Tari Haahtela Tari Haahtela Liam O'Mahony Liam O'Mahony Claudia Traidl‐Hoffmann Claudia Traidl‐Hoffmann Mubeccel Akdis Mubeccel Akdis Ozlem Ceylan Ozlem Ceylan Panagiotis Chaslaridis Panagiotis Chaslaridis Athanasios Damialis Athanasios Damialis Stefano Del Giacco Stefano Del Giacco Antti Lauerma Antti Lauerma Kari C. Nadeau Kari C. Nadeau Inês Paciência Inês Paciência Isabella Pali‐Schöll Isabella Pali‐Schöll Oscar Palomares Oscar Palomares Harald Renz Harald Renz Jurgen Schwarze Jurgen Schwarze Marilyn Urrutia‐Pereira Marilyn Urrutia‐Pereira Carina Venter Carina Venter Donata Vercelli Donata Vercelli Tonya Winders Tonya Winders Cezmi A. Akdis Cezmi A. Akdis Marek Jutel Marek Jutel Ioana Agache Ioana Agache Wiley 2026 The allergy and asthma epidemic in urban societies following World War II is mostly caused by changes in the environment, diet and lifestyle. Disconnection of urban populations from the wider environment has reduced the protective factors building up immunological resilience. The European Academy of Allergy and Clinical Immunology (EAACI) guidelines on greenness impact on allergy and asthma follow the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach and provide eight recommendations encouraging greenness exposure to support immune health. Controlled follow-up studies are still scarce, and the strength of evidence is generally low or moderate at best. For primary prevention of allergy and asthma, most of the evidence indicates beneficial effects. Exposure is also useful for secondary prevention. Asthma patients may feel better and need less medication by combining green space exposure with physical activity. During the high-pollen season, effective seasonal medication is necessary for patients with pollen allergy. In urban planning, implementing appropriate green infrastructure and easy access to green space promotes immune health and reduces risks of air pollution and heatwaves. These EAACI guidelines are the first recommendations highlighting the importance of urban green spaces on immune health and call for prioritising innovative research in this field. PDFDocument eng 2026-08-06T09:30:47.403689564Z 2026 681012 b application/pdf http://creativecommons.org/licenses/by-nc/4.0/