Influence of residential land cover on childhood allergic and respiratory symptoms and diseases: Evidence from 9 European cohorts

Eija Parmes (Corresponding Author), Giancarlo Pesce (Corresponding Author), Clive Sabel, Sandra Baldacci, Roberto Bono, Sonia Brescianini, Cristina D'Ippolito, Wojciech Hanke, Milena Horvat, Hilkka Liedes, Sara Maio, Pierpaolo Marchetti, Alessandro Marcon, Emmanuela Medda, Matthieu Molinier, Silvia Panunzi, Juha Pärkkä, Kinga Polanska, Julie Prud'homme, Paolo RicciJanja Snoj Tratnik, Giulia Squillacioti, Maria Antonietta Stazi, Cara Maesano, Isabella Annesi-Maesano

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73 Citations (Scopus)


Introduction: Recent research focused on the interaction between land cover and the development of allergic and respiratory disease has provided conflicting results and the underlying mechanisms are not fully understood. In particular, green space, which confers an overall positive impact on general health, may be significantly contributing to adverse respiratory health outcomes. This study evaluates associations between surrounding residential land cover (green, grey, agricultural and blue space), including type of forest cover (deciduous, coniferous and mixed), and childhood allergic and respiratory diseases. Methods: Data from 8063 children, aged 3–14 years, were obtained from nine European population-based studies participating in the HEALS project. Land-cover exposures within a 500 m buffer centred on each child's residential address were computed using data from the Coordination of Information on the Environment (CORINE) program. The associations of allergic and respiratory symptoms (wheeze, asthma, allergic rhinitis and eczema) with land coverage were estimated for each study using logistic regression models, adjusted for sex, age, body mass index, maternal education, parental smoking, and parental history of allergy. Finally, the pooled effects across studies were estimated using meta-analyses. Results: In the pooled analyses, a 10% increase in green space coverage was significantly associated with a 5.9%–13.0% increase in the odds of wheezing, asthma, and allergic rhinitis, but not eczema. A trend of an inverse relationship between agricultural space and respiratory symptoms was observed, but did not reach statistical significance. In secondary analyses, children living in areas with surrounding coniferous forests had significantly greater odds of reporting wheezing, asthma and allergic rhinitis. Conclusion: Our results provide further evidence that exposure to green space is associated with increased respiratory disease in children. Additionally, our findings suggest that coniferous forests might be associated with wheezing, asthma and allergic rhinitis. Additional studies evaluating both the type of green space and its use in relation to respiratory conditions should be conducted in order to clarify the underlying mechanisms behind associated adverse impacts.

Original languageEnglish
Article number108953
JournalEnvironmental Research
Publication statusPublished - Apr 2020
MoE publication typeA1 Journal article-refereed


  • land cover
  • green space
  • forests
  • allergy
  • asthma


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