Neurobehavioral assessments and biomarkers in school children who are highly exposed to air pollution
5 affiliations
- 1Stephanie Holm Consulting
- 2Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley
- 3Division of Occupational, Environmental and Climate Medicine, Department of Medicine, University of California, San Francisco
- 4Central California Asthma Collaborative
- 5Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley
Abstract
Background: Children are uniquely vulnerable to ambient air pollution. Yet, data remain limited relating standardized academic metrics with neurobehavioral outcomes measured by more in-depth testing, and how neurobehavioral outcomes are associated with non-criteria pollutants—such as polycyclic aromatic hydrocarbons (PAHs) and elemental carbon (EC).
Methods: Utilizing data from the Children’s Health and Air Pollution Study (CHAPS) in Fresno, California, we evaluated neurobehavioral outcomes in a cohort of highly exposed children ( n = 193, ages 7–18). Prenatal and year of life one exposures to PM 2.5 , PM ₁₀ , O ₃ , NO ₂ , NO x , PAH ₄₅₆ and elemental carbon (EC) were estimated daily. Outcome measures included the NIH Toolbox Cognition Battery, the Child Behavior Checklist (CBCL), standardized test scores, and serum brain-derived neurotrophic factor (BDNF) and urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) biomarkers. Correlations between the various outcomes were assessed, and linear and distributed lag models (DLM) associated outcomes with pollutant exposures.
Results: Third-grade test scores demonstrated robust correlations with the NIH Toolbox total and crystallized cognition composites ( r ~ 0.55–0.60) and moderate correlation with BDNF ( r = 0.35). Linear models revealed that first-trimester exposure to traffic-related air pollutants was associated with elevated aggressive and rule-breaking behavior. First-year of life exposure across all pollutants was associated with depressed BDNF levels with a susceptibility window around 5 to 6 months of life.
Conclusion: Early-life exposure to ambient air pollution is associated with persistent differences in neurocognitive and behavioral outcomes measured into adolescence. The strong concordance between school-administered standardized test scores and resource-intensive neurobehavioral tools indicates that academic datasets might provide proxy endpoints for assessing environmental neurotoxicity.
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BibTeX
@article{holm2026neurobehavioral,
title = {{Neurobehavioral assessments and biomarkers in school children who are highly exposed to air pollution}},
author = {Stephanie M. Holm and Nina Holland and John R. Balmes and Tim Tyner and Weihong Guo and Anabelle Garza and Debra Manzo Garcia and Briseida Vasquez-Vasquez and Sierra Loomis and Elizabeth M. Noth},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1970714},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1970714/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Neurobehavioral assessments and biomarkers in school children who are highly exposed to air pollution
AU - Stephanie M. Holm
AU - Nina Holland
AU - John R. Balmes
AU - Tim Tyner
AU - Weihong Guo
AU - Anabelle Garza
AU - Debra Manzo Garcia
AU - Briseida Vasquez-Vasquez
AU - Sierra Loomis
AU - Elizabeth M. Noth
PY - 2026
DA - 2026/10/14
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1970714
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1970714/full
AB - Background: Children are uniquely vulnerable to ambient air pollution. Yet, data remain limited relating standardized academic metrics with neurobehavioral outcomes measured by more in-depth testing, and how neurobehavioral outcomes are associated with non-criteria pollutants—such as polycyclic aromatic hydrocarbons (PAHs) and elemental carbon (EC). Methods: Utilizing data from the Children’s Health and Air Pollution Study (CHAPS) in Fresno, California, we evaluated neurobehavioral outcomes in a cohort of highly exposed children ( n = 193, ages 7–18). Prenatal and year of life one exposures to PM 2.5 , PM ₁₀ , O ₃ , NO ₂ , NO x , PAH ₄₅₆ and elemental carbon (EC) were estimated daily. Outcome measures included the NIH Toolbox Cognition Battery, the Child Behavior Checklist (CBCL), standardized test scores, and serum brain-derived neurotrophic factor (BDNF) and urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) biomarkers. Correlations between the various outcomes were assessed, and linear and distributed lag models (DLM) associated outcomes with pollutant exposures. Results: Third-grade test scores demonstrated robust correlations with the NIH Toolbox total and crystallized cognition composites ( r ~ 0.55–0.60) and moderate correlation with BDNF ( r = 0.35). Linear models revealed that first-trimester exposure to traffic-related air pollutants was associated with elevated aggressive and rule-breaking behavior. First-year of life exposure across all pollutants was associated with depressed BDNF levels with a susceptibility window around 5 to 6 months of life. Conclusion: Early-life exposure to ambient air pollution is associated with persistent differences in neurocognitive and behavioral outcomes measured into adolescence. The strong concordance between school-administered standardized test scores and resource-intensive neurobehavioral tools indicates that academic datasets might provide proxy endpoints for assessing environmental neurotoxicity.
SN - 2296-2565
ER -