Greenness and its composition and configuration in association with allergic rhinitis in preschool children

Han Chen; Xia Meng; Yongfu Yu; Jin Sun; Zhiping Niu; Jing Wei; Ling Zhang; Chan Lu; Wei Yu; Tingting Wang; Xiaohong Zheng; Dan Norbäck; Magnus Svartengren; Xin Zhang; Zhuohui Zhao

doi:10.1016/j.envres.2024.118627

Greenness and its composition and configuration in association with allergic rhinitis in preschool children

Environ Res. 2024 Mar 7;251(Pt 2):118627. doi: 10.1016/j.envres.2024.118627. Online ahead of print.

Authors

Han Chen¹, Xia Meng², Yongfu Yu¹, Jin Sun¹, Zhiping Niu¹, Jing Wei³, Ling Zhang⁴, Chan Lu⁵, Wei Yu⁶, Tingting Wang⁷, Xiaohong Zheng⁸, Dan Norbäck⁹, Magnus Svartengren⁹, Xin Zhang¹⁰, Zhuohui Zhao¹¹

Affiliations

¹ Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China.
² Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, 200438, China.
³ Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA.
⁴ Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China.
⁵ Department of Occupational and Environmental Health, School of Public Health, Xiangya Medical College, Central South University, Changsha, 410078, China.
⁶ Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, 400030, China.
⁷ School of Nursing & Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, China.
⁸ School of Energy & Environment, Southeast University, Nanjing, 210096, China.
⁹ Department of Occupational and Environmental Medicine, Uppsala University Hospital, 751 85, Uppsala, Sweden.
¹⁰ Institute of Environmental Science, Shanxi University, Taiyuan, Shanxi, China. Electronic address: xinzhang0051@sxu.edu.cn.
¹¹ Department of Environmental Health, School of Public Health, NHC Key Laboratory of Health Technology Assessment (Fudan University), Fudan University, Shanghai, 200032, China; Key Laboratory of Public Health Safety of the Ministry of Education, Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China; IRDR International Center of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, 200438, China. Electronic address: zhzhao@fudan.edu.cn.

PMID: 38460662
DOI: 10.1016/j.envres.2024.118627

Abstract

Background: Few studies focus on the associations of green space composition and configuration with children's allergic rhinitis (AR).

Methods: A multi-center population-based cross-sectional study was performed in 7 cities in mainland of China between 2019 and 2020, recruiting 36,867 preschool children. Information on the current AR symptoms and demographics were collected by questionnaire. Exposure to residential greenness was estimated by Normalized Difference Vegetation Index (NDVI, 1000 m buffer) around the residences. Greenness composition was estimated in 3 main categories: forest, grassland, shrubland. Configuration of each category and total greenness (a spatial resolution of 10 m × 10 m) was estimated by 6 landscape pattern metrics to quantify their area, shape complexity, aggregation, connectivity, and patch density. Exposure to daily ambient particulate matter (PM₁, PM_2.5 and PM₁₀, a spatial resolution of 1 km × 1 km) was estimated. Multilevel logistic regression models were applied to analyze the associations of greenness and its composition and configuration with AR, and mediation effects by PMs were examined by mediation analysis models.

Results: The prevalence of self-reported current AR in preschool children was 33.1%. Two indicators of forest, Aggregation Index of forest patches (AIforest) (odds ratio (OR):0.92, 95% Confidential Interval (CI): 0.88-0.97), and Patch Cohesion of forest (COHESIONforest) (OR: 0.93, 95% CI:0.89-0.98) showed significantly negative associations with AR symptoms. Mediation analyses found the associations were partially mediated by PMs. Age, exclusive breastfeed duration and season were the potential effect modifiers. The associations varied across seven cities.

Conclusion: Our findings suggest the inverse associations of the aggregation and connectivity of forest patches surrounding residence addresses with AR symptoms. Since the cross-sectional study only provides associations rather than causation, further studies are needed to confirm our results as well as the underlying mechanisms.

Keywords: Air pollution; Allergic rhinitis; Composition and configuration; Green space; Mediation analyses.