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Impact of air pollution and asthma on school attendance and educational attainment: a scoping review

CEDRIC BURDEN, Zakariah Gassasse, Mohammad Al Sallakh Orcid Logo, Jennifer K Quint, Rich Fry Orcid Logo, Gwyneth Davies Orcid Logo

BMJ Open Respiratory Research, Volume: 12, Issue: 1, Start page: e003527

Swansea University Authors: CEDRIC BURDEN, Mohammad Al Sallakh Orcid Logo, Rich Fry Orcid Logo, Gwyneth Davies Orcid Logo

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DOI (Published version): 10.1136/bmjresp-2025-003527

Abstract

Background: Asthma morbidity is high among young people, and studies have shown associations between asthma and school attendance and educational attainment. However, findings are unclear concerning associations between air pollution and these educational outcomes, and whether asthma might mediate a...

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Published in: BMJ Open Respiratory Research
ISSN: 2052-4439
Published: BMJ Publishing Group Ltd 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa70906
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Uncontrolled asthma was associated with lower educational attainment, but findings on air pollution exposure were mixed. Two studies found associations for air pollution with poorer educational outcomes for young people with asthma. Long-term exposure to air pollution, and an increase in the frequency of peaks of air pollution, were associated with worse educational outcomes. Inequalities in access to healthcare and education were associated with uncontrolled asthma and lower educational outcomes. Only one study used linked health, environmental and educational data. Conclusions: Linked administrative data will be important to enable longitudinal studies of exceptionally large populations to explore asthma exacerbation, baseline and spikes of air pollution and risk factors. Analyses should control for type of educational assessment and specific particulate exposure. 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spelling 2025-12-15T16:22:30.5325647 v2 70906 2025-11-14 Impact of air pollution and asthma on school attendance and educational attainment: a scoping review b72a8774e8c35f333184adaa4e9431e7 CEDRIC BURDEN CEDRIC BURDEN true false 6efc53139ba1416418a6c6e584a25f2d 0000-0002-8333-7279 Mohammad Al Sallakh Mohammad Al Sallakh true false d499b898d447b62c81b2c122598870e0 0000-0002-7968-6679 Rich Fry Rich Fry true false 92d69cf8519a334ced3f55142c811d95 0000-0003-1218-1008 Gwyneth Davies Gwyneth Davies true false 2025-11-14 Background: Asthma morbidity is high among young people, and studies have shown associations between asthma and school attendance and educational attainment. However, findings are unclear concerning associations between air pollution and these educational outcomes, and whether asthma might mediate any associations. Objective: This review aimed to summarise, and find gaps in, the research on outdoor air pollution, asthma and educational outcomes. To our knowledge, this is the first review to consider the impact of air pollution or asthma, individually or in combination, on the school attendance and educational attainment of children and young people. Design: This scoping review, using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews method, reports on searches for English language studies of air pollution, asthma and school attendance and educational attainment in eight databases with tabulation and synthesis of the extracted data. Results: Association between air pollution and school absence was found to be weaker than for active asthma with this outcome. Uncontrolled asthma was associated with lower educational attainment, but findings on air pollution exposure were mixed. Two studies found associations for air pollution with poorer educational outcomes for young people with asthma. Long-term exposure to air pollution, and an increase in the frequency of peaks of air pollution, were associated with worse educational outcomes. Inequalities in access to healthcare and education were associated with uncontrolled asthma and lower educational outcomes. Only one study used linked health, environmental and educational data. Conclusions: Linked administrative data will be important to enable longitudinal studies of exceptionally large populations to explore asthma exacerbation, baseline and spikes of air pollution and risk factors. Analyses should control for type of educational assessment and specific particulate exposure. Studies should examine temporal changes and a variety of geographical settings to identify even weak associations to inform approaches to address inequalities of public health and education. Journal Article BMJ Open Respiratory Research 12 1 e003527 BMJ Publishing Group Ltd 2052-4439 7 12 2025 2025-12-07 10.1136/bmjresp-2025-003527 COLLEGE NANME COLLEGE CODE Swansea University SU Library paid the OA fee (TA Institutional Deal) This study was funded by Health Data Research UK, Inflammation and Immunity Driver Programme, through the provision of PhD funding to CB (DSR1100-100). 2025-12-15T16:22:30.5325647 2025-11-14T16:58:10.6044177 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science CEDRIC BURDEN 1 Zakariah Gassasse 2 Mohammad Al Sallakh 0000-0002-8333-7279 3 Jennifer K Quint 4 Rich Fry 0000-0002-7968-6679 5 Gwyneth Davies 0000-0003-1218-1008 6 70906__35829__ea8eeb5436ff4e75ad7d403466ffdd92.pdf 70906.VOR.pdf 2025-12-15T16:18:50.2708076 Output 957147 application/pdf Version of Record true © Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license. true eng https://creativecommons.org/licenses/by/4.0/
title Impact of air pollution and asthma on school attendance and educational attainment: a scoping review
spellingShingle Impact of air pollution and asthma on school attendance and educational attainment: a scoping review
CEDRIC BURDEN
Mohammad Al Sallakh
Rich Fry
Gwyneth Davies
title_short Impact of air pollution and asthma on school attendance and educational attainment: a scoping review
title_full Impact of air pollution and asthma on school attendance and educational attainment: a scoping review
title_fullStr Impact of air pollution and asthma on school attendance and educational attainment: a scoping review
title_full_unstemmed Impact of air pollution and asthma on school attendance and educational attainment: a scoping review
title_sort Impact of air pollution and asthma on school attendance and educational attainment: a scoping review
author_id_str_mv b72a8774e8c35f333184adaa4e9431e7
6efc53139ba1416418a6c6e584a25f2d
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92d69cf8519a334ced3f55142c811d95
author_id_fullname_str_mv b72a8774e8c35f333184adaa4e9431e7_***_CEDRIC BURDEN
6efc53139ba1416418a6c6e584a25f2d_***_Mohammad Al Sallakh
d499b898d447b62c81b2c122598870e0_***_Rich Fry
92d69cf8519a334ced3f55142c811d95_***_Gwyneth Davies
author CEDRIC BURDEN
Mohammad Al Sallakh
Rich Fry
Gwyneth Davies
author2 CEDRIC BURDEN
Zakariah Gassasse
Mohammad Al Sallakh
Jennifer K Quint
Rich Fry
Gwyneth Davies
format Journal article
container_title BMJ Open Respiratory Research
container_volume 12
container_issue 1
container_start_page e003527
publishDate 2025
institution Swansea University
issn 2052-4439
doi_str_mv 10.1136/bmjresp-2025-003527
publisher BMJ Publishing Group Ltd
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
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description Background: Asthma morbidity is high among young people, and studies have shown associations between asthma and school attendance and educational attainment. However, findings are unclear concerning associations between air pollution and these educational outcomes, and whether asthma might mediate any associations. Objective: This review aimed to summarise, and find gaps in, the research on outdoor air pollution, asthma and educational outcomes. To our knowledge, this is the first review to consider the impact of air pollution or asthma, individually or in combination, on the school attendance and educational attainment of children and young people. Design: This scoping review, using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews method, reports on searches for English language studies of air pollution, asthma and school attendance and educational attainment in eight databases with tabulation and synthesis of the extracted data. Results: Association between air pollution and school absence was found to be weaker than for active asthma with this outcome. Uncontrolled asthma was associated with lower educational attainment, but findings on air pollution exposure were mixed. Two studies found associations for air pollution with poorer educational outcomes for young people with asthma. Long-term exposure to air pollution, and an increase in the frequency of peaks of air pollution, were associated with worse educational outcomes. Inequalities in access to healthcare and education were associated with uncontrolled asthma and lower educational outcomes. Only one study used linked health, environmental and educational data. Conclusions: Linked administrative data will be important to enable longitudinal studies of exceptionally large populations to explore asthma exacerbation, baseline and spikes of air pollution and risk factors. Analyses should control for type of educational assessment and specific particulate exposure. Studies should examine temporal changes and a variety of geographical settings to identify even weak associations to inform approaches to address inequalities of public health and education.
published_date 2025-12-07T05:34:04Z
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