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NeuroCOGNitive impact of Air pollution exposures in Childhood: Assessment of air pollution effects on the development of cognition and behaviour in children

Periodic Reporting for period 1 - COGNAC (NeuroCOGNitive impact of Air pollution exposures in Childhood: Assessment of air pollution effects on the development of cognition and behaviour in children)

Reporting period: 2017-10-01 to 2019-09-30

Neurocognitive disorders create huge burdens on children, families and society. In Europe, there are over 15 million children with special educational needs, 1 million with diagnosed Autism Spectral Disorders (ASD), although some autistic traits are present in a larger proportion (14 million).

Potential long-term consequences of poor cognitive performance and presence of autistic traits are poor social development, low educational achievement, diminished economic productivity and unemployment, mental health issues, and increased risk of antisocial behaviour. In the case of ASD, a lifelong disorder, there is no cure and limited treatment options are available. Therefore, it is essential to identify modifiable risk factors to prevent their onset and prevalence.

Air pollution is postulated as a risk factor since it is believed to cause neuroinflammation, oxidative stress, cerebrovascular damage and neurodegenerative pathology. Traffic noise shows inconclusive associations with cognitive performance.

The experience of the fellow in exposure assessment methods has dovetailed nicely with the expertise in epidemiologic analysis in areas of cognitive and neurobehavioral development and wide-scale modelling at the host institution (ISGlobal), and with the expertise in different modelling approaches at the partner´s institutions (Imperial College London, King´s College London and Utrecht University). The partner institutions (Imperial College London and King´s College London) have also made available their existing air pollution exposure models for UK and London, as well as the noise exposure model for London.

The support and training received in all the institutions involved in the fellowship along with other formal training conducted by the fellow have been essential to accomplish the goal of the COGNAC project. This was to explore the associations between air pollution and noise with cognitive performance and the presence of autistic traits in children using a large children cohort.
In WP1 the fellow compiled and evaluated a set of available maps for UK and London from COGNAC partners at Imperial College London, King´s College London and from ISGlobal.

In WP2, the fellow conducted several visits to the Centre for Longitudinal Studies (CLS) University College London to access the Millennium Cohort Study (MCS) database in their super-secure computers in order to merge all the maps of exposure to air pollution and noise gathered in WP1 with all the information from the MCS cohort available at Centre for Longitudinal Studies.

In WP3, the fellow used the merged databases to conduct epidemiological analysis to assess the effect of air pollution and noise on cognitive performance and prevalence of autism spectrum disorders in children participating in the MCS cohort.
This research has contributed evidence on the effect of air pollution and noise on cognitive performance in children and diagnosis of ADS. Prenatal exposure to several air pollutants was found to be associated with developmental milestones at 9 months (e.g. waves bye-bye or extends arms), on construction skills at age 3 years old, and with some aspects of risk taking and gambling as well as with working memory at age 12. Prenatal exposure to ozone was associated with higher odds ratio of an ADS diagnosis. Further sensitivity analysis will be conducted to ensure the robustness of these results.

Considering the emerging evidence linking exposure to toxic air during pregnancy and early years of life, and the increased chances of babies being diagnosed with ASD, policy makers should define preventative measures to reduce exposure to these harmful toxicants in air. Some of those measures could be defining guidelines for locations of new nurseries away from traffic sources; and proposing best available practices to ensure low pollution of air indoors in existing nurseries. Policy makers could also disseminate best practices to avoid and reduce exposure to air pollution during pregnancy and infancy (e.g. leaflets given to parents-to-be, antenatal classes).

Through a comprehensive programme of training, Dr Juana Maria Delgado-Saborit has acquired intellectual knowledge and practical skills in cognition and neurodevelopment, large-scale modelling, spatial analysis and epidemiological methods. She has also gained considerable expertise in developing scripts in R and Stata to conduct data refinement and data analysis enabling her to work with very large volume datasets of exposure and medical related datasets. She has also acquired knowledge on the use of machine learning techniques, which are powerful tools to conduct big data analysis. Through interactions with policy makers, the fellow has got an overview of best practices to translate research into policy, and best ways to communicate research outcomes to stakeholders and policymakers.

The fellow has engaged in delivering several communication and public engagement activities, participating in the European Researcher´s Night, engaging with high school student delivering lectures in the Researcher´s Night spin-off termed Researcher´s Morning, and supervising high-a school science dissertation.

The fellow has created a group of internationally recognised collaborators, which has led to cross-fertilisation of research ideas, leading to the generation of and strengthening of new lines of research on environmental exposures and cognition, neurodevelopment and neuropathology. This will be extremely beneficial to the European scientific landscape, creating further more opportunities for collaboration within Europe and beyond.

Overall, this fellowship has contributed to increase European competitiveness in research on the impact of air pollution and noise on cognitive and neurobehavioral development, and has allowed the fellow to establish herself as a distinctive player in the field of Environment and Brain Health.
Association of prenatal exposures to air pollution and spatial awareness (Age 3 years old)