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Lifetime cancer risks from hazardous air pollutants in US public school districts
  1. Sara Elizabeth Grineski1,
  2. Timothy Collins2
  1. 1 Sociology, University of Utah, Salt Lake City, Utah, USA
  2. 2 Geography, University of Utah, Salt Lake City, Utah, USA
  1. Correspondence to Dr Sara Elizabeth Grineski, Sociology, University of Utah, Salt Lake City, Utah, USA; sara.grineski{at}


Background Children are sensitive to the health impacts of environmental contaminants, but research assessing outdoor environmental exposures for children and schools is underdeveloped. There are no national-level studies examining geographical and social disparities in air pollution exposure for children in school districts. Focusing on school districts is important because they are meaningful decision-making entities for schools.

Methods Using data from the National Air Toxics Assessment, we spatially reallocated lifetime cancer risk (LCR) from hazardous air pollutants (HAPs) within US school district boundaries, and paired those estimates with school district level sociodemographic measures obtained through the Integrated Public Use Microdata Series National Historic Geographic Information System. We employed local Moran’s I to identify district-level hotpots and generalised estimating equations (GEEs) to quantify risk disparities.

Results We identified hotspots of elevated LCR from all sources of HAPs (called ‘total’). A regional hotspot extends throughout the southeastern USA and smaller regional hotspots are present in southern Arizona, southern California and in California’s central valley. School districts with higher proportions of children, children with disabilities, foreign-born children, black children and multiracial/other race children, and lower proportions of Native American children, had greater total LCR (p<0.001). The effect of poverty on total LCR (p<0.001) was nonlinear; the lowest and highest poverty districts had lower total LCR.

Conclusions Geographical and social disparities in LCR across US school districts may be affecting children’s health and future potential. This new knowledge can inform policy changes, as school districts can advocate for the environmental health of children.

  • children
  • environmental injustice
  • school districts
  • hazardous air pollutants

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  • Contributors SEG conceived of the study, conducted the statistical analysis and lead wrote the manuscript. TC provided input throughout all phases of the study and assisted in the writing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available in a public, open access repository.