Allergy test: Seasonal allergens and performance in school

Lead exposure and student outcomes: A study of Flint schools

This paper estimates the impacts of cumulative lead exposure on the short-run discipline and academic achievement of elementary school students. An exogenous, heterogeneous shock of lead-in-water levels within classrooms at Flint Community Schools provides the treatment variation used to focus on the understudied, short-run effects of lead on older children. At the mean level of classroom lead exposure disciplinary actions increased by 8 actions per grade within each school, and the share of students proficient in both math and reading declined. These results may help explain observed disparities in both behavior and academic achievement for underprivileged groups.

The impact of Traffic-Related air pollution on child and adolescent academic Performance: A systematic review

BACKGROUND

The negative health impacts of traffic-related air pollution (TRAP) have been investigated for many decades, however, less attention has been paid to the effect of TRAP on children's academic performance. Understanding the TRAP-academic performance relationship will assist in identifying mechanisms for improving students' learning and aid policy makers in developing guidance for protecting children in school environments.

METHODS

This systematic review assessed the relationship between TRAP and academic performance. Web of Science, PubMed, CINAHL, Medline, PsycINFO, SPORTDiscus, Scopus and ERIC databases were searched for relevant, peer reviewed, articles published in English. Articles assessing exposure to TRAP pollutants (through direct measurement, local air quality monitoring, modelling, or road proximity/density proxy measures) and academic performance (using standardised tests) in children and adolescents were included. Risk of bias was assessed within and between studies.

RESULTS

Of 3519 search results, 10 relevant articles were included. Nine studies reported that increased exposure to some TRAP was associated with poorer student academic performance. Study methodologies were highly heterogeneous and no consistent patterns of association between specific pollutants, age groups, learning domains, exposure windows, and exposure locations were established. There was a serious risk of bias within individual studies and confidence in the body of evidence was low.

CONCLUSIONS

This review found evidence suggestive of a negative association between TRAP and academic performance. However, the quality of this evidence was low. The existing body of literature is small, lacks the inclusion of high-quality exposure measures, and presents limitations in reporting. Future research should focus on using valid and reliable exposure measures, individual-level data, consistent controlling for confounders and longitudinal study designs.

Rationale and Design of a Panel Study Investigating Six Health Effects of Airborne Pollen: The EPOCHAL Study

Background: While airborne pollen is widely recognized as a seasonal cause of sneezing and itchy eyes, its effects on pulmonary function, cardiovascular health, sleep quality, and cognitive performance are less well-established. It is likely that the public health impact of pollen may increase in the future due to a higher population prevalence of pollen sensitization as well as earlier, longer, and more intense pollen seasons, trends attributed to climate change. The effects of pollen on health outcomes have previously been studied through cross-sectional design or at two time points, namely preceding and within the period of pollen exposure. We are not aware of any observational study in adults that has analyzed the dose-response relationship between daily ambient pollen concentration and cardiovascular, pulmonary, cognitive, sleep, or quality of life outcomes. Many studies have relied on self-reported pollen allergy status rather than objectively confirming pollen sensitization. In addition, many studies lacked statistical power due to small sample sizes or were highly restrictive with their inclusion criteria, making the findings less transferable to the "real world." Methods: The EPOCHAL study is an observational panel study which aims to relate ambient pollen concentration to six specific health domains: (1) pulmonary function and inflammation; (2) cardiovascular outcomes (blood pressure and heart rate variability); (3) cognitive performance; (4) sleep; (5) health-related quality of life (HRQoL); and (6) allergic rhinitis symptom severity. Our goal is to enroll 400 individuals with diverse allergen sensitization profiles. The six health domains will be assessed while ambient exposure to pollen of different plants naturally varies. Health data will be collected through six home nurse visits (at approximately weekly intervals) as well as 10 days of independent tracking of blood pressure, sleep, cognitive performance, HRQoL, and symptom severity by participants. Through repeated health assessments, we aim to uncover and characterize dose-response relationships between exposure to different species of pollen and numerous acute health effects, considering (non-)linearity, thresholds, plateaus and slopes. Conclusion: A gain of knowledge in pollen-health outcome relationships is critical to inform future public health policies and will ultimately lead toward better symptom forecasts and improved personalized prevention and treatment.

Development of a Random Forest model for forecasting allergenic pollen in North America

Pollen allergies have negative impacts on health. Information about airborne pollen concentration can improve symptom management by guiding choices affecting timing of medicines and pollen exposure. Observations provide accurate pollen concentrations at point locations. However, in the contiguous United States and southern Canada (CUSSC), observations are sparse, and sampling is often seasonal, intermittent or both. Modeling pollen concentration can fill in the gaps with estimates where direct observations are unavailable and also provide much-needed forecasts. The goal of this study is to develop and evaluate statistical models that predict daily pollen concentrations using a machine learning Random Forest algorithm. To evaluate our methods, we made retrospective forecasts of four pollen types (Quercus, Cupressaceae, Ambrosia and Poaceae), each in one of four CUSSC locations. Meteorological and vegetation conditions were input to the models at city and regional scales. A data augmentation technique was investigated and found to improve model skill. Models were also developed to forecast pollen in locations where there are no observations. Forecast skill in these models were found to be greater than in previous models. Nevertheless, the skill is limited by the spatiotemporal resolution of the pollen observations.

Cognitive dysfunction and quality of life during pollen season in children with seasonal allergic rhinitis

BACKGROUND

Allergic rhinitis often gives rise to impaired quality of life and is believed to also affect cognitive function. We aimed to examine whether cognitive functions were impaired during grass pollen season in symptomatic allergic children and to relate the degree of impairment to quality of life and biomarkers related to stress and inflammation.

METHODS

Forty-three grass pollen-allergic children (age 8-17 years) with non-satisfactory effect of medication (antihistamines and nasal steroids daily) during previous seasons were included. In addition, 26 matched non-allergic children were included as controls. Both groups performed cognitive tests (CANTAB) and completed Quality of Life questionnaires outside and during the pollen season. Blood samples were collected and analyzed for stress and inflammatory biomarkers. Pollen level was measured daily.

RESULTS

Impaired cognitive function was found in spatial working memory, where the allergic group made more errors compared to the non-allergic group during pollen season, but not off-season. No significant differences could be seen between the allergic group and the controls in the other tests investigating visual memory or attention. Quality of health questionnaires revealed more symptoms and impaired quality of life in allergic compared to non-allergic children, and increased symptoms in allergic children were associated with longer reaction time for simple movement during pollen season. No differences in stress or inflammatory biomarkers could be found between the groups.

CONCLUSION

Cognitive function was affected during pollen season in pollen-allergic children, and the more symptoms the allergic children had, the longer the reaction time in the cognitive tests.

Determinants of the utilization of allergy management measures among hay fever sufferers: a theory-based cross-sectional study

Background

The quality of life of chronically ill individuals, such as hay fever sufferers, is significantly dependent on their health behavior. This survey aimed to explain the health-related behavior of allergic individuals using the protection motivation theory (PMT) and the transtheoretical model (TTM).

Methods

The influencing variables stated by PMT were operationalized based on data from semistructured pilot interviews and a pretest with 12 individuals from the target population. The final questionnaire inquired perceived seriousness and severity of hay fever, response efficacy, response costs, self-efficacy, and the use of various hay fever management measures in relation to the TTM stages. Multivariate logistic regression was performed to investigate the relationships between the PMT constructs and the examined health behavior.

Results

A total of 569 allergic individuals completed the online questionnaire. Only 33.26% of allergic individuals were in the maintenance stage for treatment under medical supervision, and almost 60% preferred hay fever self-management. A total of 67.56% had a well-established habit of taking anti-allergic medication, but only 25.31% had undergone specific immunotherapy. The likelihood of seeking medical supervision was positively influenced by perceived severity (OR = 1.35, 95% CI: 1.02–1.81), perceived seriousness (OR = 2.12, 95% CI: 1.56–2.89), and self-efficacy (OR = 4.52, 95% CI: 3.11–6.65). The perceived severity of symptoms predicted the practice of hay fever self-management (OR = 1.60, 95% CI: 1.21–2.11), as well as anti-allergic medication intake (OR = 1.65, 95% CI: 1.16–2.35). The latter measure was also positively influenced by self-efficacy (OR = 1.52, 95% CI: 1.01–2.28) and hay fever self-management (OR = 4.76, 95% CI: 2.67–7.49). Undergoing specific immunotherapy was significantly predicted only by medical supervision (OR = 9.80, 95% CI: 8.16–13.80). Allergen avoidance was a strategy used by allergic individuals who preferred hay fever self-management (OR = 2.56, 95% CI: 1.87–3.52) and experienced notable symptom severity (OR = 2.12, 95% CI: 1.60–2.81).

Conclusion

Educational interventions that increase the awareness of health risks associated with inadequate hay fever management and measures to increase self-efficacy might be beneficial for the promotion of appropriate hay fever management among allergic individuals.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09959-w.

More sneezing, less crime? Health shocks and the market for offenses

A large literature points out that exposure to criminal victimization has far-reaching effects on public health. What remains surprisingly unexplored is that role that health shocks play in explaining aggregate fluctuations in offending. This research finds novel evidence that crime is sensitive to health shocks. We consider the responsiveness of crime to a pervasive and common health shock which we argue shifts costs and benefits for offenders and victims: seasonal allergies. Leveraging daily variation in city-specific pollen counts, we present evidence that violent crime declines in U.S. cities on days in which the local pollen count is unusually high and that these effects are driven by residential violence. While past literature suggests that property crimes have more instrumental motives, require planning, and hence are particularly sensitive to permanent changes in the cost and benefits of crime, we find that violence may be especially sensitive to health shocks.

Pollen calendars and maps of allergenic pollen in North America

Pollen is a common allergen that causes significant health and financial impacts on up to a third of the population of the USA. Knowledge of the main pollen season can improve diagnosis and treatment of allergic diseases. Our objective in this study is to provide clear, quantitative visualizations of pollen data and make information accessible to many disciplines, in particular to allergy sufferers and those in the health field. We use data from 31 National Allergy Bureau (NAB) pollen stations in the continental USA and Canada from 2003 to 2017 to produce pollen calendars. We present pollen season metrics relevant to health and describe main pollen season start and end dates, durations, and annual pollen integrals for specific pollen taxa. In most locations, a small number of taxa constitute the bulk of the total pollen concentration. Start dates for tree and grass pollen season depend strongly on latitude, with earlier start dates at lower latitudes. Season duration is correlated with the start dates, such that locations with earlier start dates have a longer season. NAB pollen data have limited spatiotemporal coverage. Increased spatiotemporal monitoring will improve analysis and understanding of factors that govern airborne pollen concentrations.

Relation of Psychiatric Symptoms with Epilepsy, Asthma, and Allergy in Youth with ASD vs. Psychiatry Referrals

The present study aimed to characterize the association of psychopathology with the clinical correlates of epilepsy, asthma, and allergy within and between neurobehavioral syndromes. Participants were consecutively evaluated youth (6-18 years, 75 % male) with autism spectrum disorder (ASD; n = 589) and non-ASD outpatient psychiatry referrals (n = 653). Informants completed a background questionnaire (parents) and a psychiatric symptom severity rating scale (parents, teachers). Youth with ASD had higher rates of epilepsy and allergy but not asthma than psychiatry referrals, even when analyses were limited to youth with IQ ≥ 70. Somatic conditions evidenced variable associations with medical services utilization, educational interventions, family income, and maternal education. Youth with ASD with versus without epilepsy had more severe ASD social deficits (parents' ratings) and less severe ASD repetitive behaviors (teachers' ratings). Epilepsy was associated with more severe depression, mania, and schizophrenia symptoms in youth with ASD. Youth with allergy (psychiatry referrals only) had more severe anxiety and depression symptoms (parents' ratings) but less severe aggression (teachers' ratings) thus providing evidence of both context- and diagnostic-specificity. Youth with ASD versus non-ASD psychiatry referrals evidence a variable pattern of relations between somatic conditions and a range of clinical correlates, which suggests that the biologic substrates and psychosocial concomitants of neurodevelopmental disorders and their co-occurring somatic conditions may interact to produce unique clinical phenotypes.

You sneeze, you lose:: The impact of pollen exposure on cognitive performance during high-stakes high school exams

Pollen is known to cause allergic reactions and affect cognitive performance in around 20% of the population. Although pollen season peaks when students take high-stakes exams, the effect of pollen allergies on school performance has received nearly no attention from economists. Using a student fixed effects model and administrative Norwegian data, this paper finds that increasing the ambient pollen levels by one standard deviation at the mean leads to a 2.5% standard deviation decrease in test scores, with potentially larger effects for allergic students. There also appear to be longer-run effects. The findings imply that random increases in pollen counts reduce test scores for allergic students relative to their peers, who consequently will be at a disadvantage when competing for jobs or higher education. This paper contributes to the literature by illuminating the interplay between individual health and human capital accumulation, which in turn can impact long-run economic growth.