Blood lead concentrations and attention deficit hyperactivity disorder in Korean children: a hospital-based case
Jae Hong Park1, Ju-Hee Seo2, Young-Seoub Hong2,3
1Department of Psychiatry, College of Medicine, Dong-A University, Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan, 602-715, Republic of Korea.
Insights
Elevated blood lead concentrations are a significant risk factor for attention deficit hyperactivity disorder (ADHD) in children. Even low levels of lead exposure can negatively impact neurodevelopment, highlighting the need for environmental lead reduction.
Area of Science:
- Environmental Health
- Neurodevelopmental Disorders
- Pediatric Toxicology
Background:
- Childhood neurodevelopment is vulnerable to environmental toxins.
- Lead exposure is linked to neurotoxicity, particularly affecting brain circuits implicated in ADHD.
- Understanding the relationship between lead and ADHD is crucial for public health.
Purpose of the Study:
- To investigate if elevated blood lead concentration is a risk factor for ADHD in children.
- To examine the association between blood lead levels and ADHD symptom severity.
Main Methods:
- A hospital-based case-control study involving 114 ADHD cases and 114 matched controls.
- ADHD diagnosis confirmed via semi-structured interviews.
- Blood lead levels measured using graphite furnace atomic absorption spectrometry.
Main Results:
- Children with ADHD had significantly higher blood lead concentrations than controls.
- Higher blood lead levels were associated with an increased risk of ADHD (OR: 1.60).
- Children with blood lead > 2.30 μg/dℓ had a 2.5-fold greater risk of ADHD; no significant association with symptom severity was found.
Conclusions:
- Low blood lead concentrations are a confirmed risk factor for childhood ADHD.
- The findings support primary prevention strategies to minimize environmental lead exposure.
- Further research is needed to clarify lead's impact on ADHD symptom severity.
Background:
Because the developing brain of a child is vulnerable to environmental toxins, even very low concentration of neurotoxin can affect children's neurodevelopment. Lead is a neurotoxic heavy metal which has the harmful effect on the striatal-frontal circuit of brain. This area of the brain is known to be closely related to attention deficit hyperactivity disorder (ADHD) pathophysiology. The primary objective of the present study was to investigate whether elevated blood lead concentration is a risk factor for ADHD. The secondary objective was to examine the association between blood lead concentration and symptom severity.
Methods:
We conducted a frequency-matched, hospital-based case-control study with 114 medically diagnosed ADHD cases and 114 controls. The participants were matched for age and sex. The diagnoses of ADHD were assessed with semi-structured diagnostic interviews. The participants completed the continuous performance test (CPT), and their parents completed the ADHD-rating scale (ADHD-RS). Blood lead concentrations were measured by using graphite furnace atomic absorption spectrometry featuring Zeeman background correction.
Results:
Children with ADHD exhibited blood lead concentrations that were significantly higher than those of the controls ( 1.90 ± 086 μg/dℓ vs. 1.59 ± 0.68 μg/dℓ, p = 0.003). The log transformed total blood lead concentration was associated with a higher risk of ADHD (OR: 1.60, 95 % CI: 1.04-2.45, p < 0.05). The analysis also revealed that the children with blood lead concentrations above 2.30 μg/dℓ were at a 2.5-fold (95 % CI: 1.09-5.87, p < 0.05) greater risk of having ADHD. After adjusting for covariates, our multivariate regression models indicated that blood lead concentrations were not significantly associated with ADHD-RS or CPT profiles among the ADHD cases.
Conclusion:
Even low blood lead concentrations are a risk factor for ADHD in children. This study warrants primary prevention policies to reduce the environmental lead burden. Future studies may be required to ascertain the effects of lead on symptom severity in ADHD.
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