Towards cleaner air: PM2.5 exposure and disparities around childcare providers in England

Air pollution poses a significant health risk for young children, particularly in urban and deprived areas. Exposure to fine particulate matter (PM 2.5 ) during early life may contribute to long-term adverse health outcomes. This study examined changes in PM 2.5 concentrations around Early Years Providers (EYPs; childcare providers) in England from 2018 to 2022. We assessed associations between small-area socio-demographic characteristics and exposure levels exceeding the World Health Organisation (WHO) 2021 annual air quality guideline (>5 μg/m 3 ). We integrated data on EYPs locations from Ordnance Survey with annual PM 2.5 estimates from DEFRA using Geographic Information Systems and socio-demographic indicators — deprivation, urbanicity, and ethnic composition. A Bayesian spatial regression model with random effects was used to estimate adjusted associations between PM 2.5 levels and local population characteristics. The number of EYPs ranged from 15,780 in 2018 to 18,427 in 2019. Mean PM 2.5 levels around EYPs changed by 17.8% over the study period (from 9.4 μg/m 3 [SD=1.8] in 2018 to 7.8 μg/m 3 [SD=1.5] in 2022). However, PM 2.5 levels at over 96% of EYPs remained above the WHO 2021 annual guideline throughout. Higher PM 2.5 concentrations were observed in EYPs located in more deprived, urban, and predominantly non-white communities. Despite recent improvements, PM 2.5 levels around most EYPs in England remain above recommended thresholds. Targeted interventions in deprived urban areas are needed to reduce young children’s exposure and address environmental health inequalities. Annual mean concentrations of PM 2.5 (μg/m 3 ) estimated at each Early Year Provider’s (EYP) locations across England • Young children in England, especially those in urban areas, are exposed to air pollution around Early Years Providers (EYPs; childcare providers). • PM 2.5 levels around EYPs remained high from 2018 to 2022, with over 96% of locations exceeding the WHO 2021 annual guideline of 5 μg/m 3 . • PM 2.5 dipped in 2020–2021 within a longer-term decline, with a rebound in 2022. • EYPs in deprived, urban areas, and areas with non-white populations faced higher PM 2.5 exposure, revealing socio-demographic disparities in pollution exposure. • The findings highlight an urgent need for local policy action to reduce air pollution around EYPs, in deprived urban areas, to protect young children’s health.