Association between traffic-related air pollution in schools and cognitive development in primary school children: a prospective cohort study

Sunyer Deu, Jordi; Esnaola, Mikel; Álvarez Pedrerol, Mar; Forns i Guzman, Joan, 1981-; Rivas, Ioar; López Vicente, Mònica, 1988-; Suades González, Elisabet; Foraster Pulido, Maria, 1984-; García Esteban, Raquel; Basagaña Flores, Xavier; Viana, Maria Carmen; Cirach, Marta; Moreno, Teresa; Alastuey, Andrés; Sebastián Gallés, Núria; Nieuwenhuijsen, Mark J.; Querol, Xavier

Association between traffic-related air pollution in schools and cognitive development in primary school children: a prospective cohort study

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dc.contributor.author Sunyer Deu, Jordica
dc.contributor.author Esnaola, Mikelca
dc.contributor.author Álvarez Pedrerol, Marca
dc.contributor.author Forns i Guzman, Joan, 1981-ca
dc.contributor.author Rivas, Ioarca
dc.contributor.author López Vicente, Mònica, 1988-ca
dc.contributor.author Suades González, Elisabetca
dc.contributor.author Foraster Pulido, Maria, 1984-ca
dc.contributor.author García Esteban, Raquelca
dc.contributor.author Basagaña Flores, Xavierca
dc.contributor.author Viana, Maria Carmenca
dc.contributor.author Cirach, Martaca
dc.contributor.author Moreno, Teresaca
dc.contributor.author Alastuey, Andrésca
dc.contributor.author Sebastián Gallés, Núriaca
dc.contributor.author Nieuwenhuijsen, Mark J.ca
dc.contributor.author Querol, Xavierca
dc.date.accessioned 2015-04-07T09:40:39Z
dc.date.available 2015-04-07T09:40:39Z
dc.date.issued 2015
dc.description.abstract Air pollution is a suspected developmental neurotoxicant. Many schools are located in close proximity to busy roads, and traffic air pollution peaks when children are at school. We aimed to assess whether exposure of children in primary school to traffic-related air pollutants is associated with impaired cognitive development. Methods and Findings: We conducted a prospective study of children (n = 2,715, aged 7 to 10 y) from 39 schools in Barcelona (Catalonia, Spain) exposed to high and low traffic-related air pollution, paired by school socioeconomic index; children were tested four times (i.e., to assess the 12-mo developmental trajectories) via computerized tests (n = 10,112). Chronic traffic air pollution (elemental carbon [EC], nitrogen dioxide [NO2], and ultrafine particle number [UFP; 10–700 nm]) was measured twice during 1-wk campaigns both in the courtyard (outdoor) and inside the classroom (indoor) simultaneously in each school pair. Cognitive development was assessed with the n-back and the attentional network tests, in particular, working memory (two-back detectability), superior working memory (three-back detectability), and inattentiveness (hit reaction time standard error). Linear mixed effects models were adjusted for age, sex, maternal education, socioeconomic status, and air pollution exposure at home. Children from highly polluted schools had a smaller growth in cognitive development than children from the paired lowly polluted schools, both in crude and adjusted models (e.g., 7.4% [95% CI 5.6%–8.8%] versus 11.5% [95% CI 8.9%–12.5%] improvement in working memory, p = 0.0024). Cogently, children attending schools with higher levels of EC, NO2, and UFP both indoors and outdoors experienced substantially smaller growth in all the cognitive measurements; for example, a change from the first to the fourth quartile in indoor EC reduced the gain in working memory by 13.0% (95% CI 4.2%–23.1%). Residual confounding for social class could not be discarded completely; however, the associations remained in stratified analyses (e.g., for type of school or high-/low-polluted area) and after additional adjustments (e.g., for commuting, educational quality, or smoking at home), contradicting a potential residual confounding explanation. Conclusions: Children attending schools with higher traffic-related air pollution had a smaller improvement in cognitive development.ca
dc.description.sponsorship The research leading to these results has received funding from the European Research Council under the ERC Grant Agreement number 268479–the BREATHE project. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
dc.format.mimetype application/pdfca
dc.identifier.citation Sunyer J, Esnaola M, Alvarez-Pedrerol M, Forns J, Rivas I, López-Vicente M. Association between traffic-related air pollution in schools and cognitive development in primary school children: a prospective cohort study. PLoS Med. 2015 Mar 3;12(3):e1001792. DOI: 10.1371/journal.pmed.1001792.ca
dc.identifier.doi http://dx.doi.org/10.1371/journal.pmed.1001792
dc.identifier.issn 1549-1277
dc.identifier.uri http://hdl.handle.net/10230/23348
dc.language.iso engca
dc.publisher Public Library of Scienceca
dc.relation.ispartof PLOS Medicine. 2015 Mar 3;12(3):e1001792
dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/268479
dc.rights © 2015 Sunyer et al. This is an open access article distributed under the terms of the: http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ca
dc.rights.accessRights info:eu-repo/semantics/openAccessca
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ca
dc.subject.other Aire -- Contaminacióca
dc.subject.other Infants -- Desenvolupamentca
dc.title Association between traffic-related air pollution in schools and cognitive development in primary school children: a prospective cohort studyca
dc.type info:eu-repo/semantics/articleca
dc.type.version info:eu-repo/semantics/publishedVersion

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