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Environ Health Perspect. 2006 Dec;114(12):1904-9.

Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children.

Author information

  • 1College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.

Abstract

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.

Comment in

  • Environmental exposures and ADHD. [Environ Health Perspect. 2007]
  • Lead and neuroprotection by iron in ADHD. [Environ Health Perspect. 2007]
PMID:
17185283
[PubMed - indexed for MEDLINE]
PMCID:
PMC1764142
Free PMC Article
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