Sun Exposure and Asthma Prevalence in Spanish Schoolchildren and Adolescents in the Global Asthma Network (GAN) Phase I Study: A Semi-Individual Cross-Sectional Study.
Level 4 - case-series / case-control
Semi-individual cross-sectional observational study linking individual outcomes to area-level environmental metrics
PubMed 42652644 · doi:10.3390/jcm15166238
What was done
A semi-individual cross-sectional study evaluated the association between sun exposure and asthma prevalence in schoolchildren (6–7 years old) and adolescents (13–14 years old) from six geographic centers in Spain (A Coruña, Bilbao, Cantabria, Cartagena, Pamplona, and Salamanca) participating in the Global Asthma Network (GAN) Phase I study between 2016 and 2019. Sun exposure was quantified via sunshine hours (SHs) and global solar surface irradiance (GSSI) from the Spanish State Meteorological Agency. Multilevel logistic regression models adjusted for age, sex, temperature, relative humidity, and gross domestic product, with permutation tests applied to account for the low number of centers.
What was found
Higher SHs and GSSI were inversely associated with prevalence of "asthma ever": - An increase of 100 annual sunshine hours was associated with lower asthma prevalence in schoolchildren (adjusted OR = 0.82; 95% CI, 0.79–0.85; crude permutation p = 0.08) and in adolescents (aOR = 0.90; 95% CI, 0.87–0.94; crude permutation p = 0.02). - An increase of 1 kWh/m²/day in GSSI was associated with lower asthma prevalence in schoolchildren (aOR = 0.15; 95% CI, 0.10–0.23; crude permutation p = 0.25) and in adolescents (aOR = 0.37; 95% CI, 0.25–0.54; crude permutation p = 0.01). Associations remained statistically significant after permutation testing only among adolescents.
Why it matters
This study adds multi-center Spanish data suggesting ambient sun exposure may be inversely associated with asthma prevalence in adolescents, supporting further research into environmental determinants of respiratory health.
Limits
The abstract does not report the total participant sample size (n). The cross-sectional design cannot establish causality or temporality. Solar exposure was measured ecologically at the center level rather than via individual-level sunlight exposure, time outdoors, or personal dosimetry. The analysis included only six geographic centers, limiting statistical power at the cluster level.
Cited by
- supports High levels of sun exposure decrease asthma symptoms or severity.