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. 2022 Jan 4;19(1):512.
doi: 10.3390/ijerph19010512.

Association between Asthma Control and Exposure to Greenness and Other Outdoor and Indoor Environmental Factors: A Longitudinal Study on a Cohort of Asthmatic Children

Giovanna Cilluffo  1   2 , Giuliana Ferrante  3 , Salvatore Fasola  1 , Velia Malizia  1 , Laura Montalbano  1 , Andrea Ranzi  4 , Chiara Badaloni  5 , Giovanni Viegi  1   6 , Stefania La Grutta  1
Affiliations

Association between Asthma Control and Exposure to Greenness and Other Outdoor and Indoor Environmental Factors: A Longitudinal Study on a Cohort of Asthmatic Children

Giovanna Cilluffo et al. Int J Environ Res Public Health. .

Abstract

Achieving and maintaining asthma control (AC) is the main goal of asthma management. Indoor and outdoor environmental factors may play an important role on AC. The aim of this longitudinal study was to evaluate the association between AC and exposure to greenness and other outdoor or indoor environmental factors in a cohort of asthmatic children. This study involved 179 asthmatic children (5-16 years). Parents were interviewed through a modified version of the SIDRIA questionnaire. AC was assessed at each visit. Exposure to greenness was measured using the normalized difference vegetation index (NDVI). A logistic regression model was applied for assessing risk factors for uncontrolled asthma (UA). Low NDVI exposure was a risk factor for UA (OR: 2.662, 95% CI (1.043-6.799)); children exposed to passive smoke during pregnancy had a higher risk of UA than those non-exposed to passive smoke during pregnancy (OR: 3.816, 95% CI (1.114-13.064)); and a unit increase in the crowding index was associated with an increased risk of UA (OR: 3.376, 95% CI (1.294-8.808)). In conclusion, the current study provided a comprehensive assessment of urban-related environmental exposures on asthma control in children, using multiple indicators of greenness and other outdoor or indoor environmental factors.

Trial registration: ClinicalTrials.gov NCT02433275.

Keywords: CORINE Land Cover; NDVI; asthma control; children; greenness; land use regression.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
CLC category map of geo-coded children. Green points indicate the residence of each child and colored polygons identify the CORINE Land Cover categories.
Figure 3
Figure 3
ORs and 95% CI of the mixed-effect logistic regression model for asthma control.
Figure 4
Figure 4
ORs and 95% CI of the mixed-effect logistic regression model for asthma control: a sensitivity analysis after missing values imputation.
Figure 5
Figure 5
ORs and 95% CI of the mixed-effect logistic regression model for asthma control: sensitivity analysis adjusting for physical activity (>3 times per week).
See this image and copyright information in PMC

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