Greenness may improve lung health in low–moderate but not high air pollution areas: Seven Northeastern Cities’ study

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Abstract
Introduction: There is growing interest in the impact of greenness exposure on airway diseases, but the impact of greenness on lung function in children is limited. We aimed to investigate the associations between greenness surrounding schools and lung function in children and whether these associations are modified by air pollution exposure. Methods: Between 2012 and 2013, a cross-sectional survey and spirometry were performed among 6740 school children. Lung function patterns were determined as obstructive forced expiratory volume 1 s/forced vital capacity (FEV 1 /FVC 1 /FVC ≥0.8 but FVC 1 (+57 mL 95% CI 44 to 70) and FVC (+58 mL 95% CI 43 to 73). NDVI was similarly associated with 25% reduced odds of spirometric restriction (OR: 0.75, 95% CI 0.65 to 0.86). However, among children exposed to the highest compared with the lowest quartile of particulate matter, increasing NDVI was paradoxically associated with lower −40 mL FVC (95% CI −47 to –33, p interaction <0.05). Discussion: Our findings suggest that, in this study population, greening urban areas may promote lung health in low–moderate pollution areas but not in high air pollution areas. If the findings are replicated in other moderate-to-high pollution settings, this highlights a need to have a flexible green policy.
Funding Information
  • National Natural Science Foundation of China (81673128, 81703179, 82003409, 91543208)
  • Science and Technology Program of Guangzhou City (201803010054, 201807010032)
  • National Key Research and Development Program of China (2016YFC0207000)
  • Guangdong Province Natural Science Foundation (2016A030313342, 2017A050501062)
  • Fundamental Research Funds for the Central Universities (16ykzd02, 17ykpy16)

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