College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China.
College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China.
Sci Total Environ. 2022 Dec 1;850:158014. doi: 10.1016/j.scitotenv.2022.158014. Epub 2022 Aug 15.
Lung cancer is a major health concern and is influenced by air pollution, which can be affected by the density of urban built environment. The spatiotemporal impact of urban density on lung cancer incidence remains unclear, especially at the sub-city level. We aimed to determine cumulative effect of community-level density attributes of the built environment on lung cancer incidence in high-density urban areas.
We selected 78 communities in the central city of Shanghai, China as the study site; communities included in the analysis had an averaged population density of 313 residents per hectare. Using data from the city cancer surveillance system, an age-period-cohort analysis of lung cancer incidence was performed over a five-year period (2009-2013), with a total of 5495 non-smoking/non-secondhand smoking exposure lung cancer cases. Community-level density measures included the density of road network, facilities, buildings, green spaces, and land use mixture.
In multivariate models, built environment density and the exposure time duration had an interactive effect on lung cancer incidence. Lung cancer incidence of birth cohorts was associated with road density and building coverage across communities, with a relative risk of 1·142 (95 % CI: 1·056-1·234, P = 0·001) and 1·090 (95 % CI: 1·053-1·128, P < 0·001) at the baseline year (2009), respectively. The relative risk increased exponentially with the exposure time duration. As for the change in lung cancer incidence over the five-year period, lung cancer incidence of birth cohorts tended to increase faster in communities with a higher road density and building coverage.
Urban planning policies that improve road network design and building layout could be important strategies to reduce lung cancer incidence in high-density urban areas.
肺癌是一个主要的健康问题，受到空气污染的影响，而空气污染又会受到城市建成环境密度的影响。城市密度对肺癌发病率的时空影响尚不清楚，尤其是在城市次区域层面。我们旨在确定建成环境社区层面密度属性对高密度城市地区肺癌发病率的累积影响。
我们选择了中国上海市中心的 78 个社区作为研究地点；纳入分析的社区平均人口密度为每公顷 313 人。利用城市癌症监测系统的数据，对五年期间（2009-2013 年）的肺癌发病率进行了年龄-时期-队列分析，共包括 5495 例非吸烟/非二手烟暴露的肺癌病例。社区层面的密度测量指标包括路网密度、设施密度、建筑密度、绿地密度和土地利用混合度。
在多变量模型中，建成环境密度和暴露时间持续时间对肺癌发病率有交互作用。各出生队列的肺癌发病率与社区内的路网密度和建筑覆盖率有关，在基线年（2009 年）的相对风险分别为 1.142（95%CI：1.056-1.234，P=0.001）和 1.090（95%CI：1.053-1.128，P<0.001）。相对风险随暴露时间的持续而呈指数增长。至于五年期间肺癌发病率的变化，出生队列的肺癌发病率在路网密度和建筑覆盖率较高的社区中呈上升趋势更快。
改善路网设计和建筑布局的城市规划政策可能是减少高密度城市地区肺癌发病率的重要策略。
