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Air pollutants, residential greenspace, and the risk of kidney stone disease: a large prospective cohort study from the UK Biobank

Journal of Exposure Science & Environmental Epidemiology volume 35, pages 859–867 (2025)Cite this article

Abstract

Background

The epidemiological evidence regarding the correlation between air pollution, residential greenspace, and the risk of kidney stone disease (KSD) is limited, with no large-scale prospective studies conducted on this relationship.

Objective

We conducted a large-scale prospective study from the UK Biobank to explore the correlation between air pollution, residential greenspace, and the risk of KSD.

Methods

This study included 419,835 UK Biobank participants who did not have KSD at baseline. An air pollution score was derived through the summation of concentrations for five air pollutants, including particulate matter (PM) with aerodynamic diameter ≤2.5 μm (PM2.5), ranging from 2.5 to 10 μm (PM2.5-10), ≤10 μm (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx). Various covariates were adjusted for in Cox proportional hazard regression to evaluate the risk of KSD associated with air pollution score, single air pollutant, and residential greenspace.

Results

During a follow-up period of 12.7 years, 4503 cases of KSD were diagnosed. Significant associations were found between KSD risk and air pollution score (HR: 1.08, 95% CI: 1.03–1.13), PM2.5 (1.06, 1.02–1.11), PM10 (1.04, 1.01–1.07), NO2 (1.09, 1.02–1.16), NOx (1.08, 1.02–1.11), greenspace buffered at 300 m (0.95, 0.91–0.99), and greenspace buffered at 1000 m (0.92, 0.86–0.98) increase per interquartile range (IQR). PM2.5 and NO2 reductions may be a key mechanism for the protective impact of residential greenspace on KSD (P for indirect path < 0.05).

Impact

  • Prolonged exposure to air pollution was correlated with a higher risk of KSD, while residential greenspace exhibits an inverse association with KSD risk, partially mediated by the reduction in air pollutants concentrations. These findings emphasize the significance of mitigating air pollution and maintaining substantial greenspace exposure as preventive measures against KSD.

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Fig. 1: Multivariable-adjusted hazard ratios (95% CI) for air pollution and residential greenspace percentage with the risk of kidney stone disease in the UK Biobank Study.
Fig. 2: Exposure−response relationship between air pollution, single air pollutant, residential greenspace and the risk of KSD.
Fig. 3: Exposure−response relationship between air pollution and the risk of KSD in different subgroups, including age, sex, BMI, Townsend deprivation index, educational attainment, and smoking status.

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Data availability

The UK Biobank data are available on application to the UK Biobank (https://www.ukbiobank.ac.uk/).

Code availability

The computer code utilized to generate results pivotal to this paper’s conclusions is available upon request. Due to data sensitivity, please contact the corresponding author to access the code.

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Acknowledgements

This research has been conducted using the UK Biobank Resource under Application Number 93044. We extend our gratitude to all the participants and the UK Biobank team for their valuable contributions.

Funding

The study was supported by the National Natural Science Foundation of China (82373337 to JC, 82170781 and 82370772 to HC) and Hunan Province Young talents Program (2021RC3027 to JC).

Author information

Authors and Affiliations

  1. Department of Urology, Xiangya Hospital, Central South University, Changsha, China

    Minghui Liu, Meng Gao, Zewu Zhu, Jiao Hu, Jian Wu, Hequn Chen, Xiaogen Kuang & Jinbo Chen

  2. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China

    Minghui Liu, Meng Gao, Zewu Zhu, Jiao Hu, Jian Wu, Hequn Chen, Xiaogen Kuang & Jinbo Chen

  3. Department of Urology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China

    Xiaogen Kuang

  4. Office of Public Health and Medical Emergency Management, Xiangya Hospital, Central South University, Changsha, China

    Jinbo Chen

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Contributions

ML: formal analysis, investigation, methodology, visualization, writing – original draft; MG and HC: data curation, methodology, software, writing – review & editing; ZZ, JH and JW: formal analysis, validation, writing – review & editing; XK: investigation, visualization, writing – review & editing; JC: conceptualization, methodology, project administration, supervision, writing – review & editing.

Corresponding authors

Correspondence to Xiaogen Kuang or Jinbo Chen.

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The authors declare no competing interests.

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The UK Biobank was approved by the North West Research Ethics Committee (11/NW/0382). All the participants had signed informed consent.

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Liu, M., Gao, M., Zhu, Z. et al. Air pollutants, residential greenspace, and the risk of kidney stone disease: a large prospective cohort study from the UK Biobank. J Expo Sci Environ Epidemiol 35, 859–867 (2025). https://doi.org/10.1038/s41370-024-00728-0

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