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Positive health effects of the natural outdoor environment in typical populations in different regions in Europe (PHENOTYPE): a study programme protocol
  1. Mark J Nieuwenhuijsen1,2,3,
  2. Hanneke Kruize4,
  3. Christopher Gidlow5,
  4. Sandra Andrusaityte6,
  5. Josep Maria Antó1,2,3,7,
  6. Xavier Basagaña1,2,3,
  7. Marta Cirach1,2,3,
  8. Payam Dadvand1,2,3,
  9. Asta Danileviciute6,
  10. David Donaire-Gonzalez1,2,3,
  11. Judith Garcia1,2,3,
  12. Michael Jerrett8,
  13. Marc Jones5,
  14. Jordi Julvez1,2,3,7,
  15. Elise van Kempen4,
  16. Irene van Kamp4,
  17. Jolanda Maas9,
  18. Edmund Seto8,
  19. Graham Smith5,
  20. Margarita Triguero1,2,3,
  21. Wanda Wendel-Vos4,
  22. John Wright10,
  23. Joris Zufferey11,
  24. Peter Jan van den Hazel12,
  25. Roderick Lawrence11,
  26. Regina Grazuleviciene6
  1. 1Centre for Research in Environmental Epidemiology (CREAL) Barcelona Spain
  2. 2CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  3. 3Universitat Pompeu Fabra (UPF), Barcelona, Spain
  4. 4RIVM, Bilthoven, The Netherlands
  5. 5CSHER, Stoke-on-Trent, UK
  6. 6Vytauto Didziojo Universitetas, Kaunas, Lithuania
  7. 7IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
  8. 8UCB, University of California Berkeley, USA
  9. 9VUMC, Amsterdam, The Netherlands
  10. 10Bradford Hospital Trust, Bradford, UK
  11. 11University of Geneva, Geneva, Switzerland
  12. 12VGGM, Arnhem, The Netherlands
  1. Correspondence to Dr Mark J Nieuwenhuijsen; mnieuwenhuijsen{at}


Introduction Growing evidence suggests that close contact with nature brings benefits to human health and well-being, but the proposed mechanisms are still not well understood and the associations with health remain uncertain. The Positive Health Effects of the Natural Outdoor environment in Typical Populations in different regions in Europe (PHENOTYPE) project investigates the interconnections between natural outdoor environments and better human health and well-being.

Aims and methods The PHENOTYPE project explores the proposed underlying mechanisms at work (stress reduction/restorative function, physical activity, social interaction, exposure to environmental hazards) and examines the associations with health outcomes for different population groups. It implements conventional and new innovative high-tech methods to characterise the natural environment in terms of quality and quantity. Preventive as well as therapeutic effects of contact with the natural environment are being covered. PHENOTYPE further addresses implications for land-use planning and green space management. The main innovative part of the study is the evaluation of possible short-term and long-term associations of green space and health and the possible underlying mechanisms in four different countries (each with quite a different type of green space and a different use), using the same methodology, in one research programme. This type of holistic approach has not been undertaken before. Furthermore there are technological innovations such as the use of remote sensing and smartphones in the assessment of green space.

Conclusions The project will produce a more robust evidence base on links between exposure to natural outdoor environment and human health and well-being, in addition to a better integration of human health needs into land-use planning and green space management in rural as well as urban areas.

  • Green space
  • Blue space
  • Health
  • Well being
  • Physical activity

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