•Very little is known about the effect of greenspaces on respiratory health.•Repeated data on greenspaces and lung function up to 24 years of age were analysed.•Children living in more vegetated ...places may have better lung function.•Children living near urban green spaces may have better lung function.•Air pollution and urbanicity could play a role, but further studies are warranted.
Residing in greener areas is increasingly linked to beneficial health outcomes, but little is known about its effect on respiratory health.
We examined associations between residential greenness and nearby green spaces with lung function up to 24 years in the UK Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort.
Lung function was measured by spirometry at eight, 15 and 24 years of age. Greenness levels within circular buffers (100–1000 m) around the birth, eight-, 15- and 24-year home addresses were calculated using the satellite-derived Normalized Difference Vegetation Index and averaged (lifetime greenness). The presence and proportion of green spaces (urban green spaces, forests and agricultural land) within a 300 m buffer was determined. First, associations between repeated greenness and green space variables and repeated lung function parameters were assessed using generalized estimation equations (N = 7094, 47.9% male). Second, associations between lifetime average greenness and lifetime average proportion of green spaces with lung function at 24-years were assessed using linear regression models (N = 1763, 39.6% male). All models were adjusted for individual and environmental covariates.
Using repeated greenspace and lung function data at eight, 15 and 24 years, greenness in a 100 m buffer was associated with higher FEV1 and FVC (11.4 ml 2.6, 20.3 and 12.2 ml 1.8, 22.7, respectively, per interquartile range increase), as was the presence of urban green spaces in a 300 m buffer (20.3 ml −0.1, 40.7 and 23.1 ml -0.3, 46.5 for FEV1 and FVC, respectively). These associations were independent of air pollution, urbanicity and socio-economic status. Lifetime average greenness within a 100 m buffer and proportion of agricultural land within a 300 m buffer were associated with better lung function at 24 years but adjusting for asthma attenuated these associations.
This study provides suggestive evidence that children whose homes are in more vegetated places or are in close proximity of green spaces have better lung function up to 24 years of age.
Body composition changes throughout life may explain the inconsistent associations reported between body mass index and lung function in children.
To assess the associations of body weight and ...composition trajectories from 7 to 15 years with lung function at 15 years and lung function growth between 8 and 15 years.
Sex-specific body mass index, lean body mass index, and fat mass index trajectories were developed using Group-Based Trajectory Modeling on data collected at least twice between 7 and 15 years from 6,964 children (49% boys) in the UK Avon Longitudinal Study of Parents and Children birth cohort. Associations of these trajectories with post-bronchodilation lung function parameters at 15 years and with lung function growth rates from 8 to 15 years were assessed using multivariable linear regression models, stratified by sex, in a subgroup with lung function data (
= 3,575).
For all body mass measures we identified parallel trajectories that increased with age. There was no consistent evidence of an association between the body mass index trajectories and lung function measures. Higher lean body mass index trajectories were associated with higher levels and growth rates of FVC, FEV
, and forced expiratory flow, midexpiratory phase in both sexes (e.g., boys in the highest lean body mass index trajectory had on average a 0.62 L 95% confidence interval, 0.44-0.79;
trend < 0.0001 higher FVC at 15 yr than boys in the lowest trajectory). Increasing fat mass index trajectories were associated with lower levels and growth rates of FEV
and forced expiratory flow, midexpiratory phase only in boys and lower levels of FEV
/FVC in both sexes.
Higher lean body mass during childhood and adolescence is consistently associated with higher lung function at 15 years in both sexes, whereas higher fat mass is associated with lower levels of only some lung function parameters.
Associations between early traffic-related air pollution (TRAP) exposure and respiratory and allergic morbidity in adolescents are inconsistent. However, sub-groups might be more vulnerable to the ...health effects of this exposure.
We investigated associations between early exposure to TRAP and respiratory and allergic morbidity at age 13 years in the PARIS birth cohort, and potential modifying effects of sex, parental allergy, stressful family event and lower respiratory tract infections (LRTI).
This study deals with data from 732 children of the PARIS birth cohort followed up using repeated questionnaires until 13 years of age. Prenatal TRAP exposure was assessed by measuring daily concentrations of nitrogen dioxide at the nearest station to mother's home. Early postnatal TRAP exposure was calculated for each child during the first year of life by a nitrogen oxides (NOx) air dispersion model taking into account both residence and daycare. Associations between TRAP exposures and asthma, rhinitis and related symptoms were assessed using multivariable logistic regression models adjusted for potential confounding factors. Effect modification was explored by testing multiplicative interactions.
An increase in interquartile range (17.0 μg/m3) of early postnatal NOx exposure was positively related to current asthma (adjusted odds ratio aOR = 1.21; 95% confidence interval CI: 1.02, 1.43), severe wheeze (aOR = 1.23; 95% CI: 1.02, 1.47) and persistent asthma at 13 years old (aOR = 1.26; 95% CI: 1.03, 1.55) and tended to be associated with asthma ever. Parental history of allergy, asthma, early stressful family event and LRTI modified these associations with TRAP exposure. No relationship with rhinitis was found. Prenatal TRAP exposure did not show any association with respiratory and allergic morbidity.
This study is one of the first to show several modifiers of the association between early postnatal TRAP exposure and asthma at adolescence. Not all adolescents seem equally affected by early postnatal TRAP exposure: those presenting parental history of allergy, especially asthma, those with early stressful family event or LRTI appear to be more vulnerable.
Indoor environmental conditions (thermal, noise, light, and indoor air quality) may affect workers' comfort, and consequently their health and well-being, as well as their productivity. This study ...aimed to assess the relations between perceived indoor environment and occupants' comfort, and to examine the modifying effects of both personal and building characteristics. Within the framework of the European project OFFICAIR, a questionnaire survey was administered to 7441 workers in 167 "modern" office buildings in eight European countries (Finland, France, Greece, Hungary, Italy, The Netherlands, Portugal, and Spain). Occupants assessed indoor environmental quality (IEQ) using both crude IEQ items (satisfaction with thermal comfort, noise, light, and indoor air quality), and detailed items related to indoor environmental parameters (e.g., too hot/cold temperature, humid/dry air, noise inside/outside, natural/artificial light, odor) of their office environment. Ordinal logistic regression analyses were performed to assess the relations between perceived IEQ and occupants' comfort. The highest association with occupants' overall comfort was found for "noise", followed by "air quality", "light" and "thermal" satisfaction. Analysis of detailed parameters revealed that "noise inside the buildings" was highly associated with occupants' overall comfort. "Layout of the offices" was the next parameter highly associated with overall comfort. The relations between IEQ and comfort differed by personal characteristics (gender, age, and the Effort Reward Imbalance index), and building characteristics (office type and building's location). Workplace design should take into account both occupant and the building characteristics in order to provide healthier and more comfortable conditions to their occupants.
Abstract
Background
Although physical activity has many known health benefits, its association with lung function in childhood/adolescence remains unclear. We examined the association of ...physical-activity trajectories between 11 and 15 years with lung function at 15 years in 2266 adolescents.
Methods
A population-based cohort of 14 305 singleton births alive at 1 year was recruited in the UK population-based Avon Longitudinal Study of Parents and Children cohort. Physical activity (counts/minute and moderate-to-vigorous physical activity) was assessed for 7 days using an accelerometer at 11, 13 and 15 years. We identified sex-specific physical-activity trajectories applying K-means for longitudinal data in children with at least two accelerometer measurements (n = 3584). We then estimated the sex-specific associations of these trajectories with post-bronchodilation lung-function parameters using multivariable linear-regression models (n = 2266, 45% boys).
Results
Fewer than 7% of participants met the WHO physical-activity recommendations (i.e. daily average of at least 60 minutes of moderate-to-vigorous physical activity). Boys were substantially more active than girls. In both sexes, we identified three distinct physical-activity trajectories (‘low’: 39.8% boys, 45.8% girls; ‘moderate’: 42.9% boys, 41.4% girls; and ‘high’ physical activity: 17.3% boys, 12.8% girls). Girls in the moderate and high physical-activity trajectories had 0.11 L 95% confidence interval (CI): 0.04–0.19 and 0.15 L (95% CI: 0.03–0.26) higher forced vital capacity than their less-active peers. No association was observed in boys.
Conclusions
Higher childhood physical activity relates to higher lung-function levels in adolescent girls. A better understanding of the mechanisms underlying this association should be pursued.
This cross-sectional study aimed to determine which objective built environmental factors, identified using a virtual neighbourhood audit, were associated with cycling for transport in adults living ...in five urban regions across Europe. The moderating role of age, gender, socio-economic status and country on these associations was also investigated. Overall, results showed that people living in neighbourhoods with a preponderance of speed limits below 30km/h, many bicycle lanes, with less traffic calming devices, more trees, more litter and many parked cars forming an obstacle on the road were more likely to cycle for transport than people living in areas with lower prevalence of these factors. Evidence was only found for seven out of 56 possible moderators of these associations. These results suggest that reducing speed limits for motorized vehicles and the provision of more bicycle lanes may be effective interventions to promote cycling in Europe.
•Speed limits below 30km/h were associated with more cycling for transport.•The presence of bicycle lanes was associated with more cycling for transport.•These associations were similar across different subgroups.
Missing data are unavoidable in environmental epidemiologic surveys. The aim of this study was to compare methods for handling large amounts of missing values: omission of missing values, single and ...multiple imputations (through linear regression or partial least squares regression), and a fully Bayesian approach. These methods were applied to the PARIS birth cohort, where indoor domestic pollutant measurements were performed in a random sample of babies' dwellings. A simulation study was conducted to assess performances of different approaches with a high proportion of missing values (from 50% to 95%). Different simulation scenarios were carried out, controlling the true value of the association (odds ratio of 1.0, 1.2, and 1.4), and varying the health outcome prevalence. When a large amount of data is missing, omitting these missing data reduced statistical power and inflated standard errors, which affected the significance of the association. Single imputation underestimated the variability, and considerably increased risk of type I error. All approaches were conservative, except the Bayesian joint model. In the case of a common health outcome, the fully Bayesian approach is the most efficient approach (low root mean square error, reasonable type I error, and high statistical power). Nevertheless for a less prevalent event, the type I error is increased and the statistical power is reduced. The estimated posterior distribution of the OR is useful to refine the conclusion. Among the methods handling missing values, no approach is absolutely the best but when usual approaches (e.g. single imputation) are not sufficient, joint modelling approach of missing process and health association is more efficient when large amounts of data are missing.
Few studies have examined the overall experience of adolescents and their families during COVID-19 lockdowns. This study describes COVID-19-related morbidity in the PARIS birth cohort families during ...the first lockdown in France and identifies family profiles in terms of morbidity, perception, behaviors, and attitudes.
Online questionnaires were sent to adolescents of the PARIS birth cohort and their parents. Possible COVID-19 was defined by symptoms using the ECDC definition. Household transmission was estimated by calculating the observed clinical secondary attack rates. Perception, behaviors and attitudes were assessed by levels of stress, degree of satisfaction regarding levels of information about COVID-19, degree of agreement with the lockdown and preventive measures. COVID-19 morbidity in adolescents and parents was compared using chi-squared or Student's
-tests. Within each family, perception, behaviors, and attitudes were compared between adolescents and parents using matched-pairs tests. To identify contrasting family profiles, a K-means cluster analysis was implemented.
Of 1,549 families contacted, 1,051 (68%) participated. Adolescents were less affected by possible COVID-19 than their parents (138.7 vs. 192.7 per 1,00,000 person-days). Household transmission of possible COVID-19 was higher when possible COVID-19 came from adults than from adolescents. Most families implemented preventive measures. Adolescents and parents generally shared the same attitudes, but adolescents were less compliant with restrictive measures. Four family profiles were identified which differed mainly regarding family stress, COVID-19 in the household, and compliance with preventive measures.
Improving information dissemination to parents and adolescents, including dedicated adolescent messages, would increase adherence to preventive measures.
Background
The Mediterranean diet (MD) has known health benefits, but its specific impact on allergy development is unclear. As part of the PARIS birth cohort follow‐up, we aimed to investigate the ...adherence of 8‐year‐old children to the MD and its association with allergic/respiratory morbidity at school age.
Methods
Diet was assessed using a food frequency questionnaire completed by the parents. Adherence to the MD was assessed based on two scores: the KIDMED index and the Mediterranean Diet Score (MDS). Current allergic diseases (asthma, rhinitis, eczema), lung function indices (FEV1 and FVC), FeNO and specific IgE levels were determined during a health check‐up at 8 years. Associations between levels of adherence to the MD and respiratory/allergic morbidity were studied using multivariable logistic and linear regression models adjusted for potential confounders.
Results
A total of 975 children were included in the present study, 35.6% with low adherence to the MD, 55.7% with moderate adherence and 8.7% with high adherence according to the KIDMED index. High family socioeconomic status, any breastfeeding at 6 months and consumption of organic food were associated with higher adherence to the MD. Compared with low adherence, high adherence was associated with lower risk of asthma and sensitization at 8 years, as well as higher FEV1 and FVC.
Conclusion
This study suggests a protective effect of high adherence to the MD on allergic and respiratory morbidity at school age. These results need to be confirmed by further longitudinal analyses. A healthy diet may prevent allergic and respiratory morbidity in school‐aged children.
Background
Exercise training optimizes cardiorespiratory fitness (CRF) after bariatric surgery, but the effect of spontaneous physical activity is not well known. This study aimed to objectively ...quantify changes in CRF and habitual physical activity 6 months after bariatric surgery and to examine whether change in CRF was related to change in physical activity.
Methods
Secondary analyses were performed on data from women who underwent Roux-en-Y gastric bypass (RYGB) between 2010 and 2014. Measurements were performed before and 6 months after RYGB and included V̇O
2
peak (graded maximal exercise test on a cycle ergometer), habitual physical activity (Actigraph GT3x accelerometer worn during 7 days), and body composition (DXA absorptiometry). Changes after RYGB were analyzed using Wilcoxon signed-rank test. Relations between change in CRF and change in physical activity were analyzed with Spearman correlations adjusted on age and preoperative BMI.
Results
Forty-five women (median P
25
–P
75
age, 43.0 38.0–51.0 year; BMI, 42.6 40.0–45.5 kg/m
2
) were included. Mean (SD) weight loss 6 months after RYGB was − 27.5 (7.9) kg (
P
< 0.001). Absolute V̇O
2
peak decreased by 0.35 (0.50) L/min (
P
< 0.001) and relative V̇O
2
peak tended to increase by 1.7 (5.3) mL/kg/min (
P
= 0.06), both with large inter-individual variability. Based on objective accelerometry data, daily steps and moderate-to-vigorous physical activity increased by 1275 (3164) steps/day and 7.6 (19.3) min/day, respectively (both
P
< 0.05). Change in absolute V̇O
2
peak was positively related to change in moderate-to-vigorous physical activity (
r
= 0.35;
P
= 0.03).
Conclusions
The decrease in absolute CRF observed 6 months after RYGB might be prevented by increasing habitual physical activity.
Trial Registration
clinicaltrials.gov
identifier: NCT01113996
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