The impact of Traffic-Related air pollution on child and adolescent academic Performance: A systematic review.

Abstract Background The negative health impacts of traffic-related air pollution (TRAP) have been investigated for many decades, however, less attention has been paid to the effect of TRAP on children’s academic performance. Understanding the TRAP-academic performance relationship will assist in identifying mechanisms for improving students’ learning and aid policy makers in developing guidance for protecting children in school environments. Methods This systematic review assessed the relationship between TRAP and academic performance. Web of Science, PubMed, CINAHL, Medline, PsycINFO, SPORTDiscus, Scopus and ERIC databases were searched for relevant, peer reviewed, articles published in English. Articles assessing exposure to TRAP pollutants (through direct measurement, local air quality monitoring, modelling, or road proximity/density proxy measures) and academic performance (using standardised tests) in children and adolescents were included. Risk of bias was assessed within and between studies. Results Of 3519 search results, 10 relevant articles were included. Nine studies reported that increased exposure to some TRAP was associated with poorer student academic performance. Study methodologies were highly heterogeneous and no consistent patterns of association between specific pollutants, age groups, learning domains, exposure windows, and exposure locations were established. There was a serious risk of bias within individual studies and confidence in the body of evidence was low. Conclusions This review found evidence suggestive of a negative association between TRAP and academic performance. However, the quality of this evidence was low. The existing body of literature is small, lacks the inclusion of high-quality exposure measures, and presents limitations in reporting. Future research should focus on using valid and reliable exposure measures, individual-level data, consistent controlling for confounders and longitudinal study designs.