title: The health effects of a forest environment on subclinical cardiovascular disease and heath-related quality of life.
abstract: BACKGROUND
  Assessment of health effects of a forest environment is an important emerging area of public health and environmental sciences.
  
  
  OBJECTIVE
  To demonstrate the long-term health effects of living in a forest environment on subclinical cardiovascular diseases (CVDs) and health-related quality of life (HRQOL) compared with that in an urban environment.
  
  
  METHODS
  This study included the detailed health examination and questionnaire assessment of 107 forest staff members (FSM) and 114 urban staff members (USM) to investigate the long-term health effects of a forest environment. Air quality monitoring between the forest and urban environments was compared. In addition, work-related factors and HRQOL were evaluated.
  
  
  RESULTS
  Levels of total cholesterol, low-density lipoprotein cholesterol, and fasting glucose in the USM group were significantly higher than those in the FSM group. Furthermore, a significantly higher intima-media thickness of the internal carotid artery was found in the USM group compared with that in the FSM group. Concentrations of air pollutants, such as NO, NO2, NOx, SO2, CO, PM2.5, and PM10 in the forest environment were significantly lower compared with those in the outdoor urban environment. Working hours were longer in the FSM group; however, the work stress evaluation as assessed by the job content questionnaire revealed no significant differences between FSM and USM. HRQOL evaluated by the World Health Organization Quality of Life-BREF questionnaire showed FSM had better HRQOL scores in the physical health domain.
  
  
  CONCLUSIONS
  This study provides evidence of the potential beneficial effects of forest environments on CVDs and HRQOL.
authors: The Experimental Forest, National Taiwan University, Nantou, Taiwan.
authors: Tsung-Ming
authors: TM
authors: Tsao
authors: The Experimental Forest, National Taiwan University, Nantou, Taiwan; The School of Forestry and Resource Conservation, National Taiwan University, Taipei, Taiwan.
authors: Ming-Jer
authors: MJ
authors: Tsai
authors: The Experimental Forest, National Taiwan University, Nantou, Taiwan; The School of Forestry and Resource Conservation, National Taiwan University, Taipei, Taiwan.
authors: Ya-Nan
authors: YN
authors: Wang
authors: Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan.
authors: Heng-Lun
authors: HL
authors: Lin
authors: Department of Public Health, National Taiwan University, Taipei, Taiwan.
authors: Chang-Fu
authors: CF
authors: Wu
authors: Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.
authors: Jing-Shiang
authors: JS
authors: Hwang
authors: Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors: Sandy-H J
authors: SH
authors: Hsu
authors: School of Public Health, Taipei Medical University, Taipei, Taiwan.
authors: Hsing
authors: H
authors: Chao
authors: School of Public Health, Taipei Medical University, Taipei, Taiwan.
authors: Kai-Jen
authors: KJ
authors: Chuang
authors: Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan.
authors: Charles-C K
authors: CC
authors: Chou
authors: Department of Internal Medicine and Cardiovascular Center, National Taiwan University Hospital, Taipei, Taiwan.
authors: Ta-Chen
authors: TC
authors: Su
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D004777:Environment; D004784:Environmental Monitoring; D005260:Female; D065928:Forests; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014505:Urban Population