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Environ Sci Pollut Res Int. 2019 Jun;26(18):17875-17884. doi: 10.1007/s11356-017-9799-2. Epub 2017 Aug 5.

Low blood lead levels and attention-deficit hyperactivity disorder in children: a systematic review and meta-analysis.

Author information

1
Changsha Medical University, Changsha, China.
2
Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China.
3
Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China. huangruixue@csu.edu.cn.

Abstract

Attention-deficit hyperactivity disorder (ADHD) of children is one of the most common neurodevelopmental diseases; the etiology remains unclear. We reviewed and meta-analyzed case-control studies to assess the effects of blood lead levels in children on ADHD symptoms. Relevant studies were identified by searching electronic databases. A meta-analysis was performed using the fixed model of Review Manager 5.3 software. Seven relevant studies were identified. The case groups exhibited significant increases in ADHD symptoms [mean difference (MD), 0.59; 95% confidence interval (CI), 0.50-0.68; p < 0.0001]. Subgroup assessment showed that even children with blood lead levels <3 μg/dL exhibited significant increases in ADHD symptoms (MD, 0.47; 95% CI, 0.39-0.56; p < 0.0001). Subgroup assessment also showed that children aged 5-12 years exhibited more significant increases in ADHD symptoms (MD, 1.35; 95% CI, 0.28-2.41; p < 0.0001) than children aged >12 years. Our findings suggest that low blood lead levels may be associated with ADHD symptoms in children. However, caution is needed when interpreting the results because among-study heterogeneity was in play. Primary interventions should focus on children with low blood lead levels.

KEYWORDS:

ADHD; Blood level; Children; Lead; Meta-analysis; Systematic review

PMID:
28780688
DOI:
10.1007/s11356-017-9799-2
[Indexed for MEDLINE]

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