Exploring the pathways linking prenatal and early childhood greenness exposure to attention-deficit/hyperactivity disorder symptoms during childhood: An approach based on robust causal inference

IF 4.5 2区医学 Q1 INFECTIOUS DISEASES

International journal of hygiene and environmental health Pub Date : 2024-10-03 DOI:10.1016/j.ijheh.2024.114475

Leire Luque-García , Gonzalo García-Baquero , Aitana Lertxundi , Wael K. Al-Delaimy , Jordi Julvez , Marisa Estarlich , Montserrat De Castro , Mònica Guxens , Manuel Lozano , Mikel Subiza-Pérez , Jesús Ibarluzea

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引用次数: 0

Abstract

Background

Epidemiological studies suggest that exposure to greenness during childhood may protect children from developing attention-deficit hyperactivity disorder (ADHD).

Objective

We analyzed the effect of both prenatal (pregnancy) and early childhood (4-5-year follow-up) residential greenness exposure and green space availability on ADHD symptoms during childhood (up to the age of 12 years) and further explored the potential mediating role of PM_2.5 and physical activity in the association.

Methods

The study population included participants from the INfancia y Medio Ambiente (INMA) prospective birth cohort (Gipuzkoa, Sabadell, and Valencia). Average Normalized Difference Vegetation Index (NDVI) in buffers of 100-, 300- and 500-m around the residential addresses was used as an indicator of greenness, while green space availability was determined based on the presence of a major green space within 150-m from the residence. Childhood ADHD symptoms were assessed at the 6-8- and 10-12-year follow-ups using Conners Parents Rating Scale-Revised: Short Form.

Results

Although no association was found for the prenatal exposure period, increased early childhood NDVI inversely associated with the OR of clinically significant ADHD symptoms during the 6-8-year follow-up at the 100-m (OR 0.03, 95% CI: 0.003 to 0.44), 300-m (OR 0.04, 95% CI: 0.003 to 0.42) and 500-m (OR 0.08, 95% CI: 0.01 to 0.76) buffers, but exclusively in the context of direct effects. Additionally, the 10-12-year follow-up analysis found moderate to weak evidence of potential total and direct effects of NDVI at both 100- and 300-m buffers on inattention scores, as well as for NDVI at the 300-m buffer on ADHD index scores. The analysis did not reveal evidence of mediation through PM_2.5 or physical activity.

Conclusions

The evidence suggests that early childhood greenness exposure may reduce the risk of developing ADHD symptoms later in childhood, and that this association is not mediated through PM_2.5 and physical activity.

查看原文本刊更多论文

探索产前和幼儿期绿色暴露与儿童期注意力缺陷/多动症状之间的联系途径：基于稳健因果推断的方法。

背景：流行病学研究表明，儿童期接触绿化可保护儿童免于患上注意力缺陷多动障碍（ADHD）：我们分析了产前（怀孕）和儿童早期（4-5 年随访）住宅绿化暴露和绿地可用性对儿童期（12 岁前）多动症症状的影响，并进一步探讨了 PM2.5 和体育锻炼在这一关联中的潜在中介作用：研究对象包括 INfancia y Medio Ambiente（INMA）前瞻性出生队列（Gipuzkoa、Sabadell 和 Valencia）中的参与者。住宅周围 100 米、300 米和 500 米缓冲区内的归一化差异植被指数（NDVI）平均值被用作绿化指标，而绿地可用性则根据距住宅 150 米范围内是否有主要绿地来确定。在6-8年和10-12年的随访中，使用康纳斯家长评定量表-修订版对儿童多动症症状进行了评估：结果：尽管在产前暴露期未发现相关性，但在 6-8 年的随访期间，在 100 米（OR 0.03，95% CI：0.003 至 0.44）、300 米（OR 0.04，95% CI：0.003 至 0.42）和 500 米（OR 0.08，95% CI：0.01 至 0.76）缓冲区内，儿童早期 NDVI 的增加与临床显著多动症状的 OR 值呈反比关系，但仅限于直接影响。此外，10-12 年的随访分析发现，100 米和 300 米缓冲区的 NDVI 对注意力不集中评分的潜在总效应和直接效应，以及 300 米缓冲区的 NDVI 对多动症指数评分的潜在总效应和直接效应的证据为中度到弱度。分析没有发现通过 PM2.5 或体育活动进行调节的证据：有证据表明，儿童早期接触绿化可能会降低儿童后期出现多动症症状的风险，而这种关联并不通过 PM2.5 和体育活动来调节。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of hygiene and environmental health 医学-传染病学

CiteScore

11.50

自引率

5.00%

发文量

151

审稿时长

22 days

期刊介绍： The International Journal of Hygiene and Environmental Health serves as a multidisciplinary forum for original reports on exposure assessment and the reactions to and consequences of human exposure to the biological, chemical, and physical environment. Research reports, short communications, reviews, scientific comments, technical notes, and editorials will be peer-reviewed before acceptance for publication. Priority will be given to articles on epidemiological aspects of environmental toxicology, health risk assessments, susceptible (sub) populations, sanitation and clean water, human biomonitoring, environmental medicine, and public health aspects of exposure-related outcomes.