Exposure to airborne particulate matter (PM) may affect neurodevelopmental outcomes in children. The mechanisms underlying these relationships are not currently known. We aim to assess whether PM affects the developing brains of schoolchildren in Poland, a country characterized by high levels of PM pollution. Children aged from 10 to 13 years (n = 800) are recruited to participate in this case–control study. Cases (children with attention deficit hyperactivity disorder (ADHD)) are being recruited by field psychologists. Population-based controls are being sampled from schools. The study area comprises 18 towns in southern Poland characterized by wide-ranging levels of PM. Comprehensive psychological assessments are conducted to assess cognitive and social functioning. Participants undergo structural, diffusion-weighted, task, and resting-state magnetic resonance imaging (MRI). PM concentrations are estimated using land use regression models, incorporating information from air monitoring networks, dispersion models, and characteristics of roads and other land cover types. The estimated concentrations will be assigned to the prenatal and postnatal residential and preschool/school addresses of the study participants. We will assess whether long-term exposure to PM affects brain function, structure, and connectivity in healthy children and in those diagnosed with ADHD. This study will provide novel, in-depth understanding of the neurodevelopmental effects of PM pollution.

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Background Exposure to airborne particulate matter (PM) may affect neurodevelopmental outcomes in children. The mechanisms underlying these relationships are not currently known. We aim to assess whether PM affects the developing brains of schoolchildren in Poland, a European country characterized by very high levels of particulate air pollution. Methods Between 2020 and 2022, 800 children aged 10 to 13 years are being recruited as participants in a case-control study. Cases (children with attention deficit hyperactivity disorder (ADHD)) are being recruited from psychology clinics. Population-based controls are being sampled from schools. The study area comprises 18 towns in southern Poland characterized by wide-ranging levels of PM. Comprehensive psychological assessments are being conducted to assess cognitive and social functioning. Cases and controls undergo MRI including T1, T2 and MP2RAGE structural imaging, task (Go/NoGo) and resting-state MRI, and diffusion-weighted imaging (DWI). Concentrations of PM are being assessed using land use regression models, which incorporate data from air monitoring networks, dispersion models, and characteristics of roads and other land cover types. The estimated concentrations will be assigned to prenatal and postnatal residential and preschool/school addresses of all study subjects. We will assess whether long-term exposure to outdoor PM affects brain function, structure, and connectivity in healthy children and those diagnosed with ADHD. Results and Discussion This comprehensive study will provide novel, in-depth understanding of the neurodevelopmental effects of air pollution.