Abstract
Exposure to natural environments may affect respiratory health. This study examined the association of the exposure to green and blue spaces with lung function in children, and assessed the mediation effect of air pollution and physical activity.
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 at the first second (FEV1) and forced expiratory flow between 25% and 75% of forced vital capacity (FEF25%-75%) at 10 years were used as outcomes. To assess associations, linear regression models and path analysis were used.
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) [β (95% CI)=0.01 (0.0002; 0.03); and β (95% CI)=0.02 (0.001; 0.05)]. No significant associations were observed for the remaining measures of exposure, and no mediation effect was found for pollution or physical activity.
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.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of Declaration of competing 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.
- Received November 28, 2021.
- Accepted June 28, 2022.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
LIBRARY USERS
Log in through your institution
Purchase access
