Residential greenness is differentially associated with childhood allergic rhinitis and aeroallergen sensitization in seven birth cohorts
Open accessAbstract
Background: The prevalence of allergic rhinitis is high, but the role of environmental factors remains unclear. We examined cohort‐specific and combined associations of residential greenness with allergic rhinitis and aeroallergen sensitization based on individual data from Swedish ( BAMSE ), Australian ( MACS ), Dutch ( PIAMA ), Canadian ( CAPPS and SAGE ), and German ( GINI plus and LISA plus) birth cohorts ( n = 13 016). Methods: Allergic rhinitis (doctor diagnosis/symptoms) and aeroallergen sensitization were assessed in children aged 6–8 years in six cohorts and 10–12 years in five cohorts. Residential greenness was defined as the mean Normalized Difference Vegetation Index ( NDVI ) in a 500‐m buffer around the home address at the time of health assessment. Cohort‐specific associations per 0.2 unit increase in NDVI were assessed using logistic regression models and combined in a random‐effects meta‐analysis. Results: Greenness in a 500‐m buffer was positively associated with allergic rhinitis at 6–8 years in BAMSE (odds ratio = 1.42, 95% confidence interval [1.13, 1.79]) and GINI / LISA South (1.69 [1.19, 2.41]) but inversely associated in GINI / LISA North (0.61 [0.36, 1.01]) and PIAMA (0.67 [0.47, 0.95]). Effect estimates in CAPPS and SAGE were also conflicting but not significant (0.63 [0.32, 1.24] and 1.31 [0.81, 2.12], respectively). All meta‐analyses were nonsignificant. Results were similar for aeroallergen sensitization at 6–8 years and both outcomes at 10–12 years. Stratification by NO 2 concentrations, population density, an urban vs rural marker, and moving did not reveal consistent trends within subgroups. Conclusion: Although residential greenness appears to be associated with childhood allergic rhinitis and aeroallergen sensitization, the effect direction varies by location.
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Conflicting results of green space effects on asthma and allergic symptoms have also been reported.
“However, conflicting results of green space effects on asthma and allergic symptoms have also been reported [44, 45, 46, 47, 48].”
From <scp>EAACI</scp> Guidelines on the Importance of Green Space in Urban Environments for Allergy and Asthma Prevention (2026) · cites this paper as [45]
The paper’s background passage (indexed under Abstract; page unavailable) says studies of greenness and allergic health outcomes have yielded inconsistent results. Its conclusion also says the direction of association with childhood allergic rhinitis and aeroallergen sensitization varies by location. The Outcome assessment section does not include asthma, so this source does not establish conflicting results for asthma specifically. (LLM, conf=0.83)
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- Authors
- Fuertes, E., Markevych, I., Bowatte, G., Gruzieva, O., Gehring, U., Becker, A., Berdel, D., von Berg, A., Bergström, A., Brauer, M., Brunekreef, B., Brüske, I., Carlsten, C., Chan‐Yeung, M., Dharmage, S. C., Hoffmann, B., Klümper, C., Koppelman, G. H., Kozyrskyj, A., Korek, M., Kull, I., Lodge, C., Lowe, A., MacIntyre, E., Pershagen, G., Standl, M., Sugiri, D., Wijga, A., MACS, & Heinrich, J.
- Affiliations
- Helmholtz Munich (DE)
- The University of Melbourne (AU)
- Karolinska Institutet (SE)
- Utrecht University (NL)
- University of Manitoba (CA)
- Marien Hospital Wesel (DE)
- Department of Pediatrics Research Institute Marien‐Hospital Wesel Wesel Germany
- University of British Columbia (CA)
- Leibniz Institute of Environmental Medicine (DE)
- University Medical Center Groningen (NL)
- University of Alberta (CA)
- Public Health Ontario (CA)
- National Institute for Public Health and the Environment (NL)
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin (DE)
- Corresponding author
- Fuertes, E.
- ORCID
- Venue
- Allergy
- Publisher
- Wiley
- Published
- 2016-05-06
- Volume
- 71
- Issue
- 10
- Pages
- 1461-1471
- ISSN
- 0105-4538 (ISSN-L)
- 1398-9995
- OpenAlex
- W2337854913
- Cited by
- 149
- References
- 2
- Citations by year
- 2026: 8 · 2025: 12 · 2024: 12 · 2023: 11 · 2022: 17 · 2021: 19 · 2020: 21 · 2019: 22 · 2018: 8 · 2017: 16 · 2016: 2
- FWCI
- 10.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Allergy (publishedVersion)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Minerva Access (University of Melbourne) (submittedVersion)
- Site cant be reached (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
- Rivm (National Institute for Public Health and the Environment) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion)
- Funders
- Vetenskapsrådet
- Hjärt-Lungfonden
- Stiftelsen Frimurare Barnhuset i Stockholm
- Stockholms Läns Landsting
- Naturvårdsverket
- Svenska Sällskapet för Medicinsk Forskning
- Stiftelsen för Strategisk Forskning
- Forskningsrådet om Hälsa, Arbetsliv och Välfärd
- ZonMw
- Bundesministerium für Umwelt, Naturschutz, Bau und Reaktorsicherheit (IUF, FKZ 20462296)
- Helmholtz-Zentrum für Umweltforschung
- Institut Universitaire de France
- Canadian Institutes of Health Research
- Asthma Foundation of Victoria
- Seventh Framework Programme (FP7/2007–2011)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- residential greenness, childhood allergic rhinitis, aeroallergen sensitization, NDVI, urban green space, birth cohort, cohort heterogeneity, NO2 exposure, population density, urban-rural differences
- MeSH terms
- Allergens, Child, Environment, Female, Humans, Immunization, Male, Residence Characteristics, Risk Factors, Cohort Studies, Patient Outcome Assessment, Rhinitis, Allergic
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