Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles.
JAMA Netw Open. 2020 Oct 1;3(10):e2017634. doi: 10.1001/jamanetworkopen.2020.17634.
Emerging research suggests that factors associated with the built environment, including artificial light, air pollution, and noise, may adversely affect children's mental health, while living near green space may reduce stress. Little is known about the combined roles of these factors on children's stress.
To investigate associations between components of the built environment with personal and home characteristics in a large cohort of children who were assessed for perceived stress.
DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, a total of 2290 Southern California Children's Health Study participants residing in 8 densely populated urban communities responded to detailed questionnaires. Exposures of artificial light at night (ALAN) derived from satellite observations, near-roadway air pollution (NRP) determined from a dispersion model, noise estimated from the US Traffic Noise Model, and green space from satellite observations of the enhanced vegetation index were linked to each participant's geocoded residence.
Children's stress was assessed at ages 13 to 14 years and 15 to 16 years using the 4-item Perceived Stress Scale (PSS-4), scaled from 0 to 16, with higher scores indicating greater perceived stress. Measurements were conducted in 2010 and 2012, and data were analyzed from February 6 to August 24, 2019. Multivariate mixed-effects models were used to examine multiple exposures; modification and mediation analyses were also conducted.
Among the 2290 children in this study, 1149 were girls (50%); mean (SD) age was 13.5 (0.6) years. Girls had significantly higher perceived stress measured by PSS-4 (mean [SD] score, 5.7 [3.4]) than boys (4.9 [3.2]). With increasing age (from 13.5 [0.6] to 15.3 [0.6] years), the mean PSS-4 score rose from 5.6 (3.3) to 6.0 (3.4) in girls but decreased for boys from 5.0 (3.2) to 4.7 (3.1). Multivariate mixed-effects models examining multiple exposures indicated that exposure to secondhand smoke in the home was associated with a 0.85 (95% CI, 0.46-1.24) increase in the PSS-4 score. Of the factors related to the physical environment, an interquartile range (IQR) increase in ALAN was associated with a 0.57 (95% CI, 0.05-1.09) unit increase in the PSS-4 score together with a 0.16 score increase per IQR increase of near-roadway air pollution (95% CI, 0.02-0.30) and a -0.24 score decrease per IQR increase of the enhanced vegetation index (95% CI, -0.45 to -0.04). Income modified the ALAN effect size estimate; participants in households earning less than $48 000 per year had significantly greater stress per IQR increase in ALAN. Sleep duration partially mediated the associations between stress and both enhanced vegetation index (17%) and ALAN (18%).
In this cohort study, children's exposure to smoke at home in addition to residential exposure to ALAN and near-roadway air pollution were associated with increased perceived stress among young adolescent children. These associations appeared to be partially mitigated by more residential green space. The findings may support the promotion of increased residential green spaces to reduce pollution associated with the built environment, with possible mental health benefits for children.
新的研究表明，与建筑环境相关的因素，包括人工光、空气污染和噪音，可能会对儿童的心理健康产生不利影响，而居住在绿地附近可能会减轻压力。对于这些因素对儿童压力的综合作用知之甚少。
在一个评估儿童感知压力的大型队列中，研究与个人和家庭特征相关的建筑环境成分之间的关联。
设计、地点和参与者：在这项队列研究中，共有 2290 名居住在 8 个人口密集的城市社区的南加州儿童健康研究参与者对详细的问卷做出了回应。夜间人工光 (ALAN) 暴露量由卫星观测得出，近路空气污染物 (NRP) 由扩散模型确定，噪声由美国交通噪声模型估算，以及通过增强植被指数的卫星观测得出的绿地，与每个参与者的地理编码住所相关联。
在 2010 年和 2012 年进行了儿童压力评估，使用 4 项感知压力量表 (PSS-4) 进行评估，范围从 0 到 16，得分越高表示感知压力越大。数据于 2019 年 2 月 6 日至 8 月 24 日进行分析。采用多变量混合效应模型来检查多种暴露情况；还进行了修饰和中介分析。
在这项研究的 2290 名儿童中，有 1149 名是女孩（50%）；平均（SD）年龄为 13.5（0.6）岁。女孩的感知压力明显高于男孩（PSS-4 评分，女孩 5.7（3.4），男孩 4.9（3.2））。随着年龄的增长（从 13.5（0.6）到 15.3（0.6）岁），女孩的 PSS-4 评分从 5.6（3.3）上升到 6.0（3.4），而男孩的评分从 5.0（3.2）下降到 4.7（3.1）。多变量混合效应模型检查多种暴露情况表明，家庭中接触二手烟与 PSS-4 评分增加 0.85（95%CI，0.46-1.24）相关。与物理环境相关的因素中，夜间人工光的 IQR 增加与 PSS-4 评分增加 0.57（95%CI，0.05-1.09）有关，同时每增加一个 IQR 的近路空气污染物（95%CI，0.02-0.30），PSS-4 评分增加 0.16 分，每增加一个 IQR 的增强植被指数（95%CI，-0.45 至 -0.04），PSS-4 评分降低 0.24 分。收入修饰了夜间人工光的效应量估计值；年收入低于 48000 美元的家庭的参与者，夜间人工光 IQR 每增加一个，压力明显更大。睡眠时间部分介导了压力与增强植被指数（17%）和夜间人工光（18%）之间的关联。
在这项队列研究中，儿童在家中接触烟雾以及居住环境中接触夜间人工光和近路空气污染物与青少年儿童的感知压力增加有关。这些关联似乎部分通过增加居住绿地得到缓解。这些发现可能支持推广增加居住绿地，以减少与建筑环境相关的污染，可能对儿童的心理健康有益。
