Eija Parmes1, Giancarlo Pesce2, Clive E Sabel3, Sandra Baldacci4, Roberto Bono5, Sonia Brescianini6, Cristina D'Ippolito6, Wojciech Hanke7, Milena Horvat8, Hilkka Liedes9, Sara Maio4, Pierpaolo Marchetti10, Alessandro Marcon10, Emanuela Medda6, Matthieu Molinier9, Silvia Panunzi10, Juha Pärkkä9, Kinga Polańska7, Julie Prud'homme2, Paolo Ricci11, Janja Snoj Tratnik8, Giulia Squillacioti5, Maria Antonietta Stazi6, Cara Nichole Maesano2, Isabella Annesi-Maesano2. 1. VTT Technical Research Centre of Finland Ltd, 02150 Espoo, Finland. Electronic address: eija.parmes@vtt.fi. 2. Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Department, Institut Pierre Louis D'Épidémiologie et de Santé Publique, F75012, Paris, France. 3. BERTHA, The Danish Big Data Centre for Environment and Health, Department of Environmental Science, Aarhus University, 4000, Roskilde, Denmark. 4. Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste No. 41, 56126, Pisa, Italy. 5. Department of Public Health and Paediatrics, University of Turin, Italy. Via Santena 5 Bis Turin, Italy. 6. Centre for Behavioural Sciences and Mental Health, Istituto Superiore di Sanità, Rome, Italy. 7. Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland. 8. Jožef Stefan Institute, Department of Environmental Sciences, Jamova Cesta 39, Ljubljana, Slovenia. 9. VTT Technical Research Centre of Finland Ltd, 02150 Espoo, Finland. 10. Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Italy. 11. Unità Operativa Complessa Osservatorio Epidemiologico, Agenzia Tutela Salute Della Val Padana, Mantova, Italy.
Abstract
INTRODUCTION: Recent research focused on the interaction between land cover and the development of allergic and respiratory disease has provided conflicting results and the underlying mechanisms are not fully understood. In particular, green space, which confers an overall positive impact on general health, may be significantly contributing to adverse respiratory health outcomes. This study evaluates associations between surrounding residential land cover (green, grey, agricultural and blue space), including type of forest cover (deciduous, coniferous and mixed), and childhood allergic and respiratory diseases. METHODS: Data from 8063 children, aged 3-14 years, were obtained from nine European population-based studies participating in the HEALS project. Land-cover exposures within a 500 m buffer centred on each child's residential address were computed using data from the Coordination of Information on the Environment (CORINE) program. The associations of allergic and respiratory symptoms (wheeze, asthma, allergic rhinitis and eczema) with land coverage were estimated for each study using logistic regression models, adjusted for sex, age, body mass index, maternal education, parental smoking, and parental history of allergy. Finally, the pooled effects across studies were estimated using meta-analyses. RESULTS: In the pooled analyses, a 10% increase in green space coverage was significantly associated with a 5.9%-13.0% increase in the odds of wheezing, asthma, and allergic rhinitis, but not eczema. A trend of an inverse relationship between agricultural space and respiratory symptoms was observed, but did not reach statistical significance. In secondary analyses, children living in areas with surrounding coniferous forests had significantly greater odds of reporting wheezing, asthma and allergic rhinitis. CONCLUSION: Our results provide further evidence that exposure to green space is associated with increased respiratory disease in children. Additionally, our findings suggest that coniferous forests might be associated with wheezing, asthma and allergic rhinitis. Additional studies evaluating both the type of green space and its use in relation to respiratory conditions should be conducted in order to clarify the underlying mechanisms behind associated adverse impacts.
INTRODUCTION: Recent research focused on the interaction between land cover and the development of allergic and respiratory disease has provided conflicting results and the underlying mechanisms are not fully understood. In particular, green space, which confers an overall positive impact on general health, may be significantly contributing to adverse respiratory health outcomes. This study evaluates associations between surrounding residential land cover (green, grey, agricultural and blue space), including type of forest cover (deciduous, coniferous and mixed), and childhood allergic and respiratory diseases. METHODS: Data from 8063 children, aged 3-14 years, were obtained from nine European population-based studies participating in the HEALS project. Land-cover exposures within a 500 m buffer centred on each child's residential address were computed using data from the Coordination of Information on the Environment (CORINE) program. The associations of allergic and respiratory symptoms (wheeze, asthma, allergic rhinitis and eczema) with land coverage were estimated for each study using logistic regression models, adjusted for sex, age, body mass index, maternal education, parental smoking, and parental history of allergy. Finally, the pooled effects across studies were estimated using meta-analyses. RESULTS: In the pooled analyses, a 10% increase in green space coverage was significantly associated with a 5.9%-13.0% increase in the odds of wheezing, asthma, and allergic rhinitis, but not eczema. A trend of an inverse relationship between agricultural space and respiratory symptoms was observed, but did not reach statistical significance. In secondary analyses, children living in areas with surrounding coniferous forests had significantly greater odds of reporting wheezing, asthma and allergic rhinitis. CONCLUSION: Our results provide further evidence that exposure to green space is associated with increased respiratory disease in children. Additionally, our findings suggest that coniferous forests might be associated with wheezing, asthma and allergic rhinitis. Additional studies evaluating both the type of green space and its use in relation to respiratory conditions should be conducted in order to clarify the underlying mechanisms behind associated adverse impacts.
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