1
|
Tang M, Liu W, Li H, Li F. Greenness and chronic respiratory health issues: a systematic review and meta-analysis. Front Public Health 2023; 11:1279322. [PMID: 38125839 PMCID: PMC10732026 DOI: 10.3389/fpubh.2023.1279322] [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: 08/17/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction The number of chronic respiratory disease (CRD) individuals worldwide has been continuously increasing. Numerous studies have shown that greenness can improve chronic respiratory health issues through different mechanisms, with inconsistent evidence. By quantitatively summarizing existing studies, our purpose is to determine the connection between greenness exposure and various chronic respiratory health. Methods We conducted a comprehensive search on PubMed, EMBASE, and Web of Science core databases to identify relevant studies on the correlation between greenness exposure and chronic respiratory health issues. Studies published up to January 2023 were included in the search. The study used the most frequent indicator (normalized difference vegetation index [NDVI]) as the definition of greenness exposure. Results We finally identified 35 studies for meta-analysis. We calculated pooled effects across studies using a random-effects model and conducted a subgroup analysis by age and buffer zones to discuss the effects on chronic respiratory health issues. This study showed that 0.1 increments in NDVI were significantly related to lower rates of asthma incidence, lung cancer incidence, and chronic obstructive pulmonary disease (COPD) mortality risk; the pooled RRs were 0.92 (95% CI: 0.85-0.98), 0.62 (95% CI: 0.40-0.95), and 0.95 (95% CI: 0.92- 0.99), respectively. For the age subgroup, the higher greenness exposure level was related to the incidence rate of asthma among teenagers aged 13-18years (RR: 0.91; 95% CI: 0.83-0.99). For the buffer subgroup, a positive relationship with greenness exposure and asthma incidence/prevalence at 200-300m and 800- 1000m buffers, as well as the COPD mortality at 800-1000m buffer, the pooled RRs were 0.92 (95% CI: 0.86-0.98), 0.87 (95% CI: 0.81-0.93), and 0.93 (95% CI: 0.88- 0.98), respectively. Evidence of publication bias was not detected in this study. Discussion Our study is the first global meta-analysis between greenness and various CRDs to report an inverse association. Further research is needed in order to determine the effect of greenness exposure on different CRDs. Therefore, when planning for green development, more consideration must be given to public health and green management as intervention measures. https://www.crd.york.ac.uk/PROSPEROFILES/384029_STRATEGY_20230116.pdf.
Collapse
Affiliation(s)
- Mingcheng Tang
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao, China
| | - Wei Liu
- School of Art, Qufu Normal University, Rizhao, Shandong, China
| | - Haifang Li
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao, China
| | - Fengyi Li
- School of Landscape Architecture and Forestry, Qingdao Agricultural University, Qingdao, China
| |
Collapse
|
2
|
Gou A, Tan G, Ding X, Wang J, Jiao Y, Gou C, Tan Q. Spatial association between green space and COPD mortality: a township-level ecological study in Chongqing, China. BMC Pulm Med 2023; 23:89. [PMID: 36932348 PMCID: PMC10024412 DOI: 10.1186/s12890-023-02359-x] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 02/10/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND There are regional differences in the effect of green space on mortality of Chronic obstructive pulmonary disease (COPD). We conduct an ecological study, using the administrative divisions of Chongqing townships in China as the basic unit, to investigate the association between COPD mortality and green space based on data of 313,013 COPD deaths in Chongqing from 2012 to 2020. Green space is defined by Fractional vegetation cover (FVC), which is further calculated based on the normalised vegetation index (NDVI) from satellite remote sensing imagery maps. METHODS After processing the data, the non-linear relationship between green space and COPD mortality is revealed by generalised additive models; the spatial differences between green space and COPD mortality is described by geographically weighted regression models; and finally, the interpretive power and interaction of each factor on the spatial distribution of COPD mortality is examined by a geographic probe. RESULTS The results show that the FVC local regression coefficients ranged from - 0.0397 to 0.0478, 63.0% of the regions in Chongqing have a positive correlation between green space and COPD mortality while 37.0% of the regions mainly in the northeast and west have a negative correlation. The interpretive power of the FVC factor on the spatial distribution of COPD mortality is 0.08. CONCLUSIONS Green space may be a potential risk factor for increased COPD mortality in some regions of Chongqing. This study is the first to reveal the relationship between COPD mortality and green space in Chongqing at the township scale, providing a basis for public health policy formulation in Chongqing.
Collapse
Affiliation(s)
- Aiping Gou
- College of Ecological Technology and Engineering, Shanghai Institute of Technology, Shanghai, 201418, China
| | - Guanzheng Tan
- College of Ecological Technology and Engineering, Shanghai Institute of Technology, Shanghai, 201418, China
| | - Xianbin Ding
- Institute of Chronic and Non-communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China.
| | - Jiangbo Wang
- College of Architecture, Nanjing Tech University, Nanjing, 211816, China.
| | - Yan Jiao
- Institute of Chronic and Non-communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Chunyan Gou
- Department of Acupuncture, Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400021, China
| | - Qiang Tan
- Institute of Chronic and Non-communicable Disease Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China
| |
Collapse
|
3
|
Cao NW, Zhou HY, Du YJ, Li XB, Chu XJ, Li BZ. The effect of greenness on allergic rhinitis outcomes in children and adolescents: A systematic review and meta-analysis. Sci Total Environ 2023; 859:160244. [PMID: 36402344 DOI: 10.1016/j.scitotenv.2022.160244] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 06/21/2022] [Revised: 10/14/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The relationship between greenness and health emerges as new public health concern. More published studies from multiple areas have explored the relationship between greenness and allergic rhinitis (AR) in children and adolescents. This study aims to determine the association between greenness and allergic rhinitis by systematic review and meta-analysis, in order to provide a more comprehensive assessment of the impact of greenness on AR in children and adolescents. METHODS The relative literature was systematically searched in PubMed, Embase, and Web of science lastly on September 25, 2022. Terms related to greenness and allergic rhinitis were used for searching. Summary effect estimates of greenness on AR in children and adolescents were calculated for per 10 % increase of greenness exposure with different buffer sizes by random-effects model. RESULTS A total of 579 studies were screened, and fourteen studies from Europe, Asia and North America were finally included. Most greenness exposure were measured by normalized difference vegetation index (NDVI). Enhanced vegetation index, outdoor-green environmental score and existed to measuring different greenness types. Greenness surrounding residences and schools were assessed. The overall effect of greenness on primary outcome was 1.00 (95%CI = 0.99-1.00). Most effect estimates of greenness were included in the NDVI-500 m group, and the pooled OR was 0.99 (95%CI = 0.97-1.01). No significant pooled estimates were found in analyses with study locations. CONCLUSION This study indicates no significant association between greenness exposure and AR in children and adolescents. Various exposure measures and conversion of data may affect the results of this meta-analysis. More precise assessment of personal greenness exposure in well-designed prospective studies are vital for drawing a definite association in future. Furthermore, greenness exposure surrounding schools should be paid considerable attention for its effect on AR in school-aged children and adolescents.
Collapse
Affiliation(s)
- Nv-Wei Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, Anhui, China
| | - Hao-Yue Zhou
- Hospital-Acquired Infection Control Department, The First Hospital of Jiaxing & The Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China
| | - Yu-Jie Du
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, Anhui, China
| | - Xian-Bao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, Anhui, China
| | - Xiu-Jie Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, Anhui, China
| | - Bao-Zhu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Anhui Provincial Laboratory of Inflammatory and Immune Diseases, Hefei, Anhui, China.
| |
Collapse
|
4
|
Jackson CM, Kaplan AN, Järvinen KM. Environmental Exposures may Hold the Key; Impact of Air Pollution, Greenness, and Rural/Farm Lifestyle on Allergic Outcomes. Curr Allergy Asthma Rep 2023; 23:77-91. [PMID: 36609951 PMCID: PMC9932951 DOI: 10.1007/s11882-022-01061-y] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE OF REVIEW There has been an increased prevalence of allergy. Due to this relatively rapid rise, changes in environmental exposures are likely the main contributor. In this review, we highlight literature from the last 3 years pertaining to the role of air pollution, greenness, and the rural/farm lifestyle and their association with the development of allergic sensitization, atopic dermatitis, food allergy, and allergic rhinitis in infancy and childhood. Because asthma has a more complex pathophysiology, it was excluded from this review. RECENT FINDINGS Recent studies support a role for air pollution, greenness, and rural/farming lifestyle influencing atopic outcomes that continue to be defined. While many studies have examined singular environmental exposures, the interconnectedness of these exposures and others points to a need for future work to consider an individual's whole exposure. Environmental exposures' influence on atopic disease development remains an ongoing and important area of study.
Collapse
Affiliation(s)
- Courtney M Jackson
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Golisano Children's Hospital, 601 Elmwood Ave. Box 777, Rochester, NY, 14642, USA
| | - Alexandra N Kaplan
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Golisano Children's Hospital, 601 Elmwood Ave. Box 777, Rochester, NY, 14642, USA
| | - Kirsi M Järvinen
- Division of Allergy and Immunology, Center for Food Allergy, Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Golisano Children's Hospital, 601 Elmwood Ave. Box 777, Rochester, NY, 14642, USA.
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave. Box 777, Rochester, NY, 14642, USA.
- Department of Microbiology and Immunology, School of Medicine and Dentistry, University of Rochester, 601 Elmwood Ave. Box 777, Rochester, NY, 14642, USA.
| |
Collapse
|
5
|
Wang X, Zhou N, Zhi Y. Association between exposure to greenness and atopic march in children and adults-A systematic review and meta-analysis. Front Public Health 2023; 10:1097486. [PMID: 36699899 PMCID: PMC9868616 DOI: 10.3389/fpubh.2022.1097486] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/14/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Allergic diseases are a global public health problem. Food allergy, atopic dermatitis (AD), allergic rhinoconjunctivitis, allergic rhinitis (AR) and asthma represent the natural course of allergic diseases, also known as the "atopic march". In recent years, a large number of studies have been published on the association between greenness exposure and allergic diseases. However, systematic reviews on the association between greenness exposure and multiple allergic diseases or atopic march are lacking. Methods In this study, PubMed, EMBASE, ISI Web of Science, and Scopus were systematically searched. Meta-analyses were performed if at least three studies reported risk estimates for the same outcome and exposure measures. Results Of 2355 records, 48 studies were included for qualitative review. Five birth cohort studies, five cross-sectional studies, and one case-control study were included for asthma meta-analysis, respectively. Four birth cohort studies were included for AR meta-analysis. Our results support that exposure to a greener environment at birth reduces the risk of asthma and AR in childhood. In addition, higher greenness exposure was associated with decreased odds of current asthma in children. Discussion There was a large heterogeneity among the included studies and most of them did not specify the vegetation type and causative allergens. Therefore the study results need to be further validated. In addition, a small number of studies evaluated the association between greenness and food allergy, AD and allergic rhinoconjunctivitis. More research is needed to strengthen our understanding of the association between greenness and allergic diseases.
Collapse
|
6
|
Ye T, Yu P, Wen B, Yang Z, Huang W, Guo Y, Abramson MJ, Li S. Greenspace and health outcomes in children and adolescents: A systematic review. Environ Pollut 2022; 314:120193. [PMID: 36122655 DOI: 10.1016/j.envpol.2022.120193] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/04/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
An increasing body of evidence has linked greenspace and various health outcomes in children and adolescents, but the conclusions were inconsistent. For this review, we comprehensively summarized the measurement methods of greenspace, resultant health outcomes, and potential mechanisms from epidemiological studies in children and adolescents (aged ≤19 years). We searched for studies published and indexed in MEDLINE and EMBASE (via Ovid) up to April 11, 2022. There were a total of 9,291 studies identified with 140 articles from 28 countries finally assessed and included in this systematic review. Over 70% of the studies were conducted in highly urbanised countries/regions, but very limited research has been done in low-and middle-income countries and none in Africa. Measures of greenspace varied. Various health outcomes were reported, including protective effects of greenspace exposure on aspects of obesity/overweight, myopia, lung health, circulatory health, cognitive function, and general health in children and adolescents. The associations between greenspace exposure and other health outcomes were inconsistent, especially for respiratory health studies. We pooled odds ratios (OR) using random-effects meta-analysis for health outcomes of asthma (OR = 0.94, 95%CI: 0.84 to 1.06), allergic rhinitis (OR = 0.95; 95% CI: 0.73 to 1.25), and obesity/overweight (OR = 0.91, 95%CI: 0.84 to 0.98) with per 0.1 unit increase in normalized difference in vegetation index (NDVI). These associations have important implications for the assessment and management of urban environment and health in children and adolescents.
Collapse
Affiliation(s)
- Tingting Ye
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Bo Wen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Zhengyu Yang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Wenzhong Huang
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Michael J Abramson
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| |
Collapse
|
7
|
Wu B, Guo X, Liang M, Sun C, Gao J, Xie P, Feng L, Xia W, Liu H, Ma S, Zhao D, Qu G, Sun Y. Association of individual green space exposure with the incidence of asthma and allergic rhinitis: a systematic review and meta-analysis. Environ Sci Pollut Res Int 2022; 29:88461-88487. [PMID: 36329245 DOI: 10.1007/s11356-022-23718-x] [Citation(s) in RCA: 7] [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: 07/18/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
The association between allergic respiratory diseases, such as asthma and allergic rhinitis (AR), and green space (GS) remains controversial. Our study aimed to summarize and synthesize the association between individual GS exposure and the incidence of asthma/AR. We systematically summarized the qualitative relationship between GS exposure and asthma and AR. The pooled odds ratio (OR) with 95% confidence intervals (CIs) was used to estimate the effect of the Normalized Difference Vegetation Index (NDVI) on asthma and AR. A total of 21 studies were included for systematic review, and 8 of them underwent meta-analysis. In the meta-analysis of current asthma, the 0 < radius ≤ 100 m group, 100 < radius ≤ 300 m group, and 500 < radius ≤ 1000 m group presented weak negative associations between the NDVI and current asthma. For ever asthma, slight positive associations existed in the 0 < radius ≤ 100 m group and 300 < radius ≤ 500 m group. In addition, the NDVI might slightly reduce the risk of AR in radius of 100 m and 500 m. Our findings suggest that the effects of GS exposure on asthma and AR were not significant. Differences in GS measurements, disease diagnoses and adjusted confounders across studies may have an impact on the results. Subsequent studies should consider potential confounding factors and use more accurate GS exposure measurements to better understand the impact of GS exposure on respiratory disease in the population.
Collapse
Affiliation(s)
- Birong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xianwei Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Mingming Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, IL, 60657, USA
| | - Juan Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Peng Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Linya Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Weihang Xia
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaodi Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Dongdong Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
- Center for Evidence-Based Practice, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Chaohu Hospital, Anhui Medical University, Hefei, 238006, Anhui, China.
- Center for Evidence-Based Practice, Anhui Medical University, Hefei, 230032, Anhui, China.
| |
Collapse
|
8
|
Lin L, Chen Y, Wei J, Wu S, Wu S, Jing J, Dong G, Cai L. The associations between residential greenness and allergic diseases in Chinese toddlers: A birth cohort study. Environ Res 2022; 214:114003. [PMID: 35931194 DOI: 10.1016/j.envres.2022.114003] [Citation(s) in RCA: 4] [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: 05/06/2022] [Revised: 06/29/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Green space in the living environment has been linked to the development of allergic diseases. However, evidence regarding early-onset allergy in toddlers was limited, and the critical exposure window remained unclear. We aimed to investigate associations between residential greenness with allergic diseases in early life. METHODS This prospective birth cohort study included 522 mother-child pairs in Guangzhou, China. We quantified prenatal, postnatal, and early-life (i.e., the first 1000 days of life) residential greenness, estimated from remote satellite data using normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and tree cover. We identified physician-diagnosed allergic diseases (eczema, atopic dermatitis, urticaria, allergic rhinitis, allergic conjunctivitis, food allergy, and asthma) based on medical records at age 2 years. Generalized linear regression was conducted to examine the associations of greenness with allergic outcomes. RESULTS The ranges of residential NDVI and EVI values in 500-m buffer during early life were 0.06-0.70 and 0.03-0.46, respectively. We found a 0.1 unit increase of NDVI in 500-m buffer throughout early life was associated with higher odds of any allergic diseases (prenatal: OR [odds ratio], 1.25; 95%CI, 1.02-1.53; postnatal: OR, 1.24; 95%CI, 1.02-1.52; early-life: OR, 1.25, 95%CI: 1.02-1.53) and higher odds of eczema (prenatal: OR, 1.28; 95%CI, 1.04-1.59; postnatal: OR, 1.24; 95%CI, 1.01-1.54; early-life: OR, 1.26, 95%CI: 1.02-1.56). The results were consistent when using EVI as a proxy for greenness. We only observed that prenatal exposure to the highest tertile of NDVI-500 was adversely associated with any allergic diseases (OR, 1.63; 95%CI, 1.03-2.58) and eczema (OR, 1.70; 95%CI: 1.04-2.78) compared with the lowest tertile. CONCLUSIONS This study identified detrimental associations of residential greenness with allergic diseases especially eczema among toddlers, and pregnancy appears to be the critical exposure window. Our findings highlighted the importance of urban planning to develop friendly-green neighborhood to improve maternal and child health.
Collapse
Affiliation(s)
- Lizi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution And Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yujing Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Shengchi Wu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shu Wu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guanghui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution And Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
9
|
Mueller W, Milner J, Loh M, Vardoulakis S, Wilkinson P. Exposure to urban greenspace and pathways to respiratory health: An exploratory systematic review. Sci Total Environ 2022; 829:154447. [PMID: 35283125 DOI: 10.1016/j.scitotenv.2022.154447] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 05/11/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND/OBJECTIVE Urban greenspace may have a beneficial or adverse effect on respiratory health. Our objective was to perform an exploratory systematic review to synthesise the evidence and identify the potential causal pathways relating urban greenspace and respiratory health. METHODS We followed PRISMA guidelines on systematic reviews and searched five databases for eligible studies during 2000-2021. We incorporated a broad range of urban greenspace and respiratory health search terms, including both observational and experimental studies. Screening, data extraction, and risk of bias, assessed using the Navigation Guide criteria, were performed independently by two authors. We performed a narrative synthesis and discuss suggested pathways to respiratory health. RESULTS We identified 108 eligible papers (n = 104 observational, n = 4 experimental). The most common greenspace indicators were the overall greenery or vegetation (also known as greenness), green land use/land cover of physical area classes (e.g., parks, forests), and tree canopy cover. A wide range of respiratory health indicators were studied, with asthma prevalence being the most common. Two thirds (n = 195) of the associations in these studies were positive (i.e., beneficial) with health, with 31% (n = 91) statistically significant; only 9% (n = 25) of reported associations were negative (i.e., adverse) with health and statistically significant. The most consistent positive evidence was apparent for respiratory mortality. There were n = 35 (32%) 'probably low' and n = 73 (68%) 'probably high' overall ratings of bias. Hypothesised causal pathways for health benefits included lower air pollution, more physically active populations, and exposure to microbial diversity; suggested mechanisms with poorer health included exposure to pollen and other aeroallergens. CONCLUSION Many studies showed positive association between urban greenspace and respiratory health, especially lower respiratory mortality; this is suggestive, but not conclusive, of causal effects. Results underscore the importance of contextual factors, greenspace metric employed, and the potential bias of subtle selection factors, which should be explored further.
Collapse
Affiliation(s)
- William Mueller
- Institute of Occupational Medicine, Edinburgh, UK; London School of Hygiene & Tropical Medicine, UK.
| | - James Milner
- London School of Hygiene & Tropical Medicine, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Edinburgh, UK
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Australian National University, Australia
| | | |
Collapse
|
10
|
Xiao Y, Gu X, Niu H, Meng X, Zhang L, Xu J, Yang L, Zhao J, Zhang X, Bai C, Kang J, Ran P, Shen H, Wen F, Huang K, Chen Y, Sun T, Shan G, Lin Y, Wu S, Zhu J, Wang R, Shi Z, Xu Y, Ye X, Song Y, Wang Q, Zhou Y, Ding L, Li D, Yao W, Guo Y, Xiao F, Lu Y, Peng X, Zhang B, Xiao D, Wang Z, Zhang H, Bu X, Zhang X, An L, Zhang S, Cao Z, Zhan Q, Yang Y, Liang L, Cao B, Dai H, Wu T, He J, Kan H, Chen R, Yang T, Wang C. Associations of residential greenness with lung function and chronic obstructive pulmonary disease in China. Environ Res 2022; 209:112877. [PMID: 35131324 DOI: 10.1016/j.envres.2022.112877] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Studies on the association of greenness with respiratory health are scarce in developing countries, and previous studies in China have focused on only one or two indicators of lung function. OBJECTIVE The study aims to evaluate the associations of residential greenness with full-spectrum lung function indicators and prevalence of chronic obstructive pulmonary disease (COPD). METHODS This nationwide cross-sectional survey included 50,991 participants from the China Pulmonary Health study. Lung function indicators included four categories: indicators of obstructive ventilatory dysfunction (FEV1, FVC and FEV1/FVC); an indicator of large-airway dysfunction (PEF); indicators of small-airway dysfunction (FEF25-75% and FEV3/FEV6); and other indicators. Residential greenness was assessed by the Normalized Difference Vegetation Index (NDVI). Multivariable linear regression models and logistic regression models were used to analyze associations of greenness with lung function and COPD prevalence. RESULTS Within the 500 m buffer, an interquartile range (IQR) increase in NDVI was associated with higher FEV1 (24.76 mL), FVC (16.52 mL), FEV1/FVC (0.38), FEF50% (56.34 mL/s), FEF75% (33.43 mL/s), FEF25-75% (60.73 mL/s), FEV3 (18.59 mL), and FEV6 (21.85 mL). However, NDVI was associated with lower PEF. In addition, NDVI was significantly associated with 10% lower odds of COPD. The stratified analyses found that the associations were only significant in middle-young people, females, and nonsmokers. The associations were influenced by geographic regions. CONCLUSIONS Residential greenness was associated with better lung function and lower odds of COPD in China. These findings provide a scientific basis for healthy community planning.
Collapse
Affiliation(s)
- Yalan Xiao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaoying Gu
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Hongtao Niu
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Lina Zhang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jianying Xu
- Shanxi Dayi Hospital, Taiyuan, Shanxi, China
| | - Lan Yang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jianping Zhao
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiangyan Zhang
- Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Chunxue Bai
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Kang
- The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; National Clinical Research Center for Respiratory Diseases, Guangzhou, Guangdong, China
| | - Huahao Shen
- The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Fuqiang Wen
- State Key Laboratory of Biotherapy of China and Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Kewu Huang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yahong Chen
- Peking University Third Hospital, Beijing, China
| | - Tieying Sun
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China; National Center of Gerontology, Beijing, China
| | - Guangliang Shan
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yingxiang Lin
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Sinan Wu
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Jianguo Zhu
- National Center of Gerontology, Beijing, China
| | | | - Zhihong Shi
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yongjian Xu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xianwei Ye
- Guizhou Provincial People's Hospital, Guiyang, Guizhou, China
| | - Yuanlin Song
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qiuyue Wang
- The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; National Clinical Research Center for Respiratory Diseases, Guangzhou, Guangdong, China
| | - Liren Ding
- The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Diandian Li
- State Key Laboratory of Biotherapy of China and Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanzhen Yao
- Peking University Third Hospital, Beijing, China
| | - Yanfei Guo
- Department of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China; National Center of Gerontology, Beijing, China
| | - Fei Xiao
- National Center of Gerontology, Beijing, China; Department of Pathology, Beijing Hospital, Beijing, China
| | - Yong Lu
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Peng
- Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Biao Zhang
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Dan Xiao
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Tobacco Medicine and Tobacco Cessation Center, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zuomin Wang
- Department of Stomatology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hong Zhang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaoning Bu
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaolei Zhang
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Li An
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shu Zhang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhixin Cao
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Qingyuan Zhan
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Yuanhua Yang
- Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China; Department of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lirong Liang
- Department of Epidemiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Bin Cao
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Huaping Dai
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China
| | - Tangchun Wu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China.
| | - Ting Yang
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China.
| | - Chen Wang
- National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, Beijing, China; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China; Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Department of Respiratory Medicine, Capital Medical University, Beijing, China.
| |
Collapse
|
11
|
Fyfe-Johnson AL, Hazlehurst MF, Perrins SP, Bratman GN, Thomas R, Garrett KA, Hafferty KR, Cullaz TM, Marcuse EK, Tandon PS. Nature and Children's Health: A Systematic Review. Pediatrics 2021; 148:e2020049155. [PMID: 34588297 DOI: 10.1542/peds.2020-049155] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Daily outdoor play is encouraged by the American Academy of Pediatrics. Existing evidence is unclear on the independent effect of nature exposures on child health. OBJECTIVE We systematically evaluated evidence regarding the relationship between nature contact and children's health. DATA SOURCES The database search was conducted by using PubMed, Cumulative Index to Nursing and Allied Health Literature, PsychInfo, ERIC, Scopus, and Web of Science in February 2021. STUDY SELECTION We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In all searches, the first element included nature terms; the second included child health outcome terms. DATA EXTRACTION Of the 10 940 studies identified, 296 were included. Study quality and risk of bias were assessed. RESULTS The strongest evidence for type of nature exposure was residential green space studies (n = 147, 50%). The strongest evidence for the beneficial health effects of nature was for physical activity (n = 108, 32%) and cognitive, behavioral, or mental health (n = 85, 25%). Physical activity was objectively measured in 55% of studies, and 41% of the cognitive, behavioral, or mental health studies were experimental in design. LIMITATIONS Types of nature exposures and health outcomes and behaviors were heterogenous. Risk of selection bias was moderate to high for all studies. Most studies were cross-sectional (n = 204, 69%), limiting our ability to assess causality. CONCLUSIONS Current literature supports a positive relationship between nature contact and children's health, especially for physical activity and mental health, both public health priorities. The evidence supports pediatricians in advocating for equitable nature contact for children in places where they live, play, and learn.
Collapse
Affiliation(s)
- Amber L Fyfe-Johnson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | | | | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, Washington
| | - Rick Thomas
- National Academy of Sciences, Washington, District of Columbia
| | - Kimberly A Garrett
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| | - Kiana R Hafferty
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| | - Tess M Cullaz
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | | | - Pooja S Tandon
- Pediatrics
- Seattle Children's Research Institute, Seattle Children's Hospital, Seattle, Washington
| |
Collapse
|
12
|
Rahimi-Ardabili H, Astell-Burt T, Nguyen PY, Zhang J, Jiang Y, Dong GH, Feng X. Green Space and Health in Mainland China: A Systematic Review. Int J Environ Res Public Health 2021; 18. [PMID: 34574854 DOI: 10.3390/ijerph18189937] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/03/2021] [Accepted: 09/13/2021] [Indexed: 12/12/2022]
Abstract
Non-communicable diseases (NCDs) have become a major cause of premature mortality and disabilities in China due to factors concomitant with rapid economic growth and urbanisation over three decades. Promoting green space might be a valuable strategy to help improve population health in China, as well as a range of co-benefits (e.g., increasing resilience to climate change). No systematic review has so far determined the degree of association between green space and health outcomes in China. This review was conducted to address this gap. Five electronic databases were searched using search terms on green space, health, and China. The review of 83 publications that met eligibility criteria reports associations indicative of various health benefits from more green space, including mental health, general health, healthier weight status and anthropometry, and more favorable cardiometabolic and cerebrovascular outcomes. There was insufficient evidence to draw firm conclusions on mortality, birth outcomes, and cognitive function, and findings on respiratory and infectious outcomes were inconsistent and limited. Future work needs to examine the health benefits of particular types and qualities of green spaces, as well as to take advantage of (quasi-)experimental designs to test greening interventions within the context of China's rapid urbanization and economic growth.
Collapse
|
13
|
Dzhambov AM, Lercher P, Rüdisser J, Browning MHEM, Markevych I. Allergic symptoms in association with naturalness, greenness, and greyness: A cross-sectional study in schoolchildren in the Alps. Environ Res 2021; 198:110456. [PMID: 33188758 DOI: 10.1016/j.envres.2020.110456] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 09/21/2020] [Revised: 11/02/2020] [Accepted: 11/07/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND Greenness may protect from or contribute to allergy risk by influencing air pollution and human-microbe interactions. However, existing research on the issue is heterogeneous and produced conflicting results. Less in known about the effects of greyness. This study investigated the association between different characteristics of residential and school environment and allergic symptoms in schoolchildren. METHODS The present cross-sectional survey was undertaken in 2004/2005 among 1251 schoolchildren (8-12 years old) in several alpine valleys in Austria and Italy. Children's mothers completed a questionnaire that asked about allergic symptoms (International Study of Asthma and Allergies in Childhood questionnaire), sociodemographic information, lifestyle, perinatal data, and housing conditions. We constructed four aggregate outcome variables: current asthma symptoms, ever asthma symptoms, ever allergic rhinitis (AR) symptoms, and ever eczema symptoms. We employed well-known greenness and greyness exposure indicators (Normalized Difference Vegetation Index, tree canopy cover, agricultural cover, imperviousness cover, and industrial cover), as well as an alternative naturalness index (Distance to Nature, D2N). Adjusted logistic regressions were used to explore associations between each exposure-outcome pair. Air pollution (NO2), traffic noise and time spent outdoors were tested as potential mediators in causal mediation analysis. RESULTS Decrease in naturalness in a 500-m buffer around the home was associated with higher prevalence of AR symptoms. Associations with asthma symptoms were in the same direction but marginally significant. Residential NDVI and tree cover were marginally associated with lower prevalence of asthma and AR symptoms. Having a domestic garden was associated with lower prevalence of asthma symptoms. School greenness in a 100-m buffer was associated with lower prevalence of AR symptoms. Residential greyness was associated with higher prevalence of AR and asthma symptoms. We observed stronger associations for greenness and greyness in non-movers and in children without a family history of allergies. Mediation by NO2 and time spent outdoors was present in some of the exposure-outcome pairs. CONCLUSIONS Schoolchildren residing in places with lower naturalness and higher greyness may be more likely to have allergic rhinitis and possibly asthma. Considering more comprehensive indicators than greenness and greyness and conducting research in children without a family history of allergic diseases may be key to better understanding who can profit from natural landscapes.
Collapse
Affiliation(s)
- Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria.
| | - Peter Lercher
- Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | | | - Matthew H E M Browning
- Department of Parks , Recreation, and Tourism Management, Clemson University, Clemson, USA
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| |
Collapse
|
14
|
Jimenez MP, DeVille NV, Elliott EG, Schiff JE, Wilt GE, Hart JE, James P. Associations between Nature Exposure and Health: A Review of the Evidence. Int J Environ Res Public Health 2021; 18:ijerph18094790. [PMID: 33946197 PMCID: PMC8125471 DOI: 10.3390/ijerph18094790] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 01/13/2023]
Abstract
There is extensive empirical literature on the association between exposure to nature and health. In this narrative review, we discuss the strength of evidence from recent (i.e., the last decade) experimental and observational studies on nature exposure and health, highlighting research on children and youth where possible. We found evidence for associations between nature exposure and improved cognitive function, brain activity, blood pressure, mental health, physical activity, and sleep. Results from experimental studies provide evidence of protective effects of exposure to natural environments on mental health outcomes and cognitive function. Cross-sectional observational studies provide evidence of positive associations between nature exposure and increased levels of physical activity and decreased risk of cardiovascular disease, and longitudinal observational studies are beginning to assess long-term effects of nature exposure on depression, anxiety, cognitive function, and chronic disease. Limitations of current knowledge include inconsistent measures of exposure to nature, the impacts of the type and quality of green space, and health effects of duration and frequency of exposure. Future directions include incorporation of more rigorous study designs, investigation of the underlying mechanisms of the association between green space and health, advancement of exposure assessment, and evaluation of sensitive periods in the early life-course.
Collapse
Affiliation(s)
- Marcia P. Jimenez
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA;
- Correspondence: (M.P.J.); (N.V.D.)
| | - Nicole V. DeVille
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA; (E.G.E.); (J.E.H.)
- Correspondence: (M.P.J.); (N.V.D.)
| | - Elise G. Elliott
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA; (E.G.E.); (J.E.H.)
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (G.E.W.)
| | - Jessica E. Schiff
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (G.E.W.)
| | - Grete E. Wilt
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (G.E.W.)
| | - Jaime E. Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA; (E.G.E.); (J.E.H.)
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (G.E.W.)
| | - Peter James
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA 02215, USA;
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA; (E.G.E.); (J.E.H.)
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA; (J.E.S.); (G.E.W.)
| |
Collapse
|
15
|
Wimalasena NN, Chang-Richards A, Wang KIK, Dirks KN. Housing Risk Factors Associated with Respiratory Disease: A Systematic Review. Int J Environ Res Public Health 2021; 18:ijerph18062815. [PMID: 33802036 PMCID: PMC7998657 DOI: 10.3390/ijerph18062815] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 02/24/2021] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 02/03/2023]
Abstract
Cold, damp and mouldy housing arises from the degradation of the housing stock over time due to weathering and a lack of maintenance. Living in such houses is associated with many adverse impacts on human health, especially for those with existing health issues. This paper presents a systematic review, using the PRISMA protocol, consisting of an exploratory analysis of housing-related risk factors associated with respiratory disease. The review consisted of 360 studies investigating 19 risk factors associated with respiratory conditions. Each fall into one of four categories, namely, (1) outdoor environment-related factors; (2) indoor air pollution-related factors; (3) housing non-structure-related factors; or (4) housing structure-related factors. The results show that effects of poor housing conditions on occupants’ respiratory health is a growing research field, where poor indoor air quality, mainly due to a lack of adequate ventilation, was found to be the most influential risk factor. Usage of solid fuel and living in an urban area without a pollutant-free air filtration system are the main risk factors related to inadequate ventilation. Therefore, an adequate and reliable ventilation system with air-infiltration was considered to be the main mitigation solution to improve indoor air quality. It is suggested that government organisations and health practitioners could use the identified risk factors to measure the healthiness of existing dwellings and take measures to improve existing conditions and develop regulations for new housing construction to promote the healthy home concept. Further research is needed for risk mitigation strategies to reduce the respiratory health burden attributed to housing.
Collapse
Affiliation(s)
- Nipuni Nilakshini Wimalasena
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand; (A.C.-R.); (K.N.D.)
- Correspondence: ; Tel.: +64-225-311-863
| | - Alice Chang-Richards
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand; (A.C.-R.); (K.N.D.)
| | - Kevin I-Kai Wang
- Department of Electrical, Computer and Software Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand;
| | - Kim N. Dirks
- Department of Civil and Environmental Engineering, Faculty of Engineering, The University of Auckland, 0600 Auckland, New Zealand; (A.C.-R.); (K.N.D.)
| |
Collapse
|
16
|
Abbasi B, Pourmirzaei M, Hariri S, Heshmat R, Qorbani M, Dadvand P, Kelishadi R. Subjective Proximity to Green Spaces and Blood Pressure in Children and Adolescents: The CASPIAN-V Study. J Environ Public Health 2020; 2020:8886241. [PMID: 33381194 DOI: 10.1155/2020/8886241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/25/2020] [Accepted: 12/02/2020] [Indexed: 12/20/2022]
Abstract
Evidence favoring a beneficial association between greenness and blood pressure (BP) in adults is accumulating. However, children and adolescents have been understudied accordingly. Methodologically, the data on “exposure” to residential green spaces are commonly satellite-derived, including rare existing studies on the relationship between proximity to green spaces and BP in children. Despite perfectly obliterating subjective biases, remote sensing methods of greenness data collection fail to address pragmatic interaction with such settings. This study aimed to assess the relationship between subjective proximity to green spaces and average/elevated BP in children. Through our study, systolic and diastolic BPs of 12,340 schoolchildren living in CASPIAN-V study areas were examined and recorded. We performed surveys to obtain the data on their proximity to green spaces, defined as having access to such spaces within a 15-minute walk from their homes. Linear mixed-effects models with BP as the outcome variable and the measure of exposure to green spaces as fixed-effect predictor were applied. The analysis was adjusted for several covariates. We found that perceived residential proximity to green spaces was associated with −0.08 mmHg (95% confidence intervals (CIs): −0.58, 0.41; p value = 0.72) reduction in systolic BP and −0.09 (95% CIs: −0.49, 0.31; p value = 0.66) reduction in diastolic BP. We also observed statistically nonsignificant odds ratio of 1.03 (95% CIs: 0.76, 1.39), 0.96 (95% CIs: 0.80, 1.16), and 0.98 (95% CIs: 0.82, 1.16) for isolated systolic/diastolic hypertension and hypertension, respectively. Our observations remained consistent after adjustment for height, parental employment, low birth weight, parental obesity, single parent, and breastfeeding. In conclusion, subjective proximity to green spaces might not be associated with a lower mean BP in children. Well-designed studies applying both subjective and objective data should be performed to elaborate on the relationship further.
Collapse
|
17
|
Markevych I, Ludwig R, Baumbach C, Standl M, Heinrich J, Herberth G, de Hoogh K, Pritsch K, Weikl F. Residing near allergenic trees can increase risk of allergies later in life: LISA Leipzig study. Environ Res 2020; 191:110132. [PMID: 32853665 DOI: 10.1016/j.envres.2020.110132] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 06/05/2020] [Revised: 07/27/2020] [Accepted: 08/20/2020] [Indexed: 05/16/2023]
Abstract
BACKGROUND We investigated whether residing in places with higher greenness, more trees and more allergenic trees early in life increases the risk of allergic outcomes, and whether these associations differ depending on the concentration of air pollutants. METHODS The analytic sample included 631 children from the German birth cohort LISA Leipzig. Asthma and allergic rhinitis, sensitization to aeroallergens and food allergens, as well as confounders, were collected prospectively up to 15 years. Greenness was assessed by Normalized Difference Vegetation Index (NDVI). A tree registry was used to derive information on trees, which were classified into allergenic and non-allergenic. Annual average concentrations of nitrogen dioxide (NO2) and ozone were also used. Geographic exposures were assigned to home addresses at birth. Longitudinal associations were analysed using generalized estimating equations. RESULTS Medium and high numbers (tertiles) of trees and allergenic trees in a 500 m buffer around birth addresses were associated with increased odds of allergic rhinitis up to 15 years regardless of NDVI. These exposures were also related to higher odds of sensitization to aeroallergens. Associations with asthma and sensitization to food allergens were less consistent. Effect estimates for allergic rhinitis were stronger in the high tertile of NO2 compared to the low tertile, while an opposite tendency was observed for ozone. CONCLUSION We observed that early life residence in places with many trees, and allergenic trees specifically, may increase the prevalence of allergic rhinitis later in life. This association and its modification by air pollution should be pursued in further studies.
Collapse
Affiliation(s)
- 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; Institute of Psychology, Jagiellonian University, Krakow, Poland.
| | - Romina Ludwig
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Faculty of Biology, TUM School of Life Sciences, Technical University of Munich, Munich, Germany; Allergens in Ecosystems, Institute of Biochemical Plant Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Gunda Herberth
- Department of Environmental Immunology, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Karin Pritsch
- Allergens in Ecosystems, Institute of Biochemical Plant Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Fabian Weikl
- Allergens in Ecosystems, Institute of Biochemical Plant Pathology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| |
Collapse
|
18
|
Alasauskas S, Ustinaviciene R, Kavaliauskas M. Residential Links to Air Pollution and School Children with Asthma in Vilnius (Population Study). ACTA ACUST UNITED AC 2020; 56:E346. [PMID: 32668717 DOI: 10.3390/medicina56070346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/08/2020] [Accepted: 07/10/2020] [Indexed: 11/17/2022]
Abstract
Background and objectives: Many studies have been carried out on the negative health effects of exposure to PM10, PM 2.5, NO2, CO, SO2 and B[a]P for small populations. The main purpose of this study was to explore the association of air pollution to diagnosis of asthma for the whole huge population of school children between 7–17 years in Vilnius (Lithuania) using geographical information system analysis tools. Material and Methods: In the research, a child population of 51,235 individuals was involved. From this large database, we identified children who had asthma diagnosis J45 (ICD-10 AM). Residential pollution concentrations and proximity to roads and green spaces were obtained using the ArcGIS spatial analysis tool from simulated air pollution maps. Multiple stepwise logistic regression was used to explore the relation between air pollution concentration and proximity between the roads and green spaces where children with asthma were living. Further, we explored the interaction between variables. Results: From 51,235 school children aged 7–17 years, 3065 children had asthma in 2017. We investigated significant associations, such as the likelihood of getting sick with age (odds ratio (OR) = 0.949, p < 0.001), gender (OR = 1.357, p = 0.003), NO2 (OR = 1.013, p = 0.019), distance from the green spaces (OR = 1.327, p = 0.013) and interactions of age × gender (OR = 1.024, p = 0.051). The influence of gender on disease is partly explained by different age dependency slopes for boys and girls. Conclusions: According to our results, younger children are more likely to get sick, more cases appended on the lowest age group from 7 to 10 years (almost half cases (49.2%)) and asthma was respectively nearly twice more common in boys (64.1%) than in girls (35.9%). The risk of asthma is related to a higher concentration of NO2 and residence proximity to green spaces.
Collapse
|
19
|
Squillacioti G, Bellisario V, Levra S, Piccioni P, Bono R. Greenness Availability and Respiratory Health in a Population of Urbanised Children in North-Western Italy. Int J Environ Res Public Health 2019; 17:E108. [PMID: 31877852 DOI: 10.3390/ijerph17010108] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 02/07/2023]
Abstract
Paediatric Asthma contributes in paediatric global burden of diseases, as the most common chronic disease in children. Children are exposed to many environmental risk-factors, able to determine or worsen respiratory diseases, and contributing to asthma and asthma-like symptoms increases, especially in metropolitan areas. In urban settings, surrounding vegetation (greenness) may provide important benefits to health, including the promotion of physical activity and the mitigation of air and noise pollution. The aim of this study was to investigate the association between greenness and respiratory health. A total of 187 children (10–13 yrs old) were recruited in Turin, the north-western part of Italy. The prevalence of asthma and asthma-like symptoms was calculated from self-reported data collected by SIDRIA questionnaire. Spirometry test was performed to obtain respiratory flow measurements. Greenness was measured at individual level through the Normalised Difference Vegetation Index (NDVI) estimations from remote-sensing images. Higher exposure (3rd tertile vs. 1st tertile) to NDVI was associated to significantly lower ORs for asthma [0.13 CI 95% 0.02–0.7, p = 0.019], bronchitis [0.14 CI 95% 0.05–0.45, p = 0.001], and current wheezing [0.25 CI 95% 0.09–0.70, p = 0.008]. A significative positive association was found between greenness and FEF25–75, since children exposed to the 2nd tertile of NDVI reported a significantly decreased FEF25–75 compared to those in the 3rd tertile [B: −2.40; C.I.95%: −0.48–0.01; p = 0.049]. This cross-sectional study provided additional data on still inconsistent literature referring to respiratory health in children and green spaces, attesting a positive effect of greenness in a specific area of Italy. Further research is still needed.
Collapse
|