Greenness and Respiratory Health in Childhood

Exposure to natural vegetation in residential and recreational environments has been proposed to influence respiratory health in children through multiple pathways. Green spaces can improve air quality by filtering pollutants, mitigate urban heat islands, and promote microbial diversity that may support immune development. They also encourage physical activity and reduce stress, both of which contribute to better lung function. However, vegetation may release pollen and volatile organic compounds that exacerbate allergic sensitisation, and poorly managed green areas can harbour mould or traffic‐related pollutants. Epidemiological studies have produced mixed findings, with some reporting protective associations between greenness and reduced asthma prevalence or wheeze, while others note null or even adverse effects on lung function and allergic outcomes. Socioeconomic context, green‐space type, spatial scale and co-exposures to air pollution appear to modify these relationships. A nuanced understanding of how vegetation characteristics, timing of exposure and urban planning intersect is essential for translating research into policies that optimise respiratory benefits for children globally.

Research from Nature Portfolio

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Greenness and Respiratory Health in Childhood publication trend

The graph below shows the total number of articles in greenness and respiratory health in childhood across all publications each year (not limited to Nature Index journals).

Technical terms

Normalized Difference Vegetation Index (NDVI): A remote-sensing metric that quantifies green vegetation density by comparing near-infrared and red light reflected by land cover.

Forced expiratory volume in one second (FEV₁): The volume of air expelled during the first second of a forced exhalation, used to assess airway obstruction.

Forced vital capacity (FVC): The total volume of air exhaled during a maximal forced breath, reflecting lung volume and compliance.

Particulate matter (PM₂.₅): Fine inhalable particles with aerodynamic diameter less than 2.5 micrometres, associated with respiratory morbidity.

Causal mediation analysis: A statistical approach to disentangle direct effects of an exposure on an outcome from indirect effects operating through a proposed mediator.

References

1. Residential greenspace and lung function throughout childhood and adolescence in five European birth cohorts. A CADSET initiative. Environment International (2025).
2. Pollen as a mediator between environmental greenness during pregnancy and infancy periods and childhood persistent asthma: A nationwide retrospective birth cohort study in Japan. Environmental Pollution (2024).
3. Greenness surrounding schools is associated with lower risk of asthma in schoolchildren. Environment International (2020).