School-area PM10 linked to differences in children’s cognitive test scores

Children attending two primary schools in Zarqa, Jordan, showed different patterns of cognitive test performance compared with children in Irbid, according to an ecological cross-sectional study published in BMC Pediatrics.

After adjustment for selected sociodemographic control variables, children at School A in Zarqa scored lower than the Irbid reference group on Visuomotor Organization, by 4.25 points, with a 95 percent confidence interval of 5.67 to 2.84 points and a p value below 0.001. The same school also scored lower on Thinking Operations, by 1.74 points, with a confidence interval of 3.15 to 0.33 points and a p value of 0.012, although the authors note this result was less consistent across models.

The pattern at School B in Zarqa was different. Children there scored higher than the Irbid reference group on Thinking Operations, by 3.38 points, with a confidence interval of 2.00 to 4.75 points and a p value below 0.001, and they did not differ significantly on Visuomotor Organization. Motor Praxis scores did not differ significantly between school groups, although the study reports that this domain showed a marked ceiling effect and low internal consistency, which limits the interpretability of that finding.

The authors are careful to frame these results as school-level differences rather than effects of individual PM10 exposure. Because exposure was assessed at the area and school level and not for individual children, the findings are associations with school-area environmental context and do not show that PM10 caused the observed differences in cognitive performance. This is a central limitation of the ecological design, in which group-level measurements are used and individual exposure histories remain unknown.

The study also addresses a gap the authors identify in the existing literature. Although executive functions and other higher-order cognitive processes have been investigated in previous studies of childhood air pollution exposure, they note that relatively limited evidence is available regarding specific cognitive and cognitive-motor domains among young school-aged children in Middle Eastern populations, and little is known about whether environmental differences between school settings are associated with distinct aspects of cognitive, perceptual-motor, and praxis-related performance.

The contrasting results between the two Zarqa schools, one showing lower scores in two domains and the other showing higher Thinking Operations scores, illustrate that school-level differences in this setting did not follow a single uniform pattern.

The published version of the article is marked as an early-release, peer-reviewed accepted research paper that carries a permanent DOI and remains subject to further editorial edits before the final Version of Record. For readers, the key takeaway is that the reported associations concern school-area environmental context in two Jordanian governorates, not proven causal effects of particulate pollution on individual children’s cognition, and that further work with individual-level exposure assessment would be needed to test such a relationship.

Subject of Research: Cognitive and cognitive-motor performance of primary school children in Jordanian school areas with different ambient PM10 profiles

Article Title: Cognitive and cognitive-motor performance among primary school children attending schools in areas with different ambient PM10 profiles: an ecological cross-sectional study

Article References: Al-zyoud, A., Abdulla, F., Almomani, F., Hammouri, H., Khader, Y., Hailat, E., & Al-Delaimy, W. K. (2026). Cognitive and cognitive-motor performance among primary school children attending schools in areas with different ambient PM10 profiles: an ecological cross-sectional study. BMC Pediatrics. https://doi.org/10.1186/s12887-026-07930-z

Image Credits: AI Generated

DOI: 10.1186/s12887-026-07930-z

Keywords: PM10, air pollution, children, cognitive performance, cross-sectional study, Jordan, LOTCA, visuomotor organization, thinking operations, school environment, ecological study, public health