Abstract Background Globally, 93% of children under the age of 15 (1.8 billion) are exposed to fine particulate matter (PM2.5) levels that might cause respiratory/cardiovascular disorders, impaired neuro/cognitive development, and cancer. Air pollution causes 1/10 deaths in children under the age of 5. Methods The purpose of this observational study was to collect data on indoor and outdoor air quality in 24 schools over 10 school days and compare it with city-wide average air quality levels reported in rural/urban areas in the UK and Northern Ireland. Nitrogen dioxide, volatile organic compounds (VOCs) and PM10,2.5,1 were monitored inside the classrooms and school surroundings with personal pollution monitors. City-wide averages were taken from local reference air quality and ground-source monitoring stations. Data was expressed using the Plume Labs Air Quality Index (PAQI) thresholds [low (0-20), moderate (21-50), high (51-100), very high (101+) pollution level] aligned with WHO's exposure recommendations. Results Despite both AQIs being in the moderate threshold, the school's average indoor AQI was ∼44% higher than the city-wide average. Only 27% of schools’ indoor air quality indexes matched the city-wide average, 59% were higher and 14% were lower. Rural schools had a marginally higher average indoor AQI than urban schools. The primary classroom pollutants observed were VOCs, followed by PM10. The average walk-exposure AQI of 33% of total schools was higher than the city's average. The school reporting the highest average walk AQI was seven times higher than the lowest. Conclusions Poor indoor air quality and higher levels of pollutants were found inside the majority of the schools across the regions. There is a need for mitigation strategies to identify responsible factors for indoor air pollution. A regulatory framework for school ventilation and behavior interventions like nasal washes may reduce pollution exposure and its impact on children's health outcomes and mortality. Key messages • Poor indoor air quality (∼44% higher than the city-wide average) and higher levels of pollutants (volatile organic compounds and PM10) were found inside the majority of the schools across the regions. • A regulatory framework for school ventilation and behavior interventions like nasal washes may reduce air pollution exposure and its impact on children’s health outcomes and mortality.
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