当地空气污染浓度是住宅绿地与儿童哮喘加重之间的调节因子还是中介因子？对宾夕法尼亚州费城儿科患者的纵向研究

IF 4.5 2区医学 Q1 INFECTIOUS DISEASES

International journal of hygiene and environmental health Pub Date : 2025-03-06 DOI:10.1016/j.ijheh.2025.114546

Yun-Ting Yen , Leah H. Schinasi , Brisa N. Sánchez , Steven Melly , Kari Moore , Christopher B. Forrest , Chén C. Kenyon , Michelle C. Kondo , Anneclaire J. De Roos

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引用次数: 0

摘要

尽管支持绿色空间与哮喘恶化之间存在联系的证据不一，但一些研究表明两者之间存在负相关。这种关系背后的机制尚不清楚，空气污染浓度可能起着关键作用。本研究探讨空气污染浓度是否改变或调解住宅绿地与儿童哮喘恶化之间的关系。方法数据来自费城儿童医院的儿童哮喘队列（2011-2016年），包括18岁的儿童。参与者从第一次就诊一直到第一次哮喘发作。评估了房屋附近的绿地（树冠、草/灌木覆盖）。每日空气污染数据，包括PM2.5、臭氧、NO2和SO2，均来自美国环境保护署。对个体和社区特征进行调整后，估计风险比（hr）和95%置信区间（ci）。考察了空气污染浓度对效果的影响，并进行了因果中介分析。结果在SO2浓度较高的日子里，居住在树冠覆盖率最高四分位数附近的儿童哮喘发作的发生率比居住在树冠覆盖率最低四分位数附近的儿童低14% （HR = 0.86, 95% CI = 0.74, 0.98）。相反，在SO2浓度较低的日子里，树冠覆盖率与发病率增加12%相关（HR = 1.12, 95% CI = 0.97, 1.28）。二氧化氮也观察到类似的模式，但PM2.5或臭氧没有发现相互作用。中介分析表明，空气污染没有显著的中介作用。结论在SO2或NO2水平较高的城市地区，住宅附近的绿色空间可能通过减轻空气污染的影响来支持哮喘儿童，建议基于绿色空间的城市策略。

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Is local air pollution concentration a moderator or mediator of the association between residential greenspace and pediatric asthma exacerbations? A longitudinal study of pediatric patients in Philadelphia, Pennsylvania

Background

Despite mixed evidence supporting the link between greenspace and asthma exacerbations, several studies suggest a negative association. The mechanisms underlying this relationship are unclear, with air pollution concentrations potentially playing a key role. This study investigated whether air pollution concentrations modify or mediate the relationship between residential greenspace and pediatric asthma exacerbations.

Methods

Data were drawn from a pediatric asthma cohort at Children's Hospital of Philadelphia (2011–2016), including children aged <18 years. Participants were followed from their initial visit until their first asthma exacerbation. Greenspace (tree canopy, grass/shrub cover) near homes was assessed. Daily air pollution data, including PM_2.5, ozone, NO₂, and SO₂, were obtained from the US Environmental Protection Agency. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated, adjusting for individual and neighborhood characteristics. Effect modification by air pollution concentrations was tested, and causal mediation analyses were conducted.

Results

On days with high SO₂ concentrations, children living near the highest quartile of tree canopy coverage had a 14% lower incidence of asthma exacerbations compared to those in the lowest quartile (HR = 0.86, 95% CI = 0.74, 0.98). Conversely, on days with low SO₂ concentrations, tree canopy coverage was associated with a nonsignificant 12% higher incidence (HR = 1.12, 95% CI = 0.97, 1.28). Similar patterns were observed for NO₂, but no interactions were found for PM_2.5 or ozone. Mediation analyses indicated no significant mediation by air pollution.

Conclusion

In urban areas with high SO₂ or NO₂ levels, greenspace near homes may support children with asthma by mitigating air pollution's impact, suggesting greenspace-based urban strategies.

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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.