Neurodevelopmental outcomes among 2- to 3-year-old children in Bangladesh with elevated blood lead and exposure to arsenic and manganese in drinking water

Rodrigues, Ema G.; Bellinger, David C.; Valeri, Linda; Hasan, Omar Sharif Ibne; Quamruzzaman, Quazi; Mostofa, Golam; Kile, Molly L.; Christiani, David C.; Wright, Robert O.; Mazumdar, Maitreyi

doi:10.1186/s12940-016-0127-y

Cited by 111 publications

(82 citation statements)

References 34 publications

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“…Details of the recruitment strategy, eligibility criteria, and sample collection from children participating in this study have been published previously [24, 25]. Briefly, participants were members of a longitudinal birth cohort established in rural Bangladesh to study the health effects of prenatal and early childhood exposures to metals in the environment.…”

Section: Methodsmentioning

confidence: 99%

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

et al. 2016

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BackgroundLead toxicity is of particular public health concern given its near ubiquitous distribution in nature and established neurotoxicant properties. Similar in its ubiquity and ability to inhibit neurodevelopment, early childhood stunting affects an estimated 34 % of children under 5 in low- and middle-income countries. Both lead and stunting have been shown to be associated with decreased neurodevelopment, although the relationship between these childhood burdens is underexplored. The association between lead exposure and stunting has been previously established, yet limited data are available on susceptibility windows.MethodsWhole blood lead samples were collected from rural Bangladeshi children at delivery (umbilical cord blood) and at age 20–40 months (fingerstick blood). Stunting was determined using the Child Growth Standards developed from the World Health Organization Multicentre Growth Reference Study. Children with height for age < -2 z-scores below the median of the WHO Child Growth Standards were classified as stunted in all analyses.ResultsMedian (IQR) umbilical cord and fingerstick blood lead levels were 3.1 (1.6–6.3) μg/dl and 4.2 (1.7–7.6) μg/dl, respectively. In adjusted multivariable regression models, the odds of stunting at 20–40 months increased by 1.12 per μg/dl increase in blood lead level (OR = 1.12, 95 % CI: 1.02–1.22). No association was found between cord blood lead level and risk of stunting (OR = 0.97, 95 % CI: 0.94–1.00).ConclusionsThere is a significant association between stunting and concurrent lead exposure at age 20–40 months. This association is slightly attenuated after controlling for study clinic site. Additional research including more precise timing of lead exposure during these critical 20–40 months is needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12940-016-0190-4) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

et al. 2016

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“…When models were adjusted for covariates, sex-stratified analysis showed a statistically significant positive relationship between hair Mn and receptive language scores among males. In Bangladesh, a study examined water Mn concentrations and BSID scores among 524 20–40 month old children [73]. No statistically significant association was observed with cognition in models that also included other neurotoxicants, such as Pb and As.…”

Section: Early Life Exposure To Manganese and Cognitive Outcomesmentioning

confidence: 99%

Manganese Exposure and Cognition Across the Lifespan: Contemporary Review and Argument for Biphasic Dose–Response Health Effects

Vollet

Haynes

Dietrich

2016

Curr Envir Health Rpt

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Manganese (Mn) is both an essential micronutrient and potential neurotoxicant. This dual role underlies a growing body of literature demonstrating that Mn exhibits a biphasic dose-response relationship with neurocognitive outcomes. We reviewed recent epidemiologic studies from 2007–2016 that investigated the relationship between Mn exposure and cognitive outcomes across the lifespan: early life, school-aged children, and adulthood. In total, 27 research articles were included in this review: 12 pediatric and 15 adult studies (10 occupational and five environmental exposures). The majority of these studies provided evidence of the negative effects of Mn exposure on cognition. The pediatric literature provides evidence that both high and low levels of Mn are negatively associated with intellectual development. Future Mn research should include examination of non-linear relationships and multiple neurotoxicants across the lifespan, and particularly during critical developmental windows.

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“…In zebrafish embryos, ~1mM (75 ppm) arsenic has been associated with hypoactivity at 24 hpf and altered neural function with arsenic exposure has been observed [61]. A significant decline in motor function, cognition, and intellectual function has been found in children in Bangladesh who are exposed to arsenic at concentrations similar to those used here in their drinking water [66–69]. It has also been shown that zinc can protect neuronal cells grown in culture from arsenic induced cell death [70].…”

Section: Discussionmentioning

confidence: 99%

Combinatorial effects of zinc deficiency and arsenic exposure on zebrafish (Danio rerio) development

et al. 2017

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Zinc deficiency and chronic low level exposures to inorganic arsenic in drinking water are both significant public health concerns that affect millions of people including pregnant women. These two conditions can co-exist in the human population but little is known about their interaction, and in particular, whether zinc deficiency sensitizes individuals to arsenic exposure and toxicity, especially during critical windows of development. To address this, we utilized the Danio rerio (zebrafish) model to test the hypothesis that parental zinc deficiency sensitizes the developing embryo to low-concentration arsenic toxicity, leading to altered developmental outcomes. Adult zebrafish were fed defined zinc deficient and zinc adequate diets and were spawned resulting in zinc adequate and zinc deficient embryos. The embryos were treated with environmentally relevant concentrations of 0, 50, and 500 ppb arsenic. Arsenic exposure significantly reduced the amount of zinc in the developing embryo by ~7%. The combination of zinc deficiency and low-level arsenic exposures did not sensitize the developing embryo to increased developmental malformations or mortality. The combination did cause a 40% decline in physical activity of the embryos, and this decline was significantly greater than what was observed with zinc deficiency or arsenic exposure alone. Significant changes in RNA expression of genes that regulate zinc homeostasis, response to oxidative stress and insulin production (including zip1, znt7, nrf2, ogg1, pax4, and insa) were found in zinc deficient, or zinc deficiency and arsenic exposed embryos. Overall, the data suggests that the combination of zinc deficiency and arsenic exposure has harmful effects on the developing embryo and may increase the risk for developing chronic diseases like diabetes.

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Neurodevelopmental outcomes among 2- to 3-year-old children in Bangladesh with elevated blood lead and exposure to arsenic and manganese in drinking water

Cited by 111 publications

References 34 publications

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

Stunting is associated with blood lead concentration among Bangladeshi children aged 2-3 years

Manganese Exposure and Cognition Across the Lifespan: Contemporary Review and Argument for Biphasic Dose–Response Health Effects

Combinatorial effects of zinc deficiency and arsenic exposure on zebrafish (Danio rerio) development

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