Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior

Yanfen Lin¹, Lihua Huang¹, Jian Xu², Aaron J Specht³, Chonghuai Yan⁴, Hongquan Geng⁵, Xiaoming Shen⁴, Linda H Nie⁶, Howard Hu⁷

Affiliations

¹ Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: sonia0616@sjtu.edu.cn.
³ School of Health Sciences, Purdue University, West Lafayette, IN, USA.
⁴ Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Department of Pediatric Surgery, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine.
⁶ School of Health Sciences, Purdue University, West Lafayette, IN, USA. Electronic address: hnie@purdue.edu.
⁷ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; School of Public Health, University of Washington, Seattle, WA, USA.

PMID: 30597466
PMCID: PMC7781015
DOI: 10.1016/j.scitotenv.2018.12.219

Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior

Yanfen Lin et al. Sci Total Environ. 2019.

. 2019 Apr 1:659:161-167.

doi: 10.1016/j.scitotenv.2018.12.219. Epub 2018 Dec 15.

Authors

Yanfen Lin¹, Lihua Huang¹, Jian Xu², Aaron J Specht³, Chonghuai Yan⁴, Hongquan Geng⁵, Xiaoming Shen⁴, Linda H Nie⁶, Howard Hu⁷

Affiliations

¹ Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: sonia0616@sjtu.edu.cn.
³ School of Health Sciences, Purdue University, West Lafayette, IN, USA.
⁴ Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Department of Pediatric Surgery, Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine.
⁶ School of Health Sciences, Purdue University, West Lafayette, IN, USA. Electronic address: hnie@purdue.edu.
⁷ Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; School of Public Health, University of Washington, Seattle, WA, USA.

PMID: 30597466
PMCID: PMC7781015
DOI: 10.1016/j.scitotenv.2018.12.219

Abstract

Background and objective: Mounting evidence showed that lead exposure increased the risk of child attention-deficit-hyperactivity disorder (ADHD). Epidemiologic studies have typically used the blood-lead as a biomarker of lead exposure; blood-lead levels mostly reflect recent lead exposure. However, few studies have examined the relationship between bone-lead, a biomarker of cumulative exposure, and ADHD. Therefore, we aimed to compare the associations of bone-lead vs blood-lead levels with child ADHD symptoms and comorbidities.

Methods: A total of 164 children aged 3-15 years were enrolled during 2014-2015. The Vanderbilt-ADHD-Diagnostic-Parent-Rating Scale (VADPRS) was used to evaluate the children's ADHD symptoms and comorbidities. Children's blood and bone lead concentrations were assessed, the latter using a non-invasive K-X-ray-fluorescence technique. According to blood-lead levels, children were classified into high (blood-lead ≥ 10.0 μg/dL) and low (blood-lead < 10.0 μg/dL) blood-lead groups. According to bone-lead levels, children were classified into high (bone-lead ≥ 2.66 μg/g) and low (bone-lead < 2.66 μg/g) bone-lead groups. We associated blood/bone lead with VADPRS data using multi-variable binary logistic regression models.

Results: Children in the high blood-lead group had higher hyperactivity/impulsivity (P = 0.02) scores than the corresponding low blood-lead group. Children in the high bone-lead group had higher hyperactivity/impulsivity (P = 0.02) and oppositional-defiant-disorder (ODD) (P = 0.03) scores than the corresponding low bone-lead group. After adjusting for relevant confounders, children in the high bone-lead group were more likely to have ODD-behavior than the low group (OR = 6.7, 95%CI: 1.2-36.5). However, no adjusted association was observed between blood-lead and any ADHD-domain score.

Conclusion: High levels of cumulative lead exposure in children may be an independent risk factor of ODD-behavior.

Keywords: ADHD; Blood; Bone; Lead; ODD.

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Conflict of interest statement

Conflict of interest: The other authors have indicated they have no potential conflicts of interest to disclose.

Figures

**Fig. 1.**
Study flow chart. Abbreviation: VADPRS: Vanderbilt ADHD (Attention Deficit Hyperactivity Disorder Diagnostic Parent Rating Scale).

See this image and copyright information in PMC

References

1. Acharya S, Acharya UR, 1997. In vivo lipid peroxidation responses of tissues in lead-treated Swiss mice. Ind. Health 35, 542–544. - PubMed
1. Adonaylo VN, Oteiza PI, 1999. Pb2+ promotes lipid oxidation and alterations in membrane physical properties. Toxicology 132, 19–32. - PubMed
1. Aebi M, Plattner B, Metzke CW, Bessler C, Steinhausen HC, 2013. Parent-and self-reported dimensions of oppositionality in youth: construct validity, concurrent validity, and the prediction of criminal outcomes in adulthood. J. Child Psychol. Psychiatry 54, 941–949. - PubMed
1. Ahlgren L, Haeger-Aronsen B, Mattsson S, Schutz A, 1980. In-vivo determination of lead in the skeleton after occupational exposure to lead. Br. J. Ind. Med 37, 109–113. - PMC - PubMed
1. APA, 2000. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition (Text Revison). American Psychiatric Association.

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Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior

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Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior

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