Abstract
Children are in contact with local environments, which may affect respiratory symptoms and allergic sensitization. We aimed to assess the effect of the environment and the walkability surrounding schools on lung function, airway inflammation and autonomic nervous system activity. Data on 701 children from 20 primary schools were analysed. Lung function, airway inflammation and pH from exhaled breath condensate were measured. Pupillometry was performed to evaluate autonomic activity. Land use composition and walkability index were quantified within a 500 m buffer zone around schools. The proportion of effects explained by the school environment was measured by mixed-effect models. We found that green school areas tended to be associated with higher lung volumes (FVC, FEV1 and FEF25–75%) compared with built areas. FVC was significantly lower in-built than in green areas. After adjustment, the school environment explained 23%, 34% and 99.9% of the school effect on FVC, FEV1, and FEF25–75%, respectively. The walkability of school neighbourhoods was negatively associated with both pupil constriction amplitude and redilatation time, explaining −16% to 18% of parasympathetic and 8% to 29% of sympathetic activity. Our findings suggest that the environment surrounding schools has an effect on the lung function of its students. This effect may be partially mediated by the autonomic nervous system.
Highlights
Symptoms[4,5]
In asthmatics patients, increased basal parasympathetic tone is observed[10,11]. This results in constricted airways and an enhanced bronchoconstriction response to different inhaled agents that are known to stimulate airway C-fibre sensory nerves[12,13]. Their activation due to environmental exposure may lead to the release of neuropeptides locally by transient receptor potential (TRP) cation channels, resulting in cough, airway irritation, mucous secretion, and bronchoconstriction mediated by the efferent pathways of the autonomic nervous system[14,15]
An increased proportion of built areas in the school neighbourhood was associated with significantly lower values of FVC, while green areas showed a tendency to be associated with higher values of FVC, FEV1 and FEF25–75% (Supplementary Table S1)
Summary
Symptoms[4,5]. the pathways whereby they influence lung function and the development of asthma are complex and interactive. This results in constricted airways and an enhanced bronchoconstriction response to different inhaled agents that are known to stimulate airway C-fibre sensory nerves[12,13] Their activation due to environmental exposure may lead to the release of neuropeptides locally by transient receptor potential (TRP) cation channels, resulting in cough, airway irritation, mucous secretion, and bronchoconstriction mediated by the efferent pathways of the autonomic nervous system[14,15]. These mechanisms are associated with urban factors and with individual determinants and behaviours, such as physical activity, diet, and obesity[16,17]. The aim of the present study was to evaluate the effect of school neighbourhoods and their walkability on lung function, airway inflammation and autonomic nervous system activity in children
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