Erkkola Riku, Gonzales-Inca Carlos, Vahtera Jussi, Bergroth Eija, Korppi Matti, Camargo Carlos A, Jartti Tuomas
Department of Paediatrics and Adolescent Medicine, Turku University Hospital, University of Turku, Turku, Finland.
Department of Geography and Geology, University of Turku, Turku, Finland.
Pediatr Pulmonol. 2025 Jan;60(1):e27436. doi: 10.1002/ppul.27436. Epub 2024 Dec 5.
Wheezing illnesses, especially those triggered by rhinovirus infection, cause a major disease burden, and they often precede asthma. Environmental exposures are known to affect recurrence of wheezing. We investigated the relations of population density, greenness (forested areas), and socioeconomic factors of the living surroundings to the burden of asthma in children with prior bronchiolitis.
Three hundred and ninety-four children, aged 0-24 months, with doctor-diagnosed bronchiolitis were enrolled in the MARC-30 Finland study. We assessed the children's early-life exposures to greenness and socioeconomic factors using time-series of Corine Land Cover data and Statistics Finland's grid data. We compared the living surroundings data to the prescription drug purchases and special asthma reimbursement benefits until the age 8 years; asthma data were from the Social Insurance Institution of Finland.
Children living in sparsely populated areas had lighter asthma disease burden than children living in densely populated ones, with burden measured in median bronchodilator (50DDD [defined daily dose] vs. 104DDD, p = 0.02) and inhaled corticosteroid (0DDD vs. 123DDD, p = 0.04) purchases. In the subgroup of children with rhinovirus-induced bronchiolitis, children living in more forested areas developed asthma 10 months later than those with less forested areas (p = 0.04). Neighborhood socioeconomic characteristics were not associated with differences in asthma burden.
Sparsely populated areas and forested environments seem to have a beneficial association with children's respiratory health. These findings warrant further studies on the protective health effects of greenness and the type of biodiversity around homes.
喘息性疾病，尤其是由鼻病毒感染引发的疾病，造成了重大的疾病负担，且常常先于哮喘出现。已知环境暴露会影响喘息的复发。我们调查了居住环境的人口密度、绿化程度（森林面积）和社会经济因素与既往患细支气管炎儿童的哮喘负担之间的关系。
394名年龄在0至24个月、经医生诊断为细支气管炎的儿童纳入了芬兰MARC - 30研究。我们使用科里纳土地覆盖数据的时间序列和芬兰统计局的网格数据评估儿童早期接触绿化和社会经济因素的情况。我们将居住环境数据与8岁前的处方药购买情况和特殊哮喘报销福利进行了比较；哮喘数据来自芬兰社会保险机构。
居住在人口稀少地区的儿童哮喘疾病负担比居住在人口密集地区的儿童轻，负担通过支气管扩张剂（中位数50限定日剂量[DDD] 对比104 DDD，p = 0.02）和吸入性糖皮质激素（0 DDD对比123 DDD，p = 0.04）的购买量来衡量。在由鼻病毒引起的细支气管炎患儿亚组中，居住在绿化程度更高地区的儿童比绿化程度较低地区的儿童患哮喘的时间晚10个月（p = 0.04）。邻里社会经济特征与哮喘负担差异无关。
人口稀少地区和绿化环境似乎与儿童的呼吸健康存在有益关联。这些发现值得进一步研究绿化以及家庭周围生物多样性类型对健康的保护作用。
