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Yang Z, Zhang J, Wang M, Wang X, Liu H, Zhang F, Fan H. Prenatal endocrine-disrupting chemicals exposure and impact on offspring neurodevelopment: A systematic review and meta-analysis. Neurotoxicology 2024; 103:335-357. [PMID: 39013523 DOI: 10.1016/j.neuro.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/11/2024] [Accepted: 07/10/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE Considering that endocrine disruptors have certain effects on fetal growth, we conducted a systematic review of epidemiological literature to elucidate the correlation between exposure to endocrine-disrupting chemicals during pregnancy and the neurodevelopment of offspring. METHOD We systematically explored PubMed, Web of Science, and CINAHL databases from inception to April 4, 2023. References from pertinent studies were reviewed, and data regarding the link between maternal prenatal EDC exposure and offspring neurological development were compiled. A domain-based approach was used to evaluate studies of neurodevelopmental effects in children ≤3 years old by two reviewers, including cognition, motor, behavior, language, and non-verbal ability. RESULTS A comprehensive search yielded 45,373 articles, from which 48 articles, involving 26,005 mother-child pairs, met the criteria and were subsequently included in our analysis. The results revealed that EDC exposure during pregnancy had a significant impact on offspring neurobehavior development, especially in cognition, motor, and language. Our findings indicated adverse associations between prenatal exposure to metals and offspring cognition (before 12 months: β coefficient: -0.28; 95 % CI, -0.50 to -0.06; 1-3 years old: β coefficient: -0.55; 95 % CI: -1.08 to -0.02). Furthermore, metals (β coefficient: -0.71; 95 % CI: -1.23 to -0.19) and phthalates (β coefficient: -0.69; 95 % CI: -1.05 to -0.33) exposure exhibited detrimental effects on motor development from1-3 years old, while poly-fluoroalkyl substances were linked to the disruption of offspring language development (β coefficient: -1.01; 95 % CI: -1.90 to -0.11) within this timeframe. Additionally, exposure to EDCs during pregnancy had a negative impact on cognition development among girls from 12 to 36 months of age (β coefficient: -0.53; 95 % CI: -1.01 to -0.06). CONCLUSION Prenatal exposure to EDCs, especially metals, phthalates and, poly-fluoroalkyl substances, was associated with disrupting the development of offspring neurobehavior in the short and long term. Additionally, cognitive development showed gender differences due to prenatal endocrine-disrupting chemicals exposure.
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Affiliation(s)
- Ziyi Yang
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Jie Zhang
- Medical School of Nantong University, Nantong, Jiangsu 226007, China
| | - Mingbo Wang
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Xin Wang
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China
| | - Huahua Liu
- Nantong Maternity and Child Health Care Hospital Affiliated to Nantong University, Nantong, Jiangsu 226018, China
| | - Feng Zhang
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China.
| | - Hong Fan
- School of Nursing and Rehabilitation, Nantong University, Nantong, Jiangsu, China.
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Rosi E, Crippa A, Pozzi M, De Francesco S, Fioravanti M, Mauri M, Molteni M, Morello L, Tosti L, Metruccio F, Clementi E, Nobile M. Exposure to environmental pollutants and attention-deficit/hyperactivity disorder: an overview of systematic reviews and meta-analyses. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:111676-111692. [PMID: 37828261 PMCID: PMC10643318 DOI: 10.1007/s11356-023-30173-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/26/2023] [Indexed: 10/14/2023]
Abstract
Although heritability estimates suggest a role for genetic components, environmental risk factors have been described as relevant in the etiology of attention deficit/hyperactivity disorder (ADHD). Several studies have investigated the role of toxicological pollution, i.e., air pollution, heavy metals, POPs, and phthalates. Clear evidence for association of ADHD and environmental factors has not been provided yet. To answer this, we have assessed all available systematic reviews and meta-analyses that focused on the association between pollutant exposure and either ADHD diagnosis or symptoms. More than 1800 studies were screened of which 14 found eligible. We found evidence of a significant role for some pollutants, in particular heavy metals and phthalates, in the increased risk of developing ADHD symptoms. However, at the current stage, data from existing literature also do not allow to weight the role of the different environmental pollutants. We also offer a critical examination of the reviews/meta-analyses and provide indications for future studies in this field. PROSPERO registration: CRD42022341496.
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Affiliation(s)
- Eleonora Rosi
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy.
| | - Alessandro Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy
| | - Marco Pozzi
- Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco, Italy
| | - Stefano De Francesco
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy
- Sigmund Freud University, Sigmund Freud University of Milan, 20143, Milan, Italy
| | - Mariachiara Fioravanti
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy
- University of Milano-Bicocca, Milan, Italy
| | - Maddalena Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy
| | - Luisa Morello
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy
- Sigmund Freud University, Sigmund Freud University of Milan, 20143, Milan, Italy
| | - Luca Tosti
- Pharmacovigilance & Clinical Research Unit and International Centre for Pesticides & Health Risk Prevention, Department of Biomedical and Clinical Sciences, "Luigi Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Francesca Metruccio
- Pharmacovigilance & Clinical Research Unit and International Centre for Pesticides & Health Risk Prevention, Department of Biomedical and Clinical Sciences, "Luigi Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Emilio Clementi
- Scientific Institute IRCCS E. Medea, Bosisio Parini, Lecco, Italy
- Pharmacovigilance & Clinical Research Unit and International Centre for Pesticides & Health Risk Prevention, Department of Biomedical and Clinical Sciences, "Luigi Sacco" University Hospital, Università degli Studi di Milano, Milan, Italy
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Via Don Luigi Monza 20, Bosisio Parini (LC), 23842, Lecco, Italy
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Ibarluzea J, Subiza-Pérez M, Arregi A, Molinuevo A, Arranz-Freijo E, Sánchez-de Miguel M, Jiménez A, Andiarena A, Santa-Marina L, Lertxundi A. Association of maternal prenatal urinary fluoride levels with ADHD symptoms in childhood. ENVIRONMENTAL RESEARCH 2023; 235:116705. [PMID: 37479215 DOI: 10.1016/j.envres.2023.116705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/17/2023] [Accepted: 07/18/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Health concerns about the potential impact of exposure to fluoride via drinking water (DW) on neuropsychological development include behavioral outcomes such as ADHD. OBJECTIVE We aimed to examine the association between prenatal maternal urinary fluoride and symptoms associated with attention-deficit/hyperactivity disorder (ADHD) at the age of 8 and 11 years. METHOD Data from 255 to 236 mother-child pairs from the "Infancia y Medio Ambiente" (INMA) birth cohort (Gipuzkoa; Spain) with maternal urinary F adjusted for creatinine (MUFcr) during pregnancy (first and third trimester) and child assessments of ADHD-like symptoms reported by Conners' Rating Scales-Revised at age of 8 and 11 years was available. Clinical approach was also used: cut off criteria (T > 66). Multiple linear regression models were fitted when outcomes were analyzed as continuous, and logistic regression models when the outcomes were analyzed with a categorical clinical approach. Covariates related to maternal characteristics, birth outcomes, childhood, quality of family context and biomarkers of neuro-toxicants were used. RESULTS No association was found between MUFcr levels during pregnancy and cognitive problems-inattention, hyperactivity or ADHD index score of symptoms at 8 or 11 years. When results were analyzed from the perspective of a clinical approach, at the age of 11 years, there were significant inverse association between MUFcr and being categorized as a cognitive problems-inattention case. ORs were also indicative of a lower risk, although not significant, for ADHD index at age 11. Sensitivity analyses, taking into consideration quality of family context or the levels of other toxicants during pregnancy showed similar results. CONCLUSIONS Higher levels of MUFcr in pregnant women were associated with a lower risk of cognitive problems-inattention at 11 years. These findings are inconsistent with those from previous studies and indicate the need for other population-based studies to confirm or overturn these results.
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Affiliation(s)
- Jesús Ibarluzea
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Mikel Subiza-Pérez
- Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, BD9 6RJ, Bradford, United Kingdom
| | - Ane Arregi
- Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain.
| | - Amaia Molinuevo
- Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Enrique Arranz-Freijo
- Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Manuel Sánchez-de Miguel
- Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Ana Jiménez
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Ainara Andiarena
- Faculty of Psychology of the University of the Basque Country (UPV-EHU), 20018, San Sebastian, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Loreto Santa-Marina
- Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Biodonostia Health Research Institute, Environmental Epidemiology and Child Development Group, 20014, San Sebastian, Spain; Faculty of Medicine and Nursery of the University of the Basque Country (UPV/EHU), 48940, Leioa, Spain
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Keil-Stietz K, Lein PJ. Gene×environment interactions in autism spectrum disorders. Curr Top Dev Biol 2022; 152:221-284. [PMID: 36707213 PMCID: PMC10496028 DOI: 10.1016/bs.ctdb.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is credible evidence that environmental factors influence individual risk and/or severity of autism spectrum disorders (hereafter referred to as autism). While it is likely that environmental chemicals contribute to the etiology of autism via multiple mechanisms, identifying specific environmental factors that confer risk for autism and understanding how they contribute to the etiology of autism has been challenging, in part because the influence of environmental chemicals likely varies depending on the genetic substrate of the exposed individual. Current research efforts are focused on elucidating the mechanisms by which environmental chemicals interact with autism genetic susceptibilities to adversely impact neurodevelopment. The goal is to not only generate insights regarding the pathophysiology of autism, but also inform the development of screening platforms to identify specific environmental factors and gene×environment (G×E) interactions that modify autism risk. Data from such studies are needed to support development of intervention strategies for mitigating the burden of this neurodevelopmental condition on individuals, their families and society. In this review, we discuss environmental chemicals identified as putative autism risk factors and proposed mechanisms by which G×E interactions influence autism risk and/or severity using polychlorinated biphenyls (PCBs) as an example.
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Affiliation(s)
- Kimberly Keil-Stietz
- Department of Comparative Biosciences, University of Wisconsin-Madison, School of Veterinary Medicine, Madison, WI, United States
| | - Pamela J Lein
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA, United States.
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Prenatal antidepressant exposure and the risk of attention-deficit/hyperactivity disorder in childhood: A cohort study with triangulation. Epidemiology 2022; 33:581-592. [PMID: 35439781 DOI: 10.1097/ede.0000000000001494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Uncontrolled confounding from maternal depression and genetic and environmental factors is expected in studies investigating the effect of prenatal antidepressant exposure on the risk of attention-deficit/hyperactivity disorder (ADHD) in childhood and may explain inconsistencies in the existing evidence. We aimed to assess this effect using triangulation. METHODS Using population-based health registries, we conducted a nationwide cohort study of all children born in Denmark between 1997 and 2017 and followed through 2018 for ADHD. We assessed the effect of prenatal antidepressant exposure on the risk of ADHD in childhood by comparing children with and without prenatal antidepressant exposure in terms of adjusted incidence rate ratios (IRRs), adjusted incidence rate differences (IRDs), and adjusted risk differences (RDs) and the associated 95% confidence intervals (CIs). We triangulated results from four different analytic approaches: an overall analysis, a negative control analysis, a sibling analysis and a former-user analysis. RESULTS The overall study cohort consisted of 1,253,362 children, among whom 28,910 (2.3%) had prenatal antidepressant exposure. ADHD during follow-up was diagnosed among 1,411 (4.9%) of the exposed and in 37,196 (3.0%) of the unexposed children. Triangulation suggested an IRR of 1.09-1.15; an IRD less than 1 case/1,000 person-years, and an RD of 0.9%-2.2% over an up to 18-year period. CONCLUSIONS Based on triangulation, we estimated a modest effect of prenatal antidepressant exposure on the risk of ADHD in childhood. However, considering the limitations of our approaches, this observed association may be partially due to residual biases.
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Xu H, Jia Y, Sun Z, Su J, Liu QS, Zhou Q, Jiang G. Environmental pollution, a hidden culprit for health issues. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:31-45. [PMID: 38078200 PMCID: PMC10702928 DOI: 10.1016/j.eehl.2022.04.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/26/2022] [Accepted: 04/23/2022] [Indexed: 12/12/2023]
Abstract
The environmental and health impacts from the massive discharge of chemicals and subsequent pollution have been gaining increasing public concern. The unintended exposure to different pollutants, such as heavy metals, air pollutants and organic chemicals, may cause diverse deleterious effects on human bodies, resulting in the incidence and progression of different diseases. The article reviewed the outbreak of environmental pollution-related public health emergencies, the epidemiological evidence on certain pollution-correlated health effects, and the pathological studies on specific pollutant exposure. By recalling the notable historical life-threatening disasters incurred by local chemical pollution, the damning evidence was presented to criminate certain pollutants as the main culprit for the given health issues. The epidemiological data on the prevalence of some common diseases revealed a variety of environmental pollutants to blame, such as endocrine-disrupting chemicals (EDCs), fine particulate matters (PMs) and heavy metals. The retrospection of toxicological studies provided illustrative clues for evaluating ambient pollutant-induced health risks. Overall, environmental pollution, as the hidden culprit, should answer for the increasing public health burden, and more efforts are highly encouraged to strive to explore the cause-and-effect relationships through extensive epidemiological and pathological studies.
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Affiliation(s)
- Hanqing Xu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- National and Local Joint Engineering Research Center of Ecological Treatment Technology for Urban Water Pollution, and Zhejiang Provincial Key Lab for Subtropical Water Environment and Marine Biological Resources Protection, Wenzhou University, Wenzhou, 325035, China
| | - Yang Jia
- National and Local Joint Engineering Research Center of Ecological Treatment Technology for Urban Water Pollution, and Zhejiang Provincial Key Lab for Subtropical Water Environment and Marine Biological Resources Protection, Wenzhou University, Wenzhou, 325035, China
| | - Zhendong Sun
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310000, China
| | - Jiahui Su
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Qian S. Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
| | - Qunfang Zhou
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310000, China
- Institute of Environment and Health, Jianghan University, Wuhan, 430056, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, 310000, China
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Amgalan A, Andescavage N, Limperopoulos C. Prenatal origins of neuropsychiatric diseases. Acta Paediatr 2021; 110:1741-1749. [PMID: 33475192 DOI: 10.1111/apa.15766] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/28/2021] [Accepted: 01/18/2021] [Indexed: 12/18/2022]
Abstract
AIM The main objective is to review the available evidence in the literature for developmental origins of neuropsychiatric diseases and their underlying mechanisms. We also probe emerging cutting-edge prenatal MR imaging tools and their future role in advancing our understanding the prenatal footprints of neuropsychiatric disorders. OBSERVATIONS Both human and animal studies support early intrauterine origins of neuropsychiatric disease, particularly autism spectrum disorders (ASD), attention and hyperactivity disorders, schizophrenia, depression, anxiety and mood disorders. Specific mechanisms of intrauterine injury include infection, inflammation, hypoxia, hypoperfusion, ischaemia polysubstance use/abuse, maternal mental health and placental dysfunction. CONCLUSIONS AND RELEVANCE There is ample evidence to suggest developmental vulnerability of the foetal brain to intrauterine exposures that increases and individual's risk for neuropsychiatric disease, especially the risk of ASD, depression and anxiety. Elucidating the exact timing and mechanisms of injury can be difficult and require novel, non-invasive approaches to the study emerging structural and functional brain development of the foetus. Clinical care should both emphasise maternal health during pregnancy, as well as close, continued monitoring for at risk offspring throughout young adulthood for the early identification and treatment of neuropsychiatric diseases.
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Affiliation(s)
| | - Nickie Andescavage
- Division of Neonatology Children’s National Health System Washington DC USA
- Department of Pediatrics George Washington University School of Medicine Washington DC USA
| | - Catherine Limperopoulos
- Department of Pediatrics George Washington University School of Medicine Washington DC USA
- Division of Diagnostic Imaging & Radiology Children’s National Health System Washington DC USA
- Department of Radiology George Washington University School of Medicine Washington DC USA
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Praveena SM, Munisvaradass R, Masiran R, Rajendran RK, Lin CC, Kumar S. Phthalates exposure and attention-deficit/hyperactivity disorder in children: a systematic review of epidemiological literature. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:44757-44770. [PMID: 32895790 DOI: 10.1007/s11356-020-10652-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 08/26/2020] [Indexed: 06/11/2023]
Abstract
Epidemiological studies have proven that children mental health can be affected by environmental pollutants which are believed to be visible in the form of psychological disorder later in their childhood. Moreover, the effects of children mental health are evidently clear in the case of phthalates which have been observed to increase psychological disorder, specifically attention-deficit hyperactivity disorder (ADHD). Hence, the present study aims to conduct a systematic review and provide an overview of the existing literature on the association between urinary phthalate metabolite concentrations and ADHD symptoms among children by emphasizing the confounding factors and limitations. Additionally, this review addressed the possible phthalate mechanism insights in human body including its impact on ADHD symptoms. In this case, 16 epidemiological studies (five cross-sectional, nine cohort and two case control studies) that met all the inclusion criteria were selected out of the total of 427 papers screened to show varying quantitative associations between phthalate exposure and ADHD symptoms among children with confounding factors and limitations in the existing studies in regard to the exposure and outcomes. This review also attempted to present possible explanation on phthalate mechanism in children body and its connection on neurodevelopment and ADHD symptom development which remains unclear in most of the studies. Finally, it is highly recommended for further research to carefully design cohort studies from prenatal to later childhood development with a complete sample size in order to understand phthalate impacts on children health.
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Affiliation(s)
- Sarva Mangala Praveena
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
- Food Safety and Food Integrity, Institute of Tropical, Agriculture and Food Security, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia.
| | - Rusheni Munisvaradass
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Ruziana Masiran
- Department of Psychiatry, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
| | - Ranjith Kumar Rajendran
- Graduate Institute of Environmental Engineering, National Central University, No.300, Zhongda Rd., Zhongli District, Taoyuan City, 32001, Taiwan
| | - Chu-Ching Lin
- Graduate Institute of Environmental Engineering, National Central University, No.300, Zhongda Rd., Zhongli District, Taoyuan City, 32001, Taiwan
| | - Suresh Kumar
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Science, Universiti Putra Malaysia, UPM, 43400, Serdang, Selangor, Malaysia
- Department of Biotechnology, BIHER, Bharath University, Chennai, 600 073, Tamil Nadu, India
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Torres-Olascoaga LA, Watkins D, Schnaas L, Meeker JD, Solano-Gonzalez M, Osorio-Valencia E, Peterson KE, Tellez-Rojo MM, Tamayo-Ortiz M. Early Gestational Exposure to High-Molecular-Weight Phthalates and Its Association with 48-Month-Old Children's Motor and Cognitive Scores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218150. [PMID: 33158190 PMCID: PMC7662459 DOI: 10.3390/ijerph17218150] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/31/2020] [Accepted: 11/02/2020] [Indexed: 01/11/2023]
Abstract
In utero phthalate exposure has been associated with neurodevelopmental disorders, nevertheless, trimester-specific susceptibility remains understudied. Our aim was to identify susceptible windows to the effects of gestational High-Molecular-Weight Phthalates (HMWP) exposure on 48 months’ neurodevelopment. We measured six HMWP metabolites (MEHP, MEHHP, MEOHP, MECPP, MBzP and MCPP) in urine samples collected during each trimester from women in the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) cohort (n = 218). We assessed children’s motor (MS), cognitive (GCI) and memory (MeS) abilities using McCarthy Scales of Children’s Abilities (MSCA). We used linear regression models to examine associations between trimester-specific phthalate metabolites and MSCA scores, adjusted for sex, gestational age, breastfeeding, and maternal IQ. Although phthalate concentrations were similar across trimesters, first and second trimester phthalates were inversely associated with MS and GCI, with first trimester associations with MS being the strongest and statistically significant. Stronger associations were seen with MS and GCI among boys compared to girls, however interaction terms were not statistically significant. Our results suggest that early gestation is a sensitive window of exposure to HMWP for neurodevelopment, particularly in boys. Regulations on phthalate content in food as well as pregnancy consumption guidelines are necessary to protect future generations.
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Affiliation(s)
- Libni A. Torres-Olascoaga
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62000, Mexico; (L.A.T.-O.); (M.S.-G.); (M.M.T.-R.)
| | - Deborah Watkins
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (D.W.); (K.E.P.)
| | - Lourdes Schnaas
- National Institute of Perinatology, Mexico City 11000, Mexico; (L.S.); (E.O.-V.)
| | - John D. Meeker
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Maritsa Solano-Gonzalez
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62000, Mexico; (L.A.T.-O.); (M.S.-G.); (M.M.T.-R.)
| | | | - Karen E. Peterson
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (D.W.); (K.E.P.)
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Martha María Tellez-Rojo
- Center for Research on Nutrition and Health, National Institute of Public Health, Cuernavaca 62000, Mexico; (L.A.T.-O.); (M.S.-G.); (M.M.T.-R.)
| | - Marcela Tamayo-Ortiz
- Research Unit in Occupational Health, Mexican Social Security Institute, Mexico City 06720, Mexico
- Correspondence: or
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He Y, Chen J, Zhu LH, Hua LL, Ke FF. Maternal Smoking During Pregnancy and ADHD: Results From a Systematic Review and Meta-Analysis of Prospective Cohort Studies. J Atten Disord 2020; 24:1637-1647. [PMID: 29039728 DOI: 10.1177/1087054717696766] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objective: Findings on maternal smoking during pregnancy and ADHD risk in children are inconsistent. A meta-analysis was performed to summarize effects of exposure to maternal smoking during pregnancy on ADHD risk in children. Method: We conducted a systematic literature search to select articles up to June 2016. Only prospective cohort studies were included. Summary relative risks (RRs) with 95% confidence intervals (CIs) were calculated. Results: Pooled RR estimates based on 12 cohort studies including 17,304 pregnant women suggested that maternal smoking during pregnancy was associated with an increased risk of ADHD (pooled RR = 1.58, 95% CI = [1.33, 1.88]). Conclusion: Results from this study indicate that maternal smoking during pregnancy is related to an increased risk of ADHD in children. There is an urgent need to increase maternal awareness of smoking risk and quitting smoking to mitigate the ADHD risk in children.
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Affiliation(s)
- Yan He
- Ningbo Women and Children's Hospital, China
| | - Jian Chen
- Ningbo Women and Children's Hospital, China
| | - Li-Hua Zhu
- Ningbo Women and Children's Hospital, China
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Hawari I, Eskandar MB, Alzeer S. The Role of Lead, Manganese, and Zinc in Autism Spectrum Disorders (ASDs) and Attention-Deficient Hyperactivity Disorder (ADHD): a Case-Control Study on Syrian Children Affected by the Syrian Crisis. Biol Trace Elem Res 2020; 197:107-114. [PMID: 32347445 DOI: 10.1007/s12011-020-02146-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 04/06/2020] [Indexed: 11/29/2022]
Abstract
Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are two developmental disorders that affect children worldwide, and are linked to both genetic and environmental factors. This study aims to investigate the levels of lead, manganese, and zinc in each of ASD, ADHD, and ASD with comorbid ADHD in Syrian children born or grown during the Syrian crisis. Lead and manganese were measured in the whole blood, and zinc was measured in the serum in 31 children with ASD, 29 children with ADHD, and 11 children with ASD with comorbid ADHD (ASD-C) compared with 30 healthy children, their ages ranged between 3 and 12 years. Blood lead levels were higher in the groups of ASD-C (245.42%), ASD (47.57%), and ADHD (14.19%) compared with control. Lead levels were significantly higher in children with ASD in the age of 5 or less compared with control, and they were also higher in the male ASD compared with females (P = 0.001). Blood manganese levels were lower in the groups of ASD-C (10.35%), ADHD (9.95%, P = 0.026), and ASD (9.64%, P = 0.046). However, serum zinc levels were within the reference range in all groups of study. Lead and manganese were positively correlated with each other (P = 0.01). Lead increase and manganese decrease may associate with the incidence of ASD, ADHD, or the co-occurrence of both of them together. Further studies are needed to examine the relationship between metal levels and the co-occurrence of ASD and ADHD together.
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Affiliation(s)
- Israa Hawari
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Damascus, 17th April, Mazzeh, Damascus, Syria.
| | - Mohamad Bashar Eskandar
- Department of Pediatrics, Faculty of Medicine, University of Damascus, 17th April, Mazzeh, Damascus, Syria
| | - Samar Alzeer
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Damascus, 17th April, Mazzeh, Damascus, Syria
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Phthalates, Para-Hydroxybenzoic Acids, Bisphenol-A, and Gonadal Hormones' Effects on Susceptibility to Attention-Deficit/Hyperactivity Disorder. TOXICS 2020; 8:toxics8030057. [PMID: 32823738 PMCID: PMC7560246 DOI: 10.3390/toxics8030057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/09/2020] [Accepted: 08/11/2020] [Indexed: 11/16/2022]
Abstract
This study aimed to examine whether endocrine-disrupting chemicals (EDCs), such as phthalates, para-hydroxybenzoic acids, and bisphenol-A (BPA), affect gonadal hormones and further link to the susceptibility to attention-deficit/hyperactivity disorder (ADHD). We recruited 98 boys with ADHD, 32 girls with ADHD, 42 boys without ADHD and any other psychiatric disorders, and 26 girls without ADHD and any other psychiatric disorders. Urine levels of EDCs, including mono-methyl phthalate (MMP), monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), monobenzyl phthalate (MBzP), monoethylhexyl phthalate (MEHP), methylparaben (MP), ethylparaben (EP), propylparaben (PP), butylparaben (BP), and bisphenol A (BPA), were examined. Endocrine systems were evaluated by using the serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, free testosterone, estradiol, progesterone, sex hormone-binding globulin (SHBG), and prolactin. We found that boys with ADHD had higher levels of MnBP and EP than control boys. There were no significant differences regarding EDCs between the females with ADHD and control groups. No significant differences in testosterone, free testosterone, FSH, LH, estradiol, progesterone, or SHBG were found between the ADHD group and controls among either boys or girls. Among boys with ADHD, urine MBzP and MEHP levels were positively correlated with serum testosterone levels. Among girls, urine MEP levels were positively correlated with serum LH, testosterone, and free testosterone levels. The findings suggest that the possibility of an adverse impact of EDCs on gonadal hormones and neurodevelopment may exist. However, the results could be subject to potential selection bias, and the findings in this study should be interpreted with caution.
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Forns J, Verner MA, Iszatt N, Nowack N, Bach CC, Vrijheid M, Costa O, Andiarena A, Sovcikova E, Høyer BB, Wittsiepe J, Lopez-Espinosa MJ, Ibarluzea J, Hertz-Picciotto I, Toft G, Stigum H, Guxens M, Liew Z, Eggesbø M. Early Life Exposure to Perfluoroalkyl Substances (PFAS) and ADHD: A Meta-Analysis of Nine European Population-Based Studies. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:57002. [PMID: 32378965 PMCID: PMC7263458 DOI: 10.1289/ehp5444] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION To date, the evidence for an association between perfluoroalkyl substances (PFAS) exposure and attention deficit and hyperactivity disorder (ADHD) is inconclusive. OBJECTIVE We investigated the association between early life exposure to perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA), and ADHD in a collaborative study including nine European population-based studies, encompassing 4,826 mother-child pairs. METHODS Concentrations of PFOS and PFOA were measured in maternal serum/plasma during pregnancy, or in breast milk, with different timing of sample collection in each cohort. We used a validated pharmacokinetic model of pregnancy and lactation to estimate concentrations of PFOS and PFOA in children at birth and at 3, 6, 12, and 24 months of age. We classified ADHD using recommended cutoff points for each instrument used to derive symptoms scores. We used multiple imputation for missing covariates, logistic regression to model the association between PFAS exposure and ADHD in each study, and combined all adjusted study-specific effect estimates using random-effects meta-analysis. RESULTS A total of 399 children were classified as having ADHD, with a prevalence ranging from 2.3% to 7.3% in the studies. Early life exposure to PFOS or PFOA was not associated with ADHD during childhood [odds ratios (ORs) ranging from 0.96 (95% CI: 0.87, 1.06) to 1.02 (95% CI: 0.93, 1.11)]. Results from stratified models suggest potential differential effects of PFAS related to child sex and maternal education. CONCLUSION We did not identify an increased prevalence of ADHD in association with early life exposure to PFOS and PFOA. However, stratified analyses suggest that there may be an increased prevalence of ADHD in association with PFAS exposure in girls, in children from nulliparous women, and in children from low-educated mothers, all of which warrant further exploration. https://doi.org/10.1289/EHP5444.
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Affiliation(s)
- Joan Forns
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Marc-Andre Verner
- Department of Occupational and Environmental Health, School of Public Health, Université de Montréal, Montreal, Canada
- Université de Montréal Public Health Research Institute (IRSPUM), Université de Montréal, Montreal, Canada
| | - Nina Iszatt
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Nikola Nowack
- Department of Developmental Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Cathrine Carlsen Bach
- Department of Pediatrics and Adolescent Medicine, Viborg Regional Hospital, Viborg, Denmark
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Martine Vrijheid
- Global Health Institute Barcelona (ISGlobal), Institute for Global Health, Barcelona, Spain
- Univeristat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Olga Costa
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO)-Universitat Jaume I-Universitat de València, Valencia, Spain
| | - Ainara Andiarena
- Health Research Institute BIODONOSTIA, Donostia-San Sebastian, Basque Country, Spain
- Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Basque Country, Spain
| | - Eva Sovcikova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Birgit Bjerre Høyer
- Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark
| | - Jürgen Wittsiepe
- Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Maria-Jose Lopez-Espinosa
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO)-Universitat Jaume I-Universitat de València, Valencia, Spain
- Department of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | - Jesus Ibarluzea
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Health Research Institute BIODONOSTIA, Donostia-San Sebastian, Basque Country, Spain
- Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Basque Country, Spain
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, School of Medicine, University of California, Davis (UC Davis), Davis, California, USA
- UC Davis Medical Investigations of Neurodevelopmental Disorders Institute, UC Davis, Davis, California, USA
| | - Gunnar Toft
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hein Stigum
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
| | - Mònica Guxens
- Global Health Institute Barcelona (ISGlobal), Institute for Global Health, Barcelona, Spain
- Univeristat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, Netherlands
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
- Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Merete Eggesbø
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Shareghfarid E, Sangsefidi ZS, Salehi-Abargouei A, Hosseinzadeh M. Empirically derived dietary patterns and food groups intake in relation with Attention Deficit/Hyperactivity Disorder (ADHD): A systematic review and meta-analysis. Clin Nutr ESPEN 2020; 36:28-35. [DOI: 10.1016/j.clnesp.2019.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 10/08/2019] [Indexed: 01/30/2023]
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The association between mode of birth delivery and attention-deficit/hyperactivity disorder: a systematic review protocol of epidemiological evidence. INT J EVID-BASED HEA 2019; 17 Suppl 1:S34-S37. [PMID: 31283578 DOI: 10.1097/xeb.0000000000000176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Caesarean section is currently the most frequently performed intervention after episiotomy in obstetrics and one of the most common abdominal operations overall. Rates of caesarean section have been rising globally. Given the increasing rate worldwide it is therefore necessary and important to understand how caesarean section affects child development. Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioural disorder in children. ADHD is characterized by a combination of symptoms including inattention, impulsivity and hyperactivity. Caesarean section may affect psychological development through changes in microbiota or stress response, and birth by caesarean section can be associated with a small increased risk of ADHD. In the current literature, there is no systematic review or protocol of the systematic review answering the question of whether the mode of delivery has influence on the risk of ADHD development.The objective of this review is to synthesize the best available evidence regarding the epidemiological association between the mode of delivery (caesarean section versus vaginal delivery) as exposure and ADHD as the outcome.A three-step strategy will be utilized in this review, aiming to find both published and unpublished studies. The initial search will be conducted using the MEDLINE, CINAHL and EMBASE. The second search will involve 21 databases and sources. Following the Preferred Reporting Items for Systematic Review and Meta-analysis statement analysis of title, abstracts and full texts, critical appraisal and data extraction will be carried out on selected studies using standardized instruments developed by Joanna Briggs Institute. All steps will be performed by two independent reviewers. If possible, statistical meta-analysis using Joanna Briggs Institute within the System for the Unified Management, Assessment and Review of Information will be pooled. Statistical heterogeneity will be assessed.The results will be disseminated by publishing in a peer-reviewed journal. Ethical assessment is not needed - we will search/evaluate the existing sources of literature.
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Air Pollution Exposure During Pregnancy and Symptoms of Attention Deficit and Hyperactivity Disorder in Children in Europe. Epidemiology 2019; 29:618-626. [PMID: 29923866 DOI: 10.1097/ede.0000000000000874] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Exposure to air pollution during pregnancy may increase attention-deficit/hyperactivity disorder (ADHD) symptoms in children, but findings have been inconsistent. We aimed to study this association in a collaborative study of eight European population-based birth/child cohorts, including 29,127 mother-child pairs. METHODS Air pollution concentrations (nitrogen dioxide [NO2] and particulate matter [PM]) were estimated at the birth address by land-use regression models based on monitoring campaigns performed between 2008 and 2011. We extrapolated concentrations back in time to exact pregnancy periods. Teachers or parents assessed ADHD symptoms at 3-10 years of age. We classified children as having ADHD symptoms within the borderline/clinical range and within the clinical range using validated cutoffs. We combined all adjusted area-specific effect estimates using random-effects meta-analysis and multiple imputations and applied inverse probability-weighting methods to correct for loss to follow-up. RESULTS We classified a total of 2,801 children as having ADHD symptoms within the borderline/clinical range, and 1,590 within the clinical range. Exposure to air pollution during pregnancy was not associated with a higher odds of ADHD symptoms within the borderline/clinical range (e.g., adjusted odds ratio [OR] for ADHD symptoms of 0.95, 95% confidence interval [CI] = 0.89, 1.01 per 10 µg/m increase in NO2 and 0.98, 95% CI = 0.80, 1.19 per 5 µg/m increase in PM2.5). We observed similar associations for ADHD within the clinical range. CONCLUSIONS There was no evidence for an increase in risk of ADHD symptoms with increasing prenatal air pollution levels in children aged 3-10 years. See video abstract at, http://links.lww.com/EDE/B379.
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Shafer TJ. Application of Microelectrode Array Approaches to Neurotoxicity Testing and Screening. ADVANCES IN NEUROBIOLOGY 2019; 22:275-297. [PMID: 31073941 DOI: 10.1007/978-3-030-11135-9_12] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Neurotoxicity can be defined by the ability of a drug or chemical to alter the physiology, biochemistry, or structure of the nervous system in a manner that may negatively impact the health or function of the individual. Electrophysiological approaches have been utilized to study the mechanisms underlying neurotoxic actions of drugs and chemicals for over 50 years, and in more recent decades, high-throughput patch-clamp approaches have been utilized by the pharmaceutical industry for drug development. The use of microelectrode array recordings to study neural network electrophysiology is a relatively newer approach, with commercially available systems becoming available only in the early 2000s. However, MEAs have been rapidly adopted as a useful approach for neurotoxicity testing. In this chapter, I will review the use of MEA approaches as they have been applied to the field of neurotoxicity testing, especially as they have been applied to the need to screen large numbers of chemicals for neurotoxicity and developmental neurotoxicity. In addition, I will also identify challenges for the field that when addressed will improve the utility of MEA approaches for toxicity testing.
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Affiliation(s)
- Timothy J Shafer
- Integrated Systems Toxicology Division, National Health and Environmental Effects Research Laboratory (NHEERL), US EPA, Research Triangle Park, NC, USA.
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Maternal breastfeeding and attention-deficit/hyperactivity disorder in children: a meta-analysis. Eur Child Adolesc Psychiatry 2019; 28:19-30. [PMID: 29907910 DOI: 10.1007/s00787-018-1182-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 06/09/2018] [Indexed: 10/28/2022]
Abstract
Previous studies have suggested environmental factors may contribute to the risk of attention-deficit/hyperactivity disorder (ADHD). The current meta-analysis examined (1) the difference in the duration of maternal breastfeeding between children with and without ADHD, and (2) the association between maternal breastfeeding and ADHD in children. The data of individual studies were synthesized with a random-effects model. Eleven articles were included in this meta-analysis. Children with ADHD had significantly less breastfeeding duration than controls (Hedges' g = - 0.36, 95% confidence intervals (CIs) = - 0.61 to - 0.11, p = 0.005; difference in means: - 2.44 months, 95% CIs = - 3.17 to - 1.71, p < 0.001). In addition, the rates of non-exclusive breastfeeding in children with ADHD is significantly higher in "under 3 months" (odds ratio (OR) = 1.90, 95% CIs = 1.45 to 2.48, p < 0.001) but lower in "6 to 12 months" (OR = 0.69, 95% CIs = 0.49 to 0.98, p = 0.039) and "over 12 months" (OR = 0.58, 95% CIs = 0.35 to 0.97, p = 0.038) than controls. Children with ADHD received significantly higher rate of exclusive breastfeeding duration "under 3 months" (OR = 1.51, 95% CIs = 1.20 to 1.89, p < 0.001) but lower in "over 3 months" (OR = 0.52, 95% CIs = 0.29 to 0.95, p = 0.033) than controls. Furthermore, an association was found between non-breastfeeding and ADHD children (adjusted OR = 3.71, 95% CI = 1.94 to 7.11, p < 0.001). Our results suggest maternal breastfeeding is associated with a lower risk of ADHD in children. Future longitudinal research is required to confirm/refute these findings and to explore possible mechanisms underlying this association.
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Zhao L, Li X, Liu G, Han B, Wang J, Jiang X. The association of maternal diabetes with attention deficit and hyperactivity disorder in offspring: a meta-analysis. Neuropsychiatr Dis Treat 2019; 15:675-684. [PMID: 30880994 PMCID: PMC6419587 DOI: 10.2147/ndt.s189200] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Recent controversial evidence suggests that maternal diabetes may increase the risk of attention deficit and hyperactivity disorder (ADHD) in offspring. To examine this potential association, a systematic literature search and meta-analysis was performed. METHODS OR or risk ratio (RR) from each study was obtained and combined for evaluating the risk. Six cohort studies and three case-control studies were included in the present study. RESULTS The meta-analysis of the highly heterogeneous case-control studies did not find significant association between maternal diabetes and ADHD risk (OR: 1.20, 95% CI: 0.96-1.49). The combining of the cohort studies demonstrated that offspring of diabetic mothers were at higher risk of ADHD (RR: 1.40, 95% CI: 1.27-1.54); however, publication bias was identified. When exposure was specified as gestational diabetes mellitus (GDM), GDM exposure increased the risk of ADHD for children by 164% (95% CI: 1.25-5.56) in a Caucasian population. Neither heterogeneity nor publication bias was detected. CONCLUSION Maternal diabetes, especially GDM, is probably a risk factor for ADHD in the Caucasian population. More studies based on large sample size and different ethnicities are needed to confirm this association.
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Affiliation(s)
- Lifeng Zhao
- Department of Endocrinology, Tianjin First Center Hospital, Tianjin, China,
| | - Xuesong Li
- First Center Clinical Medical Institute, Tianjin Medical University, Tianjin, China
| | - Guanying Liu
- Department of Endocrinology, Tianjin First Center Hospital, Tianjin, China,
| | - Baoling Han
- Department of Endocrinology, Tianjin First Center Hospital, Tianjin, China,
| | - Jian Wang
- Department of Endocrinology, Tianjin First Center Hospital, Tianjin, China,
| | - Xia Jiang
- Department of Endocrinology, Tianjin First Center Hospital, Tianjin, China,
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Bashash M, Marchand M, Hu H, Till C, Martinez-Mier EA, Sanchez BN, Basu N, Peterson KE, Green R, Schnaas L, Mercado-García A, Hernández-Avila M, Téllez-Rojo MM. Prenatal fluoride exposure and attention deficit hyperactivity disorder (ADHD) symptoms in children at 6-12 years of age in Mexico City. ENVIRONMENT INTERNATIONAL 2018; 121:658-666. [PMID: 30316181 DOI: 10.1016/j.envint.2018.09.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/20/2018] [Accepted: 09/08/2018] [Indexed: 05/23/2023]
Abstract
BACKGROUND Epidemiologic and animal-based studies have raised concern over the potential impact of fluoride exposure on neurobehavioral development as manifested by lower IQ and deficits in attention. To date, no prospective epidemiologic studies have examined the effects of prenatal fluoride exposure on behavioral outcomes using fluoride biomarkers and sensitive measures of attention. OBJECTIVE We aimed to examine the association between prenatal fluoride exposure and symptoms associated with attention-deficit/hyperactivity disorder (ADHD). METHOD 213 Mexican mother-children pairs of the Early Life Exposures to Environmental Toxicants (ELEMENT) birth cohort study had available maternal urinary samples during pregnancy and child assessments of ADHD-like behaviors at age 6-12. We measured urinary fluoride levels adjusted for creatinine (MUFcr) in spot urine samples collected during pregnancy. The Conners' Rating Scales-Revised (CRS-R) was completed by mothers, and the Conners' Continuous Performance Test (CPT-II) was administered to the children. RESULTS Mean MUFcr was 0.85 mg/L (SD = 0.33) and the Interquartile Range (IQR) was 0.46 mg/L. In multivariable adjusted models using gamma regression, a 0.5 mg/L higher MUFcr (approximately one IQR higher) corresponded with significantly higher scores on the CRS-R for DSM-IV Inattention (2.84 points, 95% CI: 0.84, 4.84) and DSM-IV ADHD Total Index (2.38 points, 95% CI: 0.42, 4.34), as well as the following symptom scales: Cognitive Problems and Inattention (2.54 points, 95% CI: 0.44, 4.63) and ADHD Index (2.47 points; 95% CI: 0.43, 4.50). The shape of the associations suggested a possible celling effect of the exposure. No significant associations were found with outcomes on the CPT-II or on symptom scales assessing hyperactivity. CONCLUSION Higher levels of fluoride exposure during pregnancy were associated with global measures of ADHD and more symptoms of inattention as measured by the CRS-R in the offspring.
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Affiliation(s)
- Morteza Bashash
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Maelle Marchand
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Christine Till
- Faculty of Health - Department of Psychology, York University, ON, Canada
| | | | - Brisa N Sanchez
- University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, QC, Canada
| | - Karen E Peterson
- University of Michigan School of Public Health, Ann Arbor, MI, United States of America; Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, United States of America; Harvard W.T. Chan School of Public Health, Boston, MA, United States of America
| | - Rivka Green
- Faculty of Health - Department of Psychology, York University, ON, Canada
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Saez M, Barceló MA, Farrerons M, López-Casasnovas G. The association between exposure to environmental factors and the occurrence of attention-deficit/hyperactivity disorder (ADHD). A population-based retrospective cohort study. ENVIRONMENTAL RESEARCH 2018; 166:205-214. [PMID: 29890425 DOI: 10.1016/j.envres.2018.05.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/02/2018] [Accepted: 05/09/2018] [Indexed: 05/23/2023]
Abstract
BACKGROUND A number of factors contribute to attention deficit hyperactivity disorder (ADHD) and although they are not fully known, the occurrence of ADHD seems to be a consequence of an interaction between multiple genetic and environmental factors. However, apart from pesticides, the evidence is inadequate and inconsistent as it differs not only in the population and time period analysed, but also in the type of study, the control of the confounding variables and the statistical methods used. In the latter case, the studies also differ in the adjustment of spatial and temporal variability. Our objective here, is to provide evidence on an association between environmental factors and ADHD. METHODS In our study, we used a population-based retrospective cohort in which we matched cases and controls (children free of the disease) by sex and year of birth (n = 5193, 78.9% boys). The cases were children born between 1998 and 2012 and diagnosed with ADHD (n = 116). To evaluate whether there was a geographical pattern in the incidence of ADHD, we first represented the smoothed standardized incidence rates on a map of the region being studied. We then estimated the probability of being a case by using a generalized liner mixed model with a binomial link. As explanatory variables of interest, we included the following environmental variables: distance to agricultural areas, distance to roads (stratified into three categories according to traffic density and intensity), distance to petrol stations, distance to industrial estates, and land use. We control for both observed (individual and family specific variables and deprivation index) and unobserved confounders (in particular, individual and familial heterogeneity). In addition, we adjusted for spatial extra variability. RESULTS We found a north-south pattern containing two clusters (one in the centre of the study region and another in the south) in relation to the risk of developing ADHD. The results from the multivariate model suggest that these clusters could be related to some of the environmental variables. Specifically, living within 100 m from an agricultural area or a residential street and/or living fewer than 300 m from a motorway, dual carriageway or one of the industrial estates analysed was associated (statistically significant) with an increased risk of ADHD. CONCLUSION Our results indicate that some environmental factors could be associated with ADHD occurring, particularly those associated with exposure to pesticides, organochlorine compounds and air pollutants because of traffic.
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Affiliation(s)
- Marc Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain.
| | - Maria A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain
| | - Mònica Farrerons
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; Medical Student, University of Girona, Spain
| | - Guillem López-Casasnovas
- Center for Research in Health and Economics (CRES), Universitat Pompeu Fabra, Barcelona, Spain; Department of Economics and Business, Universitat Pompeu Fabra, Barcelona, Spain; Barcelona Graduate School (BSGE), Universitat Pompeu Fabra, Barcelona, Spain
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22
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Roberts AL, Liew Z, Lyall K, Ascherio A, Weisskopf MG. Association of Maternal Exposure to Childhood Abuse With Elevated Risk for Attention Deficit Hyperactivity Disorder in Offspring. Am J Epidemiol 2018; 187:1896-1906. [PMID: 29762636 DOI: 10.1093/aje/kwy098] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 04/25/2018] [Indexed: 12/13/2022] Open
Abstract
Children whose mothers experienced childhood abuse are more likely to suffer various neurodevelopmental deficits. Whether an association exists specifically for attention deficit hyperactivity disorder (ADHD) is unknown. We examined the association of maternal experience of childhood abuse with ADHD in offspring, assessed by maternal report of diagnosis and validated with the ADHD Rating Scale-IV in a subsample, in the Nurses' Health Study II (n = 49,497 mothers; n = 7,607 case offspring; n = 102,151 control offspring). We examined whether 10 adverse perinatal circumstances (e.g., prematurity, smoking) or socioeconomic factors accounted for a possible association. Exposure to abuse was associated with greater prevalence of ADHD in offspring (8.7% of offspring of women exposed to severe abuse vs. 5.5% of offspring of women not abused, P = 0.0001) and with greater risk for ADHD when the model was adjusted for demographic factors (male offspring, risk ratio (RR) = 1.6, 95% confidence interval (CI): 1.3, 1.9; female offspring, RR = 2.3, 95% CI: 1.7, 3.0). After adjustment for perinatal factors, the association of maternal childhood abuse with ADHD in offspring was slightly attenuated (male offspring, RR = 1.5, 95% CI: 1.2, 1.8; female offspring, RR = 2.1, 95% CI: 1.6, 2.8). We identified an association between maternal experience of childhood abuse and risk for ADHD in offspring, which was not explained by several important perinatal risk factors or socioeconomic status.
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Affiliation(s)
- Andrea L Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Alberto Ascherio
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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23
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Tsuno K, Yoshimasu K, Hayashi T, Tatsuta N, Ito Y, Kamijima M, Nakai K. [Reliability and Validity of the Behavioral Check List for Preschool Children to Measure Attention Deficit Hyperactivity Behaviors]. Nihon Eiseigaku Zasshi 2018; 73:225-234. [PMID: 29848875 DOI: 10.1265/jjh.73.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Nowadays, attention deficit hyperactivity (ADH) problems are observed commonly among school-age children. However, questionnaires specific to ADH behaviors among preschool children are very few. The aim of this study was to investigate the reliability and validity of the 25-item Behavioral Check List (BCL), which was developed from interviews of parents with children who were diagnosed as having Attention-deficit/hyperactivity disorder (ADHD) and measures ADH behaviors in preschool age. METHODS We recruited 22 teachers from 10 nurseries/kindergartens in Miyagi Prefecture, Japan. A total of 138 preschool children were assessed using the BCL. To investigate inter-rater reliability, two teachers from each facility assess seven to twenty children in their class, and intraclass correlation coefficients (ICCs) were calculated. The teachers additionally answered questions in the 1/5-5 Caregiver-Teacher Report Form (C-TRF) to investigate the criterion validity of the BCL. To investigate structural validity, exploratory factor analysis with promax rotation and confirmatory factor analysis were performed. RESULTS The internal consistency reliability of the BCL was good (α = 0.92) and correlation analyses also confirmed its excellent criterion validity. Although exploratory factor analysis for the BCL yielded a five-factor model that consisted of a factor structure different from that of the original one, the results were similar to the original six factors. The ICCs of the BCL were 0.38-0.99 and it was not high enough for inter-rater reliability in some facilities. However, there is a possibility to improve it by giving raters adequate explanations when using BCL. CONCLUSIONS The present study showed acceptable levels of reliability and validity of the BCL among Japanese preschool children.
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Affiliation(s)
- Kanami Tsuno
- Department of Hygiene, School of Medicine, Wakayama Medical University.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
| | - Kouichi Yoshimasu
- Department of Hygiene, School of Medicine, Wakayama Medical University
| | - Takashi Hayashi
- Department of Developmental Medicine/Centre for Developmental Disabilities Studies, Nishikawa Clinic
| | - Nozomi Tatsuta
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine
| | - Yuki Ito
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences
| | - Michihiro Kamijima
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences
| | - Kunihiko Nakai
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine
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Fordyce TA, Leonhard MJ, Chang ET. A critical review of developmental exposure to particulate matter, autism spectrum disorder, and attention deficit hyperactivity disorder. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART A, TOXIC/HAZARDOUS SUBSTANCES & ENVIRONMENTAL ENGINEERING 2018; 53:174-204. [PMID: 29157090 DOI: 10.1080/10934529.2017.1383121] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Autism spectrum disorder (ASD) and attention deficit (hyperactivity) disorder (ADD/ADHD) are key focuses of current health research due to their increasing prevalence. The objective of this systematic literature search and critical review was to evaluate whether the human epidemiologic data indicate a pattern of association between ASD or ADD/ADHD and developmental exposure to particulate matter (PM), with a focus on exposures encountered before the age of three. A MEDLINE and EMBASE search was conducted; following preliminary and full-text screening, 14 relevant articles were identified for review. Three of the 14 studies were prospective cohort studies evaluating exposure to PM10; 11 studies had a case-control design. There was no consistent association between developmental PM exposure and ASD across the three of the cohort studies. Seven of the case-control studies examined the relationship between PM2.5 and/or PM10 and ASD; four examined the relationship between developmental diesel PM exposure and ASD. Overall, there was low external consistency in results among studies of PM2.5/PM10 and ASD, with some reporting high internal consistency without significant associations, others showing associations with high internal consistency for specific exposure windows only (e.g., third trimester), and still others showing high consistency for moderate to strong associations between PM and ASD. The majority of studies reporting significant results had low effect sizes in conjunction with small sample sizes. The four studies of diesel PM and ASD also had low external consistency of results. Only one study evaluated associations with ADD/ADHD, and it found no significant associations with PM10. The inconsistent findings across studies of developmental exposure to PM and ASD may be attributed to differences in the study populations, exposure assessments, outcome assessments, or chance. Further research is needed to understand the underlying biological mechanisms that lead to ASD and ADD/ADHD and how PM might be involved in those mechanisms, if at all. High-quality epidemiologic studies are also needed to conclusively determine whether developmental PM exposure is a causal factor for ASD or ADD/ADHD, with focus on a well-developed exposure assessment.
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Affiliation(s)
- Tiffani A Fordyce
- a Exponent, Inc., Center for Health Sciences , Menlo Park , California , USA
| | - Megan J Leonhard
- b Exponent, Inc., Center for Health Sciences , Bellevue , Washington , USA
| | - Ellen T Chang
- a Exponent, Inc., Center for Health Sciences , Menlo Park , California , USA
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25
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Peripheral iron levels in children with attention-deficit hyperactivity disorder: a systematic review and meta-analysis. Sci Rep 2018; 8:788. [PMID: 29335588 PMCID: PMC5768671 DOI: 10.1038/s41598-017-19096-x] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 12/16/2017] [Indexed: 01/11/2023] Open
Abstract
There is growing recognition that the risk of attention-deficit hyperactivity disorder (ADHD) in children may be influenced by micronutrient deficiencies, including iron. We conducted this meta-analysis to examine the association between ADHD and iron levels/iron deficiency (ID). We searched for the databases of the PubMed, ScienceDirect, Cochrane CENTRAL, and ClinicalTrials.gov up to August 9th, 2017. Primary outcomes were differences in peripheral iron levels in children with ADHD versus healthy controls (HCs) and the severity of ADHD symptoms in children with/without ID (Hedges' g) and the pooled adjusted odds ratio (OR) of the association between ADHD and ID. Overall, seventeen articles met the inclusion criteria. Peripheral serum ferritin levels were significantly lower in ADHD children (children with ADHD = 1560, HCs = 4691, Hedges' g = -0.246, p = 0.013), but no significant difference in serum iron or transferrin levels. In addition, the severity of ADHD was significantly higher in the children with ID than those without ID (with ID = 79, without ID = 76, Hedges' g = 0.888, p = 0.002), and there was a significant association between ADHD and ID (OR = 1.636, p = 0.031). Our results suggest that ADHD is associated with lower serum ferritin levels and ID. Future longitudinal studies are required to confirm these associations and to elucidate potential mechanisms.
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26
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Panahandeh G, Vatani B, Safavi P, Khoshdel A. The effect of adding ferrous sulfate to methylphenidate on attention-deficit/hyperactivity disorder in children. J Adv Pharm Technol Res 2017; 8:138-142. [PMID: 29184845 PMCID: PMC5680621 DOI: 10.4103/japtr.japtr_45_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Attention deficit/hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children with several complications. This study was conducted to investigate the effect of adding ferrous sulfate to methylphenidate in decreasing ADHD symptoms. This study was a double-blind, randomized clinical trial. In this study, 42 nonanemic children with ADHD and serum ferritin below 30 mg/ml were enrolled according to convenience sampling and randomly assigned to two groups of 21 each, cases and controls. The two groups were matched for age and sex. The case group was administered with ferrous sulfate 5 mg/kg in addition to methylphenidate up to 1 mg/kg and the control group with methylphenidate alone. The scores on child symptoms inventory-4 (CSI-4) were recorded at baseline and after 2 months of treatment. Data were analyzed by t-test, Pearson's correlation coefficient, and repeated measures ANOVA in SPSS 16. The scores on CSI-4 decreased significantly at month 2 in both groups (P < 0.001). The scores on attention deficit and hyperactivity subscales of the CSI-4 were significantly lower in the case group than the control group (P < 0.05). The total score on CSI-4 decreased more markedly in the case group (P < 0.04). Use of ferrous sulfate plus methylphenidate can be effective in reducing ADHD symptoms in nonanemic children with low serum ferritin.
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Affiliation(s)
- Gholamreza Panahandeh
- Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Bahareh Vatani
- Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Parvin Safavi
- Department of Psychiatry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Abolfazl Khoshdel
- Department of Pediatrics, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Laugesen K, Byrjalsen A, Frøslev T, Olsen MS, Sørensen HT. Use of glucocorticoids during pregnancy and risk of attention-deficit/hyperactivity disorder in offspring: a nationwide Danish cohort study. BMJ Open 2017; 7:e016825. [PMID: 28947451 PMCID: PMC5623520 DOI: 10.1136/bmjopen-2017-016825] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Prenatal exposure to excess endogenous glucocorticoid (GC) has been linked to attention-deficit/hyperactivity disorder (ADHD). We investigated whether prenatal exposure to exogenous GC is associated with ADHD. DESIGN Nationwide cohort study. SETTING A cohort of 875 996 singletons born alive between 1996 and 2009 in Denmark. Data were obtained from national registries. EXPOSURES We identified children exposed prenatally to GCs, children unexposed prenatally and born to maternal former users, and children unexposed and born to maternal never users. MAIN OUTCOME MEASURES We compared ADHD risk in children prenatally exposed to GCs and in children of former GC users with risk in unexposed children of never users. We computed cumulative incidence at 10 years of age and adjusted HRs (aHRs). In addition, we compared exposed children with unexposed siblings in a sibling design. RESULTS We identified 875 996 children, among whom 5319 were prenatally exposed to systemic GCs and 36 780 to local/inhaled GCs. Cumulative incidences of ADHD at 10 years of age were 2.65% in prenatally exposed children and 2.03% in unexposed children of never users. At the general population level, prenatal exposure was associated with ADHD compared with unexposed, with aHR of 1.43(95% CI 1.24 to 1.65) for systemic exposure and 1.23 (95% CI 1.15 to 1.31) for local/inhaled exposure. However, our former user analysis (aHR of 1.25 (95% CI 1.20 to 1.29)) and sibling design (aHR of 1.03 (95% CI 0.87 to 1.20)) indicated that these findings were due to confounding. CONCLUSION This study provides no evidence of a causal association between prenatal exposure to GCs and risk of ADHD.
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Affiliation(s)
- Kristina Laugesen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Anna Byrjalsen
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - Trine Frøslev
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Morten S Olsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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Richards JS, Vásquez AA, van Rooij D, van der Meer D, Franke B, Hoekstra PJ, Heslenfeld DJ, Oosterlaan J, Faraone SV, Hartman CA, Buitelaar JK. Testing differential susceptibility: Plasticity genes, the social environment, and their interplay in adolescent response inhibition. World J Biol Psychiatry 2017; 18:308-321. [PMID: 27170266 PMCID: PMC5435559 DOI: 10.3109/15622975.2016.1173724] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Impaired inhibitory control is a key feature of attention-deficit/hyperactivity disorder (ADHD). We investigated gene-environment interaction (GxE) as a possible contributing factor to response inhibition variation in context of the differential susceptibility theory. This states individuals carrying plasticity gene variants will be more disadvantaged in negative, but more advantaged in positive environments. METHODS Behavioural and neural measures of response inhibition were assessed during a Stop-signal task in participants with (N = 197) and without (N = 295) ADHD, from N = 278 families (age M = 17.18, SD =3.65). We examined GxE between candidate plasticity genes (DAT1, 5-HTT, DRD4) and social environments (maternal expressed emotion, peer affiliation). RESULTS A DRD4 × Positive peer affiliation interaction was found on the right fusiform gyrus (rFG) activation during successful inhibition. Further, 5-HTT short allele carriers showed increased rFG activation during failed inhibitions. Maternal warmth and positive peer affiliation were positively associated with right inferior frontal cortex activation during successful inhibition. Deviant peer affiliation was positively related to the error rate. CONCLUSIONS While a pattern of differential genetic susceptibility was found, more clarity on the role of the FG during response inhibition is warranted before firm conclusions can be made. Positive and negative social environments were related to inhibitory control. This extends previous research emphasizing adverse environments.
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Affiliation(s)
- Jennifer S. Richards
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Alejandro Arias Vásquez
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Daan van Rooij
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Dennis van der Meer
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Pieter J. Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, The Netherlands
| | - Dirk J. Heslenfeld
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Stephen V. Faraone
- SUNY Upstate Medical University Center, Departments of Psychiatry and of Neuroscience and Physiology, Syracuse, USA and the K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Catharina A. Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, The Netherlands
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
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Huang S, Hu H, Sánchez BN, Peterson KE, Ettinger AS, Lamadrid-Figueroa H, Schnaas L, Mercado-García A, Wright RO, Basu N, Cantonwine DE, Hernández-Avila M, Téllez-Rojo MM. Childhood Blood Lead Levels and Symptoms of Attention Deficit Hyperactivity Disorder (ADHD): A Cross-Sectional Study of Mexican Children. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:868-74. [PMID: 26645203 PMCID: PMC4892926 DOI: 10.1289/ehp.1510067] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 11/17/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND Previous studies suggest that blood lead levels are positively associated with attention deficit/hyperactivity disorder (ADHD) and ADHD-symptoms in children. However, the associations between lead exposure and ADHD subtypes are inconsistent and understudied. OBJECTIVE The objective of this study was to explore the association of low-level concurrent lead exposure with subtypes of ADHD symptoms in 578 Mexican children 6-13 years of age. METHODS We measured concurrent blood lead levels using inductively coupled plasma mass spectrometry (ICPMS). We administered the Conners' Rating Scales-Revised (CRS-R) to mothers to evaluate their children's ADHD symptoms. We used imputation to fill missing values in blood lead levels and used segmented regression models adjusted for relevant covariates to model the nonlinear relationship between blood lead and ADHD symptoms. RESULTS Mean ± SD blood lead levels were 3.4 ± 2.9 μg/dL. In adjusted models, a 1-μg/dL increase in blood lead was positively associated with Hyperactivity and Restless-Impulsivity scores on the CRS-R scale and Hyperactivity-Impulsivity scores on the CRS-R scale of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, but only in children with blood lead level ≤ 5 μg/dL. Blood lead was not associated with Inattentive symptoms or overall ADHD behavior. CONCLUSIONS In this population of Mexican children, current blood lead level among children with low exposure (≤ 5 μg/dL) was positively associated with hyperactive/impulsive behaviors, but not with inattentiveness. These results add to the existing evidence of lead-associated neurodevelopmental deficits at low levels of exposure. CITATION Huang S, Hu H, Sánchez BN, Peterson KE, Ettinger AS, Lamadrid-Figueroa H, Schnaas L, Mercado-García A, Wright RO, Basu N, Cantonwine DE, Hernández-Avila M, Téllez-Rojo MM. 2016. Childhood blood lead levels and symptoms of attention deficit hyperactivity disorder (ADHD): a cross-sectional study of Mexican children. Environ Health Perspect 124:868-874; http://dx.doi.org/10.1289/ehp.1510067.
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Affiliation(s)
- Siying Huang
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Address correspondence to S. Huang, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7 Canada. Telephone: (437) 333-2968. E-mail:
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brisa N Sánchez
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Karen E. Peterson
- University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | | | | | | | | | - Robert O. Wright
- Icahn Mount Sinai School of Medicine, New York City, New York, USA
| | - Niladri Basu
- Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Québec, Canada
| | - David E. Cantonwine
- Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Say GN, Karabekiroğlu K, Babadağı Z, Yüce M. Maternal stress and perinatal features in autism and attention deficit/hyperactivity disorder. Pediatr Int 2016; 58:265-9. [PMID: 26338105 DOI: 10.1111/ped.12822] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 07/31/2015] [Accepted: 08/25/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND We investigated the shared and non-shared perinatal risk factors for autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD) in a clinical sample. Additionally, we compared these groups regarding pre/postpartum maternal stress and the duration of breastfeeding. METHODS Children aged 3-18 years old with ASD (n = 100) were compared with age- and gender-matched children with ADHD (n = 100) and with age- and gender-matched healthy controls (n = 80). RESULTS Prematurity of the neonate and maternal stress/depressive mood in pregnancy were common risk factors shared by ASD and ADHD. Postpartum maternal depressive mood may be more specific to ASD, while shorter duration of breastfeeding may be related to ADHD. CONCLUSIONS ASD and ADHD may have some perinatal features in common. Identification of perinatal factors for ASD and ADHD carries clinical implications in terms of primary prevention.
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Affiliation(s)
- Gökçe Nur Say
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Koray Karabekiroğlu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Zehra Babadağı
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Murat Yüce
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
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Keil KP, Lein PJ. DNA methylation: a mechanism linking environmental chemical exposures to risk of autism spectrum disorders? ENVIRONMENTAL EPIGENETICS 2016; 2:dvv012. [PMID: 27158529 PMCID: PMC4856164 DOI: 10.1093/eep/dvv012] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
There is now compelling evidence that gene by environment interactions are important in the etiology of autism spectrum disorders (ASDs). However, the mechanisms by which environmental factors interact with genetic susceptibilities to confer individual risk for ASD remain a significant knowledge gap in the field. The epigenome, and in particular DNA methylation, is a critical gene expression regulatory mechanism in normal and pathogenic brain development. DNA methylation can be influenced by environmental factors such as diet, hormones, stress, drugs, or exposure to environmental chemicals, suggesting that environmental factors may contribute to adverse neurodevelopmental outcomes of relevance to ASD via effects on DNA methylation in the developing brain. In this review, we describe epidemiological and experimental evidence implicating altered DNA methylation as a potential mechanism by which environmental chemicals confer risk for ASD, using polychlorinated biphenyls (PCBs), lead, and bisphenol A (BPA) as examples. Understanding how environmental chemical exposures influence DNA methylation and how these epigenetic changes modulate the risk and/or severity of ASD will not only provide mechanistic insight regarding gene-environment interactions of relevance to ASD but may also suggest potential intervention strategies for these and potentially other neurodevelopmental disorders.
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Affiliation(s)
- Kimberly P. Keil
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Pamela J. Lein
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, Davis, CA, USA
- *Correspondence address. Department of Molecular Biosciences, School of Veterinary Medicine, University of California Davis, 1089 Veterinary Medicine Drive, Davis, CA 95616, USA. Tel:
(530) 752-1970
; Fax:
(530) 752-7690
; E-mail:
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32
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Choi WJ, Kwon HJ, Lim MH, Lim JA, Ha M. Blood lead, parental marital status and the risk of attention-deficit/hyperactivity disorder in elementary school children: A longitudinal study. Psychiatry Res 2016; 236:42-46. [PMID: 26774190 DOI: 10.1016/j.psychres.2016.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 12/27/2015] [Accepted: 01/03/2016] [Indexed: 12/15/2022]
Abstract
The aim of this study was to investigate the blood lead level and parental marital status that might influence the development of attention-deficit/hyperactivity disorder (ADHD) symptoms in school-aged children. The participants in the survey included elementary school children, and they were followed up biennially. The participants' parents or caregivers were administered a questionnaire including ADHD rating scale. Among 2967 who were not suspected to have ADHD at baseline survey, 2195 children who took follow-up test for ADHD were evaluated. The incidence rate of suspected ADHD was 5.0% (107 cases) during the two years of the follow-up period. The geometric mean blood lead level was 1.56μg/dL. Relative risk ratio for ADHD was estimated using logistic regression analysis. After adjustment for potential confounders, ADHD developed more frequently in children with blood lead levels of >2.17μg/dL (highest quartile) (RR 1.552, 95% CI 1.002-2.403) and in children with a single parent (RR 1.805, 95% CI 1.002-3.254). The RR was 3.567 (95% CI 1.595-7.980) in children with relatively high blood lead levels (>2.17μg/dL) from single-parent families, compared with those with low blood lead and a two-parent family. The ADHD risk in association with blood lead level was modified by family status.
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Affiliation(s)
- Won-Jun Choi
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
| | - Myung Ho Lim
- Department of Psychology, Dankook University College of Social Sciences, Cheonan, Republic of Korea
| | - Ji-Ae Lim
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
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Cowell WJ, Lederman SA, Sjödin A, Jones R, Wang S, Perera FP, Wang R, Rauh VA, Herbstman JB. Prenatal exposure to polybrominated diphenyl ethers and child attention problems at 3-7 years. Neurotoxicol Teratol 2015; 52:143-50. [PMID: 26344673 PMCID: PMC4785171 DOI: 10.1016/j.ntt.2015.08.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/04/2015] [Accepted: 08/31/2015] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Polybrominated diphenyl ethers (PBDEs) comprise a class of halogenated compounds used extensively as flame retardant chemicals in consumer products resulting in nearly ubiquitous human exposure. Mounting evidence suggests that PBDEs are developmental neurotoxicants; however, associations between early life exposure and child behavior have been largely limited to a single developmental time point. METHODS The study population consists primarily of white, black and Chinese women who were pregnant on 11 September 2001 and delivered at 1 of 3 downtown New York City hospitals. Maternal-child pairs were followed through age 7 years. Cord blood was collected at delivery and PBDE plasma levels for 210 samples were analyzed by the U.S. Centers for Disease Control and Prevention. The Child Behavior Checklist, a validated maternal-report instrument used for assessing child behavior, was administered annually between the ages of 3 and 7 years. We analyzed the association between natural log-transformed and dichotomized (low vs. high) PBDEs and attention problems using multivariable adjusted negative binomial regression. RESULTS We detected 4 PBDE congeners in more than 50% of samples, with concentrations highest for BDE-47 (median±IQR: 11.2±19.6 ng/g). In adjusted analyses, we detected associations between BDE-47 (1.21, 95% CI: 1.00, 1.47), and BDE-153 (1.18, 95% CI: 1.00, 1.39) in cord plasma and increased attention problems among children at age 4 (n=109) but not 6 (n=107) years. CONCLUSIONS Our findings demonstrate a positive trend between prenatal PBDE exposure and early childhood attention problems, and are consistent with previous research reporting associations between prenatal PBDE exposure and disrupted child behaviors.
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Affiliation(s)
- Whitney J Cowell
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Sally A Lederman
- Institute of Human Nutrition, Columbia University, New York, NY 10032, USA
| | - Andreas Sjödin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Richard Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Shuang Wang
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Frederica P Perera
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Richard Wang
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Virginia A Rauh
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Julie B Herbstman
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
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Obstetrical Mode of Delivery and Childhood Behavior and Psychological Development in a British Cohort. J Autism Dev Disord 2015; 46:603-14. [DOI: 10.1007/s10803-015-2616-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Liu B, Zhang H, Xie L, Li J, Wang X, Zhao L, Wang Y, Yang B. Spatial distribution and partition of perfluoroalkyl acids (PFAAs) in rivers of the Pearl River Delta, southern China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 524-525:1-7. [PMID: 25889539 DOI: 10.1016/j.scitotenv.2015.04.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 06/04/2023]
Abstract
This study investigated the occurrence of perfluoroalkyl acids (PFAAs) in surface water from 67 sampling sites along rivers of the Pearl River Delta in southern China. Sixteen PFAAs, including perfluoroalkyl carboxylic acids (PFCAs, C5-14, C16 and C18) and perfluoroalkyl sulfonic acids (PFSAs, C4, C6, C8 and C10) were determined by high performance liquid chromatography-negative electrospray ionization-tandem mass spectrometry (HPLC/ESI-MS/MS). Total PFAA concentrations (∑ PFAAs) in the surface water ranged from 1.53 to 33.5 ng·L(-1) with an average of 7.58 ng·L(-1). Perfluorobutane sulfonic acid (PFBS), perfluorooctanoic acid (PFOA), and perfluorooctane sulfonic acid (PFOS) were the three most abundant PFAAs and on average accounted for 28%, 16% and 10% of ∑ PFAAs, respectively. Higher concentrations of ∑ PFAAs were found in the samples collected from Jiangmen section of Xijiang River, Dongguan section of Dongjiang River and the Pearl River flowing the cities which had very well-developed manufacturing industries. PCA model was employed to quantitatively calculate the contributions of extracted sources. Factor 1 (72.48% of the total variance) had high loading for perfluorohexanoic acid (PFHxA), perfluoropentanoic acid (PFPeA), PFBS and PFOS. For factor 2 (10.93% of the total variance), perfluorononanoic acid (PFNA) and perfluoroundecanoic acid (PFUdA) got high loading. The sorption of PFCAs on suspended particulate matter (SPM) increased by approximately 0.1 log units for each additional CF2 moiety and that on sediment was approximately 0.8 log units lower than the SPM logKd values. In addition, the differences in the partition coefficients were influenced by the structure discrepancy of absorbents and influx of fresh river water. These data are essential for modeling the transport and environmental fate of PFAAs.
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Affiliation(s)
- Baolin Liu
- College of Physical Science and Technology, Shenzhen University, Shenzhen 518060, China; College of Chemistry, Changchun Normal University, Changchun 130032, China; College of Food Engineering and Biotechnology, Tianjin University of Science and Technology, Tianjin 300222, China
| | - Hong Zhang
- College of Physical Science and Technology, Shenzhen University, Shenzhen 518060, China.
| | - Liuwei Xie
- College of Physical Science and Technology, Shenzhen University, Shenzhen 518060, China
| | - Juying Li
- College of Chemistry and Chemical Engineering, Shenzhen University, Shenzhen 518060, China
| | - Xinxuan Wang
- College of Food Engineering and Biotechnology, Tianjin University of Science and Technology, Tianjin 300222, China
| | - Liang Zhao
- College of Physical Science and Technology, Shenzhen University, Shenzhen 518060, China
| | - Yanping Wang
- College of Food Engineering and Biotechnology, Tianjin University of Science and Technology, Tianjin 300222, China
| | - Bo Yang
- College of Chemistry and Chemical Engineering, Shenzhen University, Shenzhen 518060, China
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Zhang R, Huo X, Ho G, Chen X, Wang H, Wang T, Ma L. Attention-deficit/hyperactivity symptoms in preschool children from an e-waste recycling town: assessment by the parent report derived from DSM-IV. BMC Pediatr 2015; 15:51. [PMID: 25939992 PMCID: PMC4429982 DOI: 10.1186/s12887-015-0368-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 04/20/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To investigate the attention-deficit/hyperactivity disorder (ADHD) status among preschool-aged children in Guiyu, an electronic waste (e-waste) recycling town in Guangdong, China. METHODS Two hundred and forty-three parents were surveyed regarding ADHD behaviors in their children (aged 3-7 years) based solely on the DSM-IV criteria. The peripheral blood samples were taken from these children to measure blood lead levels (BLLs) and blood cadmium levels (BCLs). RESULTS 12.8% of children met the criteria for ADHD, of which the inattentive, hyperactive/impulsive and combined subtypes were 4.5%, 5.3% and 2.9% respectively. Of all children, 28.0% had BLLs ≥ 10 ug/dL and only 1.2% had BCLs ≥ 2 ug/L, levels conventionally considered high. Either modeled by univariate or multivariable analysis, the three ADHD scores (inattentive, hyperactive/impulsive and total scores) calculated from the Parent Rating Scale showed strong positive correlations with BLLs but not with BCLs. Furthermore, children with high BLLs had 2.4 times higher risk of ADHD than those with low BLLs (OR: 2.4 [95% CI: 1.1-5.2]). When each of the 18 categories on the Parent Rating Scale was separately analyzed, children with high BLLs had significant higher risks for positive ADHD symptoms than those with low BLLs in 12 of the 18 categories (ORs ranged from 2.1 [95% CI: 1.1-3.9] to 3.6 [95% CI: 1.7-7.5]). CONCLUSIONS This study suggests that environmental lead contamination due to e-waste recycling has an impact on neurobehavioral development of preschool children in Guiyu.
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Affiliation(s)
- Ruibiao Zhang
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China.
| | - Xia Huo
- Analytical Cytology Laboratory and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, People's Republic of China.
| | - Guyu Ho
- Translational Medicine Center, Shantou University Medical College, Shantou, Guangdong, People's Republic of China.
| | - Xiaojuan Chen
- Analytical Cytology Laboratory and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, People's Republic of China.
| | - Hongwu Wang
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China.
| | - Tianyou Wang
- Department of Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China.
| | - Lian Ma
- Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China.
- Shenzhen Pingshan Maternal and Child Health Hospital, Shenzhen, Guangdong, People's Republic of China.
- Shenzhen University Women's and Children's Hospital, Shenzhen, Guangdong, People's Republic of China.
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Polańska K, Muszyński P, Sobala W, Dziewirska E, Merecz-Kot D, Hanke W. Maternal lifestyle during pregnancy and child psychomotor development - Polish Mother and Child Cohort study. Early Hum Dev 2015; 91:317-25. [PMID: 25846841 DOI: 10.1016/j.earlhumdev.2015.03.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 03/03/2015] [Accepted: 03/12/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Nowadays special attention is paid to prenatal exposures to maternal lifestyle factors and their impact on a child development. AIM The objective of this study was to evaluate the impact of modifiable maternal lifestyle factors on child neurodevelopment based on the Polish Mother and Child Cohort study. MATERIAL AND METHODS The current analysis included 538 mother-child pairs. The following factors related to maternal lifestyle were considered: smoking and environmental tobacco smoke (ETS) exposure (based on the cotinine level in maternal saliva measured using LC-ESI+MS/MS method), alcohol consumption and leisure-time physical activity (LTPA) in pregnancy, pre-pregnancy BMI, and folic acid supplementations before and during pregnancy based on questionnaire data. Psychomotor development was assessed in children at the ages of one and two by the Bayley Scales of Infant and Toddler Development. RESULTS Significant association was observed between prenatal exposure to tobacco constituents and a decreased child motor development in assessments performed at both ages (β=-0.8, p=0.01; β=-1.4, p<0.001). Maternal pre-pregnancy underweight was associated with decreased language abilities at 12 months of age (β=-5.2, p=0.01) and cognitive and motor development at 24 months of age, for which the associations were of borderline significance (p=0.06). The recommended level of LTPA during pregnancy was beneficial for child language development at two years of age (β=4.8, p=0.02). For alcohol and folic acid consumption there were no significant associations with any of the analyzed domains of child neurodevelopment. CONCLUSIONS Children prenatally exposed to tobacco compounds and those of underweight mothers had a decreased psychomotor development. The recommended level of LTPA during pregnancy had positive impact on child development. These results underscore the importance of policies and public health interventions promoting healthy lifestyle among women in reproductive age and during pregnancy.
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Affiliation(s)
- Kinga Polańska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 8 Teresy Street, 91-348 Lodz, Poland.
| | - Paweł Muszyński
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 8 Teresy Street, 91-348 Lodz, Poland
| | - Wojciech Sobala
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 8 Teresy Street, 91-348 Lodz, Poland
| | - Emila Dziewirska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 8 Teresy Street, 91-348 Lodz, Poland
| | - Dorota Merecz-Kot
- Department of Health and Work Psychology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 8 Teresy Street, 91-348 Lodz, Poland
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Liew Z, Ritz B, von Ehrenstein OS, Bech BH, Nohr EA, Fei C, Bossi R, Henriksen TB, Bonefeld-Jørgensen EC, Olsen J. Attention deficit/hyperactivity disorder and childhood autism in association with prenatal exposure to perfluoroalkyl substances: a nested case-control study in the Danish National Birth Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:367-73. [PMID: 25616253 PMCID: PMC4383573 DOI: 10.1289/ehp.1408412] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 12/18/2014] [Indexed: 05/17/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFASs) are persistent pollutants found to be endocrine disruptive and neurotoxic in animals. Positive correlations between PFASs and neurobehavioral problems in children were reported in cross-sectional data, but findings from prospective studies are limited. OBJECTIVES We investigated whether prenatal exposure to PFASs is associated with attention deficit/hyperactivity disorder (ADHD) or childhood autism in children. METHODS Among 83,389 mother-child pairs enrolled in the Danish National Birth Cohort during 1996-2002, we identified 890 ADHD cases and 301 childhood autism cases from the Danish National Hospital Registry and the Danish Psychiatric Central Registry. From this cohort, we randomly selected 220 cases each of ADHD and autism, and we also randomly selected 550 controls frequency matched by child's sex. Sixteen PFASs were measured in maternal plasma collected in early or mid-pregnancy. We calculated risk ratios (RRs) using generalized linear models, taking into account sampling weights. RESULTS Perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA) were detected in all samples; four other PFASs were quantified in ≥ 90% of the samples. We did not find consistent evidence of associations between mother's PFAS plasma levels and ADHD [per natural log nanograms per milliliter increase: PFOS RR = 0.87 (95% CI: 0.74, 1.02); PFOA RR = 0.98 (95% CI: 0.82, 1.16)] or autism [per natural log nanograms per milliliter increase: PFOS RR = 0.92 (95% CI: 0.69, 1.22); PFOA RR = 0.98 (95% CI: 0.73, 1.31)]. We found positive as well as negative associations between higher PFAS quartiles and ADHD in models that simultaneously adjusted for all PFASs, but these estimates were imprecise. CONCLUSIONS In this study we found no consistent evidence to suggest that prenatal PFAS exposure increases the risk of ADHD or childhood autism in children.
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Affiliation(s)
- Zeyan Liew
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
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Multifactorial Origin of Neurodevelopmental Disorders: Approaches to Understanding Complex Etiologies. TOXICS 2015; 3:89-129. [PMID: 29056653 PMCID: PMC5634696 DOI: 10.3390/toxics3010089] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/06/2015] [Accepted: 03/18/2015] [Indexed: 12/12/2022]
Abstract
A significant body of evidence supports the multifactorial etiology of neurodevelopmental disorders (NDDs) affecting children. The present review focuses on early exposure to environmental chemicals as a risk factor for neurodevelopment, and presents the major lines of evidence derived from epidemiological studies, underlying key uncertainties and research needs in this field. We introduce the exposome concept that, encompassing the totality of human environmental exposures to multiple risk factors, aims at explaining individual vulnerability and resilience to early chemical exposure. In this framework, we synthetically review the role of variable gene backgrounds, the involvement of epigenetic mechanisms as well as the function played by potential effect modifiers such as socioeconomic status. We describe laboratory rodent studies where the neurodevelopmental effects of environmental chemicals are assessed in the presence of either a “vulnerable” gene background or adverse pregnancy conditions (i.e., maternal stress). Finally, we discuss the need for more descriptive and “lifelike” experimental models of NDDs, to identify candidate biomarkers and pinpoint susceptible groups or life stages to be translated to large prospective studies within the exposome framework.
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Neugebauer J, Wittsiepe J, Kasper-Sonnenberg M, Schöneck N, Schölmerich A, Wilhelm M. The influence of low level pre- and perinatal exposure to PCDD/Fs, PCBs, and lead on attention performance and attention-related behavior among German school-aged children: results from the Duisburg Birth Cohort Study. Int J Hyg Environ Health 2014; 218:153-62. [PMID: 25456149 DOI: 10.1016/j.ijheh.2014.09.005] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Revised: 09/26/2014] [Accepted: 09/26/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prenatal exposure to polychlorinated biphenyls (PCBs) and lead are thought to be risk factors for attention-deficit hyperactivity disorder (ADHD), whereas the prenatal influence of polychlorinated dibenzo-p-dioxins and -furans (PCDD/Fs) on attention performance has been less studied. OBJECTIVES Within the Duisburg Birth Cohort Study, we investigated low-level exposure to these compounds in relation to children's attention. METHODS We measured blood levels of PCDD/Fs, PCBs and lead from pregnant mothers (32(nd) week of pregnancy) and PCDD/Fs and PCBs in breast milk (2 weeks after delivery). The attention of school-aged children (N=117) was investigated with a computer-based test battery of attention performance (KITAP) and a parent rating questionnaire of behaviors related to ADHD (FBB-ADHS). Influences of the exposure on attention were analyzed by multiple regression analyses. RESULTS Increasing prenatal PCDD/F and PCB concentrations were significantly (p<0.05) associated with a higher number of omission errors in the subtest Divided Attention (47% and 42%; 95% confidence intervals (95%-CI): 1.08-2.00 and 1.07-1.89, respectively). Prenatal lead concentrations had few significant associations with attention performance (e.g., a 23% higher number of omission errors in the subtest Distractibility; 95%-CI: 1.00-1.51), whereas ADHD-related behavior (questionnaire based) was increased with increasing lead exposure (Overall-ADHD: 9%; 95%-CI: 1.01-1.17). ADHD-related behavior was negatively associated with prenatal PCDD/F or PCB exposures (e.g., for PCB exposure: -10%; 95%-CI: 0.82-0.99). CONCLUSIONS Pre- and perinatal PCDD/F and PCB exposure may have subtle influences on attention performance in healthy children at low environmental levels, while behavior changes are negatively associated. Furthermore, we provide additional evidence for the impact of prenatal lead exposure on attention deficits.
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Affiliation(s)
- Julia Neugebauer
- Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitätsstraße 150, D-44801 Bochum, Germany
| | - Jürgen Wittsiepe
- Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitätsstraße 150, D-44801 Bochum, Germany.
| | - Monika Kasper-Sonnenberg
- Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitätsstraße 150, D-44801 Bochum, Germany
| | - Nina Schöneck
- Department of Developmental Psychology, Ruhr-University Bochum, Universitätsstraße 150, D-44801 Bochum, Germany
| | - Axel Schölmerich
- Department of Developmental Psychology, Ruhr-University Bochum, Universitätsstraße 150, D-44801 Bochum, Germany
| | - Michael Wilhelm
- Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Universitätsstraße 150, D-44801 Bochum, Germany
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Laugesen K, Olsen MS, Telén Andersen AB, Frøslev T, Sørensen HT. In utero exposure to antidepressant drugs and risk of attention deficit hyperactivity disorder: a nationwide Danish cohort study. BMJ Open 2013; 3:e003507. [PMID: 24056487 PMCID: PMC3780335 DOI: 10.1136/bmjopen-2013-003507] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To investigate whether in utero exposure to antidepressants is associated with increased risk of attention deficit hyperactivity disorder (ADHD). DESIGN Cohort study. SETTING Denmark. PARTICIPANTS All Danish singletons born alive from 1996 to 2009 were included. Using national medical registries, we defined in utero exposure to antidepressants as redemption of an antidepressant prescription by the mother 30 days prior to or during pregnancy. We defined maternal former users of antidepressants as women, who had redeemed a prescription up to 30 days prior to pregnancy, and never users as women who had never redeemed a prescription. MAIN OUTCOME MEASURES ADHD was defined as redemption of a prescription for ADHD medication or an ADHD hospital diagnosis. Children were followed through 2010, and we used proportional-hazards regression to compute adjusted HRs comparing children exposed in utero and children born to former antidepressant users with children born to never users. To adjust for confounding from family-related factors, we conducted a within-mother between-pregnancy analysis comparing exposed children with unexposed siblings using conditional logistic regression. RESULTS We identified a cohort of 877 778 children, of whom 1.7% were exposed in utero. The overall median follow-up time was 8 years; selective serotonin reuptake inhibitors were the most commonly used class of antidepressant during pregnancy (78% of users). The adjusted HR comparing children exposed to any antidepressant in utero with children born to never users was 1.2 (95% CI 1.1 to 1.4), and 1.6 (95% CI 1.5 to 1.8) comparing children born to former users to children born to never users of antidepressants. In the within-mother between-pregnancy analysis (n=867), the adjusted OR was 0.7 (95% CI 0.4 to 1.4). CONCLUSIONS This study provides no evidence to support a causal association between in utero exposure to antidepressants and risk of ADHD.
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Affiliation(s)
- Kristina Laugesen
- Department of Clinical Epidemiology, Institute of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
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Zeliger HI. Lipophilic chemical exposure as a cause of cardiovascular disease. Interdiscip Toxicol 2013; 6:55-62. [PMID: 24179429 PMCID: PMC3798856 DOI: 10.2478/intox-2013-0010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 06/18/2013] [Accepted: 06/24/2013] [Indexed: 01/06/2023] Open
Abstract
Environmental chemical exposure has been linked to numerous diseases in humans. These diseases include cancers; neurological and neurodegenerative diseases; metabolic disorders including type 2 diabetes, metabolic syndrome and obesity; reproductive and developmental disorders; and endocrine disorders. Many studies have associated the link between exposures to environmental chemicals and cardiovascular disease (CVD). These chemicals include persistent organic pollutants (POPs); the plastic exudates bisphenol A and phthalates; low molecular weight hydrocarbons (LMWHCs); and poly nuclear aromatic hydrocarbons (PAHs). Here it is reported that though the chemicals reported on differ widely in chemical properties and known points of attack in humans, a common link exists between them. All are lipophilic species that are found in serum. Environmentally induced CVD is related to total lipophilic chemical load in the blood. Lipophiles serve to promote the absorption of otherwise not absorbed toxic hydrophilic species that promote CVD.
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Affiliation(s)
- Harold I Zeliger
- Zeliger Chemical, Toxicological and Environmental Research, West Charlton, New York, USA
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