Knowledge, attitudes and practices about air pollution and its health effects in 6th to 11th-grade students in Colombia: a cross-sectional study.

Introduction: Globally, air pollution is the leading environmental cause of disease and premature death. Raising awareness through environmental education and adequate communication on air quality could reduce the adverse effects. We aimed to assess the knowledge, attitudes, and practices (KAP) regarding air pollution and health and determine the factors associated with these KAP in children and adolescents. Methods: In 2019-2020, a cross-sectional study was conducted on 6th-11th grade high school students in five municipalities in Colombia. Variables collected included: age, sex, private or public school, any medical history, emergency room visits due to respiratory symptoms in the last year, and whether students played sports. The main exposure was the School Environmental Project. The outcomes were the KAP scale [0% (the lowest score) to 100% (the highest score)]. The factors associated with KAP levels were evaluated with independent mixed regressions due to the multilevel structure of the study (level 1: student; level 2: school), and the exponential coefficients (95% confidence interval-CI) were reported. Results: Among 1,676 students included, 53.8% were females. The median knowledge score about air pollution and its health effects was 33.8% (IQR: 24.0-44.9), 38.6% knew the air quality index, 30.9% knew the air quality alerts that occurred twice a year in these municipalities and 5.3% had high self-perceived knowledge. Positive attitudes, pro-environmental practices, being female, grade level, attending a private school, having respiratory diseases, and the school environmental project importance were associated with higher knowledge scores. The median attitudes score was 78.6% (IQR: 71.4-92.9). Pro-environmental attitudes were associated with knowledge-increasing, being female, attending a private school, and the school environmental project. The median pro-environmental practices score was 28.6% (IQR: 28.6-42.9). During air quality alerts, 11.6% had worn masks, 19% had reduced the opening time of windows and 15.9% avoided leaving home. Pro-environmental practices were associated with knowledge-increasing and attitudes-increasing, and lower practices with higher grade levels, visiting a doctor in the last year, and practicing sports. Discussion: Children and adolescents have low knowledge scores and inadequate pro-environmental practices scores regarding air pollution. However, they demonstrate positive attitudes towards alternative solutions and express important concerns about the planet's future.

Early-life external exposome in children 2-5 years old in Colombia.

Exposome studies are advancing in high-income countries to understand how multiple environmental exposures impact health. However, there is a significant research gap in low- and middle-income and tropical countries. We aimed to describe the spatiotemporal variation of the external exposome, its correlation structure between and within exposure groups, and its dimensionality. A one-year follow-up cohort study of 506 children under 5 in two cities in Colombia was conducted to evaluate asthma, acute respiratory infections, and DNA damage. We examined 48 environmental exposures during pregnancy and 168 during childhood in eight exposure groups, including atmospheric pollutants, natural spaces, meteorology, built environment, traffic, indoor exposure, and socioeconomic capital. The exposome was estimated using geographic information systems, remote sensing, spatiotemporal modeling, and questionnaires. The median age of children at study entry was 3.7 years (interquartile range: 2.9-4.3). Air pollution and natural spaces exposure decreased from pregnancy to childhood, while socioeconomic capital increased. The highest median correlations within exposure groups were observed in meteorology (r = 0.85), traffic (r = 0.83), and atmospheric pollutants (r = 0.64). Important correlations between variables from different exposure groups were found, such as atmospheric pollutants and meteorology (r = 0.76), natural spaces (r = -0.34), and the built environment (r = 0.53). Twenty principal components explained 70%, and 57 explained 95% of the total variance in the childhood exposome. Our findings show that there is an important spatiotemporal variation in the exposome of children under 5. This is the first characterization of the external exposome in urban areas of Latin America and highlights its complexity, but also the need to better characterize and understand the exposome in order to optimize its analysis and applications in local interventions aimed at improving the health conditions and well-being of the child population and contributing to environmental health decision-making.

Characterization of the external exposome and its contribution to the clinical respiratory and early biological effects in children: The PROMESA cohort study protocol.

BACKGROUND: Air pollution contains a mixture of different pollutants from multiple sources. However, the interaction of these pollutants with other environmental exposures, as well as their harmful effects on children under five in tropical countries, is not well known. OBJECTIVE: This study aims to characterize the external exposome (ambient and indoor exposures) and its contribution to clinical respiratory and early biological effects in children. MATERIALS AND METHODS: A cohort study will be conducted on children under five (n = 500) with a one-year follow-up. Enrolled children will be followed monthly (phone call) and at months 6 and 12 (in person) post-enrolment with upper and lower Acute Respiratory Infections (ARI) examinations, asthma development, asthma control, and genotoxic damage. The asthma diagnosis will be pediatric pulmonologist-based and a standardized protocol will be used. Exposure, effect, and susceptibility biomarkers will be measured on buccal cells samples. For environmental exposures PM2.5 will be sampled, and questionnaires, geographic information, dispersion models and Land Use Regression models for PM2.5 and NO2 will be used. Different statistical methods that include Bayesian and machine learning techniques will be used for the ambient and indoor exposures-and outcomes. This study was approved by the ethics committee at Universidad Pontificia Bolivariana. EXPECTED STUDY OUTCOMES/FINDINGS: To estimate i) The toxic effect of particulate matter transcending the approach based on pollutant concentration levels; ii) The risk of developing an upper and lower ARI, based on different exposure windows; iii) A baseline of early biological damage in children under five, and describe its progression after a one-year follow-up; and iv) How physical and chemical PM2.5 characteristics influence toxicity and children's health.

Maternidades contemporáneas: tribus digitales e interacciones con las instituciones de salud / Maternidades contemporâneas: tribos digitais e interações com as instituições de saúde / Contemporary motherhoods: digital tribes and interactions with health institutions

En la contemporaneidad, las madres encuentran en las redes sociales virtuales posibilidades para contrastar y cuestionar las prácticas institucionalizadas de los profesionales de salud. Este artículo tiene como propósito entender las percepciones de madres colombianas participantes de una red virtual sobre maternidad, respecto a sus relaciones con los programas de salud enfocados en el embarazo, parto, maternidad y crianza. El análisis se realizó a través de la teoría fundamentada, a partir de un (1) grupo focal y 17 entrevistas en profundidad a mujeres integrantes del grupo y profesionales de la salud. Se encontraron grandes frustraciones frente a los programas y profesionales, falta de apoyo y conocimientos para afrontar la llegada del nuevo bebé. Se concluye la urgencia de que los programas incorporen las necesidades percibidas por las mujeres para un mayor apoyo frente a la salud física y mental. (AU)

Na contemporaneidade, as mães encontram nas redes sociais virtuais possibilidades de contrastar e questionar as práticas institucionalizadas dos profissionais da saúde. O objetivo de este artigo foi compreender as percepções de mães colombianas participantes de uma rede digital de maternidade, sobre suas relações com programas de saúde focados na gravidez, parto, maternidade e criação dos filhos. A análise foi realizada usando a Teoria Fundamentada em Dados obtidos de um grupo focal e 17 entrevistas em profundidade com mulheres integrantes do grupo e profissionais da saúde. Grandes frustrações foram encontradas frente aos programas e profissionais, falta de apoio e conhecimentos para enfrentar a chegada do novo bebê. Conclui-se na urgência que os programas incorporem as necessidades percebidas pelas mulheres, para dar um maior apoio frente à saúde física e mental. (AU)

In contemporary times, mothers find in virtual social networks possibilities to contrast and question the institutionalized practices of health professionals. This study presents partial results on understanding the perceptions of Colombian mothers who participate in a digital network on motherhood, regarding their relationships with health programs focused on pregnancy, childbirth, motherhood, and parenting. Using a grounded theory method, one focus group and 17 interviews were conducted with women members of the group and health professionals. Mothers reported frustration perceptions in their relationships with the health professionals regarding inexistent support and insufficient knowledge before and after giving birth. As a conclusion, it is crucial that the programs may incorporate the needs for increased support over physical and mental health, as perceived by women. (AU)