住宅绿地与儿童哮喘用药销售：比利时的一项纵向生态学研究。
Residential green space and medication sales for childhood asthma: A longitudinal ecological study in Belgium.
机构信息
Risk and Health Impact Assessment, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium; Division Ecology, Evolution and Biodiversity Conservation, University of Leuven (KU Leuven), Kasteelpark Arenberg 31-2435, BE-3001, Leuven, Belgium; Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Celestijnenlaan 200E-2411, BE-3001, Leuven, Belgium; Center for Environmental Sciences, University of Hasselt, Agoralaan D, BE-3590, Diepenbeek, Hasselt, Belgium; Mycology and Aerobiology, Sciensano (Belgian Institute of Health), Juliette Wytsmanstraat 14, BE-1050, Brussels, Belgium.
Division Forest, Nature and Landscape, University of Leuven (KU Leuven), Celestijnenlaan 200E-2411, BE-3001, Leuven, Belgium; Department of Geography, Institute of Life Earth and Environment (ILEE), University of Namur, Namur, Belgium.
出版信息
Environ Res. 2020 Oct;189:109914. doi: 10.1016/j.envres.2020.109914. Epub 2020 Jul 17.
BACKGROUND
Living in green environments has been associated with various health benefits, but the evidence for positive effects on respiratory health in children is ambiguous.
OBJECTIVE
To investigate if residential exposure to different types of green space is associated with childhood asthma prevalence in Belgium.
METHODS
Asthma prevalence was estimated from sales data of reimbursed medication for obstructive airway disease (OAD) prescribed to children between 2010 and 2014, aggregated at census tract level (n = 1872) by sex and age group (6-12 and 13-18 years). Generalized log-linear mixed effects models with repeated measures were used to estimate effects of relative covers of forest, grassland and garden in the census tract of the residence on OAD medication sales. Models were adjusted for air pollution (PM), housing quality and administrative region.
RESULTS
Consistent associations between OAD medication sales and relative covers of grassland and garden were observed (unadjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, β = 0.15-0.17; garden, β = 0.13-0.17). The associations remained significant after adjusting for housing quality and chronic air pollution (adjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, β = 0.10-0.14; garden, β = 0.07-0.09). There was no association between OAD medication sales and forest cover.
CONCLUSIONS
Based on aggregated data, we found that living in close proximity to areas with high grass cover (grasslands, but also residential gardens) may negatively impact child respiratory health. Potential allergic and non-allergic mechanisms that underlie this association include elevated exposure to grass pollen and fungi and reduced exposure to environmental biodiversity. Reducing the dominance of grass in public and private green space might be beneficial to reduce the childhood asthma burden and may simultaneously improve the ecological value of urban green space.
背景
生活在绿色环境中与各种健康益处有关，但有关其对儿童呼吸系统健康的积极影响的证据尚不清楚。
目的
研究比利时儿童居住在不同类型绿色空间与哮喘患病率之间的关系。
方法
根据 2010 年至 2014 年开具的用于治疗儿童阻塞性气道疾病（OAD）的报销药物销售数据，估算哮喘患病率，按照性别和年龄组（6-12 岁和 13-18 岁）汇总到普查区水平（n=1872）。使用广义对数线性混合效应模型进行重复测量，估计居住普查区森林、草地和花园的相对覆盖率对 OAD 药物销售的影响。模型调整了空气污染（PM）、住房质量和行政区。
结果
观察到 OAD 药物销售与草地和花园的相对覆盖率之间存在一致的关联（未调整的相对覆盖率每增加一个 IQR 的参数估计值，四个分层范围：草地，β=0.15-0.17；花园，β=0.13-0.17）。调整住房质量和慢性空气污染后，这些关联仍然显著（调整后的相对覆盖率每增加一个 IQR 的参数估计值，四个分层范围：草地，β=0.10-0.14；花园，β=0.07-0.09）。OAD 药物销售与森林覆盖率之间没有关联。
结论
基于汇总数据，我们发现，居住在高草覆盖率（草地，也包括住宅花园）附近可能会对儿童呼吸健康产生负面影响。潜在的过敏和非过敏机制包括草花粉和真菌暴露增加以及环境生物多样性暴露减少。减少公共和私人绿地中草的优势地位可能有助于降低儿童哮喘负担，同时也可以提高城市绿地的生态价值。
Zotero 插件