Air pollution exposure during pregnancy and childhood has been linked to executive function impairment in children, however, very few studies have assessed these two exposure periods jointly to identify susceptible periods of exposure. We sought to identify potential periods of susceptibility of nitrogen dioxide (NO) exposure from conception to childhood on attentional function and working memory in school-aged children. Within the Spanish INMA Project, we estimated residential daily NO exposures during pregnancy and up to 6 years of childhood using land use regression models (n = 1,703). We assessed attentional function at 4–6 years and 6–8 years, using the Conners Kiddie Continuous Performance Test and the Attention Network Test, respectively, and working memory at 6–8 years, using the N-back task. We used distributed lag non-linear models to assess the periods of susceptibility of each outcome, adjusting for potential confounders and correcting for multiple testing. We also stratified all models by sex. Higher exposure to NO between 1.3 and 1.6 years of age was associated with higher hit reaction time standard error (HRT-SE) (0.14 ms (95 % CI 0.05; 0.22) per 10 μg/m increase in NO) and between 1.5 and 2.2 years of age with more omission errors (1.02 (95 % CI 1.01; 1.03) of the attentional function test at 4–6 years. Higher exposure to NO between 0.3 and 2.2 years was associated with higher HRT-SE (10.61 ms (95 % CI 3.46; 17.75) at 6–8 years only in boys. We found no associations between exposure to NO and working memory at 6–8 years. Our findings suggest that NO exposure during the first two years of life is associated with poorer attentional function in children from 4 to 8 years of age, especially in boys. These findings highlight the importance of exploring long-term effects of traffic-related air pollution exposure in older age groups.

中文翻译：

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4至8岁儿童的二氧化氮暴露、注意力功能和工作记忆：从怀孕到儿童期的易感期

怀孕和儿童时期的空气污染暴露与儿童执行功能障碍有关，然而，很少有研究联合评估这两个暴露时期，以确定易受影响的暴露时期。我们试图确定从受孕到儿童时期二氧化氮（NO）暴露对学龄儿童注意力功能和工作记忆的潜在易感期。在西班牙 INMA 项目中，我们使用土地利用回归模型估算了怀孕期间和直至 6 岁儿童时期的住宅每日 NO 暴露量 (n = 1,703)。我们分别使用 Conners Kiddie 连续表现测试和注意力网络测试评估 4-6 岁和 6-8 岁的注意力功能，并使用 N-back 任务评估 6-8 岁的工作记忆。我们使用分布式滞后非线性模型来评估每个结果的敏感性周期，调整潜在的混杂因素并纠正多重测试。我们还按性别对所有模型进行了分层。 1.3 至 1.6 岁之间较高的 NO 暴露水平与较高的命中反应时间标准误 (HRT-SE) 相关（NO 每增加 10 μg/m，增加 0.14 ms (95% CI 0.05; 0.22)），而 1.5 至 2.2 岁之间则与较高的 NO 暴露相关。 4-6 岁时注意功能测试的遗漏错误较多（1.02 (95 % CI 1.01; 1.03)。0.3 至 2.2 岁之间较高的 NO 暴露与较高的 HRT-SE 相关（10.61 ms (95 % CI 3.46；17.75）仅在 6-8 岁的男孩中我们发现，在 6-8 岁时接触 NO 与工作记忆之间没有关联。 4 至 8 岁儿童，尤其是男孩，这些发现凸显了探索与交通相关的空气污染暴露对老年人群的长期影响的重要性。