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Ahmer Z, Atif M, Zaheer S, Adil O, Shaikh S, Shafique K. Association between residential green spaces and pregnancy outcomes: a systematic review and meta-analysis. Int J Environ Health Res 2024:1-18. [PMID: 38185100 DOI: 10.1080/09603123.2023.2299242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
Residential exposure to greenness has shown positive influences on pregnancy outcomes like birth weight, preterm births, and small to gestational age (SGA) deliveries. We aimed to comprehensively review and investigate these associations by conducting a systematic review with meta-analysis. Relevant studies were retrieved from PubMed, EMBASE, ScienceDirect, and Google Scholar databases before June 2023. Summary effect estimates included birth weight, low birth weight (LBW), preterm births, and SGA which were calculated for 0.1 unit increase in residential greenness exposure. Overall quality of the evidence was examined through Joanna Briggs Institute (JBI) critical appraisal tool. The review included 31 articles and found a statistically significant increase in birth weight measured at 250 m buffer distance (β = 8.95, 95% CI = 1.63-16.27). Green spaces were also associated with lower odds of LBW (OR = 0.97, 95% CI = 0.96-0.98). Residential greenness had positive impacts on pregnancy outcomes that calls for emphasis on urban planning, especially in developing countries.
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Affiliation(s)
- Zaeema Ahmer
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Maria Atif
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Omair Adil
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Shiraz Shaikh
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
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Medeleanu MV, Qian YC, Moraes TJ, Subbarao P. Early-immune development in asthma: A review of the literature. Cell Immunol 2023; 393-394:104770. [PMID: 37837916 DOI: 10.1016/j.cellimm.2023.104770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/14/2023] [Accepted: 09/21/2023] [Indexed: 10/16/2023]
Abstract
This review presents a comprehensive examination of the various factors contributing to the immunopathogenesis of asthma from the prenatal to preschool period. We focus on the contributions of genetic and environmental components as well as the role of the nasal and gut microbiome on immune development. Predisposing genetic factors, including inherited genes associated with increased susceptibility to asthma, are discussed alongside environmental factors such as respiratory viruses and pollutant exposure, which can trigger or exacerbate asthma symptoms. Furthermore, the intricate interplay between the nasal and gut microbiome and the immune system is explored, emphasizing their influence on allergic immune development and response to environmental stimuli. This body of literature underscores the necessity of a comprehensive approach to comprehend and manage asthma, as it emphasizes the interactions of multiple factors in immune development and disease progression.
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Affiliation(s)
- Maria V Medeleanu
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Canada; Translational Medicine, SickKids Research Institute, Hospital for Sick Children, Canada
| | - Yu Chen Qian
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Canada; Translational Medicine, SickKids Research Institute, Hospital for Sick Children, Canada
| | - Theo J Moraes
- Translational Medicine, SickKids Research Institute, Hospital for Sick Children, Canada; Laboratory Medicine and Pathology, Temerty Faculty of Medicine, University of Toronto, Canada; Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Canada; Division of Respiratory Medicine, Hospital for Sick Children, Canada
| | - Padmaja Subbarao
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Canada; Translational Medicine, SickKids Research Institute, Hospital for Sick Children, Canada; Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Canada; Division of Respiratory Medicine, Hospital for Sick Children, Canada; Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Canada.
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Li H, Li Y, Wang Z, Zhang G. Green physical activity for leisure connects perceived residential greenspace and mental well-being. Front Public Health 2023; 11:1254185. [PMID: 37869186 PMCID: PMC10585364 DOI: 10.3389/fpubh.2023.1254185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/19/2023] [Indexed: 10/24/2023] Open
Abstract
Physical activity serves as a pivotal mediator in previous theoretical frameworks that link greenspace and human health. However, it remains unclear whether the domain of physical activity within and around greenspaces can alter the pathway. The present study recruited 668 participants online and examined a conceptual framework that explores the associations between residential greenspace and mental well-being, with a particular focus on the mediation effect of green physical activity (physical activity undertaken in and around greenspaces). Moreover, socio-demographic characteristics, including gender, age, household income, education status, marital status, and student status, were controlled for during the examination. The investigated green physical activities included leisure activities, transportation walking, and transportation cycling, and they were measured by a pre-established questionnaire. Meanwhile, mental well-being was measured by the WHO-5 well-being index, and residential greenspace was indicated by self-reported perceived greenspace and mean Normalized Difference Vegetation Index (NDVI) values within 500 meters (m) of residential radius. We found that both perceived greenspace (B = 1.852, p < 0.001) and NDVI 500 m (B = 3.230, p = 0.038) were positively associated with mental well-being. However, only perceived greenspace, not NDVI 500 m, exhibited positive associations with the three green physical activity items. Furthermore, only green physical activity for leisure (B = 0.223, p < 0.001), not for transportation (p > 0.05), mediated the relationship between perceived greenspace and mental well-being. Our findings reinforce previous studies on "greenspace-health" frameworks and underline the importance of leisure physical activity in promoting mental well-being.
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Affiliation(s)
- Hansen Li
- College of Physical Education, Southwest University, Chongqing, China
| | - Yun Li
- College of Physical Education, Southwest University, Chongqing, China
| | - Zhenhuan Wang
- Institute for Health and Sport (iHeS), Victoria University, Melbourne, VIC, Australia
| | - Guodong Zhang
- College of Physical Education, Southwest University, Chongqing, China
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Nethery E, Hutcheon JA, Kotaska A, Law MR, Janssen P. Weight gain in pregnancy and infant birthweight after the onset of the COVID-19 pandemic: an interrupted time series analysis. Am J Clin Nutr 2023; 117:364-372. [PMID: 36863829 PMCID: PMC9972866 DOI: 10.1016/j.ajcnut.2022.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Increased weight gain and decreased physical activity have been reported in some populations since the coronavirus disease 2019 (COVID-19) pandemic, but this has not been well characterized in pregnant populations. OBJECTIVES Our objective was to characterize the impact of the COVID-19 pandemic and associated countermeasures on pregnancy weight gain and infant birthweight in a US cohort. METHODS Washington State pregnancies and births (1 January, 2016 to 28 December, 2020) from a multihospital quality improvement organization were examined for pregnancy weight gain, pregnancy weight gain z-score adjusted for pregestational BMI and gestational age, and infant birthweight z-score, using an interrupted time series design that controls for underlying time trends. We used mixed-effect linear regression models, controlled for seasonality and clustered at the hospital level, to model the weekly time trends and changes on 23 March, 2020, the onset of local COVID-19 countermeasures. RESULTS Our analysis included 77,411 pregnant people and 104,936 infants with complete outcome data. The mean pregnancy weight gain was 12.1 kg (z-score: -0.14) during the prepandemic time period (March to December 2019) and increased to 12.4 kg (z-score: -0.09) after the onset of the pandemic (March to December 2020). Our time series analysis found that after the pandemic onset, the mean weight gain increased by 0.49 kg (95% CI: 0.25, 0.73 kg) and weight gain z-score increased by 0.080 (95% CI: 0.03, 0.13), with no changes in the baseline yearly trend. Infant birthweight z-scores were unchanged (-0.004; 95% CI: -0.04, 0.03). Overall, the results were unchanged in analyses stratified by pregestational BMI categories. CONCLUSIONS We observed a modest increase in weight gain after the onset of the pandemic among pregnant people but no changes in infant birthweights. This weight change could be more important in high BMI subgroups.
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Affiliation(s)
- Elizabeth Nethery
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
| | - Jennifer A Hutcheon
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Kotaska
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Obstetrics & Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael R Law
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Patricia Janssen
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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Brochu P, Jimenez MP, James P, Kinney PL, Lane K. Benefits of Increasing Greenness on All-Cause Mortality in the Largest Metropolitan Areas of the United States Within the Past Two Decades. Front Public Health 2022; 10:841936. [PMID: 35619828 PMCID: PMC9127575 DOI: 10.3389/fpubh.2022.841936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/14/2022] [Indexed: 01/13/2023] Open
Abstract
Across the United States, cities are creating sustainability and climate action plans (CAPs) that call to increase local vegetation. These greening initiatives have the potential to not only benefit the environment but also human health. In epidemiologic literature, greenness has a protective effect on mortality through various direct and indirect pathways. We aimed to assess how an increase in greenness could decrease mortality in the largest urban areas in the United States. We conducted a nationwide quantitative health impact assessment to estimate the predicted reduction in mortality associated with an increase in greenness across two decades (2000, 2010, and 2019). Using a recently published exposure-response function, Landsat 30 m 16-day satellite imagery from April to September, and publicly available county-level mortality data from the CDC, we calculated the age-adjusted reduction in all-cause mortality for those 65 years and older within 35 of the most populated metropolitan areas. We estimated that between 34,000 and 38,000 all-cause deaths could have been reduced in 2000, 2010, and 2019 with a local increase in green vegetation by 0.1 unit across the most populated metropolitan areas. We found that overall greenness increased across time with a 2.86% increase from 2000 to 2010 to 11.11% from 2010 to 2019. These results can be used to support CAPs by providing a quantitative assessment to the impact local greening initiatives can have on mortality. Urban planners and local governments can use these findings to calculate the co-benefits of local CAPs through a public health lens and support policy development.
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Affiliation(s)
- Paige Brochu
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States,*Correspondence: Paige Brochu
| | - Marcia P. Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Peter James
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, United States,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Patrick L. Kinney
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States
| | - Kevin Lane
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, United States
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Villeneuve PJ, Lam S, Tjepkema M, Pinault L, Crouse DL, Osornio-Vargas AR, Hystad P, Jerrett M, Lavigne E, Stieb DM. Residential proximity to greenness and adverse birth outcomes in urban areas: Findings from a national Canadian population-based study. Environ Res 2022; 204:112344. [PMID: 34742713 DOI: 10.1016/j.envres.2021.112344] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/07/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Over the last decade, several studies have reported that residential proximity to vegetation, or 'greenness', is associated with improved birth outcomes, including for term birth weight (TBW), preterm birth (PTB), and small for gestational age (SGA). However, there remain several uncertainties about these possible benefits including the role of air pollution, and the extent to they are influenced socioeconomic status. METHODS We addressed these gaps using a national population-based study of 2.2 million singleton live births in Canadian metropolitan areas between 1999 and 2008. Exposures to greenness, fine particulate matter (PM2.5), and nitrogen dioxide (NO2) were assigned to infants using the postal code of their mother's residence at the time of birth. The Normalized Difference Vegetation Index (NDVI) was used to characterize greenness, while estimates of ambient PM2.5 and NO2 were estimated using remote sensing, and a national land-use regression surface, respectively. Multivariable regression analysis was performed to describe associations between residential greenness and the birth outcomes. Stratified analyses explored whether these associations were modified by neighbourhood measures of socioeconomic status. RESULTS Mothers who lived in greener areas had a lower risk of low TBW, PTB, and SGA babies. These associations persisted after adjustment for ambient NO2 and PM2.5. Specifically, in fully adjusted models, an interquartile range (IQR = 0.16) increase in the NDVI within a residential buffer of 250 m yielded odds ratios of 0.93 (95% confidence interval (CI): 0.92, 0.94), 0.94 (95% CI: 0.92, 0.95), and 0.94 (95% CI: 0.93, 0.95) for the outcomes of PTB, low TBW, and SGA, respectively. Similarly, an IQR increase in greenness was associated with a 16.3 g (95% CI: 15.3, 17.4) increase in TBW. We found inverse associations between greenness and the occurrence of adverse birth outcomes regardless of the socioeconomic status of the neighbourhood. INTERPRETATION Our findings support the hypothesis that residential greenness contributes to healthier pregnancies, that these associations are independent from exposure to air pollution. , and that proximity to greenness benefits all mothers regardless of socioeconomic status.
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Affiliation(s)
- Paul J Villeneuve
- CHAIM Research Center, Carleton University, Herzberg Building, Room 5413, Ottawa, ON, K1S 5B6, Canada; Department of Neuroscience, Carleton University, Ottawa, ON, Canada.
| | - Sandy Lam
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Lauren Pinault
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | | | - Alvaro R Osornio-Vargas
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Canada
| | - David M Stieb
- School of Epidemiology and Public Health, University of Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Vancouver, Canada
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Madureira H, Monteiro A. Going Green and Going Dense: A Systematic Review of Compatibilities and Conflicts in Urban Research. Sustainability 2021; 13:10643. [DOI: 10.3390/su131910643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The dilemma of simultaneously promoting the advantages of urban densification and urban liveability, namely the environmental and social benefits of urban green spaces, has been widely acknowledged in the research literature. This paper aims to provide an overview of the current state of evidence on benefits, conflicts and challenges emerging from fostering both urban densification and urban greening aims. A systematic review following the PRISMA guidelines was conducted. Searches for peer-reviewed papers were conducted in Scopus and Web of Science. Our search yielded an initial 357 papers, which were then further sorted and screened to the 117 manuscripts retained and included in this review. The authors systematized the multiple perspectives in which the interactions between urban densification and urban greening have been explored. Moreover, the results revealed a lack of clear agreement about the existence or not of conflicts emerging from fostering both urban densification and urban greening aims, suggesting that the positive or negative interactions are not absolute but depend on the scale or the context on which the studies are conducted. Further research should explore multiple potential mediating variables (e.g., the mediator effect of scale and context) to deepen our understanding of interactions between density and greening.
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Akaraci S, Feng X, Suesse T, Jalaludin B, Astell-Burt T. Greener neighbourhoods, healthier birth outcomes? Evidence from Australia. Environ Pollut 2021; 278:116814. [PMID: 33677222 DOI: 10.1016/j.envpol.2021.116814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/23/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
Growing body of research recognizes the importance of green spaces on the perinatal outcomes however, further evidence from different geographies are warranted. We aimed to investigate association between, and differential responses to, maternal exposure to green space and birthweight. Birth records (n = 82,221) were extracted from the Perinatal Data Collection (PDC) in Sydney's metropolitan area between January 2016 and December 2017. Association between green space quantity and birthweight, term birthweight, low birthweight, term low birthweight and preterm were assessed using linear and logistic regressions. Potential modification by area-level socioeconomic status and maternal country of birth were tested using interaction terms. Difference in birth weight for the ≥40% versus <20% green space within SA2s was 59.0 g (95%CI: 42.9, 75.3) in unadjusted models which dropped to 25.6 g (95%CI: 13.0, 38.2) in adjusted models. Stratified analysis suggested stronger associations for babies of mothers from affluent neighbourhoods, while statistically significant association was not observed in deprived areas. Furthermore, the association was more pronounced among babies to mothers who were born overseas. Associations were consistent for term births. Higher levels of green space were associated with lower odds of preterm birth in adjusted models. However, we did not identify statistically significant association between green space quantity and the risk of low birthweight (LBW). Our study suggests that green space may support healthier birth outcomes and help to reduce the birthweight gap between newborns of mothers born in Australia and overseas. However, disproportionate benefits among women in affluent neighbourhoods may widen socioeconomic inequities in birthweight.
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Affiliation(s)
- Selin Akaraci
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia.
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, NSW 2052, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Thomas Suesse
- NIASRA, National Institute for Applied Statistics Research Australia School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Bin Jalaludin
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, NSW 2052, Australia; Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW, 2170, Australia.
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, Australia; National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Population Medicine and Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.
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Vilcins D, Scarth P, Sly PD, Jagals P, Knibbs LD, Baker P. The association of fractional cover, foliage projective cover and biodiversity with birthweight. Sci Total Environ 2021; 763:143051. [PMID: 33127150 DOI: 10.1016/j.scitotenv.2020.143051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/18/2020] [Accepted: 10/08/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Environmental exposures can contribute both benefits and risks to human health. Maternal exposure to green space has been associated with improvements in birthweight, among other birth outcomes. Newer measures of green space have been developed, which allows for an exploration of the effect of different ground covers (green, dry and bare earth), as well as measures of biodiversity. This study explores the association of these novel green space measures with birthweight in a large birth cohort in Queensland, Australia. METHODS Birthweight was acquired from the routine health records. Records were allocated green space values for fractional cover, biodiversity and foliage projective cover. Directed acyclic graphs were developed to guide variable selection. Mixed-effects linear regression and generalised linear mixed-effects models were developed, with random intercepts for maternal residential locality and year of birth. Results are presented as standardised beta coefficients or odds ratios, with 95% confidence intervals. RESULTS An IQR increase of green cover (29.6 g, 95% CI 13.8-45.5) and foliage projective cover (26.0 g, 95% CI 10.8-41.3) are associated with birthweight in urban areas. An IQR increase in dry cover -34.4 g, 95% CI -60.4 to -8.4) and bare earth (-17.7 g, 95% CI -32.8 to -2.6) are associated with lower birthweight. Mothers living in rural areas had similar results, with an IQR increase in green cover (17.8 g, 95% CI 2.9-32.7) associated with higher birthweight, and bare earth (-27.7 g, 95% CI -45.7 to -9.7) was associated with lower birthweight. The biodiversity measure used in this study was not associated with any birthweight outcomes. CONCLUSION This study finds that the types of ground cover within the maternal residential locality are associated with small, but significant, changes in estimated birthweight, and these effects are not limited to urban areas.
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Affiliation(s)
- Dwan Vilcins
- Children's Health and Environment Program, The University of Queensland, L7 Centre for Children's Health Research, 62 Graham St, South Brisbane 4101, QLD, Australia.
| | - Peter Scarth
- School of Earth and Environmental Sciences, L2, Room 210, Steele Building, The University of Queensland, St Lucia, QLD, Australia, 4072.
| | - Peter D Sly
- Children's Health and Environment Program, The University of Queensland, L7 Centre for Children's Health Research, 62 Graham St, South Brisbane 4101, QLD, Australia.
| | - Paul Jagals
- Children's Health and Environment Program, The University of Queensland, L7 Centre for Children's Health Research, 62 Graham St, South Brisbane 4101, QLD, Australia.
| | - Luke D Knibbs
- School of Public Health, Public Health Building, 288 Herston Rd, The University of Queensland, Brisbane 4006, Australia.
| | - Peter Baker
- School of Public Health, Public Health Building, 288 Herston Rd, The University of Queensland, Brisbane 4006, Australia.
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Rigolon A, Browning MHEM, McAnirlin O, Yoon HV. Green Space and Health Equity: A Systematic Review on the Potential of Green Space to Reduce Health Disparities. Int J Environ Res Public Health 2021; 18:2563. [PMID: 33806546 DOI: 10.3390/ijerph18052563] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023]
Abstract
Disadvantaged groups worldwide, such as low-income and racially/ethnically minoritized people, experience worse health outcomes than more privileged groups, including wealthier and white people. Such health disparities are a major public health issue in several countries around the world. In this systematic review, we examine whether green space shows stronger associations with physical health for disadvantaged groups than for privileged groups. We hypothesize that disadvantaged groups have stronger protective effects from green space because of their greater dependency on proximate green space, as they tend to lack access to other health-promoting resources. We use the preferred reporting items for systematic reviews and meta-analyses (PRISMA) method and search five databases (CINAHL, Cochrane, PubMed, Scopus, and Web of Science) to look for articles that examine whether socioeconomic status (SES) or race/ethnicity modify the green space-health associations. Based on this search, we identify 90 articles meeting our inclusion criteria. We find lower-SES people show more beneficial effects than affluent people, particularly when concerning public green spaces/parks rather than green land covers/greenness. Studies in Europe show stronger protective effects for lower-SES people versus higher-SES people than do studies in North America. We find no notable differences in the protective effects of green space between racial/ethnic groups. Collectively, these results suggest green space might be a tool to advance health equity and provide ways forward for urban planners, parks managers, and public health professionals to address health disparities.
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Hu CY, Yang XJ, Gui SY, Ding K, Huang K, Fang Y, Jiang ZX, Zhang XJ. Residential greenness and birth outcomes: A systematic review and meta-analysis of observational studies. Environ Res 2021; 193:110599. [PMID: 33307084 DOI: 10.1016/j.envres.2020.110599] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The amount of natural vegetation surrounding homes (residential greenness) has been proposed as a mitigation measure to buffer the adverse health effects of urban living, associated with promoting health and wellbeing including birth outcomes. This study aimed to systematically review the epidemiological evidence on the association of residential greenness with birth outcomes and quantitatively provide summary effect estimates of the current literature. METHODS We extensively searched epidemiological studies related to residential greenness and birth outcomes in three electronic databases (EMBASE, Web of Science, and PubMed) using terms related to residential greenness and birth outcomes before July 10, 2020. Summary effect estimates of residential greenness on birth outcomes including SGA (small for gestational age), PTB (preterm birth), LBW (low birth weight), and birth weight were calculated for each 0.1 unit increase in residential greenness exposure, as well as comparing the highest to the lowest categories using random-effects meta-analyses. We assessed the risk of bias of each individual study, and the overall quality of the body of evidence and level of evidence for each exposure-outcome were also evaluated. RESULTS The initial search identified 161 studies, of which 29 studies were finally included. Meta-analysis for continuous exposure suggested that an increase in residential greenness, measured by NDVI (normalized difference vegetation index) with different buffer sizes, was generally associated with higher birth weights ranging from 7.99 g [95% confidence interval (CI) = 4.29-11.70] to 15.35 g (95% CI = 11.41-19.29) and lower odds of LBW ranging from 0.79 (95% CI = 0.65-0.96) to 0.93 (95% CI = 0.86-1.00), but associations between residential greenness and PTB or SGA were not significant. When introducing the exposure as high versus low categories, similar results were found. The overall evidence for each exposure-outcome combination was considered to be of "moderate" certainty. CONCLUSIONS This study indicated a potential positive association between residential greenness and several birth outcomes. However, because of the moderate to high between-study heterogeneity, further studies with better adjustment of covariates, improved residential greenness assessment in a longitudinal approach throughout pregnancy rather than a cross-sectional approach at time of delivery, and accounting thoroughly for socioeconomic status, are warranted to replicate these findings as well as to explore in greater detail in their implications.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Jing Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yuan Fang
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000, CA Rotterdam, the Netherlands
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China; Center for Evidence-Based Practice, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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12
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Torres Toda M, Miri M, Alonso L, Gómez-Roig MD, Foraster M, Dadvand P. Exposure to greenspace and birth weight in a middle-income country. Environ Res 2020; 189:109866. [PMID: 32768705 DOI: 10.1016/j.envres.2020.109866] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 06/11/2023]
Abstract
An emerging body of evidence has associated exposure to greenspace during pregnancy with improved fetal growth; however, all available studies have been conducted in high-income countries and the available evidence evaluating such an association for visual access to greenspace, use of green spaces and indoor plants is non-existent. We aimed to evaluate the association between a comprehensive array of indicators of exposure to greenspace during pregnancy, including the aforementioned indicators, and birth weight, in a middle-income country and evaluating air pollution and visual access as possible mechanisms underlying the association. This study was based on 301 pregnant women residing in Su et al. (2019). For each pregnant woman, we characterized exposure to residential surrounding greenspace, visual access to greenspace, residential proximity to green space, use of green spaces, and the number of plant pots at home. We used linear regression models adjusted for relevant covariates including measures of socioeconomic status. We found positive associations of maternal exposure to residential surrounding greenspace across a 100 m buffer, frequent viewing of greenspace through the window, percentage of window area covered by greenspace, residential proximity to any green space regardless of its area, time spent in public green spaces and total time spent in public and private green spaces with birth weight. We also observed positive associations of maternal exposure to residential surrounding greenspace across 300 m and 500 m buffers, residential proximity to a green space with an area ≥5000 m2, and indoor plant pots with birth weight, but none of these associations were statistically significant. The magnitude of the associations tended to be higher among parents with lower socioeconomic status. Mediation through air pollution or visual access was not established. Findings from this study suggested a positive role of different aspects of exposure to greenspace during pregnancy on birth weight in a middle-income country.
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Affiliation(s)
- Maria Torres Toda
- ISGlobal, Barcelona, Spain; Pompeu FabraUniversity, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mohammad Miri
- Non-communicable Diseases Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | | | - Maria Dolores Gómez-Roig
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Sant Joan de Deu and Hospital Clínic), Barcelona, Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain; Spain Maternal and Child Health Development Network, RETICS Funded By the PN I+D+I 2013-2016 (Spain), ISCIII- Sub-Directorate General for Research Assessment and Promotion and the European Regional Development Fund (ERDF), Ref. RD16/0022, Madrid, Spain
| | - Maria Foraster
- ISGlobal, Barcelona, Spain; Pompeu FabraUniversity, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Pompeu FabraUniversity, Barcelona, Catalonia, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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13
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Nielsen CC, Gascon M, Osornio-Vargas AR, Shier C, Guttman DS, Becker AB, Azad MB, Sears MR, Lefebvre DL, Moraes TJ, Turvey SE, Subbarao P, Takaro TK, Brook JR, Scott JA, Mandhane PJ, Tun HM, Kozyrskyj AL. Natural environments in the urban context and gut microbiota in infants. Environ Int 2020; 142:105881. [PMID: 32610248 DOI: 10.1016/j.envint.2020.105881] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/27/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
The biodiversity hypothesis that contact with natural environments (e.g. native vegetation) and biodiversity, through the influence of environmental microbes, may be beneficial for human commensal microbiota has been insufficiently tested. We aimed to study the association between living near natural environments in the urban context, and gut microbiota diversity and composition in young infants. Based on data linkage between the unique Urban Primary Land and Vegetation Inventory (uPLVI) for the city of Edmonton and 355 infants in the CHILD Cohort Study, infant exposure to natural environments (any and specific types, yes/no) was determined within 500 m and 1000 m of their home residence. Gut microbiota composition and diversity at age 4 months was assessed in infant fecal samples. Adjusted for covariates, we observed a reduced odds of high microbial alpha-diversity in the gut of infants exposed to any natural environment within 500 m [Shannon index aOR (95%CI) = 0.63 (0.40, 0.98) and Simpson index = 0.63 (0.41, 0.98)]. In stratified analyses, these associations remained only among infants not breastfed or living with household pets. When doubly stratifying by these variables, the reduced likelihood of high alpha-diversity was present only among infants who were not breastfed and lived with household pets [9% of the study population, Shannon index = 0.07 (0.01, 0.49) and Simpson index = 0.11 (0.02, 0.66)]. Differences in beta-diversity was also seen (p = 0.04) with proximity to a nature space in not breastfed and pets-exposed infants. No associations were observed among infants who were fully formula-fed but without pets at home. When families and their pets had close access to a natural environment, Verrucomicrobiales colonization was reduced in the gut microbiota of formula-fed infants, the abundance of Clostridiales was depleted, whereas the abundance of Enterobacteriales was enriched. Our double-stratified results indicate that proximity to a natural environment plus pet ownership has the capacity to alter the gut microbiota of formula-fed infants. Further research is needed to replicate and better interpret these results, as well as to understand their health consequences.
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Affiliation(s)
- Charlene C Nielsen
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; inVIVO Planetary Health, Canada
| | - Mireia Gascon
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Alvaro R Osornio-Vargas
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; inVIVO Planetary Health, Canada
| | - Catherine Shier
- Urban Form and Corporate Strategic Development, City Planning, City of Edmonton, Edmonton, AB, Canada
| | - David S Guttman
- Centre for the Analysis of Genome Evolution and Function, University of Toronto, Toronto, ON, Canada
| | - Allan B Becker
- Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Meghan B Azad
- Department of Pediatrics & Child Health, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Diana L Lefebvre
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Theo J Moraes
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Stuart E Turvey
- Department of Pediatrics, Child & Family Research Institute, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Tim K Takaro
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Piush J Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Hein M Tun
- HKU-Pasteur Research Pole, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region; inVIVO Planetary Health, Canada.
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Department of Obstetrics & Gynecology, University of Alberta, AB, Canada; School of Public Health, University of Alberta, AB, Canada; inVIVO Planetary Health, Canada.
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14
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Lee KJ, Moon H, Yun HR, Park EL, Park AR, Choi H, Hong K, Lee J. Greenness, civil environment, and pregnancy outcomes: perspectives with a systematic review and meta-analysis. Environ Health 2020; 19:91. [PMID: 32854706 PMCID: PMC7457282 DOI: 10.1186/s12940-020-00649-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/21/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Various maternal conditions, especially in utero conditions and prenatal exposure to environments with air pollution and greenness, have been reviewed to address the enhancement and prevention of susceptibility to health risks, including low birthweight, preterm delivery, and preeclampsia. This study aimed to qualitatively and quantitatively investigate the associations between pregnancy outcomes and the characteristics of surrounding living environment, including greenness, air pollution, and civilization. METHODS A secondary search of the MEDLINE, EMBASE, Cochrane Library, K-eArticles, and CINAHL databases was conducted without language restrictions to identify the relevant publications from the time of inception of the databases to April 2019. RESULTS A total of 89 studies were identified, and 10 were included in the quantitative synthesis. The greenness of the environment within 100-, 250- and 500-m buffers, after adjusting for the air quality and civilization factors, was weakly but positively associated with birthweight. The pooled regression slope was 0.00134 (95% confidence interval [CI], 0.000, 0.0020). The greenness of the environment was also associated with a significant decrease in the incidence of poor pregnancy outcomes, namely, low birthweight, small for gestational age (odds ratio [OR] 0.94; 95% CI, 0.92, 0.97), and preterm delivery (OR 0.98; 95% CI, 0.97, 0.99). CONCLUSIONS The greenness of the environment had a positive effect on the pregnancy outcomes, despite poor air quality and civilization. Following urbanization, planning for greenness management, environmental medicine, and public health is important and thus should be proposed as preventive methods as way of increasing birthweight and life expectancy.
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Affiliation(s)
- Kyung Ju Lee
- Department of Obstetrics and Gynecology, Korea University Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.
- Department of Public Health, Korea University Graduate School, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | - Hyemi Moon
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Hyo Ri Yun
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Eun Lyeong Park
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Ae Ran Park
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Hijeong Choi
- Graduate School of Integrative Medicine, Cha University, Pocheon-si, Gyeonggi-do, South Korea
| | - Kwan Hong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
- Department of Public Health, Korea University Graduate School, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea.
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Lin L, Li Q, Yang J, Han N, Chen G, Jin C, Xu X, Liu Z, Liu J, Luo S, Raat H, Guo Y, Wang H. The associations of residential greenness with fetal growth in utero and birth weight: A birth cohort study in Beijing, China. Environ Int 2020; 141:105793. [PMID: 32417616 DOI: 10.1016/j.envint.2020.105793] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/17/2020] [Accepted: 05/02/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although studies have examined the association between residential greenness and birth weight, there is no evidence regarding the association between residential greenness and fetal growth in utero. We aimed to investigate the associations of residential greenness with both fetal growth in utero and birth weight. METHODS A birth cohort (2014-2017) with 18,665 singleton pregnancies was established in Tongzhou Maternal and Child hospital of Beijing, China. Residential greenness was matched with maternal residential address and estimated from remote satellite data using normalized difference vegetation index with 200 m and 500 m buffers (NDVI-200 and NDVI-500). Fetal parameters including estimated fetal weight (EFW), abdominal circumference (AC), head circumference (HC) and femur length (FL) were assessed by ultrasound measurements during pregnancy. Fetal parameters were standardized as gestational-age- and gender-adjusted Z-score and undergrowth was defined as Z-score < -1.88. Birth weight Z-score, low birth weight (LBW) and small for gestational age (SGA) were assessed as birth outcomes. Generalized estimating equations with the autoregressive working correlation structure and generalized linear regression were used to examine the associations of residential greenness with quantitative and categorized outcomes. RESULTS We found an increase Z-score of EFW [0.054, 95% confidence interval (CI): 0.020-0.087], AC (0.045, 95%CI: 0.011-0.080) and HC (0.054, 95%CI: 0.020-0.089) associated with residential greenness above NDVI-500 median compared to less than and equal to NDVI-500 median. Stratified analyses indicated that the associations might be stronger in women exposed to lower levels of particles with aerodynamic diameters ≤2.5 µm. No associations were found in the analyses of NDVI-250 with fetal growth in utero. We didn't observe significant associations of NDVI with birth weight Z-score, LBW and SGA. CONCLUSIONS This study identified a positive association of NDVI-500 and fetal growth in utero, but we didn't observe its association with birth weight measures. Our results suggest that building sufficient green infrastructure might potentially promote early life health.
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Affiliation(s)
- Lizi Lin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; Reproductive Medical Centre, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing 100191, People's Republic of China
| | - Jie Yang
- Tongzhou Maternal and Child Health Hospital, Beijing 101101, People's Republic of China
| | - Na Han
- Tongzhou Maternal and Child Health Hospital, Beijing 101101, People's Republic of China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan 430071, People's Republic of China
| | - Chuyao Jin
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Xiangrong Xu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Zheng Liu
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, People's Republic of China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haijun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, People's Republic of China; National Health Commission Key Laboratory of Reproductive Health, Beijing, People's Republic of China.
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16
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Dzhambov AM, Browning MHEM, Markevych I, Hartig T, Lercher P. Analytical approaches to testing pathways linking greenspace to health: A scoping review of the empirical literature. Environ Res 2020; 186:109613. [PMID: 32668553 DOI: 10.1016/j.envres.2020.109613] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/26/2020] [Accepted: 04/26/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Inadequate translation from theoretical to statistical models of the greenspace - health relationship may lead to incorrect conclusions about the importance of some pathways, which in turn may reduce the effectiveness of public health interventions involving urban greening. In this scoping review we aimed to: (1) summarize the general characteristics of approaches to intervening variable inference (mediation analysis) employed in epidemiological research in the field; (2) identify potential threats to the validity of findings; and (3) propose recommendations for planning, conducting, and reporting mediation analyses. METHODS We conducted a scoping review, searching PubMed, Scopus, and Web of Science for peer-reviewed epidemiological studies published by December 31, 2019. The list of potential studies was continuously updated through other sources until March 2020. Narrative presentation of the results was coupled with descriptive summary of study characteristics. RESULTS We found 106 studies, most of which were cross-sectional in design. Most studies only had a spatial measure of greenspace. Mental health/well-being was the most commonly studied outcome, and physical activity and air pollution were the most commonly tested intervening variables. Most studies only conducted single mediation analysis, even when multiple potentially intertwined mediators were measured. The analytical approaches used were causal steps, difference-of-coefficients, product-of-coefficients, counterfactual framework, and structural equation modelling (SEM). Bootstrapping was the most commonly used method to construct the 95% CI of the indirect effect. The product-of-coefficients method and SEM as used to investigate serial mediation components were more likely to yield findings of indirect effect. In some cases, the causal steps approach thwarted tests of indirect effect, even though both links in an indirect effect were supported. In most studies, sensitivity analyses and proper methodological discussion of the modelling approach were missing. CONCLUSIONS We found a persistent pattern of suboptimal conduct and reporting of mediation analysis in epidemiological studies investigating pathways linking greenspace to health; however, recent years have seen improvements in these respects. Better planning, conduct, and reporting of mediation analyses are warranted.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Matthew H E M Browning
- Department of Park, Recreation, and Tourism Management, Clemson University, Clemson, USA
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Uppsala, Sweden
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
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Anabitarte A, Subiza-Pérez M, Ibarluzea J, Azkona K, García-Baquero G, Miralles-Guasch C, Irazusta J, Whitworth KW, Vich G, Lertxundi A. Testing the Multiple Pathways of Residential Greenness to Pregnancy Outcomes Model in a Sample of Pregnant Women in the Metropolitan Area of Donostia-San Sebastián. Int J Environ Res Public Health 2020; 17:E4520. [PMID: 32586011 DOI: 10.3390/ijerph17124520] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/16/2022]
Abstract
Residential greenness may positively impact diverse human health indicators through the reduction of air pollution, the improvement of psychological health, and the promotion of physical activity. Previous studies indicate a weak but positive association with pregnancy outcomes. Our aim was to test the multiple pathways from residential greenness to pregnancy outcomes model, using residential NO2 concentrations, psychological health, and moderate-to-vigorous physical activity (MVPA) during the first trimester of pregnancy, in a sample of 440 pregnant women residing in Donostia, Spain. Three metrics of residential greenness were calculated around each participant’s home address: normalized difference vegetation index (NDVI) within 300 m, and green space (>5000 m2) availability within 300 and 500 m. Residential NO2 concentrations, psychological health, and MVPA were explored as mediators of the associations between these metrics and the following pregnancy outcomes: birth weight (BW), low birth weight (LBW), prematurity, small for gestational age (SGA), and large for gestational age (LGA). Educational attainment, parity, and body mass index (BMI) were treated as covariates. Counterfactual mediation analyses showed very low to null statistical support for an association between any of the greenspace metrics and pregnancy outcomes in the full sample. Green space availability (300 m) was associated with lower BW and showed a marginal protective effect against LGA.
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18
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Rugel EJ, Brauer M. Quiet, clean, green, and active: A Navigation Guide systematic review of the impacts of spatially correlated urban exposures on a range of physical health outcomes. Environ Res 2020; 185:109388. [PMID: 32244108 DOI: 10.1016/j.envres.2020.109388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/23/2020] [Accepted: 03/12/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Recent epidemiologic analyses have considered impacts of multiple spatially correlated urban exposures, but this literature has not been systematically evaluated. OBJECTIVES To characterize the long-term impacts of four distinct spatially correlated urban environmental exposures - traffic-related air pollution (TRAP), noise, natural spaces, and neighborhood walkability - by evaluating studies including measures of at least two such exposures in relationship to mortality, cardiovascular disease, chronic respiratory disease, allergy, type 2 diabetes, or reproductive outcomes. METHODS Following the Navigation Guide framework, the literature was searched for studies published since 2003 and meeting predefined inclusion criteria. Identified studies were scored individually for risk of bias and all studies related to an exposure-group set were appraised for overall quality and strength of evidence. RESULTS A total of 51 individual studies (TRAP and noise: n = 29; TRAP and natural spaces: n = 10; noise and natural spaces: n = 2; TRAP, noise, and natural spaces: n = 7; TRAP, noise, natural spaces, and walkability: n = 3) were included. When TRAP and noise were considered jointly, evidence was sufficient for increased cardiovascular morbidity with higher noise exposures; sufficient for no effect of TRAP on CVD morbidity; sufficient for increased mortality with higher TRAP exposures, but limited for noise; and limited for increased adverse reproductive outcomes with higher TRAP exposures and no effect of noise. Looking at natural spaces and TRAP, there was limited evidence for lower risk of chronic respiratory disease and small increases in birthweight with greater natural space; this relationship with birthweight persisted after adjustment for noise as well. Evidence was inadequate for all other exposure groups and outcomes. DISCUSSION Studies that properly account for the complexity of relationships between urban form and physical health are limited but suggest that even highly correlated exposures may have distinct effects. REVIEW REGISTRATION PROSPERO 2018 CRD42018106050.
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Affiliation(s)
- Emily Jessica Rugel
- School of Population and Public Health, University of British Columbia, 3rd Floor - 2206 East Mall, Vancouver, BC V6T1Z3, Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, 3rd Floor - 2206 East Mall, Vancouver, BC V6T1Z3, Canada; Institute for Health Metrics and Evaluation, University of Washington, 2301 5th Ave, Suite 600, Seattle, WA 98121, USA.
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19
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Zhan Y, Liu J, Lu Z, Yue H, Zhang J, Jiang Y. Influence of residential greenness on adverse pregnancy outcomes: A systematic review and dose-response meta-analysis. Sci Total Environ 2020; 718:137420. [PMID: 32325616 DOI: 10.1016/j.scitotenv.2020.137420] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND With the development of urbanization, there is a decreasing tendency for people contact with natural greenness. Whether maternal exposure to greenness has an impact on pregnancy complications and pregnancy outcomes remains to be confirmed. OBJECTIVES To estimate the association and dose-response relationship between residential greenness and pregnancy outcomes. DATA SOURCES PubMed, Embase, Ovid, Scopus and Web of Science from inception to 1st December 2019 were searched. SYNTHESIS METHODS The summary regression coefficient (β) and odds ratio (OR) with corresponding 95% confidence interval (95%CI) were calculated. The linear dose-response relationship between greenness and adverse pregnancy outcomes was also investigated. RESULTS Overall, 36 studies with a total of 11,983,089 participants were included. Birth weight was significantly higher in highest level of greenness exposure group compared to lowest level group (e.g. β:20.22, 95%CI:13.50-26.93 at 100 m buffer). The odds of low birth weight (LBW) decreased in the highest level of group compared to lowest level group (e.g. OR:0.86, 95%CI:0.75-0.99 at 100 m buffer). The odds of small for gestational age (SGA) also decreased in the highest group (OR:0.93, 95%CI:0.88-1.00 at 100 m buffer). In addition, maternal exposure to greenness was associated with increased head circumference and decreased mental disorders. The dose-response models showed a 2% decrease risk of LBW per 0.1 normalized difference vegetation index (NDVI) increase within 300 m buffer (OR:0.98, 95%CI:0.97-0.99, P < 0.001) and a 1% decrease risk of SGA per 0.1 NDVI increase within 300 m buffer (OR:0.99, 95%CI:0.98-1.00, P = 0.037). No significant associations were found on preterm birth, gestational age, gestational diabetes mellitus, gestational hypertension or preeclampsia. CONCLUSIONS This review confirms an inverse association between residential greenness and adverse pregnancy outcomes. Findings of our study provide evidences for pregnant women to increase greenness exposure.
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Affiliation(s)
- Yongle Zhan
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
| | - Jintao Liu
- Department of Urban Planning, School of Architecture & Fine Art, Dalian University of Technology, Dalian 116024, China
| | - Zhiming Lu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Hexin Yue
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Jingwen Zhang
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
| | - Yu Jiang
- School of Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China.
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Abareshi F, Sharifi Z, Hekmatshoar R, Fallahi M, Lari Najafi M, Ahmadi Asour A, Mortazavi F, Akrami R, Miri M, Dadvand P. Association of exposure to air pollution and green space with ovarian reserve hormones levels. Environ Res 2020; 184:109342. [PMID: 32172073 DOI: 10.1016/j.envres.2020.109342] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/22/2020] [Accepted: 03/02/2020] [Indexed: 05/09/2023]
Abstract
Exposure to air pollution has been associated with adverse health effects while exposure to greenspace has been associated with public health benefits. However, the available evidence on the association of exposure to air pollution with ovarian reserve markers is still scarce, with no study on such an association with greenspace exposure. Therefore, this study aimed to investigate the association of exposure to particulate matter with diameter of less than 1, 2.5 and 10 μm (PM1, PM2.5, PM10), traffic indicators (distance from women's residence to major roads and total street length in different buffers around women's residential address) and greenspace indicators (residential surrounding greenspace and distance to green spaces) with serum levels of anti-müllerian hormone (AMH) and follicle stimulating hormone (FSH) as markers of ovarian reserve. This cross-sectional study was based on 67 women residing in Sabzevar, Iran (2018). Basal serum levels of FSH and AMH were measured by the enzyme-linked immunosorbent assays (ELISA). Land use regression models were used to estimate PMs concentrations at residential addresses and the average of normalized difference vegetation index (NDVI) in different buffers was used to characterize residential surrounding greenspace. Multiple linear regression models were developed to estimate the association of AMH and FSH with exposure to air pollution, traffic, and greenspace (one at a time) controlled for relevant covariates. In fully adjusted models, there was an inverse association between exposure to PM1, PM2.5 as well as total street length in 100 m buffer around women's residence and AMH level (β = -0.89, 95% confidence interval (CI): -1.43, -0.35, P-value ≤ 0.01, β = -1.11, 95% CI: -1.67, -0.55, P-value ≤ 0.01 and β = -0.76, 95% CI: -1.48, -0.50, P-value = 0.03, respectively). Moreover, increase in distance from home to nearest major road as well as residential surrounding greenspace (100 m buffer) and decrease in residential distance to a green space larger than 5000 m2 were associated with increase in serum level of AMH. However, we did not observe any significant association between exposure to air pollution, traffic, and greenspace with FSH level. Overall, our findings supported a beneficial association of exposure to greenspace and detrimental association of exposure to air pollution with ovarian reserve.
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Affiliation(s)
- Fatemeh Abareshi
- Non-Communicable Diseases Research Center, Department of Occupational Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Zahra Sharifi
- Non-Communicable Diseases Research Center, Department of Occupational Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Reza Hekmatshoar
- Non-Communicable Diseases Research Center, Department of Occupational Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Majid Fallahi
- Non-Communicable Diseases Research Center, Department of Occupational Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Moslem Lari Najafi
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Akbar Ahmadi Asour
- Non-Communicable Diseases Research Center, Department of Occupational Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Forough Mortazavi
- Department of Midwifery, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Rahim Akrami
- Department of Epidemiology & Biostatistics, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran; Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Miri
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Akaraci S, Feng X, Suesse T, Jalaludin B, Astell-Burt T. A Systematic Review and Meta-Analysis of Associations between Green and Blue Spaces and Birth Outcomes. Int J Environ Res Public Health 2020; 17:ijerph17082949. [PMID: 32344732 PMCID: PMC7215926 DOI: 10.3390/ijerph17082949] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 04/13/2020] [Accepted: 04/21/2020] [Indexed: 12/13/2022]
Abstract
Previous studies suggest that green and blue spaces may promote several health outcomes including birth outcomes. However, no synthesis of previous work has specifically asked policy-relevant questions of how much and what type is needed in every neighborhood to elicit these benefits at the population level. A systematic review and meta-analyses were conducted to synthesize thirty-seven studies on the association between residential green and blue spaces and pregnancy outcomes. Meta-analyses were performed for birth weight (BW), small for gestational age (SGA), low birth weight (LBW) and preterm birth (PTB). Increase in residential greenness was statistically significantly associated with higher BW [β = 0.001, 95%CI: (<0.001, 0.002)] and lower odds of SGA [OR = 0.95, 95%CI: (0.92, 0.97)]. Associations between green space and LBW and PTB were as hypothesized but not statistically significant. Associations between blue spaces and pregnancy outcomes were not evident. No study explicitly examined questions of threshold, though some evidence of nonlinearity indicated that moderate amounts of green space may support more favorable pregnancy outcomes. Policy-relevant green and blue space exposures involving theory-driven thresholds warrant testing to ensure future investments in urban greening promote healthier pregnancy outcomes.
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Affiliation(s)
- Selin Akaraci
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; (S.A.); (X.F.)
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; (S.A.); (X.F.)
- School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW 2006, Australia
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
| | - Thomas Suesse
- NIASRA, National Institute for Applied Statistics Research Australia School of Mathematics and Applied Statistics, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW 2170, Australia;
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW 2522, Australia; (S.A.); (X.F.)
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW 2006, Australia
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (China CDC), Beijing 102206, China
- School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing 100730, China
- Correspondence:
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22
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Wilding S, Ziauddeen N, Smith D, Roderick P, Chase D, Alwan NA. Are environmental area characteristics at birth associated with overweight and obesity in school-aged children? Findings from the SLOPE (Studying Lifecourse Obesity PrEdictors) population-based cohort in the south of England. BMC Med 2020; 18:43. [PMID: 32188454 PMCID: PMC7081603 DOI: 10.1186/s12916-020-01513-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/06/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Geographical inequalities in overweight and obesity prevalence among children are well established in cross-sectional research. We aimed to examine how environmental area characteristics at birth are related to these outcomes in childhood. METHODS Anonymised antenatal and birth data recorded by University Hospital Southampton linked to school-measured weight and height data for children within Southampton, UK, were utilised (14,084 children at ages 4-5 and 5637 at ages 10-11). Children's home address at birth was analysed at the Lower and Middle layer Super Output Area (LSOA/MSOA) levels (areas with average populations of 1500 and 7000, respectively). Area-level indices (walkability, relative density of unhealthy food outlets, spaces for social interaction), natural greenspace coverage, supermarket density and measures of air pollution (PM2.5, PM10 and NOx) were constructed using ArcGIS Network Analyst. Overweight/obesity was defined as a body mass index (BMI; kg/m2) greater than the 85th centile for sex and age. Population-average generalised estimating equations estimated the risk of being overweight/obese for children at both time points. Confounders included maternal BMI and smoking in early pregnancy, education, ethnicity and parity. We also examined associations for a subgroup of children who moved residence between birth and outcome measurement. RESULTS There were mixed results between area characteristics at birth and overweight/obesity at later ages. MSOA relative density of unhealthy food outlets and PM10 were positively associated with overweight/obesity, but not among children who moved. LSOA greenspace coverage was negatively associated with the risk of being overweight/obese at ages 10-11 in all children (relative risk ratio 0.997, 95% confidence interval 0.995-0.999, p = 0.02) and among children who moved. CONCLUSIONS Local access to natural greenspaces at the time of birth was inversely associated with becoming overweight or obese by age 10-11, regardless of migration. Increased access/protection of greenspace may have a role in the early prevention of childhood obesity.
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Affiliation(s)
- Sam Wilding
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nida Ziauddeen
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Dianna Smith
- School of Geography and Environmental Science, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Paul Roderick
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - Nisreen A Alwan
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK. .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.
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23
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Aerts R, Stas M, Vanlessen N, Hendrickx M, Bruffaerts N, Hoebeke L, Dendoncker N, Dujardin S, Saenen ND, Van Nieuwenhuyse A, Aerts JM, Van Orshoven J, Nawrot TS, Somers B. Residential green space and seasonal distress in a cohort of tree pollen allergy patients. Int J Hyg Environ Health 2019; 223:71-79. [PMID: 31628039 DOI: 10.1016/j.ijheh.2019.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/04/2019] [Accepted: 10/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Residential green space may improve human health, for example by promoting physical activity and by reducing stress. Conversely, residential green space may increase stress by emitting aeroallergens and exacerbating allergic disease. Here we examine impacts of exposure to residential green space on distress in the susceptible subpopulation of adults sensitized to tree pollen allergens. METHODS In a panel study of 88 tree pollen allergy patients we analyzed self-reported mental health (GHQ-12), perceived presence of allergenic trees (hazel, alder, birch) near the residence and residential green space area within 1 km distance [high (≥3 m) and low (<3 m) green]. Results were adjusted for patients' background data (gender, age, BMI, smoking status, physical activity, commuting distance, education level, allergy medication use and chronic respiratory problems) and compared with distress in the general population (N = 2467). RESULTS Short-term distress [mean GHQ-12 score 2.1 (95% confidence interval 1.5-2.7)] was higher in the study population than in the general population [1.5 (1.4-1.7)]. Residential green space had protective effects against short-term distress [high green, per combined surface area of 10 ha: adjusted odds ratio OR = 0.94 (95% confidence interval 0.90-0.99); low green, per 10 ha: OR = 0.85 (0.78-0.93)]. However, distress was higher in patients who reported perceived presence of allergenic trees near their residence [present vs. absent: OR = 2.04 (1.36-3.07)]. CONCLUSIONS Perceived presence of allergenic tree species in the neighbourhood of the residence of tree pollen allergy patients modulates the protective effect of residential green space against distress during the airborne tree pollen season.
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Affiliation(s)
- Raf Aerts
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium; Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium; Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium.
| | - Michiel Stas
- Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium; Division Animal and Human Health Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | | | - Marijke Hendrickx
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Nicolas Bruffaerts
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Lucie Hoebeke
- Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Brussels, Belgium
| | - Nicolas Dendoncker
- Department of Geography, Institute of Life Earth and Environment (ILEE), University of Namur, Namur, Belgium
| | - Sebastien Dujardin
- Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium; Department of Geography, Institute of Life Earth and Environment (ILEE), University of Namur, Namur, Belgium
| | - Nelly D Saenen
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium; Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium
| | - An Van Nieuwenhuyse
- Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Brussels, Belgium; Department of Public Health and Primary Care, University of Leuven (KU Leuven), Belgium
| | - Jean-Marie Aerts
- Division Animal and Human Health Engineering, University of Leuven (KU Leuven), Leuven, Belgium
| | - Jos Van Orshoven
- Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, University of Hasselt, Hasselt, Belgium; Department of Public Health and Primary Care, University of Leuven (KU Leuven), Belgium
| | - Ben Somers
- Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Leuven, Belgium
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24
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Sbihi H, Jones MJ, MacIsaac JL, Brauer M, Allen RW, Sears MR, Subbarao P, Mandhane PJ, Moraes TJ, Azad MB, Becker AB, Brook JR, Kobor MS, Turvey SE. Prenatal exposure to traffic-related air pollution, the gestational epigenetic clock, and risk of early-life allergic sensitization. J Allergy Clin Immunol 2019; 144:1729-1731.e5. [PMID: 31470034 DOI: 10.1016/j.jaci.2019.07.047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/18/2019] [Accepted: 07/26/2019] [Indexed: 01/29/2023]
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25
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Dzhambov AM, Markevych I, Lercher P. Associations of residential greenness, traffic noise, and air pollution with birth outcomes across Alpine areas. Sci Total Environ 2019; 678:399-408. [PMID: 31077918 DOI: 10.1016/j.scitotenv.2019.05.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/29/2019] [Accepted: 05/02/2019] [Indexed: 05/25/2023]
Abstract
UNLABELLED Aim This explorative study aimed to investigate the association of residential greenness, traffic noise, and air pollution with birth outcomes in several Alpine areas with unique topography. METHODS We used data from two cross-sectional studies (UIT, n = 573 and BBT, n = 518) in the Tyrol Region (Austria/Italy). Only mothers who had lived in their current residence during the whole pregnancy were included. They completed a questionnaire, and medical records were used to draw data on birth weight, low birth weight (LBW), preterm birth, and small for gestational age (SGA). Normalized Difference Vegetation Index (NDVI) in the year of birth was assigned at the residential address as a measure of greenness. Road/railway traffic noise (Ldn) and air pollution (NO2) were calculated about 10 years after birth and used as surrogates for exposure levels during pregnancy. RESULTS In the UIT survey, higher NDVI500-m was consistently associated with lower odds for LBW and SGA, while an increase of Ldn was associated with higher odds for LBW. Other effect estimates were in the expected direction albeit non-significant. In the BBT survey, most findings were inconclusive (for NDVI) or present only in subgroups (for Ldn and NO2). CONCLUSION This study provides inconclusive evidence that the surrounding environment might be associated with birth outcomes in mountainous areas. Given the disparate associations across the study areas, further research in larger representative samples is warranted.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
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26
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Dzhambov AM, Lercher P. Road Traffic Noise Exposure and Birth Outcomes: An Updated Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2019; 16:E2522. [PMID: 31311086 PMCID: PMC6678260 DOI: 10.3390/ijerph16142522] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/11/2019] [Accepted: 07/13/2019] [Indexed: 11/26/2022]
Abstract
Unlike the other WHO evidence reviews, the systematic review on birth outcomes could not provide a quantitative estimate of the effect of environmental noise. With that in mind, we aimed to update it with additional studies published through to 12 May, 2019 to allow for a formal meta-analysis of the association of residential road traffic noise with birth weight, low birth weight (LBW), small for gestational age (SGA), and preterm birth (PTB). The quality effects and random effects estimators were used for meta-analysis and the robustness of findings was tested in several sensitivity analyses. Nine studies were included in the qualitative synthesis, from which we extracted seven estimates for birth weight (n = 718,136 births) and LBW (n = 620,221), and five for SGA (n = 547,256) and PTB (n = 74,609). We found -8.26 g (95% CI: -20.61 g, 4.10 g) (I2 = 87%) lower birth weight associated with a 10 dB(A) increase in day-evening-night noise level (Lden), and this effect became significant in sensitivity analyses. No evidence of significant effects was found for LBW (OR = 1.06; 95% CI: 0.91, 1.23) (I2 = 49%), SGA (OR = 1.02; 95% CI: 0.86, 1.21) (I2 = 90%), or PTB (OR = 1.00; 95% CI: 0.79, 1.27) (I2 = 69%). The quality of evidence for continuous birth weight was graded as "moderate", while for the other outcomes it was deemed "very low". Finally, we discuss limitations of the risk of bias assessment criteria employed by Nieuwenhuijsen et al.
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Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, 8010 Graz, Austria
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