Abstract
Background Exposure to natural environments may affect respiratory health. This study examined the association of exposure to green and blue spaces with lung function in children, and assessed the mediation effect of air pollution and physical activity.
Methods The study used data from the Generation XXI, a population-based birth cohort from the Porto Metropolitan Area (Portugal). Residential Normalised Difference Vegetation Index (NDVI) at different buffers (100, 250 and 500 m), the accessibility to urban green spaces (UGS) within 400 and 800 m and the minimum distance to the nearest UGS and to the nearest blue spaces were assessed at birth, 4, 7 and 10 years of age. Three life-course measures were calculated: averaged exposure, early-life exposure (birth) and exposure trend over time (change in exposure). Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and forced expiratory flow between 25% and 75% of FVC (FEF25–75%) at 10 years were used as outcomes. To assess associations, linear regression models and path analysis were used.
Results This study included 3278 children. The adjusted models showed that increasing the NDVI exposure over time within 100 m of the child's residence was associated with higher values of FEV1 (L) and FEF25–75% (L·s−1) (β 0.01, 95% CI 0.0002–0.03 and β 0.02, 95% CI 0.001–0.05, respectively). No significant associations were observed for the remaining measures of exposure, and no mediation effect was found for pollution or physical activity.
Conclusion Increasing exposure to greenness at close proximity from residences was associated with improved lung function. While the mechanism remains unknown, this study brings evidence that city greening may improve children's respiratory health.
Abstract
More people are living in urban areas lacking natural spaces, which can have deleterious health effects. Children who increased their exposure to greenness had better lung function. Making cities greener may lead to respiratory health improvements. https://bit.ly/39ZGG4c
Footnotes
Author contributions: D. Queiroz Almeida: methodology, investigation, writing original draft, reviewing and editing the manuscript. I. Paciência: methodology, formal analysis, investigation, writing original draft, reviewing and editing the manuscript. C. Moreira: methodology, formal analysis, reviewing and editing the manuscript. J. Cavaleiro Rufo: formal analysis, reviewing and editing the manuscript. A. Moreira: validation of lung function data, reviewing and editing the manuscript, supervision. A.C. Santos: reviewing and editing the manuscript, supervision. H. Barros: supervision, reviewing and editing the manuscript. A.I. Ribeiro: methodology, formal analysis, investigation, supervision, reviewing and editing the manuscript.
Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Support statement: The EXALAR 21 project was funded by the European Regional Development Fund (FEDER), through the Competitiveness and Internationalization Operational Programme, and by national funding from the Foundation for Science and Technology (FCT) under the scope of the project PTDC/GES-AMB/30193/2017 (POCI-01-0145-FEDER-030193, 02/SAICT/2017 – project number 30193). This study was also funded by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education) under the Unidade de Investigação em Epidemiologia – Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (UIDB/04750/2020). G21 was funded by Programa Operacional de Saúde – Saúde XXI, Quadro Comunitário de Apoio III and Administração Regional de Saúde Norte (Regional Department of Ministry of Health). A.I. Ribeiro was supported by National Funds through FCT, under the programme of “Stimulus of Scientific Employment – Individual Support” within the contract CEECIND/02386/2018. J. Cavaleiro Rufo was supported by National Funds through FCT, under the programme of “Stimulus of Scientific Employment – Individual Support” within the contract 2020.01350.CEECIND. A.C. Santos holds a FCT investigator contract IF/01060/2015. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received November 28, 2021.
- Accepted June 28, 2022.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
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