Lett Elle, Stingone Jeanette A, Claudio Luz
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Int J Environ Res Public Health. 2017 Oct 26;14(11):1295. doi: 10.3390/ijerph14111295.
Cognitive skills are one component of school readiness that reflect a child's neurodevelopment and are influenced by environmental and social factors. Most studies assess the impact of these factors individually, without taking into consideration the complex interactions of multiple factors. The objective of this study was to examine the joint association of markers of environmental pollution and of social factors on early cognitive skills in an urban cohort of children. For this, we chose isophorone in ambient air as a marker of industrial air pollution. Low quality home learning environments was chosen as a marker of the social factors contributing to cognitive development. Using a subpopulation from the Early Childhood Longitudinal Study, Birth Cohort (N = 4050), isophorone exposure was assigned using the 2002 National Air Toxics Assessment. Home learning environment was assessed with a modified version of the Home Observation for Measurement of the Environment (HOME) Inventory, and standardized math assessment scores were used as a measure of early cognitive skills. Multiple linear regression was used to estimate the effect of both exposures on math scores. After adjustment for confounders, children living in areas with ambient isophorone in the upper quintile of exposure (>0.49 ng/m³) had math scores that were 1.63 points lower than their less exposed peers [95% CI: -2.91, -0.34], and children with lower HOME scores (at or below 9 out of 12) had math scores that were 1.20 points lower than children with better HOME scores [95% CI: -2.30, -0.10]. In adjusted models accounting for identified confounders and both exposures of interest, both high isophorone exposure and low HOME score remained independently associated with math scores [-1.48, 95% CI: -2.79, -0.18; -1.05, 95% CI: -2.15, 0.05, respectively]. There was no statistical evidence of interaction between the two exposures, although children with both higher isophorone exposure and a low HOME score had a decrement in math scale score beyond the additive effect of each exposure. This was primarily observed among male children. These findings suggest that aspects of both the physical and social environments are independently associated with children's early cognitive skills. Future research aiming to improve children's early cognitive skills and subsequent school readiness should address both domains.
认知技能是入学准备的一个组成部分，反映了儿童的神经发育情况，并受到环境和社会因素的影响。大多数研究单独评估这些因素的影响，而没有考虑多种因素之间复杂的相互作用。本研究的目的是在一个城市儿童队列中，考察环境污染标志物和社会因素对早期认知技能的联合关联。为此，我们选择环境空气中的异佛尔酮作为工业空气污染的标志物。选择低质量的家庭学习环境作为影响认知发展的社会因素的标志物。利用儿童早期纵向研究出生队列中的一个亚群体（N = 4050），使用2002年国家空气毒物评估来确定异佛尔酮暴露情况。家庭学习环境采用修订版的家庭环境观察量表（HOME）进行评估，标准化数学评估分数用作早期认知技能的衡量指标。使用多元线性回归来估计两种暴露对数学分数的影响。在对混杂因素进行调整后，生活在异佛尔酮暴露处于最高五分位数（>0.49 ng/m³）地区的儿童，其数学分数比暴露较少的同龄人低1.63分[95%置信区间：-2.91，-0.34]，而家庭学习环境得分较低（12分中处于或低于9分）的儿童，其数学分数比家庭学习环境得分较高的儿童低1.20分[95%置信区间：-2.30，-0.10]。在考虑已识别的混杂因素和两种感兴趣的暴露的调整模型中，高异佛尔酮暴露和低家庭学习环境得分仍然分别与数学分数独立相关[-1.48，95%置信区间：-2.79，-0.18；-1.05，95%置信区间：-2.15，0.05]。虽然异佛尔酮暴露较高且家庭学习环境得分较低的儿童，其数学量表分数的下降幅度超过了每种暴露的相加效应，但没有统计学证据表明两种暴露之间存在相互作用。这主要在男性儿童中观察到。这些发现表明，物理环境和社会环境的各个方面都与儿童的早期认知技能独立相关。未来旨在提高儿童早期认知技能和后续入学准备的研究应同时关注这两个领域。
