Associations between neighbourhood greenness and asthma in preschool children in Kaunas, Lithuania: a case-control study
Associations between neighbourhood greenness and asthma in preschool children in Kaunas, Lithuania: a case-control study
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DOI：
10.1136/bmjopen-2015-010341
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发表时间：
2016-01-01
期刊：
影响因子：
2.9
通讯作者：
Nieuwenhuijsen, Mark J.
中科院分区：
文献类型：
--
作者：
Andrusaityte, Sandra;Grazuleviciene, Regina;Nieuwenhuijsen, Mark J.
目的：本研究的目的是调查周围绿化水平与儿童哮喘之间的关联，并探讨居住地与城市公园的距离对这种关联的可能影响。设计：巢式病例对照研究。背景：立陶宛考纳斯出生后居住在当前地址的 4-6 岁儿童，其母亲于 2007-2009 年招募参加 KANC 新生儿队列研究。参与者：参与者2012-2013 年，1489 名儿童的父母填写了调查问卷并同意参加该研究。 主要和次要结果指标：我们估计了临床诊断的哮喘危险因素。周围绿化度测量为距离每个孩子家庭住址 100、300 和 500 m 缓冲区内基于卫星的归一化植被指数 (NDVI) 的平均值，到城市公园的距离定义为到最近的城市公园的距离。采用多变量逻辑回归来研究绿色暴露与哮喘之间的关系，并根据相关协变量进行调整。结果：100、300 和 500 m 缓冲区中 NDVI（>中位数）的增加与哮喘风险略有增加相关，而 NDVI-100 m IQR 的增加在统计学上显着增加了哮喘风险（OR 1.43，95% CI 1.10 至 1.85）。按周围绿化度进行的分层分析表明，与 NDVI-100 1000 m 相比，周围绿化度较高（NDVI-100> 中位数）的儿童与居住在距离公园较远 (>1000 m) 的儿童之间的关联性更强（OR 1.47，95% CI 0.56 至 3.87）。结论：较高水平的周围绿化度与儿童哮喘相对风险略有增加相关。需要进一步调查来阐明城市公园和社区绿化水平对哮喘的影响。
Objectives: The aim of this study was to investigate the associations between surrounding greenness levels and asthma among children, and to explore a possible change of this association by the distance of the residence to a city park.Design: A nested case-control study.Setting: Children aged 4-6 years residing at their current address since birth in Kaunas, Lithuania, whose mothers were recruited in 2007-2009 to the KANC newborns cohort study.Participants: The participants were 1489 children whose parents in 2012-2013 filled in the questionnaires and agreed to participate in the study.Primary and secondary outcome measures: We estimated clinically diagnosed asthma risk factors. The surrounding greenness was measured as the average of the satellite-based Normalised Difference Vegetation Index (NDVI) within the buffers of 100, 300 and 500 m from each child's home address, and the distance to a city park was defined as the distance to the nearest city park. Multivariate logistic regression was performed to study the relationship between the greenness exposures and asthma adjusted for relevant covariates.Results: An increase in the NDVI (>median) in buffers of 100, 300 and 500 m was associated with a slightly increased risk of asthma, while an IQR increase in NDVI-100 m statistically significantly increased the risk of asthma (OR 1.43, 95% CI 1.10 to 1.85). The stratified analysis by surrounding greenness revealed indications of stronger associations for children with higher surrounding greenness (NDVI-100> median) and those living farther away from parks (>1000 m), compared to NDVI-100 1000 m (OR 1.47, 95% CI 0.56 to 3.87).Conclusions: A higher level of the surrounding greenness was associated with a slightly increased relative risk of asthma in children. Further investigation is needed to elucidate the influence of city parks and neighbourhood greenness levels on asthma.