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Abstract
Given the drastic changes in our lifestyles and ecosystems worldwide, the potential health effects of natural environments have grown into a highly pervasive topic. Recent scientific findings suggest beneficial effects from nature exposure on human immune responses. This review aims at providing a comprehensive overview of literature published on immunomodulatory effects of nature exposure by inhalation of natural substances. A systematic database search was performed in SCOPUS and PubMed. The quality and potential bias of included studies (n = 33) were assessed by applying the EPHPP (Effective Public Health Practice Project) tool for human studies and the ARRIVE (Animal Research: Reporting of In Vivo Experiments) and SYRCLE (Systematic Review Centre for Laboratory Animal Experimentation) tools for animal studies. The synthesis of reviewed studies points to positive effects of nature exposure on immunological health parameters; such as anti-inflammatory, anti-allergic, anti-asthmatic effects or increased NK (natural killer) cell activity. Decreased expression of pro-inflammatory molecules, infiltration of leukocytes and release of cytotoxic mediators are outcomes that may serve as a baseline for further studies. However, partially weak study designs evoked uncertainties about outcome reproducibility and key questions remain open concerning effect sizes, duration of exposure and contributions of specific vegetation or ecosystem types.
Highlights
During the last century, environmental degradation and urbanisation have caused drastic changes in our lifestyles and living environments [1,2]
This review focuses on direct mechanisms by which nature can affect human health, on air-borne compounds emitted by natural environments that have the potential to modulate immunological responses when inhaled, such as biogenic volatile organic compounds (BVOCs), terpenes, essential oils, charged ions, pollen, fungi and bacteria
The findings on natural killer (NK) cell distributions were underlined by positive results from one laboratory experiment simulating BVOC exposure in natural environments [58]; this study provided no control group and must be interpreted cautiously
Summary
Environmental degradation and urbanisation have caused drastic changes in our lifestyles and living environments [1,2]. More than half of the world’s population live in urban areas [3], and advancements of the digital era have led to a substantial rise in screen time and time spent indoors along with a decline in outdoor activities, especially in the developed world [4]. This has caused a loss of interaction between humans and nature and a progressing feeling of disconnection from the natural world, which can be defined as everything that exists independently of human conduct [5].
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