Association of residential greenness with incident chronic obstructive pulmonary disease: A prospective cohort study in the UK Biobank

Residential greenness has been linked to respiratory mortality, but its long-term effect on incident chronic obstructive pulmonary disease (COPD) has rarely been investigated. This prospective cohort study was based on over 350 000 participants aged 38–70 of the UK Biobank, followed from 2006 to 2010 baseline to 2021. COPD cases were ascertained through linkages to health administrative datasets. Residential greenness was measured by satellite-derived normalized difference vegetation index (NDVI) within the 500- and 1 000-m buffer. Effects of greenness on COPD incidence were assessed using Cox proportional hazards models. We also explored mediation by physical activity, particular matter