Journal article
Is local air pollution concentration a moderator or mediator of the association between residential greenspace and pediatric asthma exacerbations? A longitudinal study of pediatric patients in Philadelphia, Pennsylvania
International journal of hygiene and environmental health, v 266, 114546
May 2025
PMID: 40054040
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Despite mixed evidence supporting the link between greenspace and asthma exacerbations, several studies suggest a negative association. The mechanisms underlying this relationship are unclear, with air pollution concentrations potentially playing a key role. This study investigated whether air pollution concentrations modify or mediate the relationship between residential greenspace and pediatric asthma exacerbations.
Data were drawn from a pediatric asthma cohort at Children's Hospital of Philadelphia (2011–2016), including children aged <18 years. Participants were followed from their initial visit until their first asthma exacerbation. Greenspace (tree canopy, grass/shrub cover) near homes was assessed. Daily air pollution data, including PM2.5, ozone, NO2, and SO2, were obtained from the US Environmental Protection Agency. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated, adjusting for individual and neighborhood characteristics. Effect modification by air pollution concentrations was tested, and causal mediation analyses were conducted.
On days with high SO2 concentrations, children living near the highest quartile of tree canopy coverage had a 14% lower incidence of asthma exacerbations compared to those in the lowest quartile (HR = 0.86, 95% CI = 0.74, 0.98). Conversely, on days with low SO2 concentrations, tree canopy coverage was associated with a nonsignificant 12% higher incidence (HR = 1.12, 95% CI = 0.97, 1.28). Similar patterns were observed for NO2, but no interactions were found for PM2.5 or ozone. Mediation analyses indicated no significant mediation by air pollution.
In urban areas with high SO2 or NO2 levels, greenspace near homes may support children with asthma by mitigating air pollution's impact, suggesting greenspace-based urban strategies.
•Children's asthma exacerbations may be mitigated by greenspace near their homes.•The negative association of greenspace varies depending on air pollution types.•Greenspace helps mitigate asthma exacerbations on days with high gaseous air pollution.•Evidence does not suggest air pollution mediates greenspace and asthma exacerbations.
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Details
- Title
- Is local air pollution concentration a moderator or mediator of the association between residential greenspace and pediatric asthma exacerbations? A longitudinal study of pediatric patients in Philadelphia, Pennsylvania
- Creators
- Yun-Ting Yen - Department of Population Health Science and Policy, Ichan School of Medicine at Mount Sinai, New York, NY, USALeah H. Schinasi - Drexel UniversityBrisa N. Sánchez - Drexel UniversitySteven Melly - Drexel UniversityKari Moore - Drexel UniversityChristopher B. Forrest - Children's Hospital of PhiladelphiaChén C. Kenyon - Children's Hospital of PhiladelphiaMichelle C. Kondo - Northern Research StationAnneclaire J. De Roos - Drexel University
- Publication Details
- International journal of hygiene and environmental health, v 266, 114546
- Publisher
- Elsevier
- Number of pages
- 10
- Grant note
- State of PennsylvaniaCommonwealth Universal Research Enhancement (C.U.R.E) program - Pennsylvania Department of Health-2015 Formula award: 4100072543
This study is part of the Pediatric Big Health Data initiative funded by the State of Pennsylvania and led by the Children's Hospital of Philadelphia, University of Pennsylvania, and the Urban Health Collaborative at Drexel University. We would like to thank the investigators of the Pediatric Big Health Data initiative for their contributions. This work was supported by a grant from the Commonwealth Universal Research Enhancement (C.U.R.E) program funded by the Pennsylvania Department of Health-2015 Formula award-AP #4100072543.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics; Environmental and Occupational Health
- Web of Science ID
- WOS:001444534500001
- Scopus ID
- 2-s2.0-85219547575
- Other Identifier
- 991022040179604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Infectious Diseases
- Public, Environmental & Occupational Health