TY - JOUR
T1 - Green spaces and respiratory, cardiometabolic, and neurodevelopmental outcomes
T2 - An individual-participant data meta-analysis of >35.000 European children
AU - Fernandes, Amanda
AU - Avraam, Demetris
AU - Cadman, Tim
AU - Dadvand, Payam
AU - Guxens, Mònica
AU - Binter, Anne Claire
AU - Pinot de Moira, Angela
AU - Nieuwenhuijsen, Mark
AU - Duijts, Liesbeth
AU - Julvez, Jordi
AU - De Castro, Montserrat
AU - Fossati, Serena
AU - Márquez, Sandra
AU - Vrijkotte, Tanja
AU - Elhakeem, Ahmed
AU - McEachan, Rosemary
AU - Yang, Tiffany
AU - Pedersen, Marie
AU - Vinther, Johan
AU - Lepeule, Johanna
AU - Heude, Barbara
AU - Jaddoe, Vincent W.V.
AU - Santos, Susana
AU - Welten, Marieke
AU - El Marroun, Hanan
AU - Mian, Annemiek
AU - Andrušaitytė, Sandra
AU - Lertxundi, Aitana
AU - Ibarluzea, Jesús
AU - Ballester, Ferran
AU - Esplugues, Ana
AU - Torres Toda, Maria
AU - Harris, Jennifer R.
AU - Lucia Thorbjørnsrud Nader, Johanna
AU - Moirano, Giovenale
AU - Maritano, Silvia
AU - Catherine Wilson, Rebecca
AU - Vrijheid, Martine
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024
Y1 - 2024
N2 - Studies evaluating the benefits and risks of green spaces on children's health are scarce. The present study aimed to examine the associations between exposure to green spaces during pregnancy and early childhood with respiratory, cardiometabolic, and neurodevelopmental outcomes in school-age children. We performed an Individual-Participant Data (IPD) meta-analysis involving 35,000 children from ten European birth cohorts across eight countries. For each participant, we calculated residential Normalized Difference Vegetation Index (NDVI) within a 300 m buffer and the linear distance to green spaces (meters) during prenatal life and childhood. Multiple harmonized health outcomes were selected: asthma and wheezing, lung function, body mass index, diastolic and systolic blood pressure, non-verbal intelligence, internalizing and externalizing problems, and ADHD symptoms. We conducted a two-stage IPD meta-analysis and evaluated effect modification by socioeconomic status (SES) and sex. Between-study heterogeneity was assessed via random-effects meta-regression. Residential surrounding green spaces in childhood, not pregnancy, was associated with improved lung function, particularly higher FEV1 (β = 0.06; 95 %CI: 0.03, 0.09 I2 = 4.03 %, p < 0.001) and FVC (β = 0.07; 95 %CI: 0.04, 0.09 I2 = 0 %, p < 0.001) with a stronger association observed in females (p < 0.001). This association remained robust after multiple testing correction and did not change notably after adjusting for ambient air pollution. Increased distance to green spaces showed an association with lower FVC (β = −0.04; 95 %CI: −0.07, −0.02, I2 = 4.8, p = 0.001), with a stronger effect in children from higher SES backgrounds (p < 0.001). No consistent associations were found between green spaces and asthma, wheezing, cardiometabolic, or neurodevelopmental outcomes, with direction of effect varying across cohorts. Wheezing and neurodevelopmental outcomes showed high between-study heterogeneity, and the age at outcome assessment was only associated with heterogeneity in internalizing problems. This large European meta-analysis suggests that childhood exposure to green spaces may lead to better lung function. Associations with other respiratory outcomes and selected cardiometabolic and neurodevelopmental outcomes remain inconclusive.
AB - Studies evaluating the benefits and risks of green spaces on children's health are scarce. The present study aimed to examine the associations between exposure to green spaces during pregnancy and early childhood with respiratory, cardiometabolic, and neurodevelopmental outcomes in school-age children. We performed an Individual-Participant Data (IPD) meta-analysis involving 35,000 children from ten European birth cohorts across eight countries. For each participant, we calculated residential Normalized Difference Vegetation Index (NDVI) within a 300 m buffer and the linear distance to green spaces (meters) during prenatal life and childhood. Multiple harmonized health outcomes were selected: asthma and wheezing, lung function, body mass index, diastolic and systolic blood pressure, non-verbal intelligence, internalizing and externalizing problems, and ADHD symptoms. We conducted a two-stage IPD meta-analysis and evaluated effect modification by socioeconomic status (SES) and sex. Between-study heterogeneity was assessed via random-effects meta-regression. Residential surrounding green spaces in childhood, not pregnancy, was associated with improved lung function, particularly higher FEV1 (β = 0.06; 95 %CI: 0.03, 0.09 I2 = 4.03 %, p < 0.001) and FVC (β = 0.07; 95 %CI: 0.04, 0.09 I2 = 0 %, p < 0.001) with a stronger association observed in females (p < 0.001). This association remained robust after multiple testing correction and did not change notably after adjusting for ambient air pollution. Increased distance to green spaces showed an association with lower FVC (β = −0.04; 95 %CI: −0.07, −0.02, I2 = 4.8, p = 0.001), with a stronger effect in children from higher SES backgrounds (p < 0.001). No consistent associations were found between green spaces and asthma, wheezing, cardiometabolic, or neurodevelopmental outcomes, with direction of effect varying across cohorts. Wheezing and neurodevelopmental outcomes showed high between-study heterogeneity, and the age at outcome assessment was only associated with heterogeneity in internalizing problems. This large European meta-analysis suggests that childhood exposure to green spaces may lead to better lung function. Associations with other respiratory outcomes and selected cardiometabolic and neurodevelopmental outcomes remain inconclusive.
KW - Cardiometabolic
KW - Child
KW - Green space
KW - Lung function
KW - Neurodevelopment
KW - Respiratory
U2 - 10.1016/j.envint.2024.108853
DO - 10.1016/j.envint.2024.108853
M3 - Journal article
C2 - 38963986
AN - SCOPUS:85197308998
VL - 190
JO - Environment international
JF - Environment international
SN - 0160-4120
M1 - 108853
ER -