Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children.
Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children.
复制标题
美国儿童的环境有毒物质和注意力缺陷多动障碍的暴露。
DOI：
10.1289/ehp.9478
复制
发表时间：
2006-12
影响因子：
10.4
通讯作者：
Lanphear, Bruce P
中科院分区：
文献类型：
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作者：
Braun, Joe M;Kahn, Robert S;Froehlich, Tanya;Auinger, Peggy;Lanphear, Bruce P
本研究的目的是探讨烟草烟雾和环境铅暴露与注意缺陷多动障碍（ADHD）的关系。数据来自1999-2002年全国健康和营养检查调查。出生前和出生后的烟草暴露是基于父母的报告，铅暴露使用血铅浓度测量。ADHD被定义为目前使用兴奋剂药物，并且父母报告由医生或健康专业人员诊断为ADHD。在4，704名4-15岁的儿童中，4.2%的儿童报告患有ADHD和兴奋剂药物使用，相当于美国的180万儿童。在多变量分析中，产前烟草暴露[比值比（OR）= 2.5; 95%置信区间（CI），1.2-5.2]和较高的血铅浓度（第一个与第五个五分位数，OR = 4.1; 95% CI，1.2-14.0）与ADHD显著相关。出生后烟草烟雾暴露与ADHD无关（OR = 0.6; 95%CI，0.3-1.3; p = 0.22）。如果有因果关系，这些数据表明，产前烟草暴露占270，000多例ADHD病例，铅暴露占290，000多例ADHD病例。我们的结论是，暴露于产前烟草和环境铅是美国儿童多动症的危险因素。
The purpose of this study was to examine the association of exposures to tobacco smoke and environmental lead with attention deficit hyperactivity disorder (ADHD). Data were obtained from the National Health and Nutrition Examination Survey 1999–2002. Prenatal and postnatal tobacco exposure was based on parent report; lead exposure was measured using blood lead concentration. ADHD was defined as having current stimulant medication use and parent report of ADHD diagnosed by a doctor or health professional. Of 4,704 children 4–15 years of age, 4.2% were reported to have ADHD and stimulant medication use, equivalent to 1.8 million children in the United States. In multivariable analysis, prenatal tobacco exposure [odds ratio (OR) = 2.5; 95% confidence interval (CI), 1.2–5.2] and higher blood lead concentration (first vs. fifth quintile, OR = 4.1; 95% CI, 1.2–14.0) were significantly associated with ADHD. Postnatal tobacco smoke exposure was not associated with ADHD (OR = 0.6; 95% CI, 0.3–1.3; p = 0.22). If causally linked, these data suggest that prenatal tobacco exposure accounts for 270,000 excess cases of ADHD, and lead exposure accounts for 290,000 excess cases of ADHD in U.S. children. We conclude that exposure to prenatal tobacco and environmental lead are risk factors for ADHD in U.S. children.