Prenatal organochlorine exposure and behaviors associated with attention deficit hyperactivity disorder in school-aged children.

Organochlorines are environmentally persistent contaminants that readily cross the placenta, posing a potential risk to the developing fetus. Evidence for neurodevelopmental effects at low levels of these compounds is growing, though few studies have focused on behavioral outcomes. The authors investigated the association between prenatal polychlorinated biphenyl (PCB) and p,p'-dichlorodiphenyl dichloroethylene (p,p'-DDE) levels and behaviors associated with attention deficit hyperactivity disorder (ADHD), measured with the Conners' Rating Scale for Teachers (CRS-T), in a cohort of 607 children aged 7-11 years (median age, 8.2 years) born in 1993-1998 to mothers residing near a PCB-contaminated harbor in New Bedford, Massachusetts. The median umbilical cord serum level of the sum of 4 prevalent PCB congeners (118, 138, 153, and 180) was 0.19 ng/g serum (range, 0.01-4.41 ng/g serum). The authors found higher risk for ADHD-like behaviors assessed with the CRS-T at higher levels of PCBs and p,p'-DDE. For example, the authors found higher risk of atypical behavior on the Conners' ADHD Index for the highest quartile of the sum of 4 PCB congeners versus the lowest quartile (risk ratio = 1.76, 95% confidence interval: 1.06, 2.92) and a similar relation for p,p'-DDE. These results support an association between low-level prenatal organochlorine exposure and ADHD-like behaviors in childhood.