3.5 年间在校儿童暴露于空气污染环境与认知发展之间的纵向关联。
Longitudinal association between air pollution exposure at school and cognitive development in school children over a period of 3.5 years.
作者信息
Forns Joan, Dadvand Payam, Esnaola Mikel, Alvarez-Pedrerol Mar, López-Vicente Mònica, Garcia-Esteban Raquel, Cirach Marta, Basagaña Xavier, Guxens Mònica, Sunyer Jordi
机构信息
ISGlobal-Center for Research in Environmental Epidemiology, Barcelona, Spain; Hospital del Mar Research Institute, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain.
ISGlobal-Center for Research in Environmental Epidemiology, Barcelona, Spain; Hospital del Mar Research Institute, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain.
出版信息
Environ Res. 2017 Nov;159:416-421. doi: 10.1016/j.envres.2017.08.031. Epub 2017 Sep 1.
INTRODUCTION
Recently, we showed that exposure to traffic-related air pollutants (TRAPs) at school was negatively associated with cognitive development, specifically working memory and inattentiveness, in primary schoolchildren during a course of 12 months. The persistence of such associations over longer periods remains as an open question.
OBJECTIVE
To study the longitudinal association between TRAPs at school and cognitive development over a period of 3.5 years.
METHODS
Indoor and outdoor levels of TRAPs (elemental carbon (EC), dioxide nitrogen (NO), particulate matter (PM) from traffic sources and ultrafine particles (UFP)) were measured at 39 schools across Barcelona during 2012/2013. Working memory, as a measure of cognitive development, was evaluated 4 times in 2012/2013 assessment and was re-evaluated one more time in 2015 using computerized n-back test (3-back d' as main outcome). Linear mixed effects models were used to test the association between TRAPs and 3-back d', adding child and school as random effects to account for the multilevel nature of the data, and school air pollutants levels (one at a time) as predictor.
RESULTS
We found detrimental associations between all TRAPs and annual change in 3-back d' (working memory) (i.e. slower development of working memory in children attending schools with higher levels of air pollution). The associations (per one interquartile range increase in exposure) were strongest for outdoor NO (Coefficient (Coef) = - 4.22, 95% confidence interval (CI), - 6.22, - 2.22) and indoor UFP (Coef = - 4.12, 95%CI, - 5.68, - 1.83). These reductions were equivalent to - 20% (95%CI, - 30.1, - 10.7) and - 19.9% (95%CI, - 31.5, - 8.4) change in annual working memory development associated with one interquartile range increase in outdoor NO and indoor UFP, respectively.
CONCLUSION
Our findings suggest the persistence of the negative association between TRAPs exposure at school and cognitive trajectory measured by n-back test over a period of 3.5 years.
引言
最近，我们发现，在12个月的时间里，小学生在学校接触与交通相关的空气污染物（TRAPs）与认知发展呈负相关，特别是工作记忆和注意力不集中。这种关联在更长时期内的持续性仍是一个悬而未决的问题。
目的
研究在3.5年的时间里，学校中的TRAPs与认知发展之间的纵向关联。
方法
2012/2013年期间，对巴塞罗那的39所学校的室内和室外TRAPs水平（元素碳（EC）、二氧化氮（NO）、交通源颗粒物（PM）和超细颗粒物（UFP））进行了测量。作为认知发展的一项指标，工作记忆在2012/2013年的评估中进行了4次评估，并于2015年使用计算机化n-back测试再次进行评估（以3-back d'作为主要结果）。使用线性混合效应模型来测试TRAPs与3-back d'之间的关联，将儿童和学校作为随机效应纳入，以考虑数据的多层次性质，并将学校空气污染物水平（每次一个）作为预测变量。
结果
我们发现，所有TRAPs与3-back d'（工作记忆）的年度变化之间存在有害关联（即，在空气污染水平较高的学校上学的儿童，其工作记忆发展较慢）。对于室外NO（系数（Coef）=-4.22，95%置信区间（CI），-6.22，-2.22）和室内UFP（Coef=-4.12，95%CI，-5.68，-1.83），关联（暴露每增加一个四分位数间距）最强。这些降低分别相当于与室外NO和室内UFP每增加一个四分位数间距相关的年度工作记忆发展变化的-20%（95%CI，-30.1，-10.7）和-19.9%（95%CI，-31.5，-8.4）。
结论
我们的研究结果表明，在3.5年的时间里，学校接触TRAPs与通过n-back测试测量的认知轨迹之间存在负关联，且这种关联具有持续性。
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