur more frequently, be longer, and be more intense as a result of global warming. A growing body of evidence indicates that increasing temperature and heatwaves are associated with excess mortality and therefore global heating may become a major public health threat. However, the heat-mortality relationship has been shown to be location-specific and differences could largely be explained by the most frequent temperature. So far, in Belgium there is little known regarding the heat-mortality relationship in the different urban&nbsp;areas. Objectives The objective of this study is to assess the heat-mortality relationship in the two largest urban areas in Belgium, i.e. Antwerp and Brussels for the warm seasons from 2002 until 2011 taking into account the effect of air&nbsp;pollution. Methods The threshold in temperature above which mortality increases was determined using segmented regressions for both urban areas. The relationship between daily temperature and mortality above the threshold was investigated using a generalized estimated equation with Poisson distribution to finally determine the percentage of deaths attributable to the effect of&nbsp;heat. Results Although only 50&nbsp;km apart, the heat-mortality curves for the two urban areas are different. More specifically, an increase in mortality occurs above a maximum temperature of 25.2&nbsp;°C in Antwerp and 22.8&nbsp;°C in Brussels. We estimated that above these thresholds,&nbsp;there is an increase in mortality of 4.9% per 1&nbsp;°C in Antwerp and of 3.1% in Brussels. During the study period, 1.5% of the deaths in Antwerp and 3.5% of the deaths in Brussels can be attributed to the effect of heat. The thresholds differed considerably from the most frequent temperature, particularly in Antwerp. Adjustment for air pollution attenuated the effect of temperature on mortality and this attenuation was more pronounced when adjusting for ambient&nbsp;ozone. Conclusion Our results show a significant effect of temperature on mortality above a city-specific threshold, both in Antwerp and in Brussels. These findings are important given the ongoing global warming. Recurrent, intense and longer episodes of high temperature and expected changes in air pollutant levels will have an important impact on health in urban&nbsp;areas.</p