Exposures to Environmental Toxicants and Attention Deficit Hyperactivity Disorder in U.S. Children

Abstract

ObjectiveThe purpose of this study was to examine the association of exposures to tobacco smoke and environmental lead with attention deficit hyperactivity disorder (ADHD).MethodsData were obtained from the National Health and Nutrition Examination Survey 1999–2002. Prenatal and postnatal tobacco exposure was based on parent report; lead exposure was measured using blood lead concentration. ADHD was defined as having current stimulant medication use and parent report of ADHD diagnosed by a doctor or health professional.ResultsOf 4,704 children 4–15 years of age, 4.2% were reported to have ADHD and stimulant medication use, equivalent to 1.8 million children in the United States. In multivariable analysis, prenatal tobacco exposure [odds ratio (OR) = 2.5; 95% confidence interval (CI), 1.2–5.2] and higher blood lead concentration (first vs. fifth quintile, OR = 4.1; 95% CI, 1.2–14.0) were significantly associated with ADHD. Postnatal tobacco smoke exposure was not associated with ADHD (OR = 0.6; 95% CI, 0.3–1.3; p = 0.22). If causally linked, these data suggest that prenatal tobacco exposure accounts for 270,000 excess cases of ADHD, and lead exposure accounts for 290,000 excess cases of ADHD in U.S. children.ConclusionsWe conclude that exposure to prenatal tobacco and environmental lead are risk factors for ADHD in U.S. children.

Lead Bullet Fragments in Venison from Rifle-killed Deer: Potential for Human Dietary Exposure

“…Lead quantities formerly regarded as trivial are associated with permanent cognitive damage in children [3], including those prenatally exposed [4]. Lead is associated with impaired motor function [5], attentional dysfunction [6], and even criminal behavior [7,8].…”

Review of current evidence on the impact of pesticides, polychlorinated biphenyls and selected metals on attention deficit / hyperactivity disorder in children

“…For instance, the analysis from the National Health and Nutrition Examination Sur vey on 4704 children aged 4-15 years indicated the preva lence of parent-reported ADHD diagnosis or treatment four times higher among children with the blood lead level > 2.0 μg/dl, compared with those with the blood lead level < 0.8 μg/dl (OR = 4.1; 95% CI: 1.2-10.0) [6]. The later analysis conducted as part of the same survey (on 2588 children at 8-15 years of age) indicated that children who were exposed to prenatal tobacco and lead had greater risk of ADHD than it would be expected if the indepen dent risk was multiplied (OR = 8.1; 95% CI: 3.5-18.7; to bacco -lead exposure interaction p < 0.001) [51].…”

Bisphenol A and Obesity in Children and Adolescents

“…If further research reveals that the latter is more likely, our study raises concerns that obese children may be susceptible to adverse neurodevelopmental and respiratory effects that have been associated with BPA exposure in children. 5,6 …”

“…The latter group of patients showed the largest benefit by biomarker-guided treatment in a previous study. 5 Adding novel management strategies in patients for whom the physician already knows best is not necessary. Such strategies may be needed for patients when the physician's assessment fails.…”