Environmental Risk Factors, Toxic Metals, and Essential Elements in Urine Samples of Algerian Children with Severe...

This study investigates urinary levels of aluminum (Al), arsenic (As), cadmium (Cd), copper (Cu), and lead (Pb), along with essential elements (manganese (Mn), selenium (Se) and zinc (Zn)), in Algerian children with severe ASD, and explores associations with environmental risk factors. This case-control study involved 100 children with ASD and 80 neurotypical children. All participants were subjected to measurements of Al, As, Cd, Cu, Pb, Mn, Se and Zn levels in urine, and to an investigation about possible environmental risk factors. The mean levels of Cd, Pb, Cu and Mn in the ASD group were significantly higher than those in the neurotypical group (p = 0.02, 0.01, 0.04 and 0.02, respectively). However, levels of urinary As, Al, Se and Zn were considerably lower in children with ASD group than those in the neurotypical group (p = 0.001, 0.003, 0.03 and 0.002 respectively). The most associated environmental risk factors were nearby gasoline station (AOR = 7.6, 95% CI: 2.5-24.3 and AOR = 6.5, 95% CI: 2.1-20.3, respectively) and sea food consumption (AOR = 12.3, 95% CI: 3.82-38.02 and AOR = 2.43, 95% CI: 1.25-4.94, respectively). A rich cereal diet during pregnancy (AOR = 0.08, 95% CI: 0.03-0.2) and infancy (AOR = 0.15, 95% CI: 0.07-0.31) may play a protective role. Similarly, iron and multivitamin supplementation during pregnancy (AOR = 0.05, 95% CI: 0.02-0.15), as well as fruit and vegetable consumption in infancy (AOR = 0.18, 95% CI: 0.09-0.51), are also associated with a possible protective effect. Environmental exposure to toxic metals at key developmental stages and essential elements imbalance is associated with ASD.