Congratulations to our student travel award recipients!

September 17 | 2018

Evaluating the Impact of Neighborhood Characteristics on Differences between Residential and Mobility-Based Exposures to Outdoor Air Pollution. 

Fallah-Shorshani M, Hatzopoulou M, Ross NA, Patterson Z, Weichenthal S.

Environ Sci Technol. 2018 Aug 29. DOI: 10.1021/acs.est.8b02260



Epidemiological studies often assign outdoor air pollution concentrations to residential locations without accounting for mobility patterns. In this study, we examined how neighborhood characteristics may influence differences in exposure assessments between outdoor residential concentrations and mobility-based exposures. To do this, we linked residential location and mobility data to exposure surfaces for NO2, PM2.5, and ultrafine particles in Montreal, Canada for 5452 people in 2016. Mobility data were collected using the MTL Trajet smartphone application (mean: 16 days/subject). Generalized additive models were used to identify important neighborhood predictors of differences between residential and mobility-based exposures and included residential distances to highways, traffic counts within 500 m of the residence, neighborhood walkability, median income, and unemployment rate. Final models including these parameters provided unbiased estimates of differences between residential and mobility-based exposures with small root-mean-square error values in 10-fold cross validation samples. In general, our findings suggest that differences between residential and mobility-based exposures are not evenly distributed across cities and are greater for pollutants with higher spatial variability like NO2. It may be possible to use neighborhood characteristics to predict the magnitude and direction of this error to better understand its likely impact on risk estimates in epidemiological analyses.


Travel Awards Available

Post-doctoral, graduate and undergraduate students who are developing data for CANUE, or who have used our data to produce new research are eligible to apply for a student travel award.

We will provide up to $2,500 toward the costs of presenting at a conference (travel, hotel, and registration fees) or visiting a research team at another institution for training. Applications will be reviewed by a Committee of CANUE members within 30 days of the submission deadline.





September 10 | 2018

Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter.

Burnett R, Chen H, Szyszkowicz M, Fann N, Hubbell B, Pope CA 3rd, Apte JS, Brauer M, Cohen A, Weichenthal S, Coggins J, Di Q, Brunekreef B, Frostad J, Lim SS, Kan H, Walker KD, Thurston GD, Hayes RB, Lim CC, Turner MC, Jerrett M, Krewski D, Gapstur SM, Diver WR, Ostro B, Goldberg D, Crouse DL, Martin RV, Peters P, Pinault L, Tjepkema M, van Donkelaar A, Villeneuve PJ, Miller AB, Yin P, Zhou M, Wang L, Janssen NAH, Marra M, Atkinson RW, Tsang H, Quoc Thach T, Cannon JB, Allen RT, Hart JE, Laden F, Cesaroni G, Forastiere F, Weinmayr G, Jaensch A, Nagel G, Concin H, Spadaro JV.

Proc Natl Acad Sci U S A. 2018 Sep 4. pii: 201803222. [Epub ahead of print]  DOI:10.1073/pnas.1803222115



Exposure to ambient fine particulate matter (PM2.5) is a major global health concern. Quantitative estimates of attributable mortality are based on disease-specific hazard ratio models that incorporate risk information from multiple PM2.5 sources (outdoor and indoor air pollution from use of solid fuels and secondhand and active smoking), requiring assumptions about equivalent exposure and toxicity. We relax these contentious assumptions by constructing a PM2.5-mortality hazard ratio function based only on cohort studies of outdoor air pollution that covers the global exposure range. We modeled the shape of the association between PM2.5 and nonaccidental mortality using data from 41 cohorts from 16 countries-the Global Exposure Mortality Model (GEMM). We then constructed GEMMs for five specific causes of death examined by the global burden of disease (GBD). The GEMM predicts 8.9 million [95% confidence interval (CI): 7.5-10.3] deaths in 2015, a figure 30% larger than that predicted by the sum of deaths among the five specific causes (6.9; 95% CI: 4.9-8.5) and 120% larger than the risk function used in the GBD (4.0; 95% CI: 3.3-4.8). Differences between the GEMM and GBD risk functions are larger for a 20% reduction in concentrations, with the GEMM predicting 220% higher excess deaths. These results suggest that PM2.5 exposure may be related to additional causes of death than the five considered by the GBD and that incorporation of risk information from other, nonoutdoor, particle sources leads to underestimation of disease burden, especially at higher concentrations.

September 5 | 2018

Diabetes status and susceptibility to the effects of PM2.5 exposure on cardiovascular mortality in a national Canadian cohort.

Pinault L, Brauer M, Crouse DL, Weichenthal S, Erickson A, van Donkelaar A, Martin RV, Charbonneau S, Hystad P, Brook JR, Tjepkema M, Christidis T, Ménard R, Robichaud A, Burnett RT.

Epidemiology. 2018 Aug 1. DOI: 10.1097/EDE.0000000000000908 [Epub ahead of print]


BACKGROUND: Diabetes is infrequently coded as the primary cause of death but may contribute to cardiovascular disease (CVD) mortality in response to fine particulate matter (PM2.5) exposure. We analyzed all contributing causes of death to examine susceptibility of diabetics to CVD mortality from long-term exposure.

METHODS: We linked a subset of the 2001 Canadian Census Health and Environment Cohort (CanCHEC) with 10 years of follow-up to all causes of death listed on death certificates. We used survival models to examine the association between CVD deaths (n=123,500) and exposure to PM2.5 among deaths that co-occurred with diabetes (n=20,600) on the death certificate. More detailed information on behavioral covariates and diabetes status at baseline available in the Canadian Community Health Survey (CCHS) – mortality cohort (n=12,400 CVD deaths, with 2,800 diabetes deaths) complemented the CanCHEC analysis.

RESULTS: Among CanCHEC subjects, co-mention of diabetes on the death certificate increased the magnitude of association between CVD mortality and PM2.5 (HR=1.51 [1.39-1.65] per 10 μg/m) – versus all CVD deaths (HR=1.25 [1.21-1.29]) or CVD deaths without diabetes (HR=1.20 [1.16-1.25]). Among CCHS subjects, diabetics who used insulin or medication (included as proxies for severity) had higher HR estimates for CVD deaths from PM2.5 (HR=1.51 [1.08-2.12]) relative to the CVD death estimate for all respondents (HR=1.31 [1.16-1.47]).

CONCLUSIONS: Mention of diabetes on the death certificate resulted in higher magnitude associations between PM2.5 and CVD mortality, specifically amongst those who manage their diabetes with insulin or medication. Analyses restricted to the primary cause of death likely underestimate the role of diabetes in air pollution-related mortality.

August 13 | 2018

Comparing the Normalized Difference Vegetation Index with the Google Street View Measure of Vegetation to Assess Associations between Greenness, Walkability, Recreational Physical Activity, and Health in Ottawa, Canada

Paul J. Villeneuve, Renate L. Ysseldyk, Ariel Root, Sarah Ambrose, Jason DiMuzio, Neerija Kumar, Monica Shehata, Min Xi, Evan Seed, Xiaojiang Li, Mahdi Shooshtari, and Daniel Rainham.

Int. J. Environ. Res. Public Health 201815(8),1719;


The manner in which features of the built environment, such as walkability and greenness, impact participation in recreational activities and health are complex. We analyzed survey data provided by 282 Ottawa adults in 2016. The survey collected information on participation in recreational physical activities by season, and whether these activities were performed within participants’ neighbourhoods. The SF-12 instrument was used to characterize their overall mental and physical health. Measures of active living environment, and the satellite derived Normalized Difference Vegetation Index (NDVI) and Google Street View (GSV) greenness indices were assigned to participants’ residential addresses. Logistic regression and least squares regression were used to characterize associations between these measures and recreational physical activity, and self-reported health. The NDVI was not associated with participation in recreational activities in either the winter or summer, or physical or mental health. In contrast, the GSV was positively associated with participation in recreational activities during the summer. Specifically, those in the highest quartile spent, on average, 5.4 more hours weekly on recreational physical activities relative to those in the lowest quartile (p = 0.01). Active living environments were associated with increased utilitarian walking, and reduced reliance on use of motor vehicles. Our findings provide support for the hypothesis that neighbourhood greenness may play an important role in promoting participation in recreational physical activity during the summer.

August 7 | 2018

Effect of Greening Vacant Land on Mental Health of Community-Dwelling Adults  A Cluster Randomized Trial

Eugenia C. South, MD, MS; Bernadette C. Hohl, PhD; Michelle C. Kondo, PhD; John M. MacDonald, PhD; Charles C. Branas, PhD.

JAMA Network Open. 2018;1(3):e180298.doi:10.1001/jamanetworkopen.2018.0298

And Invited Commentary doi:10.1001/jamanetworkopen.2018.0299


Importance Neighborhood physical conditions have been associated with mental illness and may partially explain persistent socioeconomic disparities in the prevalence of poor mental health.

Objective To evaluate whether interventions to green vacant urban land can improve self-reported mental health.

Design, Setting, and Participants This citywide cluster randomized trial examined 442 community-dwelling sampled adults living in Philadelphia, Pennsylvania, within 110 vacant lot clusters randomly assigned to 3 study groups. Participants were followed up for 18 months preintervention and postintervention. This trial was conducted from October 1, 2011, to November 30, 2014. Data were analyzed from July 1, 2015, to April 16, 2017.

Interventions  The greening intervention involved removing trash, grading the land, planting new grass and a small number of trees, installing a low wooden perimeter fence, and performing regular monthly maintenance. The trash cleanup intervention involved removal of trash, limited grass mowing where possible, and regular monthly maintenance. The control group received no intervention.

Main Outcomes and Measures Self-reported mental health measured by the Kessler-6 Psychological Distress Scale and the components of this scale.

Results  A total of 110 clusters containing 541 vacant lots were enrolled in the trial and randomly allocated to the following 1 of 3 study groups: the greening intervention (37 clusters [33.6%]), the trash cleanup intervention (36 clusters [32.7%]), or no intervention (37 clusters [33.6%]). Of the 442 participants, the mean (SD) age was 44.6 (15.1) years, 264 (59.7%) were female, and 194 (43.9%) had a family income less than $25 000. A total of 342 participants (77.4%) had follow-up data and were included in the analysis. Of these, 117 (34.2%) received the greening intervention, 107 (31.3%) the trash cleanup intervention, and 118 (34.5%) no intervention. Intention-to-treat analysis of the greening intervention compared with no intervention demonstrated a significant decrease in participants who were feeling depressed (−41.5%; 95% CI, −63.6% to −5.9%; P = .03) and worthless (−50.9%; 95% CI, −74.7% to −4.7%; P = .04), as well as a nonsignificant reduction in overall self-reported poor mental health (−62.8%; 95% CI, −86.2% to 0.4%; P = .051). For participants living in neighborhoods below the poverty line, the greening intervention demonstrated a significant decrease in feeling depressed (−68.7%; 95% CI, −86.5% to −27.5%; P = .007). Intention-to-treat analysis of those living near the trash cleanup intervention compared with no intervention showed no significant changes in self-reported poor mental health.

Conclusions and Relevance Among community-dwelling adults, self-reported feelings of depression and worthlessness were significantly decreased, and self-reported poor mental health was nonsignificantly reduced for those living near greened vacant land. The treatment of blighted physical environments, particularly in resource-limited urban settings, can be an important treatment for mental health problems alongside other patient-level treatments.

July 30 | 2018

Associations between Living Near Water and Risk of Mortality among Urban Canadians.

Crouse DL, Balram A, Hystad P, Pinault L, van den Bosch M, Chen H, Rainham D, Thomson EM, Close CH, van Donkelaar A, Martin RV, Ménard R, Robichaud A, Villeneuve PJ.

Environ Health Perspect. 2018 Jul 24;126(7):077008. eCollection 2018 Jul.


BACKGROUND: Increasing evidence suggests that residential exposures to natural environments, such as green spaces, are associated with many health benefits. Only a single study has examined the potential link between living near water and mortality.

OBJECTIVE: We sought to examine whether residential proximity to large, natural water features (e.g., lakes, rivers, coasts, “blue space”) was associated with cause-specific mortality.

METHODS: Our study is based on a population-based cohort of nonimmigrant adults living in the 30 largest Canadian cities [i.e., the 2001 Canadian Census Health and Environment Cohort) (CanCHEC)]. Subjects were drawn from the mandatory 2001 Statistics Canada long-form census, who were linked to the Canadian mortality database and to annual income-tax filings, through 2011. We estimated associations between living within of blue space and deaths from several common causes of death. We adjusted models for many personal and contextual covariates, as well as for exposures to residential greenness and ambient air pollution.

RESULTS: Our cohort included approximately 1.3 million subjects at baseline, 106,180 of whom died from nonaccidental causes during follow-up. We found significant, reduced risks of mortality in the range of 12-17% associated with living within of water in comparison with living farther away, among all causes of death examined, except with external/accidental causes. Protective effects were found to be higher among women and all older adults than among other subjects, and protective effects were found to be highest against deaths from stroke and respiratory-related causes.

CONCLUSIONS: Our findings suggest that living near blue spaces in urban areas has important benefits to health, but further work is needed to better understand the drivers of this association.




The Canadian Institutes for Health Research has announced a new Operating Grant Competition for data analysis using existing databases and cohorts. We are especially proud to be the focus of two grants available under the Environments and Health Signature Initiatives portion of this competition.

CANUE data have the potential to be linked to a wide range of health data holdings at the 6-digit postal code level.

The CANUE team hosted an informational webinar on August 17th to answer any questions about our data holdings and how to access them to support the development of grant applications. Representatives from the Canadian Longitudinal Study on Aging cohort  and the Canadian Partnership for Tomorrow Project also attended to highlight opportunities for using  pre-linked CANUE data with their data holdings.





The journal Epidemiology recently interviewed study co-author and CANUE member Dan Crouse about exposure to fine particulate matter and diabetes in the Canadian Census Health and Environment Cohort.

Pinault, Lauren, Michael Brauer, Daniel L. Crouse, Scott Weichenthal, Anders Erickson, Aaron van Donkelaar, Randall V. Martin et al. “Diabetes Status and Susceptibility to the Effects of PM2. 5 Exposure on Cardiovascular Mortality in a National Canadian Cohort.” Epidemiology 29, no. 6 (2018): 784-794.