Association between street view greenness and allergic rhinitis in children
方法 2012—2013年，在我国东北地区3个城市40868名2~17岁儿童青少年中开展了1项横断面研究，其中男孩20886人（51.1%）、女孩19982人（48.9%），通过问卷调查获得AR患病的相关信息。应用人工智能方法提取2012—2013年腾讯街景图像中的绿地信息（包括树木和草地等），计算研究对象所在学校附近（800 m和1000 m缓冲区）的绿景指数（GVI），并将其作为绿地空间暴露的评价指标。应用混合效应logistic回归模型评估GVI每增加1个四分位间距（IQR），AR患病的比值比（OR）。此外，根据PM2.5暴露情况，将研究对象分为PM2.5低暴露组（≤56.23 μg·m−3）和高暴露组（>56.23 μg·m−3），并探讨PM2.5是否在GVI与AR的关联中发挥效应修正作用。
结果 研究对象的年龄为（10.40±3.68）岁，其中3 963（9.7%）人曾经被医生诊断为AR。调整协变量后，在800 m缓冲区，树木和总绿地的GVI每增加1个IQR（树木：0.031；总绿地：0.029），AR的OR及95%CI值分别降低15%（10%~19%）和14%（10%~19%）。PM2.5与GVI的交互作用存在统计学意义（P＜0.1），在PM2.5低暴露组中树木和总绿地的GVI与AR患病率降低相关，而在PM2.5高暴露组则无关联。应用1000 m缓冲区GVI进行敏感性分析，其所得结果与800 m缓冲区基本一致。
Background Studies on the association between greenness exposure and allergic rhinitis (AR) in children are mostly conducted in developed countries, and the conclusion is not consistent.
Objective Using street view data to explore the association between greenness exposure and allergic rhinitis (AR) prevalence in Chinese children.
Methods A cross-sectional study was conducted among 40868 children aged 2-17 years in three cities of Northeast China from 2012 to 2013, which consisted of 20886 (51.1%) boys and 19982 (48.9%) girls. The information of AR prevalence was obtained through questionnaire. Based on downloaded street view images from Tencent Maps, a green view index (GVI) of green vegetation (trees and grass) within 800 m and 1000 m buffer of the participants' schools was calculated by using artificial intelligence, and it was used as a surrogate of the greenness exposure. A mixed-effect logistic regression model was used to estimate the odds ratio (OR) of AR prevalence in children for per increase of inter-quartile range (IQR) of GVI. In addition, according to ambient PM2.5 concentration, the participants were divided into a low PM2.5 exposure group (≤56.23 μg·m−3) and a high exposure group (>56.23 μg·m−3) to investigate whether PM2.5 was a modifier on the association between GVI and AR.
Results The average age of the subjects was (10.40±3.68) years and 3 963 (9.7%) subjects reported diagnosed AR. Within 800 m buffer, an IQR increase in GVI for trees (IQR=0.031,OR=0.85, 95%CI: 0.81-0.90) and overall greenness (IQR=0.029, OR=0.86, 95%CI: 0.81-0.90) was associated with lower adjusted odds ratio of AR. The interaction between PM2.5 and GVI was statistically significant (P< 0.1), that is, the negative associations of trees and overall greenness with AR were observed only at low PM2.5 exposure levels. The sensitivity analysis results of GVI within 1000 m buffer was consistent with that within 800 m buffer.
Conclusion Exposure to green vegetation, especially trees, may be associated with decreased risks of AR in children, and such associations may be more obvious in areas with a low PM2.5concentration.