Association between the First Occurrence of Asthma and Residential Greenness in Children and Teenagers in Taiwan

Abstract

Green spaces have benefits but may also increase the risk of allergic disease. This study examined the association between the first occurrence of asthma and greenness exposure in children and teenagers. We conducted a 1:1 matched case-control study matched by sex, age, and the first diagnosis year with 7040 eligible subjects from a systematic sampling cohort database in Taiwan from 2001 to 2013. A normalized difference vegetation index (NDVI) value ≥0.4 was used as the criterion to determine the green space. The green cover images were then transformed to the green coverage rate in the township surrounding the residential areas of the asthma and control subjects. Conditional logistic regression analyses demonstrated that a significantly increased risk of asthma in preschool children was associated with the surrounding greenness after adjusting for urbanization level, frequency of healthcare provider visits, mean township family income, CO, NOx, and PM2.5. The risk of asthma occurrence increased significantly with increasing greenness exposure (p-trend < 0.05). Nevertheless, exposure to the highest greenness levels (81–100%) was not associated with a significantly higher risk of asthma occurrence than was exposure to the lowest values (0–20%) of greenness. This study suggests that green space design should consider more effective methods of reducing the allergy impact.

Greenness Availability and Respiratory Health in a Population of Urbanised Children in North-Western Italy

“…The proximity to residential greenness was reported as protective for bronchitis and wheezing, in the Mediterranean and Euro-Siberian region, respectively [3]. Finally, even no association has been observed [25,[31][32][33].…”

Tree pollen exposure is associated with reduced lung function in children

“…Exposure to natural vegetation (greenness) may benefit human health through the promotion of activities such as exercise and socializing, the reduction of harmful exposures such as noise, heat, pollution and stress relief 18 . The Normalised Difference Vegetation Index (NDVI) provides a measure of greenness around the home that is of increasing interest to children's health 19,20 . Our earlier work 21 suggested residential greenness may modify the effects of early life pollen exposure on lung function in a high‐risk cohort of children residing in Melbourne, Australia.…”

Vegetation, Air Pollution, and Asthma and Allergy: A Narrative Review

“…The studies were published during the last seven years, between 2014 14 and 2021 15 . Eight studies were cross-sectional [15][16][17][18][19][20][21][22] , four studies were longitudinal 14,[23][24][25] , one study was a combination of cross-sectional and longitudinal design 26 , three studies were case-control [27][28][29] , and the remaining two studies 30,31 were ecological. Sample sizes of the included studies ranged from 174 zip codes 30 to over 65,000 children 29 .…”

“…Eight studies were conducted on European data 14,15,19,[24][25][26][27]31 , four studies were of North American origin 16,17,29,30 , three studies originated from Asia 18,20,28 , two studies were based on Australian and New Zealand data 21,23 , and finally, one study combined data from Europe, North America, and Australia 22 .…”