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Exposure to green space and pollen allergy symptom severity: A case-crossover study in Belgium
Journal Contribution - Journal Article
Background: The prevalence of pollen allergy has increased due to urbanization, climate change and air pollution.The effects of green space and air pollution on respiratory health of pollen allergy patients are complex and beststudied in spatio-temporal detail.Methods:We tracked 144 adults sensitized to Betulaceae pollen during the tree pollen season (January–May) of2017 and 2018 and assessed their spatio-temporal exposure to green space, allergenic trees, air pollutants and birch pollen. Participants reported daily symptom severity scores.We extracted 404 case days with high symptomseverityscores and matched these to 404 control days. The data were analyzed using conditional logistic regressionwith a 1:1 case-crossover design.Results: Case days were associated with exposure to birch pollen concentration (100 grains/m3) [adjusted oddsratio 1.045 and 95% confidence interval (1.014–1.078)], O3 concentration (10 μg/m3) [1.504 (1.281–1.766)]and PM10 concentration (10 μg/m3) [1.255 (1.007–1.565)] on the day of the severe allergy event andwith the cumulativeexposure of one and two days before. Exposure to grass cover (10% area fraction) [0.655 (0.446–0.960)],forest cover (10% area fraction) [0.543 (0.303–0.973)] and density of Alnus (10%) [0.622 (0.411–0.942)] wereprotective for severe allergy, but only on the day of the severe allergy event. Increased densities of Betula trees(10%) were a risk factor [unadjusted OR: 2.014 (1.162–3.490)].Conclusion: Exposure to green space may mitigate tree pollen allergy symptom severity but only when the densityof allergenic trees is low. Air pollutants contribute to more severe allergy symptoms. Spatio-temporal trackingallows for a more realistic exposure assessment.
Journal: Science of the Total Environment
Number of pages: 10