Abstract
The contemporary efforts toward economic growth and rapid industrialization have increased the risk of pollution-related ailments. Lahore is placed 20th on the list of most polluted cities with high levels of atmospheric particulate matter, exceeding the baseline value given by the WHO. The prolonged exposure to air pollution has been associated with cognitive dysfunction, deficit in working memory, executive function, attention and fluid intelligence. The study aimed to assess the relationship between cognitive issues among residents where the residents were divided into two groups with distinction to severity of pollution: Lahore—a highly polluted city; and Islamabad: a relatively cleaner city. The target population was healthy children aged 7–11 years, residing in the polluted area (Lahore) and the unpolluted area (Islamabad). They were assessed through computerized tests (the dual n-back test for working memory and the Stroop color-word test for attention). Independent samples t-test was used to test the hypothesis. The results revealed significant association between exposure to pollution and performance on working memory as well as attention task. Students residing in Lahore (polluted city) showed poor performance on both working memory and attention tasks, including a lower number of hits, lower dʹ score, longer reaction time on both congruent and incongruent trials, and higher error rate, than in Islamabad. The study's findings indicate that students exposed to pollution perform poorly on cognitive tasks, compared to children with little/no exposure.
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Notes
‘E’ corresponds to Executive Block with 11 consecutive serial no. This sector remains clean and green with no industries.
‘I’ stand for industrial sector in the capital city of Islamabad.
References
Ahmad M, Cheng S, Yu Q, Qin W, Zhang Y, Chen J (2019) Chemical and source characterization of PM2.5 in summertime in severely polluted Lahore, Pakistan. Atmos Res 234:104715. https://doi.org/10.1016/j.atmosres.2019.104715
Alexander LK, Lopes B, Ricchetti-Masterson K, Yeatts KB (2014) Cross-sectional Studies. Eric Notebook. Retrieved from, https://sph.unc.edu/wp-content/uploads/sites/112/2015/07/nciph_ERIC8.pdf
Alvarez-Pedrerol M, Rivas I, López-Vicente M, Suades-González E, Donaire-Gonzalez D, Cirach M, Sunyer J (2017) Impact of commuting exposure to traffic-related air pollution on cognitive development in children walking to school. Environ Pollut 231:837–844. https://doi.org/10.1016/j.envpol.2017.08.075
Ashraf A, Butt A, Khalid I, Alam U, Ahmad S (2018) Smog analysis and its effect on reported ocular surface diseases: a case study of 2016 smog event of Lahore. Atmos Environ. https://doi.org/10.1016/j.atmosenv.2018.10.029
Balali-Mood M, Ghorani-Azam A, Riahi-Zanjani B (2016) Effects of air pollution on human health and practical measures for prevention in Iran. J Res Med Sci 21(1):65. https://doi.org/10.4103/1735-1995.189646
Bano R, Khayyam U (2021) Industrial air pollution and self-reported respiratory and irritant health effects on adjacent residents: a case study of Islamabad Industrial Estate (IEI). Air Qual Atmos Health 14(10):1709–1722
Bhatti A (2014, April 15). Not so elite. The Nation. https://nation.com.pk/15-Apr-2014/not-so-elite
Calderón-Garcidueña L, Mora-Tiscareño A, Ontiveros E, Gómez-Garza G, Barragán-Mejía G, Broadway J, Engle RW (2008) Air pollution, cognitive deficits and brain abnormalities: a pilot study with children and dogs. Brain Cognition 68(2):117–127. https://doi.org/10.1016/j.bandc.2008.04.008
Calderón-Garcidueñas L, Engle R, Mora-Tiscareño A, Styner M, Gómez-Garza G, Zhu H, Jewells V, Torres-Jardón R, Romero L, Monroy-Acosta ME, Bryant C, González-González LO, Medina-Cortina H, D’Angiulli A (2011) Exposure to severe urban air pollution influences cognitive outcomes brain volume and systemic inflammation in clinically healthy children. Brain Cognit. 77(3):345–355. https://doi.org/10.1016/j.bandc.2011.09.006
Chen X (2018) Smog, cognition and real-world decision-making. Int J Health Policy Manag 8(2):76–80. https://doi.org/10.15171/ijhpm.2018.105
Chen JY, Johnson MK (1991) The Stroop congruency effect is more observable under a speed strategy than an accuracy strategy. Percept Mot Skills 73(1):67–76. https://doi.org/10.2466/pms.1991.73.1.67
Dahlin E, Nyberg L, Bäckman L, Neely AS (2008) Plasticity of executive functioning in young and older adults: immediate training gains, transfer, and long-term maintenance. Psychol Aging 23(4):720–730. https://doi.org/10.1037/a0014296
Dar H (2012, June 24). Private schools—quality of education in Pakistan. The Express Tribune. https://tribune.com.pk/story/398535/private-schools-%E2%80%93-quality-of-education-in-pakistan
Forns J, Esnaola M, López-Vicente M, Suades-González E, Alvarez-Pedrerol M, Julvez J, Sunyer J (2014) The n-back test and the attentional network task as measures of child neuropsychological development in epidemiological studies. Neuropsychology 28(4):519–529. https://doi.org/10.1037/neu0000085
Forns J, Dadvand P, Esnaola M, Alvarez-Pedrerol M, López-Vicente M, Garcia-Esteban R, Sunyer J (2017) Longitudinal association between air pollution exposure at school and cognitive development in school children over a period of 3.5 years. Environ Res 159:416–421. https://doi.org/10.1016/j.envres.2017.08.031
Ghimire N, Paudel BH, Khadka R, Singh PN (2014) Reaction time in Stroop test in Nepalese medical students. J Clin Diagn Res: JCDR. https://doi.org/10.7860/jcdr/2014/10615.4891zzz
Hankee LD, Preis SR, Piers RJ, Beiser AS, Devine SA, Liu Y, Seshadri S, Wolf PA, Au R (2016) Population normative data for the CERAD word list and Victoria Stroop Test in younger- and middle-aged adults: cross-sectional analyses from the Framingham Heart Study. Exp Aging Res 42(4):315–328. https://doi.org/10.1080/0361073X.2016.1191838
Herting MM, Younan D, Campbell CE, Chen J-C (2019) Outdoor air pollution and brain structure and function from across childhood to young adulthood: a methodological review of brain MRI studies. Front Public Health 7:332. https://doi.org/10.3389/fpubh.2019.00332
Imbrosciano A, Berlach RG (2005) The Stroop test and its relationship to academic performance and general behaviour of young students. Teach Dev 9(1):131–144. https://doi.org/10.1080/13664530500200234
Jaeggi SM, Buschkuehl M, Perrig WJ, Meier B (2010) The concurrent validity of the n-back task as a working memory measure. Memory 18(4):394–412. https://doi.org/10.1080/09658211003702171
Khaniabadi YO, Polosa R, Chuturkova RZ, Daryanoosh M, Goudarzi G, Borgini A, Tittarellig A, Basirih H, Armini H, Nourmoradij H, Babaeie AA, Naserian P (2017) Human health risk assessment due to ambient PM10 and SO2 by an air quality modeling technique. Process Saf Environ Prot 111:346–354. https://doi.org/10.1016/j.psep.2017.07.018
Landrigan PJ, Fuller R, Acosta NJR, Adeyi O, Arnold R, Basu N, Zhong M (2018) The lancet commission on pollution and health. Lancet 391(10119):462–512. https://doi.org/10.1016/s0140-6736(17)32345-0
Landrigan PJ, Fuller R, Fisher S, Suk WA, Sly P, Chiles TC, Bose-O’Reilly S (2019) Pollution and children’s health. Sci Total Environ 650:2389–2394. https://doi.org/10.1016/j.scitotenv.2018.09.375
Leung DYC (2015) Outdoor–indoor air pollution in urban environment: challenges and opportunity. Front Environ Sci 2:69
Miller KM, Price CC, Okun MS, Montijo H, Bowers D (2009) Is the n-back task a valid neuropsychological measure for assessing working memory. Arch Clin Neuropsychol 24(7):711–717. https://doi.org/10.1093/arclin/acp063
Munawer ME (2018) Human health and environmental impacts of coal combustion and post-combustion wastes. J Sustain Min 17(2):87–96. https://doi.org/10.1016/j.jsm.2017.12.007
Nadeem O, Hameed R, Basheer A, Azam A, Ismail I (2015) Impact of land use change on climate: a case study of Gulberg scheme, Lahore, Pakistan. J Fac Eng Technol 22(2):111–121
Oliveira RM, Mograbi DC, Gabrig IA, Charchat-Fichman H (2016) Normative data and evidence of validity for the Rey Auditory Verbal Learning Test, Verbal Fluency Test, and Stroop Test with Brazilian children. Psychol Neurosci 9(1):54–67. https://doi.org/10.1037/pne0000041
Pelegrina S, Lechuga MT, García-Madruga JA, Elosúa MR, Macizo P, Carreiras M, Fuentes LJ, Bajo MT (2015) Normative data on the n-back task for children and young adolescents. Front Psychol. https://doi.org/10.3389/fpsyg.2015.01544
Porta D, Narduzzi S, Badaloni C, Bucci S, Cesaroni G, Colelli V, Davoli M, Sunyer J, Zirro E, Schwartz J, Forastiere F (2015) Air pollution and cognitive development at age seven in a prospective Italian birth cohort. Epidemiology 27(2):228–236. https://doi.org/10.1097/EDE.0000000000000405
Pujol J, Martínez-Vilavella G, Macià D, Fenoll R, Alvarez-Pedrerol M, Rivas I, Forns J, Blanco-Hinojo L, Capellades J, Querol X, Deus J, Sunyer J (2016) Traffic pollution exposure is associated with altered brain connectivity in school children. Neuroimage 129:175–184. https://doi.org/10.1016/j.neuroimage.2016.01.036
Rayan M, Gruehn D, Khayyam U (2021a) Green infrastructure planning. A strategy to safeguard urban settlements in Pakistan. Planning in Germany and Iran. Responding challenges of climate change through intercultural dialogue. Mensch und Buch Verlag, Berlin, pp 197–220
Rayan M, Gruehn D, Khayyam U (2021b) Green infrastructure indicators to plan resilient urban settlements in Pakistan: local stakeholder’s perspective. Urban Clim 38:100899
Rehman A, Liu G, Yousaf B, Zia-Ur-Rehman M, Ali MU, Rashid MS, Farooq MR, Javed Z (2020) Characterizing pollution indices and children health risk assessment of potentially toxic metal(oid)s in school dust of Lahore, Pakistan. Ecotoxicol Environ Saf 190:110059. https://doi.org/10.1016/j.ecoenv.2019.110059
Saenen ND, Provost EB, Viaene MK, Vanpoucke C, Lefebvre W, Vrijens K, Roels HA, Nawrot TS (2016) Recent versus chronic exposure to particulate matter air pollution in association with neurobehavioral performance in a panel study of primary schoolchildren. Environ Int 95:112–119. https://doi.org/10.1016/j.envint.2016.07.014
Schmidt H, Jogia J, Fast K, Christodoulou T, Haldane M, Kumari V et al (2009) No gender differences in brain activation during the n-back task: an fMRI study in healthy individuals. Hum Brain Mapp 30:3609–3615. https://doi.org/10.1002/hbm.20783
Setia MS (2016) Methodology series module 3: cross-sectional studies. Indian J Dermatol 61(3):261–264. https://doi.org/10.4103/0019-5154.182410
Shahid I, Chishtie F, Bulbul G, Shahid MZ, Shafique S (2019) State of air quality in twin cities of Pakistan: Islamabad and Rawalpindi. Atmósfera 32(1):71–84. https://doi.org/10.20937/atm.2019.32.01.06
Shin J, Han SH, Choi J (2019) Exposure to ambient air pollution and cognitive impairment in community-dwelling older adults: the Korean frailty and aging cohort study. Int J Environ Res Public Health 16(19):3767. https://doi.org/10.3390/ijerph16193767
Sidra S, Ali Z, Nasir ZA, Colbeck I (2015) Seasonal variation of fine particulate matter in residential micro-environments of Lahore, Pakistan. Atmos Pollut Res 6(5):797–804. https://doi.org/10.5094/APR.2015.088
Siegrist M (1995) Reliability of the Stroop test with single-stimulus presentation. Percept Mot Skills 81(3_suppl):1295–1298. https://doi.org/10.2466/pms.1995.81.3f.1295
Sunyer J, Esnaola M, Alvarez-Pedrerol M, Forns J, Rivas I, López-Vicente M, Suades-González E, Foraster M, Garcia-Esteban R, Basagaña X, Viana M, Cirach M, Moreno T, Alastuey A, Sebastian-Galles N, Nieuwenhuijsen M, Querol X, Lanphear BP (2015) Association between traffic-related air pollution in schools and cognitive development in primary school children: a prospective cohort study. PLoS Med 12(3):e1001792. https://doi.org/10.1371/journal.pmed.1001792
Van der Elst W (2006) The Stroop color-word test: influence of age, sex, and education; and normative data for a large sample across the adult age range. Assessment 13(1):62–79. https://doi.org/10.1177/1073191105283427
VandenBos GR (2015) d prime. APA Dictionary of Psychology. American Psychological Association, Washington, DC
Wang S, Zhang J, Zeng X, Zeng Y, Wang S, Chen S (2009) Association of traffic-related air pollution with children’s neurobehavioral functions in Quanzhou, China. Environ Health Perspect 117(10):1612–1618. https://doi.org/10.1289/ehp.0800023
Waseem S, Khayyam U (2019) Loss of vegetative cover and increased land surface temperature: a case study of Islamabad, Pakistan. J Clean Prod 234:972–983. https://doi.org/10.1016/j.jclepro.2019.06.228
Wright BC (2016) What Stroop tasks can tell us about selective attention from childhood to adulthood. Br J Psychol 108(3):583–607. https://doi.org/10.1111/bjop.12230
Zhang J, Wei Y, Fang Z (2019) Ozone pollution: a major health hazard worldwide. Front Immunol 10:2518. https://doi.org/10.3389/fimmu.2019.02518
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The authors owe thanks to Dr. Wajiha Haq (official discussant, Assistant Professor at the Department of Economics, S3H NUST) for her insight to improve the quality of this research. Thanks also to editor for their kind processing, and anonymous reviewers for their time, review and detailed comments that have greatly uplifted the manuscript’s quality.
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Naveed, Z., Khayyam, U. Smog and cognitive issues in the school going children of Lahore and Islamabad, Pakistan. Int. J. Environ. Sci. Technol. 20, 4151–4166 (2023). https://doi.org/10.1007/s13762-022-04264-y
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DOI: https://doi.org/10.1007/s13762-022-04264-y