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Association between the First Occurrence of Asthma and Residential Greenness in Children and Teenagers in Taiwan

1
Department and Graduate Institute of Public Health, Tzu Chi University, Hualien 97004, Taiwan
2
Institute of Medical Science, Tzu Chi University, Hualien 97004, Taiwan
3
Department of Pediatrics, Tzu Chi Hospital Hualien, Hualien 970, Taiwan
4
Department of Geography, National Taiwan University, Taipei 10617, Taiwan
5
Department of Natural Resources and Environmental Studies, National Dong Hwa University, Hualien 97401, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(12), 2076; https://doi.org/10.3390/ijerph16122076
Received: 22 March 2019 / Revised: 2 May 2019 / Accepted: 10 June 2019 / Published: 12 June 2019
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Abstract

Green spaces have benefits but may also increase the risk of allergic disease. This study examined the association between the first occurrence of asthma and greenness exposure in children and teenagers. We conducted a 1:1 matched case-control study matched by sex, age, and the first diagnosis year with 7040 eligible subjects from a systematic sampling cohort database in Taiwan from 2001 to 2013. A normalized difference vegetation index (NDVI) value ≥0.4 was used as the criterion to determine the green space. The green cover images were then transformed to the green coverage rate in the township surrounding the residential areas of the asthma and control subjects. Conditional logistic regression analyses demonstrated that a significantly increased risk of asthma in preschool children was associated with the surrounding greenness after adjusting for urbanization level, frequency of healthcare provider visits, mean township family income, CO, NOx, and PM2.5. The risk of asthma occurrence increased significantly with increasing greenness exposure (p-trend < 0.05). Nevertheless, exposure to the highest greenness levels (81–100%) was not associated with a significantly higher risk of asthma occurrence than was exposure to the lowest values (0–20%) of greenness. This study suggests that green space design should consider more effective methods of reducing the allergy impact. View Full-Text
Keywords: asthma; preschool children; greenness space; air pollution asthma; preschool children; greenness space; air pollution
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Hsieh, C.-J.; Yu, P.-Y.; Tai, C.-J.; Jan, R.-H.; Wen, T.-H.; Lin, S.-W.; Tseng, C.-C. Association between the First Occurrence of Asthma and Residential Greenness in Children and Teenagers in Taiwan. Int. J. Environ. Res. Public Health 2019, 16, 2076.

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