Lifetime exposure to air pollution and academic achievement: A nationwide cohort study in Denmark

[Display omitted] •We examined the 9th-grade exit exams of 785,312 children in Denmark.•Children’s GPA was associated with lifetime exposure to air pollution.•An increase of 5 µg/m3 in PM2.5 was linked to a one-point decrease in GPA.•The negative associations were noticeable in the mathematics and natural sciences.•Girls and children with non-Danish mothers were susceptible to the association. Recent research suggests a link between air pollution and cognitive development in children, and studies on air pollution and academic achievement are emerging. We conducted a nationwide cohort study in Denmark to explore the associations between lifetime exposure to air pollution and academic performance in 9th grade. The study encompassed 785,312 children born in Denmark between 1989 and 2005, all of whom completed 9th-grade exit examinations. Using linear mixed models with a random intercept for each school, we assessed the relationship between 16 years of exposure to PM2.5, PM10, and gaseous pollutants and Grade Point Averages (GPA) in exit examinations, covering subjects such as Danish literature, Danish writing, English, mathematics, and natural sciences. The study revealed that a 5 µg/m3 increase in PM2.5 and PM10 was associated with a decrease of 0.99 (95 % Confidence Intervals: −1.05, −0.92) and 0.46 (−0.50, −0.41) in GPA, respectively. Notably, these negative associations were more pronounced in mathematics and natural sciences compared to language-related subjects. Additionally, girls and children with non-Danish mothers were found to be particularly susceptible to the adverse effects of air pollution exposure. These results underscore the potential long-term consequences of air pollution on academic achievement, emphasizing the significance of interventions that foster healthier environments for children's cognitive development.