Impact of Residential Greeness Exposure on the Development of Allergic Diseases and Asthma and on Asthma Control—A Systematic Review for the EAACI Guidelines of Environmental Science for Allergic Diseases and Asthma
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The role of residential greenness exposure (RGE) in prevention and control of allergic diseases remains controversial. This systematic review evaluated the association between RGE and the risk of developing asthma, allergic rhinitis (AR), food allergy, atopic dermatitis (AD), and asthma control. MEDLINE and EMBASE searches retrieved 17 cohort and case–control longitudinal studies (12 for asthma, 6 AR, 1 food allergy, 1 ad ). Risk of bias was assessed with ROBINS‐E, and certainty of evidence with GRADE. Data were meta‐analyzed using adjusted odds ratios (aORs) with random‐effects models. For “ever asthma” and “ever AR” a non‐significant protective trend of RGE was observed (aOR 0.92, 95% CI 0.72–1.18; aOR 0.61; 95% CI 0.24–1.55). For “current asthma” RGE was associated with increased risk (aOR 1.17, 95% CI 1.04–1.33), with no clear association for “current AR” (aOR 1.03; 95% CI 0.80–1.32). Prenatal RGE reduced the risk of “ever asthma” (aOR 0.94, 95% CI 0.93–0.950) and AD (aOR 0.996, 95% CI 0.993–0.999). RGE increased the risk for peanut (aOR 1.78, 95% CI 1.13–2.82) and egg allergy (aOR 1.38, 95% CI [1.05–1.82]). Reduced RGE decreased asthma control (OR: 2.662, 95% CI [1.043–6.799]). Potential benefits or potential harms of RGE should be judged in a context‐specific manner.
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The current guideline recommendations on environmental greenness are partially based on a comprehensive systematic review and meta-analysis examining preventive effects of urban green spaces compared to non-green environments on asthma and allergic diseases.
“The current guideline recommendations on environmental greenness are partially based on the comprehensive systematic review and meta‐analysis examining the preventive effects of urban green spaces compared to non‐green environments on asthma and allergic diseases [16].”
From <scp>EAACI</scp> Guidelines on the Importance of Green Space in Urban Environments for Allergy and Asthma Prevention (2026) · cites this paper as [16]
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From Risks to Protection—Natural Strategy to Prevent Allergy and Support Public Health
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Self-citation
- Authors
- Agache, I., Balbin‐Ramon, G. J., Saenz, F. K. F., Sola‐Arnau, I., Alonso‐Coello, P., Haahtela, T., Traidl‐Hoffmann, C., O'Mahony, L., Damialis, A., Lauerma, A., Nadeau, K. C., Pali‐Schöll, I., Palomares, O., Renz, H., Schwarze, J., Vercelli, D., Canelo‐Aybar, C., Jutel, M., & Akdis, C. A.
- Affiliations
- Transilvania University of Brașov (RO)
- Iberoamerican Cochrane Centre Barcelona Spain
- Iberoamerican Cochrane Centre (ES)
- University of Helsinki (FI)
- University of Augsburg (DE)
- Departments of Medicine and Microbiology, APC Microbiome Ireland National University of Ireland Cork Ireland
- Aristotle University of Thessaloniki (GR)
- Harvard University (US)
- University of Veterinary Medicine Vienna (AT)
- Department of Biochemistry and Molecular Biology, School of Chemistry Complutense University Madrid Spain
- Tongji University (CN)
- Child Life and Health, Centre for Inflammation Research, Institute for Regeneration and Repair The University of Edinburgh Edinburgh UK
- University of Arizona (US)
- Wroclaw Medical University (PL)
- Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland
- Corresponding author
- Agache, Ioana
- Jutel, Marek
- ORCID
- Agache, Ioana
- Balbin‐Ramon, Graciela J.
- Saenz, Fiorella Karina Fernandez
- Sola‐Arnau, Ivan
- Alonso‐Coello, Pablo
- Haahtela, Tari
- Traidl‐Hoffmann, Claudia
- O'Mahony, Liam
- Damialis, Athanasios
- Lauerma, Antti
- Nadeau, Kari C.
- Pali‐Schöll, Isabella
- Palomares, Oscar
- Renz, Harald
- Schwarze, Jurgen
- Vercelli, Donata
- Canelo‐Aybar, Carlos
- Jutel, Marek
- Akdis, Cezmi A.
- Venue
- Allergy
- Publisher
- Wiley
- Published
- 2025-07-09
- Volume
- 80
- Issue
- 11
- Pages
- 3027-3042
- ISSN
- 0105-4538 (ISSN-L)
- 1398-9995
- OpenAlex
- W4412118348
- Cited by
- 6
- References
- 83
- Citations by year
- 2026: 3 · 2025: 3
- FWCI
- 0.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Allergy (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Keywords
- residential greenness, green space exposure, allergic diseases, asthma, asthma control, allergic rhinitis, food allergy, atopic dermatitis, peanut allergy, egg allergy, environmental risk factors
- MeSH terms
- Asthma, Environmental Exposure, Humans, Hypersensitivity, Residence Characteristics, Odds Ratio, Practice Guidelines as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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