Residential greenness and allergic respiratory diseases in children and adolescents – A systematic review and meta-analysis

Lambert, Katrina A.; Bowatte, Gayan; Tham, Rachel; Lodge, Caroline; Prendergast, Luke A.; Heinrich, Joachim; Abramson, Michael J.; Dharmage, Shyamali C.; Erbas, Bircan

doi:10.1016/j.envres.2017.08.002

Cited by 91 publications

(67 citation statements)

References 41 publications

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“…However, in that analysis, only three studies reported NDVI in the same buffer (100 m) to qualify for meta‐analysis (I 2 = 68%, p = .02). This supports the suggestion that standardization of NDVI measurement would aid in future meta‐analyses (Lambert et al, ).…”

Section: Resultssupporting

confidence: 86%

“…Among seven studies reviewed, six reported no direct association between greenness and child asthma, while one reported increased greenness protective of asthma. When findings of this review are considered with findings of the review by Lambert et al (), who found two articles showing benefit of greenness for child asthma, two articles showing a detrimental relationship, and four articles showing no relationship, it seems a direct relationship either does not exist or has not been accurately measured. No studies included here found a negative direct association between greenness and child asthma.…”

Section: Discussionmentioning

confidence: 74%

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Effect of greenness on asthma in children: A systematic review

Hartley

Ryan

Brokamp

et al. 2020

Public Health Nursing

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Greenness such as trees, plants, and shrubs may positively influence mental and physical health, but the relationship between greenness and asthma is poorly understood. Because asthma is the most prevalent child respiratory disease internationally, elucidating the role of greenness may substantially benefit public health. The purpose of this systematic review was to synthesize findings related to effects of greenness on asthma in children. Following PRISMA guidelines, six databases were searched for international publication of primary research results relevant to the relationship between greenness and child asthma. Of 82 initial results, seven articles remained after removal of duplicates and applying exclusion criteria. Six reported no direct association between greenness and child asthma, while one found increased greenness protective for asthma. None found a negative direct association between greenness and child asthma. Evidence supported benefits of greenness on child asthma through mediation of factors such as exposure to tobacco smoke, high traffic volume, and difficult family relationships. Even without a direct association, greenness can be considered a public health asset as it may mediate other factors contributing to asthma in children. Public health nurses can use these findings to educate clients and partners while advocating for policies to protect greenness.

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Section: Resultssupporting

confidence: 86%

Section: Discussionmentioning

confidence: 74%

Effect of greenness on asthma in children: A systematic review

Hartley

Ryan

Brokamp

et al. 2020

Public Health Nursing

View full text Add to dashboard Cite

show abstract

“…New Evidence In the context of asthma, studies suggest that greenspace could increase exposure to microbial antigens that may impact immune system development, counteract environmental pollution of urban communities, and mediate family relationship stress [82][83][84]. Despite these hypotheses, there are inconsistent associations with greenspace and asthma [85][86][87]. Two meta-analyses demonstrated a non-significant trend toward reduced asthma incidence in areas with higher greenspace, though they are limited by heterogeneity [85,87].…”

Section: Intermediary Determinantsmentioning

confidence: 99%

“…Despite these hypotheses, there are inconsistent associations with greenspace and asthma [85][86][87]. Two meta-analyses demonstrated a non-significant trend toward reduced asthma incidence in areas with higher greenspace, though they are limited by heterogeneity [85,87]. Factors that may account for the inconsistencies among studies include seasonality and the timing of the exposure (e.g., perhaps early life exposures are beneficial for immune system development, but after atopy has developed, allergen exposures could precipitate worse control).…”

Section: Intermediary Determinantsmentioning

confidence: 99%

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

Sullivan

Thakur

2020

Curr Allergy Asthma Rep

107

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Purpose of Review Using the WHO Conceptual Framework for Action on the Social Determinants of Health, this review provides a discussion of recent epidemiologic, mechanistic, and intervention studies of structural and social determinants of health and asthma outcomes covering the period from 2014 to 2019. Recent Findings A majority of studies and interventions to date focus on the intermediary determinants of health (e.g., housing), which as the name suggests, exist between the patient and the upstream structural determinants of health (e.g., housing policy). Race/ethnicity remains a profound social driver of asthma disparities with cumulative risk from many overlapping determinants. A growing number of studies on asthma are beginning to elucidate the underlying mechanisms that connect social determinants to human disease. Several effective interventions have been developed, though a need for large-scale policy research and innovation remains. Summary Strong evidence supports the key role of the structural determinants, which generate social stratification and inequity, in the development and progression of asthma; yet, interventions in this realm are challenging to develop and therefore infrequent. Proximal, intermediary determinants have provided a natural starting point for interventions, though structural interventions have the most potential for major impact on asthma outcomes. Further research to investigate the interactive effect of multiple determinants, as well as intervention studies, specifically those that are cross-sector and propose innovative strategies to target structural determinants, are needed to address asthma morbidities, and more importantly, close the asthma disparity gap.

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“…27 Few studies indicate protective effects of residential greenness on respiratory health, 28 and COPD 29 in particular. Evidence for asthma, allergic rhinitis, and aeroallergen sensitisation (thus far mostly among children) has been inconsistent 30 with some studies reporting protective effects, 31 as well as null, 32 or non-beneficial associations. 33,34 The evidence associating environmental exposures with COPD thus far has been inconclusive.…”

Section: Introductionmentioning

confidence: 99%

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

Sarkar

Zhang

et al. 2019

The Lancet Planetary Health

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Background The role of environmental exposures in chronic obstructive pulmonary disease (COPD) remains inconclusive. We examined the association between environmental exposures (PM 2·5 , greenness, and urbanicity) and COPD prevalence using the UK Biobank cohort data to identify key built environment correlates of COPD. MethodsIn this cross-sectional, observational study we used baseline data for UK Biobank participants. Included participants were aged 39 years and older, white, had available spirometry data, and had complete data for phenotypes and exposures. COPD was defined by spirometry with the 2017 Global Initiative for Chronic Obstructive Lung Disease criteria. Environmental exposures were PM 2·5 derived from monitoring data and interpolated using land-use regression at the participants' geocoded residential addresses. Built environment metrics of residential greenness were modelled in terms of normalised difference vegetation index from remotely sensed colour infrared data within a 500 m residential catchment, and an urbanicity index derived from spatial analyses and measured with a 1 km buffer around each participant's residential address. Logistic regression models examined the associations between environmental exposures and COPD prevalence adjusting for a range of confounders. Subgroup analyses by urbanicity and effect modification by white blood cell count as an inflammatory marker were also done. FindingsWe assessed 96 779 participants recruited between April 4, 2006, and Oct 1, 2010, of which 5391 participants had COPD with a prevalence of 5·6%. Each 10 µg/m³ increment in ambient PM 2·5 exposure at a participant's residential location was associated with higher odds of COPD (odds ratio 1·55, 95% CI 1·14-2·10). Among the built environment metrics, urbanicity was associated with higher odds of COPD (1·05, 1·01-1·08 per interquartile increment), whereas residential greenness was protective, being associated with lower odds of COPD (0·89, 0·84-0·93 for each interquartile increment in greenness). The results remained consistent in models of COPD defined as per lower limit of normal criteria. The highest quartile of white blood cell count was associated with lower lung function and higher COPD risk with a significant interaction between PM 2·5 and white blood cell count only in the model of lung function (p=0·0003).Interpretation In this study of the built environment and COPD, to our knowledge the largest done in the UK, we found that exposure to ambient PM 2·5 and urbanicity were associated with a higher risk of COPD. Residing in greener areas, as measured by normalised difference vegetation index, was associated with lower odds of COPD, suggesting the potential value of urban planning and design in minimising or offsetting environmental risks for the prevention and management of COPD.

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Residential greenness and allergic respiratory diseases in children and adolescents – A systematic review and meta-analysis

Cited by 91 publications

References 41 publications

Effect of greenness on asthma in children: A systematic review

Effect of greenness on asthma in children: A systematic review

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

Environmental correlates of chronic obstructive pulmonary disease in 96 779 participants from the UK Biobank: a cross-sectional, observational study

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