Institute of Epidemiology I, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany.
Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
Allergy. 2016 Oct;71(10):1461-71. doi: 10.1111/all.12915. Epub 2016 May 6.
The prevalence of allergic rhinitis is high, but the role of environmental factors remains unclear. We examined cohort-specific and combined associations of residential greenness with allergic rhinitis and aeroallergen sensitization based on individual data from Swedish (BAMSE), Australian (MACS), Dutch (PIAMA), Canadian (CAPPS and SAGE), and German (GINIplus and LISAplus) birth cohorts (n = 13 016).
Allergic rhinitis (doctor diagnosis/symptoms) and aeroallergen sensitization were assessed in children aged 6-8 years in six cohorts and 10-12 years in five cohorts. Residential greenness was defined as the mean Normalized Difference Vegetation Index (NDVI) in a 500-m buffer around the home address at the time of health assessment. Cohort-specific associations per 0.2 unit increase in NDVI were assessed using logistic regression models and combined in a random-effects meta-analysis.
Greenness in a 500-m buffer was positively associated with allergic rhinitis at 6-8 years in BAMSE (odds ratio = 1.42, 95% confidence interval [1.13, 1.79]) and GINI/LISA South (1.69 [1.19, 2.41]) but inversely associated in GINI/LISA North (0.61 [0.36, 1.01]) and PIAMA (0.67 [0.47, 0.95]). Effect estimates in CAPPS and SAGE were also conflicting but not significant (0.63 [0.32, 1.24] and 1.31 [0.81, 2.12], respectively). All meta-analyses were nonsignificant. Results were similar for aeroallergen sensitization at 6-8 years and both outcomes at 10-12 years. Stratification by NO2 concentrations, population density, an urban vs rural marker, and moving did not reveal consistent trends within subgroups.
Although residential greenness appears to be associated with childhood allergic rhinitis and aeroallergen sensitization, the effect direction varies by location.
过敏性鼻炎的患病率很高，但环境因素的作用仍不清楚。我们根据来自瑞典（BAMSE）、澳大利亚（MACS）、荷兰（PIAMA）、加拿大（CAPPS 和 SAGE）和德国（GINIplus 和 LISAplus）出生队列的个体数据，检查了基于队列的和综合的居住绿化与过敏性鼻炎和空气过敏原致敏的关联（n=13016）。
在六个队列中，在儿童 6-8 岁时评估过敏性鼻炎（医生诊断/症状）和空气过敏原致敏情况，在五个队列中，在儿童 10-12 岁时评估过敏性鼻炎和空气过敏原致敏情况。居住绿化被定义为健康评估时家庭住址周围 500 米缓冲区的归一化差异植被指数（NDVI）的平均值。使用逻辑回归模型评估每增加 0.2 个单位的 NDVI 的队列特异性关联，并在随机效应荟萃分析中进行综合。
在 BAMSE 和 GINI/LISA South 中，500 米缓冲区的绿化与 6-8 岁时的过敏性鼻炎呈正相关（优势比=1.42，95%置信区间[1.13，1.79]），而在 GINI/LISA North 和 PIAMA 中呈负相关（0.61 [0.36，1.01] 和 0.67 [0.47，0.95]）。CAPPS 和 SAGE 的效应估计也存在冲突，但不显著（分别为 0.63 [0.32，1.24] 和 1.31 [0.81，2.12]）。所有荟萃分析均无统计学意义。在 6-8 岁时的空气过敏原致敏和 10-12 岁时的两个结果中，结果也相似。按二氧化氮浓度、人口密度、城市与农村标志物以及搬家进行分层，并未在亚组内发现一致的趋势。
尽管居住绿化似乎与儿童过敏性鼻炎和空气过敏原致敏有关，但作用方向因地点而异。
