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

By J. Braun, R. Kahn, Tanya E. Froehlich, P. Auinger, B. Lanphear. Environmental Health Perspectives, 2006

605 citations recorded by the source corpus.

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

Subfields: Health, Toxicology and Mutagenesis, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/26fefbdf51976c541d9a5e3873310e5956c04d3e

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Citations in the corpus

Evaluating Dopamine Reward Pathway in ADHD (2009, neutral): “Genetic studies have identified a few genes with polymorphisms associated with ADHD, with the most replicated being 2 dopamine genes (eg, DRD4 and DAT 1 genes),(3) and environmental studies have identified important nongenetic risk factors (eg, maternal smoking during pregnancy and lead levels) that”
Etiologic Subtypes of Attention-Deficit/Hyperactivity Disorder: Brain Imaging, Molecular Genetic and Environmental Factors and the Dopamine Hypothesis (2007, methodology): “Braun et al. (2006) also reported that risk of ADHD was associated with lead exposures even below 5 µg/dL, which highlights the importance of evaluation of a possible geneenvironment interaction model, because these levels of lead are common in the US population (CDC, 2005).”
The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder. (2021, positive): “A similar study, with over 4700 youths from the same national survey, found that those with blood lead levels in the highest fifth were four times more likely to have ADHD compared with those in the bottom fifth (Braun et al., 2006).”