{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:48:14Z","timestamp":1762325294614,"version":"build-2065373602"},"reference-count":55,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI19CIII\/00025","PI16CIII\/00009"],"award-info":[{"award-number":["PI19CIII\/00025","PI16CIII\/00009"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Fondo de Investigaci\u00f3n Sanitaria","award":["12\/01416"],"award-info":[{"award-number":["12\/01416"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Blue spaces have been a key part of human evolution, providing resources and helping economies develop. To date, no studies have been carried out to explore how they may be linked to paediatric oncological diseases. Objectives: To explore the possible relationship of residential proximity to natural and urban blue spaces on childhood leukaemia. Methods: A population-based case\u2013control study was conducted in four regions of Spain across the period 2000\u20132018. A total of 936 incident cases and 5616 controls were included, individually matched by sex, year of birth and place of residence. An exposure proxy with four distances (250 m, 500 m, 750 m, and 1 km) to blue spaces was built using the geographical coordinates of the participants\u2019 home residences. Odds ratios (ORs) and 95% confidence intervals (95%CIs) for blue-space exposure were calculated for overall childhood leukaemia, and the acute lymphoblastic (ALL) and acute myeloblastic leukaemia (AML) subtypes, with adjustment for socio-demographic and environmental covariates. Results: A decrease in overall childhood leukaemia and ALL-subtype incidence was found as we came nearer to children\u2019s places of residence, showing, for the study as a whole, a reduced incidence at 250 m (odds ratio (OR) = 0.77; 95%CI = 0.60\u20130.97), 500 m (OR = 0.78; 95%CI = 0.65\u20130.93), 750 m (OR = 0.80; 95%CI = 0.69\u20130.93), and 1000 m (OR = 0.84; 95%CI = 0.72\u20130.97). AML model results showed an increasing incidence at closest to subjects\u2019 homes (OR at 250m = 1.06; 95%CI=0.63\u20131.71). Conclusions: Our results suggest a possible association between lower childhood leukaemia incidence and blue-space proximity. This study is a first approach to blue spaces\u2019 possible effects on childhood leukaemia incidence; consequently, it is necessary to continue studying these spaces\u2014while taking into account more individualised data and other possible environmental risk factors.<\/jats:p>","DOI":"10.3390\/ijerph19095232","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T21:16:28Z","timestamp":1650921388000},"page":"5232","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Exploring Blue Spaces\u2019 Effects on Childhood Leukaemia Incidence: A Population-Based Case\u2013Control Study in Spain"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7565-2703","authenticated-orcid":false,"given":"Carlos","family":"Ojeda S\u00e1nchez","sequence":"first","affiliation":[{"name":"Albacete University Hospital, 02006 Albacete, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0300-1810","authenticated-orcid":false,"given":"Javier","family":"Garc\u00eda-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Instituto de Salud Carlos III (Carlos III Institute of Health), 28029 Madrid, Spain"},{"name":"Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica\u2014CIBERESP), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"G\u00f3mez-Barroso","sequence":"additional","affiliation":[{"name":"Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica\u2014CIBERESP), 28029 Madrid, Spain"},{"name":"National Center for Epidemiology, Instituto de Salud Carlos III (Carlos III Institute of Health), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Dom\u00ednguez-Castillo","sequence":"additional","affiliation":[{"name":"Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Instituto de Salud Carlos III (Carlos III Institute of Health), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Pardo Romaguera","sequence":"additional","affiliation":[{"name":"Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adela","family":"Ca\u00f1ete","sequence":"additional","affiliation":[{"name":"Spanish Registry of Childhood Tumours (RETI-SEHOP), University of Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8577-4168","authenticated-orcid":false,"given":"Juan","family":"Ortega-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Environment and Human Health (EH2) Lab., Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, 30120 Murcia, Spain"},{"name":"European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), 30120 Murcia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6154-9142","authenticated-orcid":false,"given":"Rebeca","family":"Ramis","sequence":"additional","affiliation":[{"name":"Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Instituto de Salud Carlos III (Carlos III Institute of Health), 28029 Madrid, Spain"},{"name":"Centre for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiolog\u00eda y Salud P\u00fablica\u2014CIBERESP), 28029 Madrid, Spain"},{"name":"European and Latin American Environment, Survival and Childhood Cancer Network (ENSUCHICA), 30120 Murcia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"key":"ref_1","unstructured":"United Nations, Department of Economic and Social Affairs, Population Division (2019). World Urbanization Prospects: The 2018 Revision, United Nations, Department of Economic and Social Affairs, Population Division."},{"key":"ref_2","unstructured":"Laybourn-Langton, L., and Quilter-Pinner, H. (2016). London Global Green City, Institute for Public Policy Research."},{"key":"ref_3","unstructured":"City of Vancouver (2015). Greenest City Vancouver Action Plan 2020, City of Vancouver."},{"key":"ref_4","unstructured":"Solomon, S. (2011). Water: The Epic Struggle for Wealth, Power, and Civilization, Harper Perennial."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Pearson, A.L., Bottomley, R., Chambers, T., Thornton, L., Stanley, J., Smith, M., Barr, M., and Signal, L. (2017). Measuring Blue Space Visibility and \u2018Blue Recreation\u2019 in the Everyday Lives of Children in a Capital City. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14060563"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e016188","DOI":"10.1136\/bmjopen-2017-016188","article-title":"BlueHealth: A study programme protocol for mapping and quantifying the potential benefits to public health and well-being from Europe\u2019s blue spaces","volume":"7","author":"Grellier","year":"2017","journal-title":"BMJ Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1016\/j.ijheh.2017.08.004","article-title":"Outdoor blue spaces, human health and well-being: A systematic review of quantitative studies","volume":"220","author":"Gascon","year":"2017","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"913","DOI":"10.3390\/ijerph10030913","article-title":"What are the Benefits of Interacting with Nature?","volume":"10","author":"Keniger","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.envres.2017.06.028","article-title":"Exploring pathways linking greenspace to health: Theoretical and methodological guidance","volume":"158","author":"Markevych","year":"2017","journal-title":"Environ. Res."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Huynh, Q., Craig, W., Janssen, I., and Pickett, W. (2013). Exposure to public natural space as a protective factor for emotional well-being among young people in Canada. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-407"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.healthplace.2016.05.010","article-title":"Exploring the relationship between childhood obesity and proximity to the coast: A rural\/urban perspective","volume":"40","author":"Wood","year":"2016","journal-title":"Health Place"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4354","DOI":"10.3390\/ijerph120404354","article-title":"Mental Health Benefits of Long-Term Exposure to Residential Green and Blue Spaces: A Systematic Review","volume":"12","author":"Gascon","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1023\/A:1010717502442","article-title":"Global-Scale Relationships between Climate and the Dengue Fever Vector, Aedes Aegypti","volume":"48","author":"Hopp","year":"2001","journal-title":"Clim. Chang."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1038\/bjc.1996.275","article-title":"The multicentre south European study \u2018Helios\u2019. II: Different sun exposure patterns in the aetiology of basal cell and squamous cell carcinomas of the skin","volume":"73","author":"Rosso","year":"1996","journal-title":"Br. J. Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"iii103","DOI":"10.1093\/annonc\/mdq092","article-title":"Childhood cancer incidence and survival in Spain","volume":"21","author":"Galceran","year":"2010","journal-title":"Ann. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1054\/bjoc.2000.1376","article-title":"A pooled analysis of magnetic fields and childhood leukaemia","volume":"83","author":"Ahlbom","year":"2000","journal-title":"Br. J. Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1080\/10937404.2012.689555","article-title":"Environmental Radon Exposure and Childhood Leukemia","volume":"15","author":"Tong","year":"2012","journal-title":"J. Toxicol. Environ. Health Part B"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.envint.2018.08.056","article-title":"Childhood leukaemia risk and residential proximity to busy roads","volume":"121","author":"Boldo","year":"2018","journal-title":"Environ. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1080\/10590501.2015.1002999","article-title":"A Review and Meta-Analysis of Outdoor Air Pollution and Risk of Childhood Leukemia","volume":"33","author":"Filippini","year":"2015","journal-title":"J. Environ. Sci. Health Part C"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.envres.2015.05.014","article-title":"Childhood leukemia and residential proximity to industrial and urban sites","volume":"140","author":"Romaguera","year":"2015","journal-title":"Environ. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"111723","DOI":"10.1016\/j.envres.2021.111723","article-title":"Urban green spaces and childhood leukemia incidence: A population-based case-control study in Madrid","volume":"202","author":"Romaguera","year":"2021","journal-title":"Environ. Res."},{"key":"ref_22","unstructured":"Pardo Romaguera, E., Mu\u00f1oz L\u00f3pez, A., Valero Poveda, S., Porta Cebolla, S., Fern\u00e1ndez-Delgado, R., Barreda Reines, M.S., and Peris Bonet, R. (2021, November 06). C\u00e1ncer Infantil en Espa\u00f1a. Estad\u00edsticas 1980\u20132017. Registro Espa\u00f1ol de Tumores Infantiles (RETI-SEHOP) 2018. Available online: https:\/\/www.uv.es\/rnti\/pdfs\/Informe_RETI-SEHOP_1980-2017.pdf."},{"key":"ref_23","unstructured":"(2021, October 01). Centro Nacional de Informaci\u00f3n Geogr\u00e1fica (CNIG). Available online: http:\/\/centrodedescargas.cnig.es."},{"key":"ref_24","unstructured":"(2022, January 12). Instituto Nacional de Estad\u00edstica (INE). Available online: https:\/\/www.ine.es\/."},{"key":"ref_25","unstructured":"Eurostat (2021, July 05). Degree of Urbanisation Classification\u20142011 Revision 2011, Available online: https:\/\/ec.europa.eu\/eurostat\/statistics-explained\/index.php?title=Degree_of_urbanisation_classification_-_2011_revision."},{"key":"ref_26","unstructured":"(2022, January 20). Poblaci\u00f3n Residente Por Provincias Seg\u00fan Tipo de Hogar y Densidad de Poblaci\u00f3n. INE n.d. Available online: https:\/\/www.ine.es\/jaxi\/Datos.htm?path=\/t20\/p274\/serie\/def\/p06\/&file=05010.px."},{"key":"ref_27","unstructured":"(2021, July 11). Interpolated Air Quality Data\u2014European Environment Agency n.d. Available online: https:\/\/www.eea.europa.eu\/data-and-maps\/data\/interpolated-air-quality-data-2."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"109613","DOI":"10.1016\/j.envres.2020.109613","article-title":"Analytical approaches to testing pathways linking greenspace to health: A scoping review of the empirical literature","volume":"186","author":"Dzhambov","year":"2020","journal-title":"Environ. Res."},{"key":"ref_29","unstructured":"Yengoh, G.T., Dent, D., Olsson, L., Tengberg, A.E., and Tucker, C.J. (2014). The Use of the Normalized Difference Vegetation Index (NDVI) to Assess Land Degradation at Multiple Scales: A Review of the Current Status, Future Trends, and practical Considerations, Springer."},{"key":"ref_30","unstructured":"(2021, July 04). Earth Observing System Data and Information System (EOSDIS), Available online: https:\/\/earthdata.nasa.gov\/learn\/discipline\/land\/."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1046\/j.1365-2672.94.s1.5.x","article-title":"Climate change and waterborne and vector-borne disease","volume":"94","author":"Hunter","year":"2003","journal-title":"J. Appl. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"209","DOI":"10.2471\/BLT.11.093427","article-title":"The global burden of cholera","volume":"90","author":"Ali","year":"2012","journal-title":"Bull. World Health Organ."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.clindermatol.2007.10.001","article-title":"Outdoor sports and skin cancer","volume":"26","author":"Moehrle","year":"2008","journal-title":"Clin. Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"7024","DOI":"10.1007\/s11356-014-2620-6","article-title":"Will urban expansion lead to an increase in future water pollution loads?\u2014A preliminary investigation of the Haihe River Basin in northeastern China","volume":"21","author":"Dong","year":"2014","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"151","DOI":"10.5334\/aogh.2831","article-title":"Human Health and Ocean Pollution","volume":"86","author":"Landrigan","year":"2020","journal-title":"Ann. Glob. Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S0967-0645(96)00093-8","article-title":"Mass budget and dynamics of polycyclic aromatic hydrocarbons in the Mediterranean Sea","volume":"44","author":"Lipiatou","year":"1997","journal-title":"Deep Sea Res. Part II Top. Stud. Oceanogr."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.chemosphere.2016.09.157","article-title":"Occurrence and seasonal distribution of polycyclic aromatic hydrocarbons and legacy and current-use pesticides in air from a Mediterranean coastal lagoon (Mar Menor, SE Spain)","volume":"167","year":"2017","journal-title":"Chemosphere"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.envpol.2012.03.003","article-title":"Polycyclic aromatic hydrocarbons (PAHs) in the Mediterranean Sea: Atmospheric occurrence, deposition and decoupling with settling fluxes in the water column","volume":"166","author":"Berrojalbiz","year":"2012","journal-title":"Environ. Pollut."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.healthplace.2013.05.006","article-title":"Coastal proximity, health and well-being: Results from a longitudinal panel survey","volume":"23","author":"White","year":"2013","journal-title":"Health Place"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1123\/jpah.2011-0332","article-title":"The Effect of Proximity on Park and Beach Use and Physical Activity Among Rural Adolescents","volume":"11","author":"Edwards","year":"2014","journal-title":"J. Phys. Act. Health"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1068\/a35111","article-title":"Natural Environments\u2014Healthy Environments? An Exploratory Analysis of the Relationship between Greenspace and Health","volume":"35","author":"Verheij","year":"2003","journal-title":"Environ. Plan. A"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.envint.2015.01.012","article-title":"Natural outdoor environments and mental and physical health: Relationships and mechanisms","volume":"77","author":"Dadvand","year":"2015","journal-title":"Environ. Int."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s12942-016-0047-7","article-title":"Agricultural crop exposure and risk of childhood cancer: New findings from a case\u2013control study in Spain","volume":"15","author":"Romaguera","year":"2016","journal-title":"Int. J. Health Geogr."},{"key":"ref_44","unstructured":"(2019, June 12). CLC 2018\u2014Copernicus Land Monitoring Service n.d.. Available online: https:\/\/land.copernicus.eu\/pan-european\/corine-land-cover\/clc2018."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1198","DOI":"10.1016\/j.healthplace.2012.06.015","article-title":"Does living by the coast improve health and wellbeing?","volume":"18","author":"Wheeler","year":"2012","journal-title":"Health Place"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1080\/10937400601034589","article-title":"Pesticides and Childhood Cancer: An Update of Zahm and Ward\u2019s 1998 Review","volume":"10","author":"Weichenthal","year":"2007","journal-title":"J. Toxicol. Environ. Health Part B"},{"key":"ref_47","first-page":"102","article-title":"Increased incidence of childhood leukemia in urban areas: A population-based case-control study","volume":"34","author":"Malagoli","year":"2015","journal-title":"Epidemiol. Prev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.cppeds.2016.08.004","article-title":"Childhood Leukemia and Primary Prevention","volume":"46","author":"Whitehead","year":"2016","journal-title":"Curr. Probl. Pediatr. Adolesc. Health Care"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1093\/aje\/kwx322","article-title":"Socioeconomic Status and Childhood Cancer Incidence: A Population-Based Multilevel Analysis","volume":"187","author":"Kehm","year":"2017","journal-title":"Am. J. Epidemiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1289\/ehp.1104609","article-title":"Surrounding Greenness and Exposure to Air Pollution During Pregnancy: An Analysis of Personal Monitoring Data","volume":"120","author":"Dadvand","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.envint.2016.10.024","article-title":"Residential greenness and risk of prostate cancer: A case-control study in Montreal, Canada","volume":"98","author":"Demoury","year":"2017","journal-title":"Environ. Int."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1289\/ehp.1510363","article-title":"Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women","volume":"124","author":"James","year":"2016","journal-title":"Environ. Health Perspect."},{"key":"ref_53","unstructured":"(2022, January 21). Interprovincial Migration Balance by Semester, Province, Sex, Age Group and Nationality. INE. Available online: https:\/\/www.ine.es\/jaxiT3\/Tabla.htm?t=24450&L=1."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"046002","DOI":"10.1289\/EHP4381","article-title":"Association between Outdoor Air Pollution and Childhood Leukemia: A Systematic Review and Dose\u2013Response Meta-Analysis","volume":"127","author":"Filippini","year":"2019","journal-title":"Environ. Health Perspect."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1080\/09593330.2012.692719","article-title":"A preliminary study on ambient levels of carbonyls, benzene, toluene and xylene in the south-west of the Iberian Peninsula (Huelva coast), Spain","volume":"34","author":"Villanueva","year":"2013","journal-title":"Environ. Technol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/9\/5232\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:00:59Z","timestamp":1760137259000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/9\/5232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,25]]},"references-count":55,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["ijerph19095232"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19095232","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2022,4,25]]}}}