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Association between ambient air pollution exposure and pubertal development: An ecological study.

Diego Rivas-Otero¹, Tomás González-Vidal¹, Cristina Rodríguez-Dehli²

¹Department of Endocrinology and Nutrition, Central University Hospital of Asturias/University of Oviedo, Oviedo, Spain; Health Research Institute of Principality of Asturias/Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine, University of Oviedo, Oviedo, Spain.

Endocrinologia, Diabetes Y Nutricion

|May 12, 2026

Summary

Rising precocious puberty (PP) rates may be linked to air pollution. This study found a correlation between carbon monoxide (CO) and nitrogen oxides (NOx) and overall PP incidence in Spanish children.

Keywords:

Air pollution Contaminación ambiental Contaminantes Pollutants Precocious puberty Pubertad precoz

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Area of Science:

Environmental Health
Pediatric Endocrinology
Epidemiology

Background:

Increasing incidence of precocious puberty (PP) raises concerns about contributing factors.
Ambient air pollutants are hypothesized to influence the timing of puberty.
This study investigates the relationship between air quality and PP in children.

Purpose of the Study:

To explore the association between exposure to ambient air pollutants and the incidence of precocious puberty (PP) and normal variants of puberty (NVP).
To analyze the correlation between specific air pollutants and PP diagnoses in a pediatric population in Spain.

Main Methods:

Retrospective ecological study design in Asturias, Spain (2021-2024).
Inclusion of children ≤9 years diagnosed with PP or NVP.
Analysis of air pollutant data (PM10, PM2.5, SO2, NO2, CO, O3, NO, NOx) from the two years preceding diagnosis, linked to monitoring stations and categorized by exposure levels (high/low).

Main Results:

Overall PP incidence showed positive correlations with carbon monoxide (CO) and nitrogen oxides (NOx).
No statistically significant associations were found between central PP incidence and any specific air pollutant.
A trend suggested a positive correlation between central PP incidence and CO exposure, with higher incidence in high-exposure areas for all pollutants, though not statistically significant.

Conclusions:

Findings suggest a potential environmental role of air pollution in the development of precocious puberty.
Further investigation with larger, longitudinal studies is warranted to confirm these associations.
Highlights the need to explore environmental influences on pubertal timing.