住宅绿化与中国幼儿过敏性疾病之间的关系:一项出生队列研究
2022/08/19
摘要
背景：生活环境中的绿色空间与过敏性疾病的发展有关。然而，关于幼儿早发性过敏的证据有限，关键暴露窗口仍不清楚。我们的目的是调查住宅绿化与生命早期过敏性疾病之间的关联。
方法：采用前瞻性出生队列研究方法，对中国广州522对母婴进行研究。我们用归一化植被指数(NDVI)、增强植被指数(EVI)和树木覆盖数据估算了出生前、出生后和生命早期(即生命前1000天)的住宅绿化。我们根据2岁儿童的病历确定了医生诊断的过敏性疾病(湿疹、特应性皮炎、荨麻疹、过敏性鼻炎、过敏性结膜炎、食物过敏和哮喘)。采用广义线性回归研究了绿化与过敏结果的关系。
结果：500 m缓冲区居民生命早期的NDVI和EVI值范围分别为0.06～0.70和0.03～0.46;我们发现，在整个生命早期500m缓冲区内，NDVI增加0.1个单位与任何过敏性疾病的几率增加相关(产前:OR:1.25;95%CI:1.02-1.53;产后:OR:1.24;95%CI:1.02-1.52;生命早期:OR: 1.25;95%CI:1.02-1.53)和湿疹几率增加相关(产前:OR:1.28;95%CI:1.04-1.59;产后:OR:1.24;95% CI:1.01-1.54;生命早期:OR:1.26;95%CI:1.02-1.56)。当使用EVI作为绿化的代表时，结果是一致的。我们只观察到，与最低的三分位数相比，产前暴露于最高三分位数的NDVI-500与任何过敏性疾病(OR:1.63;95%CI:1.03-2.58)和湿疹(OR:1.70;95%CI: 1.04-2.78)相关。
结论：这项研究确定了住宅绿化与过敏性疾病的有害关联，特别是幼儿的湿疹，怀孕似乎是关键的暴露窗口。我们的研究结果强调了城市规划对发展友好绿色社区以改善孕产妇和儿童健康的重要性。
The associations between residential greenness and allergic diseases in Chinese toddlers: A birth cohort study
Lizi Lin, Yujing Chen, Jing Wei,
Abstrast
Background：Green space in the living environment has been linked to the development of allergic diseases. However, evidence regarding early-onset allergy in toddlers was limited, and the critical exposure window remained unclear. We aimed to investigate associations between residential greenness with allergic diseases in early life.
Methods：This prospective birth cohort study included 522 mother-child pairs in Guangzhou, China. We quantified prenatal, postnatal, and early-life (i.e., the first 1000 days of life) residential greenness, estimated from remote satellite data using normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and tree cover. We identified physician-diagnosed allergic diseases (eczema, atopic dermatitis, urticaria, allergic rhinitis, allergic conjunctivitis, food allergy, and asthma) based on medical records at age 2 years. Generalized linear regression was conducted to examine the associations of greenness with allergic outcomes.
Results：The ranges of residential NDVI and EVI values in 500-m buffer during early life were 0.06-0.70 and 0.03-0.46, respectively. We found a 0.1 unit increase of NDVI in 500-m buffer throughout early life was associated with higher odds of any allergic diseases (prenatal: OR [odds ratio], 1.25; 95%CI, 1.02-1.53; postnatal: OR, 1.24; 95%CI, 1.02-1.52; early-life: OR, 1.25, 95%CI: 1.02-1.53) and higher odds of eczema (prenatal: OR, 1.28; 95%CI, 1.04-1.59; postnatal: OR, 1.24; 95%CI, 1.01-1.54; early-life: OR, 1.26, 95%CI: 1.02-1.56). The results were consistent when using EVI as a proxy for greenness. We only observed that prenatal exposure to the highest tertile of NDVI-500 was adversely associated with any allergic diseases (OR, 1.63; 95%CI, 1.03-2.58) and eczema (OR, 1.70; 95%CI: 1.04-2.78) compared with the lowest tertile.
Conclusions：This study identified detrimental associations of residential greenness with allergic diseases especially eczema among toddlers, and pregnancy appears to be the critical exposure window. Our findings highlighted the importance of urban planning to develop friendly-green neighborhood to improve maternal and child health.
背景：生活环境中的绿色空间与过敏性疾病的发展有关。然而，关于幼儿早发性过敏的证据有限，关键暴露窗口仍不清楚。我们的目的是调查住宅绿化与生命早期过敏性疾病之间的关联。
方法：采用前瞻性出生队列研究方法，对中国广州522对母婴进行研究。我们用归一化植被指数(NDVI)、增强植被指数(EVI)和树木覆盖数据估算了出生前、出生后和生命早期(即生命前1000天)的住宅绿化。我们根据2岁儿童的病历确定了医生诊断的过敏性疾病(湿疹、特应性皮炎、荨麻疹、过敏性鼻炎、过敏性结膜炎、食物过敏和哮喘)。采用广义线性回归研究了绿化与过敏结果的关系。
结果：500 m缓冲区居民生命早期的NDVI和EVI值范围分别为0.06～0.70和0.03～0.46;我们发现，在整个生命早期500m缓冲区内，NDVI增加0.1个单位与任何过敏性疾病的几率增加相关(产前:OR:1.25;95%CI:1.02-1.53;产后:OR:1.24;95%CI:1.02-1.52;生命早期:OR: 1.25;95%CI:1.02-1.53)和湿疹几率增加相关(产前:OR:1.28;95%CI:1.04-1.59;产后:OR:1.24;95% CI:1.01-1.54;生命早期:OR:1.26;95%CI:1.02-1.56)。当使用EVI作为绿化的代表时，结果是一致的。我们只观察到，与最低的三分位数相比，产前暴露于最高三分位数的NDVI-500与任何过敏性疾病(OR:1.63;95%CI:1.03-2.58)和湿疹(OR:1.70;95%CI: 1.04-2.78)相关。
结论：这项研究确定了住宅绿化与过敏性疾病的有害关联，特别是幼儿的湿疹，怀孕似乎是关键的暴露窗口。我们的研究结果强调了城市规划对发展友好绿色社区以改善孕产妇和儿童健康的重要性。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(Environmental research 2022 Aug 02;:114003 doi:10.1016/j.envres.2022.114003 IF: 8.431)
(Environmental research 2022 Aug 02;:114003 doi:10.1016/j.envres.2022.114003 IF: 8.431)
The associations between residential greenness and allergic diseases in Chinese toddlers: A birth cohort study
Lizi Lin, Yujing Chen, Jing Wei,
Abstrast
Background：Green space in the living environment has been linked to the development of allergic diseases. However, evidence regarding early-onset allergy in toddlers was limited, and the critical exposure window remained unclear. We aimed to investigate associations between residential greenness with allergic diseases in early life.
Methods：This prospective birth cohort study included 522 mother-child pairs in Guangzhou, China. We quantified prenatal, postnatal, and early-life (i.e., the first 1000 days of life) residential greenness, estimated from remote satellite data using normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), and tree cover. We identified physician-diagnosed allergic diseases (eczema, atopic dermatitis, urticaria, allergic rhinitis, allergic conjunctivitis, food allergy, and asthma) based on medical records at age 2 years. Generalized linear regression was conducted to examine the associations of greenness with allergic outcomes.
Results：The ranges of residential NDVI and EVI values in 500-m buffer during early life were 0.06-0.70 and 0.03-0.46, respectively. We found a 0.1 unit increase of NDVI in 500-m buffer throughout early life was associated with higher odds of any allergic diseases (prenatal: OR [odds ratio], 1.25; 95%CI, 1.02-1.53; postnatal: OR, 1.24; 95%CI, 1.02-1.52; early-life: OR, 1.25, 95%CI: 1.02-1.53) and higher odds of eczema (prenatal: OR, 1.28; 95%CI, 1.04-1.59; postnatal: OR, 1.24; 95%CI, 1.01-1.54; early-life: OR, 1.26, 95%CI: 1.02-1.56). The results were consistent when using EVI as a proxy for greenness. We only observed that prenatal exposure to the highest tertile of NDVI-500 was adversely associated with any allergic diseases (OR, 1.63; 95%CI, 1.03-2.58) and eczema (OR, 1.70; 95%CI: 1.04-2.78) compared with the lowest tertile.
Conclusions：This study identified detrimental associations of residential greenness with allergic diseases especially eczema among toddlers, and pregnancy appears to be the critical exposure window. Our findings highlighted the importance of urban planning to develop friendly-green neighborhood to improve maternal and child health.
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