Department of Public Health Science, Graduate School, Korea University, Seoul 02841, Korea.
Division of Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul 04933, Korea.
Int J Environ Res Public Health. 2022 Oct 27;19(21):13966. doi: 10.3390/ijerph192113966.
Many epidemiological studies have suggested that air pollution adversely affects neurodevelopment in children; however, evidence is still lacking. This study aimed to determine the association between particulate matter (PM) exposure and attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Data were obtained from the Korean National Health and Nutrition Examination Survey 2008-2018. Outcomes were defined from parental reports of ever doctor-diagnosed ADHD, and ADHD cases were matched to non-cases with 1:10 age-sex matching. Individual exposure levels were assigned according to each study participant's administrative address during the year of diagnosis. Multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). After age-sex matching at a 1:10 ratio, the final study participants comprised 1,120 children aged 6-19 years old. A unit increase in the PM concentration was significantly associated with ADHD (OR, 1.44; 95% CI, 1.02-2.02 per 10 µg/m). The association with ADHD was stronger at higher quartiles than in the lower quartiles of PM exposure; however, it was not statistically significant. Our results suggested that long-term PM exposure was associated with increased ADHD in children and adolescents. Children diagnosed with ADHD suffer from a variety of social activity and have a significant economic burden. Therefore, it is considered an important role to find out the effects of environmental risk factors, including air pollution, on children and adolescents. This may also help to increase the body of knowledge in this field and to stimulate further research.
许多流行病学研究表明，空气污染对儿童的神经发育有不良影响；然而，目前仍缺乏证据。本研究旨在确定儿童和青少年中颗粒物（PM）暴露与注意力缺陷多动障碍（ADHD）之间的关联。数据来自 2008-2018 年韩国国家健康和营养检查调查。结果是根据父母报告的曾被医生诊断为 ADHD 的情况来定义的，将 ADHD 病例与年龄和性别匹配的非病例进行 1:10 匹配。根据研究参与者在诊断当年的行政地址，为每个个体分配个体暴露水平。采用多变量逻辑回归模型来估计比值比（ORs）和 95%置信区间（CIs）。在以 1:10 的比例进行年龄和性别匹配后，最终的研究参与者包括 1120 名 6-19 岁的儿童。PM 浓度每增加 10µg/m³，ADHD 的发生风险显著增加（OR, 1.44；95%CI, 1.02-2.02）。与 PM 暴露较低四分位数相比，较高四分位数与 ADHD 的相关性更强，但无统计学意义。我们的研究结果表明，长期 PM 暴露与儿童和青少年 ADHD 的发生相关。被诊断为 ADHD 的儿童会遭受各种社交活动的困扰，并带来显著的经济负担。因此，研究环境风险因素（包括空气污染）对儿童和青少年的影响被认为是非常重要的。这也有助于增加该领域的知识体系，并激发进一步的研究。
