Urban environment and children's health: An umbrella review of exposure response functions for health impact assessment.

Blanche Wies, In��s Valls, Amanda Fernandes, M��nica Ubalde-L��pez, Audrey Rocabois, Martine Vrijheid, R��my Slama, Mark Nieuwenhuijsen
Author Information
  1. Blanche Wies: Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiolog��a y Salud P��blica (CIBERESP), Madrid, Spain. Electronic address: blanchewies@outlook.com.
  2. In��s Valls: Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiolog��a y Salud P��blica (CIBERESP), Madrid, Spain.
  3. Amanda Fernandes: Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiolog��a y Salud P��blica (CIBERESP), Madrid, Spain.
  4. M��nica Ubalde-L��pez: Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiolog��a y Salud P��blica (CIBERESP), Madrid, Spain.
  5. Audrey Rocabois: French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France.
  6. Martine Vrijheid: Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiolog��a y Salud P��blica (CIBERESP), Madrid, Spain.
  7. R��my Slama: French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France.
  8. Mark Nieuwenhuijsen: Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiolog��a y Salud P��blica (CIBERESP), Madrid, Spain. Electronic address: mark.nieuwenhuijsen@isglobal.org.

Abstract

BACKGROUND: Urban settlements have become the main living environment. Understanding the impact of urban exposures on human health has therefore become a growing area of research. Up-to-date knowledge about the influence of urban exposures on pregnant women's and children's health is especially relevant, as they are particularly vulnerable to certain external influences.
AIM: This review aims to provide a synthesis of systematic reviews with meta-analyses reporting on an association between the urban environmental risk factors and health outcomes in pregnancy, infants, children and adolescents.
METHODS: We conducted an umbrella review, methodically analysing systematic reviews with meta-analyses, published between January 2016 and December 2022 in PubMed or Scopus. Adhering to the PRISMA checklist, we searched for free text using Medical Subject Headings (MeSH) terms related to air pollution, noise pollution, temperature, green space exposure, built and food environment, health outcomes, children (aged 0-18 years), pregnancy and systematic reviews with meta-analyses. We extracted key characteristics of each included study and assessed the quality of the included studies via the R-AMSTAR 2 tool.
RESULTS: Twenty-four studies met our inclusion criteria and identified 104 associations including 15 exposures and 60 health outcomes. The most frequently studied associations were related to air pollutants, followed by the built and food environment and noise. Birth outcomes (including low birth weight, pre-term birth or stillbirth) were the most commonly affected health outcomes, followed by respiratory outcomes such as asthma or respiratory infections. A total of 45 exposure-response function were reported to be statistically significant, including 10 exposures and 23 health effects.
CONCLUSION: This umbrella review provides an overview of the evidence and availability of exposure response functions between selected urban exposures and child health outcomes. This helps to identify research gaps and to build the basis for health impact assessment.

Keywords

MeSH Term

Humans
Child Health
Child
Environmental Exposure
Health Impact Assessment
Child, Preschool
Infant
Pregnancy
Adolescent
Female
Infant, Newborn
Systematic Reviews as Topic

Word Cloud

Created with Highcharts 10.0.0healthoutcomesexposuresenvironmenturbanreviewimpactsystematicreviewsmeta-analysesumbrellapollutionexposureincludingresponseUrbanbecomeresearchchildren'spregnancychildrenrelatedairnoisespacebuiltfoodincludedstudiesassociationsfollowedbirthrespiratoryfunctionsassessmentBACKGROUND:settlementsmainlivingUnderstandinghumanthereforegrowingareaUp-to-dateknowledgeinfluencepregnantwomen'sespeciallyrelevantparticularlyvulnerablecertainexternalinfluencesAIM:aimsprovidesynthesisreportingassociationenvironmentalriskfactorsinfantsadolescentsMETHODS:conductedmethodicallyanalysingpublishedJanuary2016December2022PubMedScopusAdheringPRISMAchecklistsearchedfreetextusingMedicalSubjectHeadingsMeSHtermstemperaturegreenaged0-18yearsextractedkeycharacteristicsstudyassessedqualityviaR-AMSTAR2toolRESULTS:Twenty-fourmetinclusioncriteriaidentified1041560frequentlystudiedpollutantsBirthlowweightpre-termstillbirthcommonlyaffectedasthmainfectionstotal45exposure-responsefunctionreportedstatisticallysignificant1023effectsCONCLUSION:providesoverviewevidenceavailabilityselectedchildhelpsidentifygapsbuildbasishealth:AirChildrenExposureGreenHealthNoiseTemprature

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