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1.
Environ Res ; 179(Pt A): 108751, 2019 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-31557601

RESUMO

Self-perceived general health (SGH) is one of the most inclusive and widely used measures of health status and a powerful predictor of mortality. However, only a limited number of studies evaluated associations of combined environmental exposures on SGH. Our aim was to evaluate associations of combined residential exposure to surrounding green, air pollution and traffic noise with poor SGH in the Netherlands. We linked data on long-term residential exposure to surrounding green based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and road- and rail-traffic noise with a Dutch national health survey, resulting in a study population of 354,827 adults. We analyzed associations of single and combined exposures with poor SGH. In single-exposure models, NDVI within 300 m was inversely associated with poor SGH [odds ratio (OR) = 0.91, 95% CI: 0.89, 0.94 per IQR increase], while NO2 was positively associated with poor SGH (OR = 1.07, 95% CI: 1.04, 1.11 per IQR increase). In multi-exposure models, associations with surrounding green and air pollution generally remained, but attenuated. Joint odds ratios (JOR) of combined exposure to air pollution, rail-traffic noise and decreased surrounding green were higher than the odds ratios of single-exposure models. Studies including only one of these correlated exposures may overestimate the risk of poor SGH attributed to the studied exposure, while underestimating the risk of combined exposures.

2.
Environ Health Perspect ; 127(8): 87003, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393793

RESUMO

BACKGROUND: Surrounding green, air pollution, and noise have been associated with cardiometabolic diseases, but most studies have assessed only one of these correlated exposures. OBJECTIVES: We aimed to evaluate associations of combined exposures to green, air pollution, and road traffic noise with cardiometabolic diseases. METHODS: In this cross-sectional study, we studied associations between self-reported physician-diagnosed diabetes, hypertension, heart attack, and stroke from a Dutch national health survey of 387,195 adults and residential surrounding green, annual average air pollutant concentrations [including particulate matter with aerodynamic diameter [Formula: see text] ([Formula: see text]), PM with aerodynamic diameter [Formula: see text] ([Formula: see text]), nitrogen dioxide ([Formula: see text]), and oxidative potential (OP) with the dithiothreitol (DTT) assay ([Formula: see text])] and road traffic noise. Logistic regression models were used to analyze confounding and interaction of surrounding green, air pollution, and noise exposure. RESULTS: In single-exposure models, surrounding green was inversely associated with diabetes, while air pollutants ([Formula: see text], [Formula: see text]) and road traffic noise were positively associated with diabetes. In two-exposure analyses, associations with green and air pollution were attenuated but remained. The association between road traffic noise and diabetes was reduced to unity when adjusted for surrounding green or air pollution. Air pollution and surrounding green, but not road traffic noise, were associated with hypertension in single-exposure models. The weak inverse association of surrounding green with hypertension attenuated and lost significance when adjusted for air pollution. Only [Formula: see text] was associated with stroke and heart attack. CONCLUSIONS: Studies including only one of the correlated exposures surrounding green, air pollution, and road traffic noise may overestimate the association of diabetes and hypertension attributed to the studied exposure. https://doi.org/10.1289/EHP3857.

3.
Clin Exp Allergy ; 49(10): 1352-1361, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31336400

RESUMO

BACKGROUND: Pet and dampness or mould exposure are considered risk factors for asthma and sensitization. It is unclear whether timing of exposure to these factors is differentially associated with asthma risk and sensitization in adolescence. OBJECTIVE: We investigated the role of timing of pet and dampness or mould exposure in asthma and sensitization in adolescence. Understanding this role is essential to build targeted prevention strategies. METHODS: We used data from 1871 participants of the Dutch Prevention and Incidence of Asthma and Mite Allergy (PIAMA) cohort. Residential exposure to pets, dampness or mould was assessed by repeated parental questionnaires. We used asthma data from the 17-year questionnaire and sensitization data from the 16-year medical examination. We characterized timing using longitudinal exposure patterns from pregnancy till age 17 using longitudinal latent class growth modelling. We used logistic regression models to analyse associations of exposure patterns with asthma at age 17 and sensitization at age 16. RESULTS: For none of the time windows, exposure to pets and dampness or mould was associated with asthma at age 17, but a lower sensitization risk at age 16 was suggested, for example the odds ratio (95% confidence interval) for sensitization was 0.63 (0.35-1.11) and 0.69 (0.44-1.08) for early life and persistently high pet exposure, respectively, compared with very low exposure. An inverse association was also suggested for sensitization and moderate early childhood dampness or mould exposure (0.71 [0.42-1.19]). CONCLUSION AND CLINICAL RELEVANCE: Different timing of pet and dampness or mould exposure was not associated with asthma, but lower risk of sensitization in adolescence was suggested, which could be partly attributable to reversed causation. Current findings are not sufficient to recommend pet avoidance to prevent allergic disease. More prospective studies are needed to obtain insights that can be used in clinical practice.

4.
Environ Int ; 131: 104991, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31302482

RESUMO

BACKGROUND: Green space has been hypothesized to improve cardiometabolic health of adolescents, whereas air pollution and traffic noise may negatively impact cardiometabolic health. OBJECTIVES: To examine the associations of green space, air pollution and traffic noise with cardiometabolic health in adolescents aged 12 and 16 years. METHODS: Waist circumference, blood pressure, cholesterol and glycated hemoglobin (HbA1c) were measured in subsets of participants of the Dutch PIAMA birth cohort, who participated in medical examinations at ages 12 (n = 1505) and/or 16 years (n = 797). We calculated a combined cardiometabolic risk score for each participant, with a higher score indicating a higher cardiometabolic risk. We estimated exposure to green space (i.e. the average Normalized Difference Vegetation Index (NDVI) and percentages of green space in circular buffers of 300 m and 3000 m), air pollution (by land-use regression models) and traffic noise (using the Standard Model Instrumentation for Noise Assessments (STAMINA) model) at the adolescents' home addresses at the time of the medical examinations. We assessed associations of these exposures with cardiometabolic health outcomes at ages 12 and 16 by multiple linear regression, adjusting for potential confounders. RESULTS: We did not observe consistent patterns of associations of green space, air pollution and traffic noise with the cardiometabolic risk score, blood pressure, total cholesterol levels, the total/HDL cholesterol ratio and HbA1c. We found inverse associations of air pollution with waist circumference at both age 12 and 16. These associations weakened after adjustment for region, except for particulate matter with a diameter of <2.5 µm (PM2.5) at age 12. The association of PM2.5 with waist circumference at age 12 remained after adjustment for green space and road traffic noise (adjusted difference - 1.42 cm [95% CI -2.50, -0.35 cm] per 1.16 µg/m3 increase in PM2.5). CONCLUSION: This study does not provide evidence for beneficial effects of green space or adverse effects of air pollution and traffic noise on cardiometabolic health in adolescents.

5.
Environ Int ; 129: 525-537, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31158598

RESUMO

BACKGROUND: Evidence is emerging that poor mental health is associated with the environmental exposures of surrounding green, air pollution and traffic noise. Most studies have evaluated only associations of single exposures with poor mental health. OBJECTIVES: To evaluate associations of combined exposure to surrounding green, air pollution and traffic noise with poor mental health. METHODS: In this cross-sectional study, we linked data from a Dutch national health survey among 387,195 adults including questions about psychological distress, based on the Kessler 10 scale, to an external database on registered prescriptions of anxiolytics, hypnotics & sedatives and antidepressants. We added data on residential surrounding green in a 300 m and a 1000 m buffer based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), modeled annual average air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and modeled road- and rail-traffic noise (Lden and Lnight) to the survey. We used logistic regression to analyze associations of surrounding green, air pollution and traffic noise exposure with poor mental health. RESULTS: In single exposure models, surrounding green was inversely associated with poor mental health. Air pollution was positively associated with poor mental health. Road-traffic noise was only positively associated with prescription of anxiolytics, while rail-traffic noise was only positively associated with psychological distress. For prescription of anxiolytics, we found an odds ratio [OR] of 0.88 (95% CI: 0.85, 0.92) per interquartile range [IQR] increase in NDVI within 300 m, an OR of 1.14 (95% CI: 1.10, 1.19) per IQR increase in NO2 and an OR of 1.07 (95% CI: 1.03, 1.11) per IQR increase in road-traffic noise. In multi exposure analyses, associations with surrounding green and air pollution generally remained but attenuated. Joint odds ratios [JOR], based on the Cumulative Risk Index (CRI) method, of combined exposure to air pollution, traffic noise and decreased surrounding green were higher than the ORs of single exposure models. Associations of environmental exposures with poor mental health differed somewhat by age. CONCLUSIONS: Studies including only one of these three correlated exposures may overestimate the influence of poor mental health attributed to the studied exposure, while underestimating the influence of combined environmental exposures.

6.
PLoS One ; 14(5): e0216803, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31116770

RESUMO

Adolescents with high educational attainment generally have better outcomes across the lifespan than adolescents with lower educational attainment. This study investigated how three measures of socioeconomic status (SES)-maternal education, paternal education, and neighbourhood SES-combined to predict adolescent educational attainment (track level at age 17). We proposed three mechanisms for this pathway: cognitive ability (at age 11), primary school teacher assessment (stating the secondary education level suitable for a child at age 11), and educational expectations (at age 14). Using the data of 2,814 Dutch adolescents from the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) study, logistic regressions tested associations between SES and educational attainment. Structural equation modelling (SEM) tested mediational pathways between SES and educational attainment. In models with three SES measures, having a medium-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 1.83; 1.41-2.38), and having a high-educated mother was associated with higher educational attainment relative to having a low-educated mother (OR; 95% CI: 3.44; 2.59-4.55). The odds ratios for paternal education showed a similar pattern. We found no association between neighbourhood SES and adolescent educational attainment, so neighbourhood SES was removed from further analyses. Mediational analyses revealed that cognitive ability (30.0%), teacher assessment (28.5%), and educational expectations (1.2%) explained 59.8% of the total association between parental SES and educational attainment. The results showed that mother education and father education were both important for understanding the strong association between parental SES and adolescent educational attainment. In the Netherlands, the association between parental SES and educational attainment can be largely explained by cognitive ability and teacher assessments.

8.
Br J Nutr ; 121(8): 905-913, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30728088

RESUMO

Observational studies suggest that breast-feeding is associated with a more favourable BMI and cardio-metabolic markers, but potential underlying mechanisms are unclear. As serum adiponectin has an important function in adults for glucose and lipid metabolism, we assessed 251 participants of the Prevention and Incidence of Asthma and Mite Allergy birth cohort whether breast milk adiponectin is associated with childhood BMI and cardio-metabolic markers. We measured adiponectin levels in breast milk collected around 3 months after birth of the child and subsequently obtained weight and height repeatedly up to the age of 17 years. A medical examination (including blood pressure, glycated Hb and cholesterol) was performed at the age of 8, 12 and 16 years. We used multivariable mixed models to assess the association between breast milk adiponectin and BMI and cardio-metabolic markers at these ages. In models adjusted for exact age of breast milk collection, maternal age, presence of siblings, maternal BMI, pregnancy weight gain and child's birth weight, each unit increase in log breast milk adiponectin (in ng/ml) was associated with a 0·28 lower BMI z score (95 % CI -0·56, 0·00) at 3 months. After the age of 1 year, there was a tendency towards a higher BMI z score with increased breast milk adiponectin at some ages, but this pattern was not consistent throughout childhood. There were no associations between breast milk adiponectin and any of the cardio-metabolic markers in childhood. We conclude that in our study with follow-up until 17 years of age, breast milk adiponectin has no long-term effect on BMI and cardio-metabolic health during childhood.

9.
Environ Res ; 169: 348-356, 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30504077

RESUMO

BACKGROUND: Air pollution, traffic noise and absence of green space may contribute to the development of overweight in children. OBJECTIVES: To investigate the combined associations of air pollution, traffic noise and green space with overweight throughout childhood. METHODS: We used data for 3680 participants of the Dutch PIAMA birth cohort. We estimated exposure to air pollution, traffic noise and green space (i.e. the average Normalized Difference Vegetation Index (NDVI) and percentages of green space in circular buffers of 300 m and 3000 m) at the children's home addresses at the time of parental reported weight and height measurements. Associations of these exposures with overweight from age 3 to 17 years were analyzed by generalized linear mixed models, adjusting for potential confounders. Odds ratios (OR's) are presented for an interquartile range increase in exposure. RESULTS: odds of being overweight increased with increasing exposure to NO2 (adjusted OR 1.40 [95% confidence interval (CI) 1.12-1.74] per 8.90 µg/m3) and tended to decrease with increasing exposure to green space in a 3000 m buffer (adjusted OR 0.86 [95% CI 0.71-1.04] per 0.13 increase in the NDVI; adjusted OR 0.86 [95% CI 0.71-1.03] per 29.5% increase in the total percentage of green space). After adjustment for NO2, the associations with green space in a 3000 m buffer weakened. No associations of traffic noise with overweight throughout childhood were found. In children living in an urban area, living further away from a park was associated with a lower odds of being overweight (adjusted OR 0.67 [95% CI 0.52-0.85] per 359.6 m). CONCLUSIONS: Exposure to traffic-related air pollution, but not traffic noise or green space, may contribute to childhood overweight. Future studies examining the associations of green space with childhood overweight should account for air pollution exposure.

11.
BMJ Open ; 8(11): e023912, 2018 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-30467134

RESUMO

OBJECTIVES: To develop a dynamic prediction model for high blood pressure at the age of 9-10 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare. DESIGN, SETTING AND PARTICIPANTS: Data were used from 5359 children in a population-based prospective cohort study in Rotterdam, the Netherlands. OUTCOME MEASURE: High blood pressure was defined as systolic and/or diastolic blood pressure ≥95th percentile for gender, age and height. Using multivariable pooled logistic regression, the predictive value of characteristics at birth, and of longitudinal information on the body mass index (BMI) of the child until the age of 6 years, was assessed. Internal validation was performed using bootstrapping. RESULTS: 227 children (4.2%) had high blood pressure at the age of 9-10 years. Final predictors were maternal hypertensive disease during pregnancy, maternal educational level, maternal prepregnancy BMI, child ethnicity, birth weight SD score (SDS) and the most recent BMI SDS. After internal validation, the area under the receiver operating characteristic curve ranged from 0.65 (prediction at age 3 years) to 0.73 (prediction at age 5-6 years). CONCLUSIONS: This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease.

12.
Am J Epidemiol ; 2018 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-30351340

RESUMO

International collaborations among birth cohorts to better understand asthma and allergies have increased in the last years. However, differences in definitions and methods preclude direct pooling of original individual participant data. We harmonized data from 14 birth cohorts, with three to 20 follow-ups, from nine European countries, as part of the Mechanisms of the Development of Asthma and Allergies (MeDALL) project. The harmonization process followed six steps: organization of the harmonization panel; identification of variables relevant to MeDALL objectives (candidate variables); proposal of a definition for each candidate variable (reference definition); assessment of the compatibility of each cohort variable to its reference definition (inferential equivalence) and classifications of this inferential equivalence as complete, partial, or impossible; workshop to agree on the reference definitions and classifications of inferential equivalence; and data preparation and delivery through a knowledge management portal. We agreed on 137 reference definitions. The inferential equivalence of 3,551 cohort variables to their corresponding reference definition was classified as complete, partial and impossible for 70%, 15% and 15% of the variables, respectively. A harmonized database was delivered. In birth cohorts of asthma and allergies, the harmonization of data for pooled analyses is feasible and may achieve high inferential comparability. The MeDALL harmonization approach can be used in other collaborative projects.

13.
Environ Int ; 121(Pt 1): 435-442, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30266014

RESUMO

BACKGROUND: It has been suggested that children who are exposed to agricultural pesticides have an increased risk of asthma, but evidence for associations betweeen residential pesticide exposure and childhood asthma is inconsistent. OBJECTIVES: To investigate the associations of residential pesticide exposure with the prevalence of asthma and related symptoms within a Dutch birth cohort study. METHODS: In this cross-sectional analysis, we included participants of the PIAMA birth cohort study with data on residential pesticide exposure and asthma from parent-completed questionnaires at age 14, collected in 2012 (N = 1473). We used spatial data on the presence of individual crops (cereals, open field vegetables, commercial crops, open field floriculture/bulbs, corn and potatoes) and pesticide application on these crops to estimate residential exposure to pesticides with known irritant properties for the respiratory system within distances of 100, 500, and 1000 m of the participants' homes. Logistic regression was used to estimate associations between exposure and outcomes, adjusting for potential confounders. RESULTS: No associations were found between living within 100, 500 and 1000 m of agricultural fields likely treated with pesticides and symptoms of asthma. For instance, for participants living within 100 m of fields with any crops likely treated with pesticides, the adjusted odds ratios (95% confidence interval) for the prevalence of asthma, shortness of breath and dry night cough at age 14 were 0.31 (0.07, 1.32), 0.61 (0.23, 1.57) and 1.26 (0.56, 2.80), respectively. No associations were found between estimated exposure to pesticides with known irritant properties for the respiratory system and asthma or related symptoms. CONCLUSIONS: There was no association between living near agricultural fields likely treated with pesticides and asthma and related respiratory symptoms, among our study participants.

14.
Eur Respir J ; 52(3)2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30209194

RESUMO

The parallel epidemics of childhood asthma and obesity over the past few decades have spurred research into obesity as a risk factor for asthma. However, little is known regarding the role of asthma in obesity incidence. We examined whether early-onset asthma and related phenotypes are associated with the risk of developing obesity in childhood.This study includes 21 130 children born from 1990 to 2008 in Denmark, France, Germany, Greece, Italy, The Netherlands, Spain, Sweden and the UK. We followed non-obese children at 3-4 years of age for incident obesity up to 8 years of age. Physician-diagnosed asthma, wheezing and allergic rhinitis were assessed up to 3-4 years of age.Children with physician-diagnosed asthma had a higher risk for incident obesity than those without asthma (adjusted hazard ratio (aHR) 1.66, 95% CI 1.18-2.33). Children with active asthma (wheeze in the last 12 months and physician-diagnosed asthma) exhibited a higher risk for obesity (aHR 1.98, 95% CI 1.31-3.00) than those without wheeze and asthma. Persistent wheezing was associated with increased risk for incident obesity compared to never wheezers (aHR 1.51, 95% CI 1.08-2.09).Early-onset asthma and wheezing may contribute to an increased risk of developing obesity in later childhood.

15.
Eur Respir J ; 52(3)2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30139777

RESUMO

Evidence for the effects of air pollution exposure on lung function growth into adolescence is scarce. We investigated associations of air pollution exposure with lung function and lung function growth until age 16.We conducted both longitudinal (n=915) and cross-sectional (n=721) analyses of associations of air pollution exposure with forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) growth from ages eight to 16 and FEV1 and FVC at age 16. We estimated residential concentrations of nitrogen dioxide (NO2), "soot" and particulate matter (PMx, where x is the 50% cut-off aerodynamic diameter in µm) with diameters of <2.5 µm (PM2.5), <10 µm (PM10) and 2.5-10 µm (PMcoarse) during the preschool, primary school and secondary school time windows by land use regression models. Associations with (growth in) FEV1 and FVC were analysed by linear (mixed effects) regression.Higher air pollution exposure was associated with reduced FEV1 growth (e.g. adjusted difference -0.26% (95% CI -0.49 to -0.03%) per interquartile range increase in secondary school PM2.5) and lower FEV1 (adjusted difference -2.36% (95% CI -3.76 to -0.94%)), but was not adversely associated with FVC. Associations with FEV1 were stronger in boys than girls and were not modified by asthma status.Higher air pollution exposure may lead to increased airway obstruction, but not reduced lung volume in adolescence.

16.
Environ Health ; 17(1): 61, 2018 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-30016982

RESUMO

BACKGROUND: Air pollution has been found to adversely affect children's lung function. Forced expiratory volume in 1 s and forced vital capacity from spirometry have been studied most frequently, but measurements of airway resistance may provide additional information. We assessed associations of long-term air pollution exposure with airway resistance. METHODS: We measured airway resistance at age 8 with the interrupter resistance technique (Rint) in participants of the Dutch PIAMA birth cohort study. We linked Rint with estimated annual average air pollution concentrations [nitrogen oxides (NO2, NOx), PM2.5 absorbance ("soot"), and particulate matter < 2.5 µm (PM2.5), < 10 µm (PM10) and 2.5-10 µm (PMcoarse)] at the birth address and current home address (n = 983). Associations between air pollution exposure and interrupter resistance (Rint) were assessed using multiple linear regression adjusting for potential confounders. RESULTS: We found that higher levels of NO2 at the current address were associated with higher Rint [adj. mean difference (95% confidence interval) per interquartile range increase in NO2: 0.018 (0.001, 0.035) kPa·s·L- 1]. Similar trends were observed for the other pollutants, except, PM10. No association was found between Rint and exposure at the birth address. CONCLUSIONS: Our results support the hypothesis that air pollution exposure is associated with a lower lung function in schoolchildren.

17.
J Epidemiol Community Health ; 72(10): 940-943, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29891636

RESUMO

BACKGROUND: Quantification of the burden of overweight on the healthcare system is becoming increasingly urgent for health policy, but accurate estimates are hard to obtain. METHODS: In order to assess healthcare utilisation and expenditure of overweight and non-overweight children, we linked, on an individual basis, data on body mass index from a birth cohort study with administrative health insurance claims data. In children aged 14-15 years, we compared utilisation and expenditure on general practice care, dental care, hospital/specialist care, prescribed medication, allied healthcare and mental healthcare of overweight children (overweight at age 11 and 14, n=80) and non-overweight children (no overweight at age 11 and 14, n=1253). RESULTS: For overweight children, mean 1-year healthcare expenditure was €837 per child and for non-overweight children €616. This difference was mainly due to significant differences in utilisation of hospital care (49% vs 37%) and mental healthcare (14% vs 7%) and to a lesser extent to higher expenditure per user. CONCLUSION: Our results indicate the potential value of linking survey data to claims data in order to obtain insight into the healthcare costs of childhood overweight. Further studies should elucidate whether the observed differences are causally related to overweight.

18.
Environ Health Perspect ; 126(4): 047016, 2018 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-29714963

RESUMO

BACKGROUND: Green space may influence health through several pathways, for example, increased physical activity, enhanced social cohesion, reduced stress, and improved air quality. For green space to increase physical activity and social cohesion, spending time in green spaces is likely to be important. OBJECTIVES: We examined whether adolescents visit green spaces and for what purposes. Furthermore, we assessed the predictors of green space visits. METHODS: In this cross-sectional study, data for 1911 participants of the Dutch PIAMA (Prevention and Incidence of Asthma and Mite Allergy) birth cohort were analyzed. At age 17, adolescents reported how often they visited green spaces for physical activities, social activities, relaxation, and to experience nature and quietness. We assessed the predictors of green space visits altogether and for different purposes by log-binomial regression. RESULTS: Fifty-three percent of the adolescents visited green spaces at least once a week in summer, mostly for physical and social activities. Adolescents reporting that a green environment was (very) important to them visited green spaces most frequently {adjusted prevalence ratio (PR) [95% confidence interval (CI)] very vs. not important: 6.84 (5.10, 9.17) for physical activities and 4.76 (3.72, 6.09) for social activities}. Boys and adolescents with highly educated fathers visited green spaces more often for physical and social activities. Adolescents who own a dog visited green spaces more often to experience nature and quietness. Green space visits were not associated with the objectively measured quantity of residential green space, i.e., the average normalized difference vegetation index (NDVI) and percentages of urban, agricultural, and natural green space in circular buffers around the adolescents' homes. CONCLUSIONS: Subjective variables are stronger predictors of green space visits in adolescents than the objectively measured quantity of residential green space. https://doi.org/10.1289/EHP2429.

20.
Environ Health Perspect ; 126(4): 047005, 2018 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-29664587

RESUMO

BACKGROUND: The role of tobacco smoke exposure in the development and persistence of asthma and rhinoconjunctivitis through childhood into adolescence is unclear. OBJECTIVES: We assessed the associations of parental smoking from fetal life through adolescence with asthma and rhinoconjunctivitis during childhood and adolescence. METHODS: We analyzed data for 10,860 participants of five European birth cohort studies from the Mechanisms of the Development of Allergy (MeDALL) consortium. Parental smoking habits and health outcomes (early transient, persistent, and adolescent-onset asthma and rhinoconjunctivitis) were based on questionnaires covering the period from pregnancy to 14-16 y of age. Data were combined and analyzed using a one-stage and two-stage individual participant data meta-analysis. RESULTS: Overall, any maternal smoking during pregnancy tended to be associated with an increased odds of prevalent asthma [adjusted odds ratio (aOR)=1.19 (95% CI: 0.98, 1.43)], but not prevalent rhinoconjunctivitis [aOR=1.05 (95% CI: 0.90, 1.22)], during childhood and adolescence. In analyses with phenotypes related to age of onset and persistence of disease, any maternal smoking during pregnancy was associated with early transient asthma [aOR=1.79 (95% CI: 1.14, 2.83)]. Maternal smoking of ≥10 cigarettes/day during pregnancy was associated with persistent asthma [aOR=1.66 (95% CI: 1.29, 2.15)] and persistent rhinoconjunctivitis [aOR=1.55 (95% CI, 1.09, 2.20)]. Tobacco smoke exposure during fetal life, infancy, childhood, and adolescence was not associated with adolescent-onset asthma or rhinoconjunctivitis. CONCLUSIONS: Findings from this combined analysis of five European birth cohorts strengthen evidence linking early exposure to tobacco smoke with asthma during childhood and adolescence. Children with high early-life exposure were more likely than unexposed children to have early transient and persistent asthma and persistent rhinoconjunctivitis. https://doi.org/10.1289/EHP2738.

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