title: Traffic-Related Air Pollution, Noise at School, and Behavioral Problems in Barcelona Schoolchildren: A Cross-Sectional Study.
abstract: BACKGROUND
  The available evidence of the effects of air pollution and noise on behavioral development is limited, and it overlooks exposure at schools, where children spend a considerable amount of time.
  
  
  OBJECTIVE
  We aimed to investigate the associations of exposure to traffic-related air pollutants (TRAPs) and noise at school on behavioral development of schoolchildren.
  
  
  METHODS
  We evaluated children 7-11 years of age in Barcelona (Catalonia, Spain) during 2012-2013 within the BREATHE project. Indoor and outdoor concentrations of elemental carbon (EC), black carbon (BC), and nitrogen dioxide (NO2) were measured at schools in two separate 1-week campaigns. In one campaign we also measured noise levels inside classrooms. Parents filled out the strengths and difficulties questionnaire (SDQ) to assess child behavioral development, while teachers completed the attention deficit/hyperactivity disorder criteria of the DSM-IV (ADHD-DSM-IV) list to assess specific ADHD symptomatology. Negative binomial mixed-effects models were used to estimate associations between the exposures and behavioral development scores.
  
  
  RESULTS
  Interquartile range (IQR) increases in indoor and outdoor EC, BC, and NO2 concentrations were positively associated with SDQ total difficulties scores (suggesting more frequent behavioral problems) in adjusted multivariate models, whereas noise was significantly associated with ADHD-DSM-IV scores.
  
  
  CONCLUSIONS
  In our study population of 7- to 11-year-old children residing in Barcelona, exposure to TRAPs at school was associated with increased behavioral problems in schoolchildren. Noise exposure at school was associated with more ADHD symptoms.
  
  
  BACKGROUND
  Forns J, Dadvand P, Foraster M, Alvarez-Pedrerol M, Rivas I, López-Vicente M, Suades-Gonzalez E, Garcia-Esteban R, Esnaola M, Cirach M, Grellier J, Basagaña X, Querol X, Guxens M, Nieuwenhuijsen MJ, Sunyer J. 2016. Traffic-related air pollution, noise at school, and behavioral problems in Barcelona schoolchildren: a cross-sectional study. Environ Health Perspect 124:529-535; http://dx.doi.org/10.1289/ehp.1409449.
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Catalonia, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Forns
authors.forename: Payam
authors.initials: P
authors.lastname: Dadvand
authors.forename: Maria
authors.initials: M
authors.lastname: Foraster
authors.forename: Mar
authors.initials: M
authors.lastname: Alvarez-Pedrerol
authors.forename: Ioar
authors.initials: I
authors.lastname: Rivas
authors.forename: Mònica
authors.initials: M
authors.lastname: López-Vicente
authors.forename: Elisabet
authors.initials: E
authors.lastname: Suades-Gonzalez
authors.forename: Raquel
authors.initials: R
authors.lastname: Garcia-Esteban
authors.forename: Mikel
authors.initials: M
authors.lastname: Esnaola
authors.forename: Marta
authors.initials: M
authors.lastname: Cirach
authors.forename: James
authors.initials: J
authors.lastname: Grellier
authors.forename: Xavier
authors.initials: X
authors.lastname: Basagaña
authors.forename: Xavier
authors.initials: X
authors.lastname: Querol
authors.forename: Mònica
authors.initials: M
authors.lastname: Guxens
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.forename: Jordi
authors.initials: J
authors.lastname: Sunyer
mesh_terms: D000393:Air Pollutants / Q000633:toxicity*; D000397:Air Pollution / Q000009:adverse effects; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000139:chemically induced / Q000453:epidemiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009585:Nitrogen Dioxide / Q000633:toxicity; D009622:Noise / Q000009:adverse effects*; D052638:Particulate Matter / Q000633:toxicity*; D000066553:Problem Behavior; D012574:Schools; D013030:Spain / Q000453:epidemiology; D001335:Vehicle Emissions / Q000032:analysis*
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D001335:Vehicle Emissions; D009585:Nitrogen Dioxide