Fluoride exposure and reported learning disability diagnosis among Canadian children: Implications for community water fluoridation
Fluoride exposure and reported learning disability diagnosis among Canadian children: Implications for community water fluoridation
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DOI：
10.17269/cjph.108.5951
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发表时间：
2017-01-01
影响因子：
4.3
通讯作者：
McLaren, Lindsay
中科院分区：
文献类型：
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作者：
Barberio, Amanda M.;Quinonez, Carlos;McLaren, Lindsay
目的：最近的研究表明，氟暴露增加与神经发育相关结果的风险增加有关，如注意缺陷多动障碍(ADHD)和儿童智商下降。我们的主要目标是在加拿大3-12岁儿童的人群样本中检查氟化物暴露与报告的学习障碍诊断之间的联系。方法：我们分析了加拿大健康措施调查第2和第3周期的数据。氟暴露有四个衡量标准：1)尿氟(Mu/L)，2)肌酐调节尿氟(Mu/Mol)，3)比重调节尿氟(Mu/L)，4)自来水氟浓度(mg/L)(仅限周期3)。学习障碍的诊断(是/否)是基于父母或自我报告。结果：当分别检查周期2和周期3时，在未调整或调整的模型中，报告的学习障碍诊断与氟化物暴露的任何指标均无显著关联。当周期2和周期3结合在一起时，观察到了一个很小但具有统计学意义的影响，在调整后的模型中，尿氟含量较高的儿童报告学习障碍的几率更高(p=0.03)。然而，在使用肌酐调整的尿氟和比重调整的尿氟的模型中没有观察到这种关联，这两种方法被认为是更准确的测量方法，因为它们对尿液稀释进行了校正。结论：总体而言，加拿大儿童中，氟暴露与父母或自我报告的学习障碍诊断之间似乎没有明显的关联。
OBJECTIVES: Recent studies have connected increased fluoride exposure with increased risk of neurodevelopmental-related outcomes, such as ADHD (attention deficit hyperactivity disorder) and lower IQ in children. Our primary objective was to examine the association between fluoride exposure and reported diagnosis of a learning disability among a population-based sample of Canadian children aged 3-12 years.METHODS: We analyzed data from Cycles 2 and 3 of the Canadian Health Measures Survey. Four measures of fluoride exposure were available: 1) urinary fluoride (mu mol/L), 2) creatinine-adjusted urinary fluoride (mu mol/mmol), 3) specific gravity-adjusted urinary fluoride (mu mol/L), and 4) fluoride concentration of tap water (mg/L) (Cycle 3 only). Diagnosis of a learning disability (yes/no) was based on parental-or self-report. Associations were examined using logistic regression (where possible), unadjusted and adjusted for covariates.RESULTS: When Cycles 2 and 3 were examined separately, reported learning disability diagnosis was not significantly associated with any measure of fluoride exposure in unadjusted or adjusted models. When Cycles 2 and 3 were combined, a small but statistically significant effect was observed such that children with higher urinary fluoride had higher odds of having a reported learning disability in the adjusted model (p = 0.03). However, the association was not observed in models that used creatinine-adjusted urinary fluoride and specific gravity-adjusted urinary fluoride, which are believed to be more accurate measures due to their correction for urinary dilution.CONCLUSION: Overall, there did not appear to be a robust association between fluoride exposure and parental-or self-reported diagnosis of a learning disability among Canadian children.