Objective This meta-analysis evaluated the associations between noise exposure, air pollutants, and attention-deficit/hyperactivity disorder (ADHD) in children, aiming to inform future prevention strategies. Methods Studies were systematically retrieved from CNKI, Wanfang, PubMed, Web of Science, Embase, and the Cochrane Library, covering publications from inception to November 2025. Heterogeneity was assessed using Cochran’s Q test and the I² statistic. Subgroup analyses, meta-regression, and sensitivity analyses were performed to evaluate the robustness of the findings. Results Noise exposure was associated with a small increase in ADHD risk (odds ratio OR = 1.03, 95% confidence interval CI: 1.01–1.05), with stronger associations for childhood exposure, whereas prenatal exposure showed no significant effect. Given the modest effect size, this finding should be interpreted cautiously. Particulate matter (PM 2.5 and PM 10 ) was significantly associated with ADHD in continuous-exposure models—PM 2.5 ( OR = 1.32, 95% CI: 1.16–1.50) and PM 10 ( OR = 1.47, 95% CI: 1.15–1.87). In dichotomous models, PM 2.5 was not significant, while PM 10 remained positively associated ( OR = 1.58, 95% CI: 1.11–2.26). Elevated nitrogen dioxide (NO 2 ) exposure was also associated with a modest increase in ADHD risk ( OR = 1.11, 95% CI: 1.02–1.20), whereas nitrogen oxides (NO x ), ozone (O 3 ), and sulfur dioxide (SO 2 ) did not show significant associations. Conclusions Noise and several air pollutants (PM 2.5 , PM 10 , and NO 2 ) were significantly associated with increased ADHD risk, particularly during childhood exposure. Other pollutants, including O 3 and SO 2 , did not demonstrate significant effects. These findings suggest that environmental noise and several air pollutants may be associated with ADHD; however, some observed associations, particularly for noise and NO 2 , were modest in magnitude and should be interpreted cautiously. These results reflect observational associations rather than evidence of a strong or causal effect, while the evidence for some pollutants remains limited or inconclusive. Further research is needed to clarify pollutant-specific associations and the role of exposure timing. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024593274 , identifier CRD42024593274; https://www.crd.york.ac.uk/PROSPERO/view/CRD42025632899 , identifier CRD42025632899.
Zhang et al. (Tue,) studied this question.