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Short report
Greenness and allergies: evidence of differential associations in two areas in Germany
  1. Elaine Fuertes1,2,
  2. Iana Markevych1,3,
  3. Andrea von Berg4,
  4. Carl-Peter Bauer5,
  5. Dietrich Berdel4,
  6. Sibylle Koletzko6,
  7. Dorothea Sugiri7,
  8. Joachim Heinrich1
  1. 1Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany
  2. 2School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  3. 3Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
  4. 4Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
  5. 5Department of Pediatrics, Technical University of Munich, Munich, Germany
  6. 6Division of Paediatric Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
  7. 7IUF—Leibniz Research Institute for Environmental Medicine, University of Düsseldorf, Düsseldorf, Germany
  1. Correspondence to Joachim Heinrich, Institute of Epidemiology I, Helmholtz Zentrum München, German Research Centre for Environmental Health, Ingolstädter Landstr. 1, Neuherberg 85764, Germany; heinrich{at}helmholtz-muenchen.de

Abstract

Background Positive greenness effects on health are increasingly reported, although studies on allergic outcomes remain limited and conflicting. We examined whether residential greenness is associated with childhood doctor diagnosed allergic rhinitis, eyes and nose symptoms and aeroallergen sensitisation using two combined birth cohorts (GINIplus and LISAplus) followed from birth to 10 years in northern and southern Germany (Ntotal=5803).

Methods Mean residential greenness in a 500 m buffer around the 10-year home addresses was defined using the Normalized Difference Vegetation Index, a green biomass density indicator. Longitudinal associations were assessed per study area (GINI/LISA South and GINI/LISA North) using generalised estimation equations adjusted for host and environmental covariates.

Results Despite identical study designs and statistical modelling, greenness effects differed across the two study areas. Associations were elevated for allergic rhinitis and eyes and nose symptoms in the urban GINI/LISA South area. In contrast, risk estimates were significantly below one for these outcomes and aeroallergen sensitisation in rural GINI/LISA North. Area-specific associations were similar across buffer sizes and addresses (birth and 6 years) and remained heterogeneous after air pollution and population density stratification.

Conclusions Existing and future single-area studies on greenness and green spaces should be interpreted with caution.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/jech-2014-203903

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