Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/32849
Title: Residential green space and medication sales for childhood asthma: A longitudinal ecological study in Belgium
Authors: AERTS, Raf 
Dujardin, Sebastien
Nemery, Benoit
Van Nieuwenhuyse, An
Van Orshoven, Jos
Aerts, Jean-Marie
Somers, Ben
Hendrickx, Marijke
Bruffaerts, Nicolas
Bauwelinck, Mariska
Casas, Lidia
Demoury, Claire
PLUSQUIN, Michelle 
NAWROT, Tim 
Issue Date: 2020
Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE
Source: Environmental research (New York, N.Y. Print), 189 (Art N° 109914)
Abstract: Background: Living in green environments has been associated with various health benefits, but the evidence for positive effects on respiratory health in children is ambiguous. Objective: To investigate if residential exposure to different types of green space is associated with childhood asthma prevalence in Belgium. Methods: Asthma prevalence was estimated from sales data of reimbursed medication for obstructive airway disease (OAD) prescribed to children between 2010 and 2014, aggregated at census tract level (n = 1872) by sex and age group (6-12 and 13-18 years). Generalized log-linear mixed effects models with repeated measures were used to estimate effects of relative covers of forest, grassland and garden in the census tract of the residence on OAD medication sales. Models were adjusted for air pollution (PM10), housing quality and administrative region. Results: Consistent associations between OAD medication sales and relative covers of grassland and garden were observed (unadjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, beta = 0.15-0.17; garden, beta = 0.13-0.17). The associations remained significant after adjusting for housing quality and chronic air pollution (adjusted parameter estimates per IQR increase of relative cover, range across four strata: grassland, beta = 0.10-0.14; garden, beta = 0.07-0.09). There was no association between OAD medication sales and forest cover. Conclusions: Based on aggregated data, we found that living in close proximity to areas with high grass cover (grasslands, but also residential gardens) may negatively impact child respiratory health. Potential allergic and non-allergic mechanisms that underlie this association include elevated exposure to grass pollen and fungi and reduced exposure to environmental biodiversity. Reducing the dominance of grass in public and private green space might be beneficial to reduce the childhood asthma burden and may simultaneously improve the ecological value of urban green space.
Notes: Aerts, R (corresponding author), Sciensano, Juliette Wytsmanstr 14, BE-1050 Brussels, Belgium.
raf.aerts@sciensano.be
Other: Aerts, R (corresponding author), Sciensano, Juliette Wytsmanstr 14, BE-1050 Brussels, Belgium. raf.aerts@sciensano.be
Keywords: Pediatric asthma;Environmental epidemiology;Medication sales;Residential green space;Respiratory health
Document URI: http://hdl.handle.net/1942/32849
ISSN: 0013-9351
e-ISSN: 1096-0953
DOI: 10.1016/j.envres.2020.109914
ISI #: WOS:000576645700010
Category: A1
Type: Journal Contribution
Validations: ecoom 2021
Appears in Collections:Research publications

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