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Eur J Pediatr. 2011 Jul;170(7):923-9. doi: 10.1007/s00431-010-1379-0. Epub 2010 Dec 30.

Attention-deficit hyperactivity disorder in children chronically exposed to high level of vehicular pollution.

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  • 1Health Canada, Environmental Health Center (EHC, HECS), Tunneys Pasture, AL: 0800C, Ottawa, K1A 0K9, ON, Canada.


The purpose of this study is to explore whether sustained exposure to vehicular air pollution affects the behavior and activities of children. The prevalence of attention-deficit hyperactivity disorder (ADHD) was assessed in two childhood populations. In a cross-sectional study 969 school-going children (9-17 years) and 850 age- and sex-matched children from rural areas were assessed, following the criteria of Diagnostic and Statistical Manual of conduct disorders (DSM-IV) of American Pediatric Association. Data of ambient particulate matter with a diameter of less than 10 μm (PM₁₀) were obtained from Central Pollution Control Board and aerosol monitor. ADHD was found in 11.0% of urban children in contrast to 2.7% of the control group (p < 0.001). Major risk factors were male gender, lower socioeconomic status, 12-14 year age group, and PM₁₀ level in breathing air. ADHD was more prevalent among boys both in urban and rural areas. It was prevalent among 18.0% of the boys enrolled in Delhi against 4.0% of the girls, giving a male/female ratio of 4.5:1. Inattentive type of ADHD was predominant followed by hyperactive-impulsive type and combined type of ADHD. Controlling potential confounder, ambient PM₁₀ level was positively correlated with ADHD (OR = 2.07; 95% CI, 1.08-3.99).


The results of this study point to a possible association between air pollution and behavioral problems in children. Though gender, socioeconomic status, and age play a very important factor in ADHD prevalence, the association is highest and strongest between particulate pollution and prevalence of ADHD.

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