PT - JOURNAL ARTICLE AU - Elaine Fuertes AU - Iana Markevych AU - Andrea von Berg AU - Carl-Peter Bauer AU - Dietrich Berdel AU - Sibylle Koletzko AU - Dorothea Sugiri AU - Joachim Heinrich TI - Greenness and allergies: evidence of differential associations in two areas in Germany AID - 10.1136/jech-2014-203903 DP - 2014 Aug 01 TA - Journal of Epidemiology and Community Health PG - 787--790 VI - 68 IP - 8 4099 - http://jech.bmj.com/content/68/8/787.short 4100 - http://jech.bmj.com/content/68/8/787.full SO - J Epidemiol Community Health2014 Aug 01; 68 AB - 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.