Structural pathways linking sociodemographic characteristics, air pollution exposure, 24-hour movement behaviours, and health-related outcomes in children: An exploratory study using network science.

Abstract

Introduction: Air pollution exposure is a major global health concern, particularly for children, given their susceptibility to systemic inflammation and oxidative stress. While physical activity is known to benefit health, its interaction with APE and other codependant behaviours within a 24-hour continuum remains understudied. Objective: This study utilizes network science to investigate the structural pathways linking sociodemographic characteristics, individual air pollution exposure, 24-hour movement behaviours, and health-related outcomes in Portuguese primary school children. Methods: A pilot cross-sectional exploratory study was conducted with 14 children (aged 8-11) from Valongo, Portugal. Sociodemographic data and household characteristics were assessed via questionnaire. Individual APE (PM2.5, PM10, and CO2) was measured using portable sensors over 48 hours, while movement behaviours were assessed via accelerometry over five weekdays. Health outcomes included cardiorespiratory fitness, body mass index, total oxidant status, and total antioxidant status. An extended structural impact model was employed for data analysis in Python (3.14). Results: Sociodemographic factors exerted the strongest direct impact on movement behaviours (normalized impact = 0.96). Movement behaviours emerged as a partial structural bottleneck, mediating the impact of environmental exposure on health outcomes (indirect impact = 0.66) more significantly than the direct environmental-health pathway (impact = 0.43). Conclusion: 24-hour movement behaviours presented a mediating impact on the relationship between air pollutants and health-related outcomes in the evaluated children.