Neurobehavioral test performance in the third National Health and Nutrition Examination Survey☆
Introduction
The National Center for Health Statistics periodically conducts large surveys to assess the health and nutrition of persons in the United States. The surveys consist of questionnaires, physical examinations and laboratory tests. The components of the surveys are administered in homes and in mobile examination centers. The surveys have provided national reference data for biological markers and anthropometric measurements (e.g., [20], [21], [32], [55], [61]). The last completed survey was the third National Health and Nutrition Examination Survey (NHANES III). This survey's documentation [49] and data [50], [51] are available on CD-ROM.
NHANES III contained three neurobehavioral tests from a computerized test battery called the Neurobehavioral Evaluation System (NES) that were used to assess central nervous system (CNS) function. The three tests were simple reaction time, symbol–digit substitution and serial digit learning. They are often referred to as the CNS component of the survey. The NES was designed to measure neurobehavioral performance in populations that are occupationally or environmentally exposed to chemicals [7], [8], [34], [35], [36], [38], [39]. It has been used to investigate the neurotoxic effects of organic solvents [6], [13], [15], [19], [24], [27], [48], organophosphate pesticides [47], [63], nitrous oxide [26], [46], styrene [40], [64], volatile organic compounds [53], lead [60], [65], [69], mercury [22], [23], [44], [65], tetrachloroethane [2] and sulfuryl fluoride and methyl bromide [16].
The purposes of this article are to describe the survey methods with respect to the neurobehavioral tests and to summarize the neurobehavioral data statistically using the demographic variables that were included in the survey and questionnaire items that were administered with the tests. There are no data for the NES from a large sample of the general population. The data collected by NHANES III are from a nationally representative sample. Estimates calculated from this sample can be used as reference values for workplace and other studies designed to explore the etiology of nervous system disorders. They provide a reference point against which future national surveys can be compared in order to evaluate trends over time. The estimates can be used for power and sample size calculations, and they can be used as a guide for deciding which variables to include and control for in future studies.
Section snippets
Subjects
The subjects in NHANES III were civilian, non-institutionalized persons in the United States 2 months of age or older. The survey was conducted from 1988 to 1994. Approximately 40,000 persons were selected to participate. Of these, 5662 adults, 20–59 years old, were selected to take the neurobehavioral tests. Persons were not excluded from the CNS test for medical or safety reasons. Persons who could not speak English or Spanish, or who were legally blind were not given the CNS test.
Sample design
The sample
Results
Table 2 shows the proportion of persons who did not complete the tests by demographic categories. The nonresponse rates increased from test to test in the order that the tests were administered. The nonresponse rates of the males were higher than the rates of the females. As age increased, the nonresponse rates increased. The nonresponse rates tended to decrease as the level of education increased. The nonresponse rates of the non-Hispanic white group were lower than those of the other
Discussion
All of the demographic variables that were considered were related to neurobehavioral test performance. The performance of males and females differed on all the tests. Performance on all the tests decreased as age increased. Performance on all the tests increased as education level and family income increased. There were also consistent race-ethnicity differences.
For the questionnaire variables, persons who reported having more sleep performed better on the simple reaction time and serial digit
References (69)
- et al.
Neurobehavioral and neurophysiological outcome of chronic low-level tetrachloroethene exposure measured in neighborhoods of dry cleaning shops
Environ. Res.
(1995) - et al.
Comparison of performance from three continents on the WHO-recommended Neurobehavioral Core Test Battery
Environ. Res.
(1993) - et al.
Human neurobehavioral research methods: Impact of subject variables
Environ. Res.
(1997) - et al.
Experiences with the Milan Automated Neurobehavioral System (MANS) in occupational neurotoxic exposure
Neurotoxicol. Teratol.
(1989) - et al.
A cross-sectional survey of neurobehavioral effects of chronic solvent exposure on workers in a paint manufacturing plant
Environ. Res.
(1993) - et al.
Behavioral effects of low-level exposure to Hg° among dentists
Neurotoxicol. Teratol.
(1995) - et al.
The influence of vision on computerized neurobehavioral test scores: A proposal for improving test protocols
Neurotoxicol. Teratol.
(1996) - et al.
A mathematical model of performance on a simple reaction time test
Neurotoxicol. Teratol.
(1996) Covariates of computerized neurobehavioral test performance in epidemiologic investigations
Environ. Res.
(1993)- et al.
Development of a computer-based battery designed to screen adults for neuropsychological impairment
Neurotoxicol. Teratol.
(1996)
Neurobehavioral effects of acute styrene exposure in fiberglass boatbuilders
Neurotoxicol. Teratol.
The development of neurobehavioral toxicology in China: The 1994 Hänninen Lecture
Environ. Res.
Psychological effects of low exposure to mercury vapor: Application of a computer-administrated neurobehavioral evaluation system
Environ. Res.
Experimental nitrous oxide exposure as a model system for evaluating neurobehavioral tests
Toxicology
Behavioral effects of exposure to organic solvents in carpet layers
Neurotoxicol. Teratol.
Neuropsychological assessment of organic solvent effects in South Africa: Test selection, adaptation, scoring, and validation issues
Environ. Res.
Neurobehavioral Evaluation System (NES): Comparative performance of 2nd-, 4th-, and 8th-grade Czech Children
Neurotoxicol. Teratol.
Neurobehavioral effects of occupational exposure to low-level styrene
Neurotoxicol. Teratol.
Cognitive and sensorimotor functions in 6-year-old children in relation to lead and mercury levels: Adjustment for intelligence and contrast sensitivity in computerized testing
Neurotoxicol. Teratol.
Validation of the NES2 in patients with neurological disorders
Neurotoxicol. Teratol.
The development of a neurobehavioral test battery for use in hazard evaluations in occupational settings
Neurotoxicol. Teratol.
Heat exposure-induced changes in motor outflow component of reaction time
Percept. Motor Skills
Occupational lead neurotoxicity—A behavioral electrophysiologic evaluation: I. Study design and year one results
Br. J. Ind. Med.
Neurobehavioral effects of solvents in construction painters
J. Occup. Med.
A computer-administered neurobehavioral evaluation system for occupational and environmental epidemiology: Rationale, methodology and pilot study results
J. Occup. Med.
A computer-based neurobehavioral evaluation system for occupational and environmental epidemiology: Methodology and validation studies
Neurobehav. Toxicol. Teratol.
Health effects of common organic solvents in the workplace
Fam. Community Health
Effect of body cooling on vigilance in hot environments
Aerosp. Med.
Performance of psychological tests in hot environments
Indian J. Med. Res.
Acute effects of heat on neuropsychological changes and physiological responses under noise condition
Indian J. Exp. Biol.
Neurobehavioral test performance among apprentice painters: Baseline data
Am. J. Ind. Med.
Comparison of the NES and CNS/B neuropsychological screening batteries
Neurotoxicology
Work-site clinical and neurobehavioral assessment of solvent-exposed microelectronic workers
Am. J. Ind. Med.
Health effects associated with sulfuryl fluoride and methyl bromide exposure among structural fumigation workers
Am. J. Public Health
Cited by (53)
Increased uncoupling protein 1 levels are associated with attention deficit and hyperactivity disorder in medication-free children
2022, Journal of Psychiatric ResearchCitation Excerpt :The SDLT was first proposed by Zangwill (1943) as a method for assessing short-term memory deficits (Hamsher et al., 1980; Zangwill, 1943). The SDLT measures learning and recall (Krieg et al., 2001). Studies on standardization of the SDLT to Turkish culture were carried out by Karakaş et al. (Sirel Karakaş et al., 1999).
Effects of aerobic fitness on cognitive performance as a function of dual-task demands in older adults
2019, Experimental GerontologyGenetic polymorphisms of GRIN2A and GRIN2B modify the neurobehavioral effects of low-level lead exposure in children
2018, Environmental ResearchCitation Excerpt :Age at study entry, race, and nonverbal IQ (CONTI) (niq) determined at baseline were included as fixed effects. These covariates were selected because of their potential to bias neurobehavioral test performance in relation to Pb exposure (Bellinger, 2007; Krieg et al., 2001) and because data pertinent to these specific variables were available from the clinical trial from which subjects in the present study were acquired (Martins et al., 2005; Townes et al., 2003). Adjustment for nonverbal IQ at baseline was also made to minimize the effects of language and culture on the measures of neurobehavioral ability evaluate here (Hammill et al., 1997).
Infectious disease burden and cognitive function in young to middle-aged adults
2016, Brain, Behavior, and ImmunityGenetic polymorphisms affecting susceptibility to mercury neurotoxicity in children: Summary findings from the Casa Pia Children's Amalgam Clinical Trial
2014, NeuroToxicologyCitation Excerpt :Covariates in this model included age at assessment, race, and non-verbal IQ (determined at baseline). These covariates were selected because of their potential to bias neurobehavioral test performance in relation to Hg exposure (Echeverria et al., 1995) or other stressors (Krieg et al., 2001) and because data pertinent to these specific variables were available from the clinical trial from which subjects in the present study were acquired (Martins et al., 2005; Townes et al., 2003). Restricting our analyses to these three covariates, which are not highly correlated, minimized the possibility of having an over-determined model.
- ☆
This document has been reviewed in accordance with U.S. Environmental Protection Agency policy and approved for publication. Approval does not signify that the contents necessarily reflect the views and policies of the agency. Mention of trade names or commercial products does not constitute endorsement or recommendation for use by the agency.