Land cover and air pollution are associated with asthma hospitalisations: A cross-sectional study

Alcock, Ian; White, Mathew P.; Cherrie, Mark; Wheeler, Benedict W.; Taylor, Jonathon; McInnes, Rachel N.; Kampe, Eveline Otte im; Vardoulakis, Sotiris; Sarran, Christophe; Soyiri, Ireneous; Fleming, Lora E.

doi:10.1016/j.envint.2017.08.009

Cited by 96 publications

(72 citation statements)

References 57 publications

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“…beneficial effects of 10% increments in green cover within a 1 km residential buffer on COPD and asthma prevalence (OR 0·97, 95% CI 0·96-0·98); however, unlike the present study, prevalence data were derived from routine primary care electronic records and participants' residences were geocoded at the postcode level with green cover expressed as the percentage within 1 km of the postcode centroid in which a participant resided. 29 A UK study reported that green space and gardens were associated with reduced rates of asthma-related hospitalisations, 31 while a Spanish study of children reported beneficial effects on wheezing and bronchitis. 28 Our non-linear restricted cubic spline models, however, indicated that the beneficial effects of greenness on COPD levelled off after a threshold NDVI of 0·21 ( figure 2A), while a slight negative effect on lung function was observed beyond this threshold, with a 1·15% net reduction in lung function ( figure 2B).…”

Section: : Logistic Regression Models Of Association Between Copd Anmentioning

confidence: 99%

“…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%

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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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Section: : Logistic Regression Models Of Association Between Copd Anmentioning

confidence: 99%

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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“…Lack of planning in the design of urban spaces with low species biodiversity at planting, overabundance of species acting as pollen sources, exotic species prompting new allergies in the population, botanical sexism, the presence of invasive species, inappropriate garden management and maintenance activities, cross‐reactivity between phylogenetically related species and the interaction between pollen, its microbiome, and air pollutants are major causes triggering pollen allergy . In recent decades, city planning strategies have favored pollen‐producing male bushes, trees, and plants.…”

Section: Framing the Issuementioning

confidence: 99%

Emerging concepts and challenges in implementing the exposome paradigm in allergic diseases and asthma: a Practall document

Agache

Miller

Gern

et al. 2018

Allergy

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Exposome research can improve the understanding of the mechanistic connections between exposures and health to help mitigate adverse health outcomes across the life span. The exposomic approach provides a risk profile instead of single predictors and thus is particularly applicable to allergic diseases and asthma. Under the PRAC- TALL collaboration between the European Academy of Allergy and ClinicalImmunology (EAACI) and the American Academy of Allergy, Asthma, and Immunology (AAAAI), we evaluated the current concepts and the unmet needs on the role of the exposome in allergic diseases and asthma.

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“…Even at a very basic level, the air we breathe, the water we drink, the food we eat, and the sources of energy we rely on all depend on natural processes that support and regulate the environmental systems that support all life on the planet [2,91,92]. Given the extensive literature available on the direct and indirect benefits of natural ecosystems for human health and well-being (e.g., food, water, fuel etc.…”

Section: Benefits Of Natural Environmentsmentioning

confidence: 99%

Beyond Climate Change and Health: Integrating Broader Environmental Change and Natural Environments for Public Health Protection and Promotion in the UK

et al. 2018

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Increasingly, the potential short and long-term impacts of climate change on human health and wellbeing are being demonstrated. However, other environmental change factors, particularly relating to the natural environment, need to be taken into account to understand the totality of these interactions and impacts. This paper provides an overview of ongoing research in the Health Protection Research Unit (HPRU) on Environmental Change and Health, particularly around the positive and negative effects of the natural environment on human health and well-being and primarily within a UK context. In addition to exploring the potential increasing risks to human health from water-borne and vector-borne diseases and from exposure to aeroallergens such as pollen, this paper also demonstrates the potential opportunities and co-benefits to human physical and mental health from interacting with the natural environment. The involvement of a Health and Environment Public Engagement (HEPE) group as a public forum of "critical friends" has proven useful for prioritising and exploring some of this research; such public involvement is essential to minimise public health risks and maximise the benefits which are identified from this research into environmental change and human health. Research gaps are identified and recommendations

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Land cover and air pollution are associated with asthma hospitalisations: A cross-sectional study

Abstract: We found differential effects of natural environments at high and low background pollutant concentrations. These findings can provide evidence for urban planning decisions which aim to leverage health co-benefits from environmental improvements.

Cited by 96 publications

References 57 publications

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

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

Emerging concepts and challenges in implementing the exposome paradigm in allergic diseases and asthma: a Practall document

Beyond Climate Change and Health: Integrating Broader Environmental Change and Natural Environments for Public Health Protection and Promotion in the UK

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