Mizen, A; Lyons, J; Rodgers, S; Berridge, D; Akbari, A; Wilkinson, P; Milojevic, A; ... Davies, G; + view all Mizen, A; Lyons, J; Rodgers, S; Berridge, D; Akbari, A; Wilkinson, P; Milojevic, A; Doherty, R; Dearden, L; Lake, I; Carruthers, D; Strickland, S; Mavrogianni, A; Davies, G; - view fewer (2018) Are Children Who Are Treated for Asthma and Seasonal Allergic Rhinitis Disadvantaged in Their Educational Attainment When Acutely Exposed to Air Pollution and Pollen? A Feasibility Study. Presented at: International Conference for Administrative Data Research, Belfast, Northern Ireland, UK.

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Abstract

BACKGROUND: There is a lack of evidence of the adverse effects which air quality has on cognition for people with air quality-related health conditions, these are not widely documented in the literature. Educational attainment, as a proxy for cognition, may increase with improved air quality. OBJECTIVES: Prepare individual and household level linked environmental and health data for analysis within an anonymised safe haven; analyse the linked dataset for our study investigating: Cognition, Respiratory Tract illness and Effects of eXposure (CORTEX). METHODS: Anonymised, routinely collected health and education data were linked with high spatial resolution pollution measurements and daily pollen measurements to provide repeated cross-sectional cohorts (2009-2015) on 18,241 pupils across the city of Cardiff, using the SAIL databank. A fully adjusted multilevel linear regression analysis examined associations between health status and/or air quality. Cohort, school and individual level confounders were controlled for. We hope that using individual-level multi-location daily exposure assessment will help to clarify the role of traffic and prevent potential community-level confounding. Combined effects of air quality on variation in educational attainment between those treated for asthma and/or Severe Allergic Rhinitis (SAR), and those not treated, was also investigated. FINDINGS: Asthma was not associated with exam performance (p=0.7). However, SAR was positively associated with exam performance (p<0.001). Exposure to air pollution was negatively associated with educational attainment regardless of health status. CONCLUSIONS: Irrespective of health status, air quality was negatively associated with educational attainment. Treatment seeking behaviour may explain the positive association between SAR and educational attainment. For a more accurate reflection of health status, health outcomes not subject to treatment seeking behaviours, such as emergency hospital admission, should be investigated.

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