Satellite-derived data on greenness and access to green spaces are related to children's health indicators

There is increasing epidemiologic evidence on beneficial effects of green environments on survival, perceived health and quality of life, mental health, obesity and physical activity. However, most studies have been conducted in adults. Further research to assess the impacts of green environments on children's health is warranted. Moreover, an investigation of potential mechanisms underlying the associations is required. This thesis comprises three publications, which are based on data from the German birth cohorts GINIplus and LISAplus. The first publication assessed the effects of residential greenness at the mother's residential address as well as access to green spaces assessed by satellite-derived data on birth weight of newborns. Greenness in a 500-m buffer around the mother's residential address at delivery was positively associated with the birth weight of neonates. Air pollution, noise, population density and maternal stress during pregnancy did not mediate the discovered association. In the stratified analyses, the association between greenness and birth weight was more pronounced in mothers with low socioeconomic status. Access to green spaces and birth weight were not associated. Thus, increased accessibility to green spaces also does not explain the observed association with greenness. The second publication investigated whether access to green spaces as well as residential greenness are associated with behavioural problems in 10-year-old children. Hyperactivity/inattention and peer relationship problems were positively associated with increasing distances to urban green spaces. The observed association with hyperactivity/inattention was only statistically significant among males. Children living further than 500 m away from any urban green space had more overall behavioural problems than those living within 500 m of an urban green space. Behavioural problems were not associated with the distance to a forest or with residential surrounding greenness. Thus, our findings suggest beneficial effects of living in close proximity to well-maintained green spaces on children's mental health. The third publication explored for the first time an association between residential greenness and blood pressure in 10-year-old children. The found association was not influenced by environmental stressors (ambient temperature and air pollution, noise annoyance, altitude and level of urbanisation). The discovered link is in line with the existing evidence from experimental studies and thus, with the psychoevolutionary theory of Ulrich; the latter argues that green environments mitigate stress by activating the parasympathetic system. The associations were only significant in the urban Munich study area but null in the rural Wesel area. This result might indicate that children living in urbanised regions, which generally lack vegetation, might bene t more from high residential greenness than those from the rural areas. In summary, these results support the hypothesis that better access to green spaces as well as higher residential surrounding greenness bene t children health. The results of my thesis suggest that greenness might improve health through the mechanism of physiological stress alleviation. But, contrary to my expectations, the observed effects of greenness and green spaces could not be additionally explained by mediation via physical activity, air pollution, noise, or urbanisation, possibly, because of insufficient data. Thus, future research should test more specifically what stands behind the discovered associations. Finally, health impacts of green environmentson children's health should be further investigated in different geographic areas with incorporation of data on time spent in the neighbourhood and the activities conducted as well as area-level socioeconomic status

Satellite-derived data on greenness and access to green spaces are related to children's health indicators

There is increasing epidemiologic evidence on beneficial effects of green environments on survival, perceived health and quality of life, mental health, obesity and physical activity. However, most studies have been conducted in adults. Further research to assess the impacts of green environments on children's health is warranted. Moreover, an investigation of potential mechanisms underlying the associations is required. This thesis comprises three publications, which are based on data from the German birth cohorts GINIplus and LISAplus. The first publication assessed the effects of residential greenness at the mother's residential address as well as access to green spaces assessed by satellite-derived data on birth weight of newborns. Greenness in a 500-m buffer around the mother's residential address at delivery was positively associated with the birth weight of neonates. Air pollution, noise, population density and maternal stress during pregnancy did not mediate the discovered association. In the stratified analyses, the association between greenness and birth weight was more pronounced in mothers with low socioeconomic status. Access to green spaces and birth weight were not associated. Thus, increased accessibility to green spaces also does not explain the observed association with greenness. The second publication investigated whether access to green spaces as well as residential greenness are associated with behavioural problems in 10-year-old children. Hyperactivity/inattention and peer relationship problems were positively associated with increasing distances to urban green spaces. The observed association with hyperactivity/inattention was only statistically significant among males. Children living further than 500 m away from any urban green space had more overall behavioural problems than those living within 500 m of an urban green space. Behavioural problems were not associated with the distance to a forest or with residential surrounding greenness. Thus, our findings suggest beneficial effects of living in close proximity to well-maintained green spaces on children's mental health. The third publication explored for the first time an association between residential greenness and blood pressure in 10-year-old children. The found association was not influenced by environmental stressors (ambient temperature and air pollution, noise annoyance, altitude and level of urbanisation). The discovered link is in line with the existing evidence from experimental studies and thus, with the psychoevolutionary theory of Ulrich; the latter argues that green environments mitigate stress by activating the parasympathetic system. The associations were only significant in the urban Munich study area but null in the rural Wesel area. This result might indicate that children living in urbanised regions, which generally lack vegetation, might bene t more from high residential greenness than those from the rural areas. In summary, these results support the hypothesis that better access to green spaces as well as higher residential surrounding greenness bene t children health. The results of my thesis suggest that greenness might improve health through the mechanism of physiological stress alleviation. But, contrary to my expectations, the observed effects of greenness and green spaces could not be additionally explained by mediation via physical activity, air pollution, noise, or urbanisation, possibly, because of insufficient data. Thus, future research should test more specifically what stands behind the discovered associations. Finally, health impacts of green environmentson children's health should be further investigated in different geographic areas with incorporation of data on time spent in the neighbourhood and the activities conducted as well as area-level socioeconomic status

Exposure to greenspace and bluespace and cognitive functioning in children - a systematic review

Background: The field of greenspace and bluespace research in relation to cognitive outcomes is rapidly growing. Several systematic reviews have already been published on this topic but none of them are specific to cognitive outcomes in the entire age range of children. Moreover, only a few of them have examined the effects of bluespace in addition to greenspace. Also, theses reviews are focused either only on observational studies or experimental studies. Our systematic review focuses on cognitive outcomes in relation to greenspace and bluespace in children and adolescents aged 0–18; it captures both observational and experimental studies. Cognitive outcomes are presented according to an evidence-based taxonomy of human cognitive abilities: the Cattell-Horn-Carroll (CHC) theory. Methods: We conducted searches in the PubMed and PsychInfo databases, from their inception dates to 17 December 2021. We used three-text terms related to outcome, exposure, and population as well as MeSH terms for outcome and population. Further, the reference lists and existing reviews were searched (“snowball” search) until 21 April 2022 to detect additional studies. For the results reporting, we followed the updated guidelines of the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA). We included observational and experimental studies on greenspace or bluespace exposure in relation to cognitive functioning, published in English, German, or Polish. Two reviewers independently checked study eligibility and extracted data. Two reviewers evaluated the risk of bias according to the Office of Health Assessment and Translation (OHAT) tool. At all stages, discrepancies between the two reviewers were solved via discussion with a third reviewer. Results: Records identified from PubMed (n = 2030) and PsycINFO (n = 1168) were deduplicated and screened. Twenty one reports were first selected. The “snowball” search revealed 16 additional reports. Altogether, 39 studies (17 experimental and 22 observational) published in 37 reports were qualified. The data extraction showed that the methodology used in the studies was heterogenous and the findings were inconsistent. The majority of the studies investigated attentional functioning, which we subdivided into two categories according to the CHC theory: attentional control and reaction and decision speed (12 studies) and attentional control and processing speed (10 studies). Eleven studies investigated working memory and/or short-term memory that we categorized as CHC working memory capacity. Nine studies investigated intellectual functioning, which we categorized as CHC general ability, fluid reasoning, and comprehension-knowledge. Two studies investigated visual-spatial skills, which we categorized as CHC visual processing and psychomotor speed. One study measured parent-reported attention; two studies examined early childhood/cognitive development; three studies examined decision-making and self-regulation, which can be categorized as several CHC theory abilities. Discussion: The heterogeneity of the included studies does not permit clear conclusions for our review. In accordance with previous systematic reviews, greenspace and bluespace were not more strongly related to a particular domain of cognitive functioning than other cognitive domains, and no effects of age or type of exposure assessment on the association between nature and cognition were detected. Further research is needed, including state-of-the-art of assessment of cognitive outcomes and diverse exposure assessment methods within both observational and experimental approaches. Expertise will be required in several domains, such as environmental epidemiology, cognitive psychology, and neuropsychology

Does exposure to nature make children more intelligent? : analysis in Polish children with and without ADHD

Previous studies have shown that exposure to nature and physical activity (PA) may be associated with higher intelligence in children. We examined whether there is an association between lifelong exposure to greenspace and bluespace and intelligence in children aged 10–13 with and without attention deficit hyperactivity disorder (ADHD), and whether PA mediates this association. The sample (N = 714) was collected within the NeuroSmog case-control study, where children with (N = 206) and without ADHD (N = 508) were recruited from 18 towns in Southern Poland. Nature exposure was estimated as the sum of the z-scores of the objective and perceived measures. Objective greenspace exposure was defined as the percentage of grass and tree cover in 500 m and 1 km buffers around lifelong residential addresses, respectively. Objective bluespace exposure was defined as the percentage of water cover in 500 m and 1 km buffers. Perceived greenspace/bluespace was measured as the parent-rated availability, quality, and use of greenspace/bluespace. Intelligence was assessed using the Polish version of the Stanford-Binet Intelligence Scales, 5th edition (SB5). SB5 Full Scale Intelligence Quotient (IQ), Nonverbal IQ, Verbal IQ, five factor and ten subtest scores were analysed as outcomes. The associations between nature and IQ scores were assessed by linear regressions separately for cases and controls, adjusting the models for sex, parental education, and urbanicity. Structural equation modeling was implemented to test whether PA mediated the association between nature and intelligence. None of the greenspace or bluespace measures were consistently associated with intelligence. PA was not found to be a mediator. We did not find evidence that higher lifelong nature exposure is associated with higher intelligence in Polish schoolchildren with or without ADHD. This casts doubts on whether exposure to nature has relevant influence on IQ

Residential greenspace and lung function up to 24 years of age: The ALSPAC birth cohort.

Background Residing in greener areas is increasingly linked to beneficial health outcomes, but little is known about its effect on respiratory health. Objective We examined associations between residential greenness and nearby green spaces with lung function up to 24 years in the UK Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort. Methods Lung function was measured by spirometry at eight, 15 and 24 years of age. Greenness levels within circular buffers (100–1000 m) around the birth, eight-, 15- and 24-year home addresses were calculated using the satellite-derived Normalized Difference Vegetation Index and averaged (lifetime greenness). The presence and proportion of green spaces (urban green spaces, forests and agricultural land) within a 300 m buffer was determined. First, associations between repeated greenness and green space variables and repeated lung function parameters were assessed using generalized estimation equations (N = 7094, 47.9% male). Second, associations between lifetime average greenness and lifetime average proportion of green spaces with lung function at 24-years were assessed using linear regression models (N = 1763, 39.6% male). All models were adjusted for individual and environmental covariates. Results Using repeated greenspace and lung function data at eight, 15 and 24 years, greenness in a 100 m buffer was associated with higher FEV1 and FVC (11.4 ml [2.6, 20.3] and 12.2 ml [1.8, 22.7], respectively, per interquartile range increase), as was the presence of urban green spaces in a 300 m buffer (20.3 ml [−0.1, 40.7] and 23.1 ml [-0.3, 46.5] for FEV1 and FVC, respectively). These associations were independent of air pollution, urbanicity and socio-economic status. Lifetime average greenness within a 100 m buffer and proportion of agricultural land within a 300 m buffer were associated with better lung function at 24 years but adjusting for asthma attenuated these associations. Discussion This study provides suggestive evidence that children whose homes are in more vegetated places or are in close proximity of green spaces have better lung function up to 24 years of age

Air pollution and attention in Polish schoolchildren with and without ADHD

Background: Development and functioning of attention—a key component of human cognition—can be affected by en vironmental factors. We investigated whether long- and short-term exposure to particulate matter with aerodynamic diameter < 10 μm (PM10) and nitrogen dioxide (NO2) are related to attention in 10- to 13-year-old children living in Polish towns recruited in the NeuroSmog case-control study. Methods: We investigated associations between air pollution and attention separately in children with attention deficit hyperactivity disorder (ADHD, n = 187), a sensitive, at-risk population with impaired attention and in population based typically developing children (TD, n = 465). Alerting, orienting, and executive aspects of attention were mea sured using the attention network test (ANT), while inhibitory control was measured with the continuous performance test (CPT). We assessed long-term exposure to NO2 and PM10 using novel hybrid land use regression (LUR) models. Short-term exposures to NO2 and PM10 were assigned to each subject using measurements taken at the air pollution monitoring station nearest to their home address. We tested associations for each exposure-outcome pair using adjusted linear and negative binomial regressions. Results: We found that long-term exposures to both NO2 and PM10 were associated with worse visual attention in chil dren with ADHD. Short-term exposure to NO2 was associated with less efficient executive attention in TD children and more errors in children with ADHD. It was also associated with shorter CPT response times in TD children; however, this effect was accompanied by a trend towards more CPT commission errors, suggestive of more impulsive performance in these subjects. Finally, we found that short-term PM10 exposure was associated with fewer omission errors in CPT in TD children. Conclusions: Exposure to air pollution, especially short-term exposure to NO2, may have a negative impact on attention in children. In sensitive populations, this impact might be different than in the general population

Associations of preconception exposure to air pollution and greenness with offspring asthma and hay fever

We investigated if greenness and air pollution exposure in parents’ childhood affect offspring asthma and hay fever, and if effects were mediated through parental asthma, pregnancy greenness/pollution exposure, and offspring exposure. We analysed 1106 parents with 1949 offspring (mean age 35 and 6) from the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study. Mean particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), black carbon (BC), ozone (O3) (µg/m3) and greenness (normalized difference vegetation index (NDVI)) were calculated for parents 0-18 years old and offspring 0-10 years old, and were categorised in tertiles. We performed logistic regression and mediation analyses for two-pollutant models (clustered by family and centre, stratified by parental lines, and adjusted for grandparental asthma and education). Maternal medium PM2.5 and PM10 exposure was associated with higher offspring asthma risk (odds ratio (OR) 2.23, 95%CI 1.32-3.78, OR 2.27, 95%CI 1.36-3.80), and paternal high BC exposure with lower asthma risk (OR 0.31, 95%CI 0.11-0.87). Hay fever risk increased for offspring of fathers with medium O3 exposure (OR 4.15, 95%CI 1.28-13.50) and mothers with high PM10 exposure (OR 2.66, 95%CI 1.19-5.91). The effect of maternal PM10 exposure on offspring asthma was direct, while for hay fever, it was mediated through exposures in pregnancy and offspring’s own exposures. Paternal O3 exposure had a direct effect on offspring hay fever. To conclude, parental exposure to air pollution appears to influence the risk of asthma and allergies in future offspring

Is PM1 similar to PM2.5? : a new insight into the association of PM1 and PM2.5 with children's lung function

Experimental data suggests that PM1 is more toxic than PM2.5 although the epidemiologic evidence suggests that the health associations are similar. However, few objective exposure data are available to compare the associations of PM1 and PM2.5 with children lung function. Our objectives are a) to evaluate associations between long-term exposure to PM1, PM2.5 and children’s lung function, and b) to compare the associations between PM1 and PM2.5. From 2012 to 2013, we enrolled 6,740 children (7-14 years), randomly recruited from primary and middle schools located in seven cities in northeast China. We measured lung function including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), and maximal mid-expiratory flow (MMEF) utilizing two portable electronic spirometers. We dichotomized continuous lung function measures according the expected values for gender and age. The spatial resolution at which PM1 and PM2.5 estimated were estimated using a machine learning method and the temporal average concentrations were averaged from 2009 to 2012. A multilevel regression model was used to estimate the associations of PM1, PM2.5 exposure and lung function measures, adjusted for confounding factors. Associations with lower lung function were consistently larger for PM1 than for PM2.5. Adjusted odds ratios (OR) per interquartile range greater PM1 ranged from 1.53 for MMEF (95% confidence interval [CI]: 1.20-1.96) to 2.14 for FEV1 (95% CI: 1.66-2.76) and ORs for PM2.5 ranged from 1.36 for MMEF (95%CI: 1.12–1.66) to 1.82 for FEV1 (95%CI: 1.49-2.22), respectively. PM1 and PM2.5 had

Maternal exposure to ambient air pollution and congenital heart defects in China

Background: Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China.Method: This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤1 µm (PM1), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes.Results: A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m3] increase in PM1 was associated with 1.09-fold ([95% confidence interval, 1.01-1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed.Conclusions: Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings