Association between Asthma Control and Exposure to Greenness and Other Outdoor and Indoor Environmental Factors: A Longitudinal Study on a Cohort of Asthmatic Children

Abstract

Achieving and maintaining asthma control (AC) is the main goal of asthma management. Indoor and outdoor environmental factors may play an important role on AC. The aim of this longitudinal study was to evaluate the association between AC and exposure to greenness and other outdoor or indoor environmental factors in a cohort of asthmatic children. This study involved 179 asthmatic children (5–16 years). Parents were interviewed through a modified version of the SIDRIA questionnaire. AC was assessed at each visit. Exposure to greenness was measured using the normalized difference vegetation index (NDVI). A logistic regression model was applied for assessing risk factors for uncontrolled asthma (UA). Low NDVI exposure was a risk factor for UA (OR: 2.662, 95% CI (1.043–6.799)); children exposed to passive smoke during pregnancy had a higher risk of UA than those non-exposed to passive smoke during pregnancy (OR: 3.816, 95% CI (1.114–13.064)); and a unit increase in the crowding index was associated with an increased risk of UA (OR: 3.376, 95% CI (1.294–8.808)). In conclusion, the current study provided a comprehensive assessment of urban-related environmental exposures on asthma control in children, using multiple indicators of greenness and other outdoor or indoor environmental factors.

Biodiversity for resilience—What is needed for allergic children

“…A 2 weeks indoor exposure to green walls had also a positive effect 50 . Recent observations from Italy indicate that low environmental vegetation index is a risk factor for uncontrolled asthma in children 58 . Thus, enrichment of the vegetation may have an opposite effect.…”

“…50 Recent observations from Italy indicate that low environmental vegetation index is a risk factor for uncontrolled asthma in children. 58 Thus, enrichment of the vegetation may have F I G U R E 3 Urban, build environment, and changes in lifestyle (left) have increasingly disconnected children from the natural air, soil, and waters, the evolutionary home of Homo sapiens (right) (modified). 54 The lower panels of beetles illustrate that biodiversity means a lot of species but in small numbers.…”

Socioeconomic determinants of asthma health

“…Increased crowding, lower access to greenspace, and slightly higher measures of particulate matter and pollutants in the air, water, and soil were among the hotspot characteristics. Greenness was a specific focus of a geospatial analysis performed in Palermo, Italy, which also found strong association between low greenness (defined by standardized measure of normalized difference vegetation index from satellite imaging) and uncontrolled asthma [34], independent of local traffic and NO 2 exposures.…”

Oxidative Stress, Environmental Pollution, and Lifestyle as Determinants of Asthma in Children

“…During recent decades, research has highlighted the deleterious effects of environmental pollutants on respiratory health of adults and children. In particular, air pollution is currently receiving great attention, and the relationship between exposure in childhood and development or exacerbation of adverse respiratory outcomes, including asthma, is becoming more evident [69][70][71][72]. Indeed, several air pollutants are known to impair lung development and function, indirectly (prenatal exposure) and directly (postnatal exposure).…”