都市環境の改善で喘息の1割が予防可能(One in ten asthma cases can be avoided with a better urban environment)

2025-05-17

2025-05-16 カロリンスカ研究所(KI)

カロリンスカ研究所が主導するEU共同研究(EXPANSEプロジェクト)により、都市環境の改善が喘息の発症リスクを低減する可能性が示されました。ヨーロッパ7カ国の14コホート、約35万人を対象に、居住地の空気汚染、都市密度、緑地の不足など複数の環境要因を分析した結果、約11.6%の喘息症例がこれらの要因に起因することが判明しました。特に、空気汚染と緑地不足、過密な都市開発の組み合わせが喘息発症に強く関連していました。研究チームは、都市計画におけるリスク地域の特定や将来の都市環境設計にこの手法を活用できると述べています。今後は、参加者の血液サンプルを用いた代謝物解析を通じて、環境要因が身体に与える影響をさらに解明する予定です。この研究成果は『Lancet Regional Health – Europe』誌に掲載されました。

<関連情報>

欧州の14コホートにおけるライフコースに渡る外部エクスポソームと喘息発症:EXPANSEプロジェクトにおける前向き分析 External exposome and incident asthma across the life course in 14 European cohorts: a prospective analysis within the EXPANSE project

Zhebin Yu ∙ Sara Kress ∙ Natalia Blay ∙ Petr Gregor ∙ Hanna-Maria Kukk ∙ Miriam Leskien ∙ et al.
The Lancet Regional Health – Europe Published: May 15, 2025
DOI:https://doi.org/10.1016/j.lanepe.2025.101314

Summary

Background

The joint impact of exposure to multiple urban environmental factors on asthma remains unclear.

Methods

We analysed data from 14 European cohorts to assess the impact of the urban exposome on asthma incidence across the life course. We linked three external exposome domains (air pollution, built environment, ambient temperature) to the participants’ home addresses at baseline. We performed k-means clustering within each domain and assessed associations of clusters with asthma adjusting for potentially relevant covariates in cohort-specific analyses, with subsequent separate meta-analyses for birth and adult cohorts. An environmental risk score using a coefficient-weighted sum approach was used to assess the impact of combining the three domains.

Findings

A total of 7428 incident asthma cases were identified among 349,037 participants (from birth up to age 70+). Overall, we observed higher risks of asthma for clusters characterized by high particulate matter and nitrogen dioxide exposure in adults (OR_meta = 1.13, 95%CI:1.01–1.25), and clusters characterized by high built-up area and low levels of greenness in both children and adults (OR_meta = 1.36, 95%CI: 1.14–1.64 for birth cohorts and OR_meta = 1.15, 95%CI: 1.03–1.28 for adult cohorts, respectively). The joint exposure using the environment risk score combining the three domains was consistently associated with higher risks of incident asthma (OR_meta = 1.13, 95%CI: 1.07–1.20 for birth cohorts, OR_meta = 1.15, 95%CI: 1.10–1.20 for adult cohorts per 20% increase). On average 11.6% of the incident asthma cases could be attributed to environmental risk score above cohort-specific median levels.

Interpretation

Multiple environmental exposures jointly contribute to incident asthma risk across the life course. Urban planning accounting for these factors may help mitigate asthma development.