綠地暴露對學校兒童過敏性鼻炎的影響

Abstract

背景 過敏性鼻炎(Allergic Rhinitis，AR)是最常見的呼吸道過敏性疾病之一。綠地暴露會透過許多不同的途徑來影響人類健康。不同於空氣污染，綠地暴露對於健康大多帶來正面效應。然而在過敏性疾病上，綠地暴露的影響證據仍然不充份且相互矛盾。因此，本研究的目的是調查綠地暴露對於學校兒童過敏性鼻炎的影響。 研究材料及方法 本研究於2011年在全台行政院環境保護署(Environmental Protection Agency，EPA)共24個空氣品質監測站1公里範圍內的23所小學和22所國中的學生進行了呼吸系統疾病的問卷調查。在全部7154名受訪者中，共有6346名學生完成了問卷調查。我們從空氣監測站獲得了從2000年至2010年間5種空氣污染物濃度的年平均值，並使用常態化差值植生指標(NDVI)評估了綠地暴露並採用了廣義估計方程式模型來研究綠地暴露與兒童過敏性鼻炎風險的關係。 結果 研究顯示在以學校為中心250公尺、500 公尺和1000公尺環形緩衝區的常態化差值植生指標(NDVI)與兒童過敏性鼻炎呈現負相關，且具有統計學上的意義。在主要模型中，250公尺、500公尺和1000公尺環形緩衝距離中的NDVI每增加0.1個單位，過敏性鼻炎的調整後勝算比(adjusted odds ratios)分別為0.87(95%信賴區間：0.81，0.94)、0.88(95%信賴區間：0.81，0.96)和0.91(95%信賴區間：0.82，1.00)，這個效應在額外調整空氣污染物包括懸浮微粒(PM10)，二氧化氮(NO2)、二氧化硫(SO2)和臭氧(O3)後並未受影響。 結論 我們的研究結果顯示學校周圍的綠地暴露與兒童時期醫生診斷的過敏性鼻炎間存在保護性關聯。這個發現為綠地暴露對於呼吸健康影響的有限研究增加了新的證據。

Background Allergic rhinitis (AR) is one of the most common allergic diseases. In contrast to air pollution, greenness affects human health through many different pathways that may promote health, but evidence on the effect of greenness on allergic diseases remains conflicting and inconclusive. Therefore, the aim of the study is to investigate the influence of greenness on schoolchildren AR. Methods In 2011, a nationwide questionnaire survey on respiratory diseases was conducted among Taiwanese students. The survey covered 23 elementary schools and 22 middle schools located within a 1-kilometer radius of 24 Taiwan Environmental Protection Administration (EPA) air monitoring stations. Questionnaires were completed by a total of 6346 students out of 7154 candidates. Annual averages of 5 air pollutant concentrations were obtained from EPA stations, and vegetation exposure was assessed using Normalized Difference Vegetation Index (NDVI) from 2000 to 2010. Generalized estimating equation models were used to examine the association between greenness and the risk of AR. Results The results showed that NDVI within circular buffer zones of 250m、500m and 1000m around schools was negatively and statistically significantly associated with childhood allergic rhinitis. Higher NDVI values were associated with lower odds of AR. For a 0.1 unit increase in NDVI 250m, NDVI 500m, and NDVI 1000m, the adjusted odds ratios of AR were 0.87 (95% confidence interval: 0.81, 0.94), 0.88 (95% confidence interval: 0.81, 0.96), and 0.91 (95% confidence interval: 0.82, 1.00), respectively, in the main model, and the effect estimates were not affected by additional adjustment for air pollutants, including PM10, NO2, SO2, and O3 Conclusion Our findings suggest a protective association of green space around schools with physician-diagnosed allergic rhinitis in childhood. These findings add new evidence to the limited research on the respiratory health effects of greenness.