Neighborhood greenness associated with chronic obstructive pulmonary disease: A nationwide cross-sectional study in China

Green Space and Health in Mainland China: A Systematic Review

“…A few studies ( n = 7) measured respiratory outcomes; of them, one had an experimental design (RCT) and the rest were observational (cross-sectional n = 5; case–control n = 1) [ 47 , 52 , 53 , 80 , 96 , 97 ]. The sample size was 10 in each group for the RCT study [ 54 ], and for the observational studies, it ranged from 312 [ 53 ] to 75, 105 [ 96 ], except for one study that examined Shanghai’s entire population [ 97 ]. Participants were children [ 47 , 52 ] and middle-aged and older adults [ 53 , 54 , 80 , 96 , 97 ].…”

“…The sample size was 10 in each group for the RCT study [ 54 ], and for the observational studies, it ranged from 312 [ 53 ] to 75, 105 [ 96 ], except for one study that examined Shanghai’s entire population [ 97 ]. Participants were children [ 47 , 52 ] and middle-aged and older adults [ 53 , 54 , 80 , 96 , 97 ]. Outcomes were allergies and asthma in children [ 47 , 52 ], lung cancer [ 53 , 97 ], COPD or its markers [ 54 , 96 ], and the presence of any respiratory diseases [ 80 ].…”

“…Participants were children [ 47 , 52 ] and middle-aged and older adults [ 53 , 54 , 80 , 96 , 97 ]. Outcomes were allergies and asthma in children [ 47 , 52 ], lung cancer [ 53 , 97 ], COPD or its markers [ 54 , 96 ], and the presence of any respiratory diseases [ 80 ]. The outcomes were either measured objectively [ 53 , 96 , 97 ] or subjectively with a validated questionnaire [ 47 , 52 ].…”

“…An RCT study that assessed the effect of forest bathing on COPD biomarkers (pulmonary and activation-regulated chemokine, surfactant protein D and tissue inhibitor of metalloproteinase) showed a beneficial effect of the intervention after seven days of forest bathing [ 54 ]. However, green space was positively associated with COPD in a study [ 96 ]. This association was only significant for residents from north-eastern and northern China and was significant in the younger group (40–65 years).…”

“…One study examined the mediation effect of air pollution, doctor-diagnosed allergy symptoms, physical activity, and BMI on the potential effect of green space on asthma and allergies and found that air pollution and doctor-diagnosed allergy symptoms mediated the association [ 47 ]. Another study assessed whether sex, smoking status, or economic status has any impact on the association of COPD with green space but could not find any effect [ 96 ].…”