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注意缺陷多动障碍与智利北部儿童重金属的关系。

Attention deficit hyperactivity disorder and its association with heavy metals in children from northern Chile.

机构信息

Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.

Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.; Centro de Epidemiología y Políticas de Salud Pública, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile.

出版信息

Int J Hyg Environ Health. 2020 May;226:113483. doi: 10.1016/j.ijheh.2020.113483. Epub 2020 Feb 24.

Abstract

INTRODUCTION

Exposure to lead and arsenic has been associated with child behavior problems. In Arica, a northern city of Chile, the natural presence of arsenic in water has been registered. Also, the city has a history of heavy metals contamination of anthropogenic origin. The purpose of this study was to explore the association between the concentration of blood lead and urinary inorganic arsenic with attention deficit hyperactivity disorder (ADHD) as reported by parents.

METHODS

Cross-sectional design with data analysis of 2656 children between the ages of 3 and 17 enrolled at the Environmental Health Center of Arica between 2009 and 2015. The diagnosis of ADHD was made based on the parents' response to questions about health history. Multiple logistic regression models were used to adjust for confounding variables.

RESULTS

The prevalence of ADHD was 6.4%. The means urinary inorganic arsenic and blood lead were 21 μg/L and 1.5 μg/dl, respectively. In the lead model adjusted for sex, age, housing material quality and exposure to secondhand tobacco smoke report; children with blood lead concentrations ≥5 μg/dl were more likely to develop ADHD [Odds Ratio (OR): 2.33 95% confidence intervals (CI) 1.32-4.12)]. Regarding arsenic, the adjusted model revealed a higher chance of developing ADHD in the fifth quintile of exposure (OR = 2.02 IC 95% 1.12-3.61).

CONCLUSION

The findings of this study suggest that exposure of children to lead and inorganic arsenic was associated with ADHD. This study provides additional evidence to existing literature regarding the potential role of toxic metals such as lead and arsenic in children's behavior. However, our findings should be interpreted with caution due to the limitations of the study.

摘要

简介

接触铅和砷与儿童行为问题有关。在智利北部城市阿里卡,水中砷的自然存在已被记录在案。此外,该市还有重金属人为污染的历史。本研究旨在探讨血液中铅浓度和尿无机砷与父母报告的注意力缺陷多动障碍(ADHD)之间的关系。

方法

这是一项横断面设计研究,对 2009 年至 2015 年期间在阿里卡环境健康中心登记的 2656 名 3 至 17 岁儿童进行数据分析。根据父母对健康史问题的回答来诊断 ADHD。使用多变量逻辑回归模型调整混杂变量。

结果

ADHD 的患病率为 6.4%。尿无机砷和血铅的平均值分别为 21μg/L 和 1.5μg/dl。在性别、年龄、住房材料质量和二手烟暴露调整的铅模型中;血铅浓度≥5μg/dl 的儿童更有可能患 ADHD[比值比(OR):2.33 95%置信区间(CI)1.32-4.12)]。关于砷,调整后的模型显示,接触量第 5 个五分位数的儿童发生 ADHD 的几率更高(OR=2.02 95%CI 1.12-3.61)。

结论

本研究结果表明,儿童接触铅和无机砷与 ADHD 有关。这项研究为现有关于铅和砷等有毒金属对儿童行为潜在作用的文献提供了额外的证据。然而,由于研究的局限性,我们的发现应该谨慎解释。

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