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Low blood lead levels and attention-deficit hyperactivity disorder in children: a systematic review and meta-analysis

  • Environmental Pollution and Energy Management
  • Published:
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Abstract

Attention-deficit hyperactivity disorder (ADHD) of children is one of the most common neurodevelopmental diseases; the etiology remains unclear. We reviewed and meta-analyzed case-control studies to assess the effects of blood lead levels in children on ADHD symptoms. Relevant studies were identified by searching electronic databases. A meta-analysis was performed using the fixed model of Review Manager 5.3 software. Seven relevant studies were identified. The case groups exhibited significant increases in ADHD symptoms [mean difference (MD), 0.59; 95% confidence interval (CI), 0.50–0.68; p < 0.0001]. Subgroup assessment showed that even children with blood lead levels <3 μg/dL exhibited significant increases in ADHD symptoms (MD, 0.47; 95% CI, 0.39–0.56; p < 0.0001). Subgroup assessment also showed that children aged 5–12 years exhibited more significant increases in ADHD symptoms (MD, 1.35; 95% CI, 0.28–2.41; p < 0.0001) than children aged >12 years. Our findings suggest that low blood lead levels may be associated with ADHD symptoms in children. However, caution is needed when interpreting the results because among-study heterogeneity was in play. Primary interventions should focus on children with low blood lead levels.

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Authors and Affiliations

  1. Changsha Medical University, Changsha, China

    Jianjun He

  2. Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, Hunan Province, 410078, China

    Huacheng Ning & Ruixue Huang

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  1. Jianjun He
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  2. Huacheng Ning
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  3. Ruixue Huang
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Contributions

Ruixue Huang conceived and designed the study. Ruixue Huang, Huacheng Ning performed eligibility screening and data extraction. Jianjun He analyzed the data and performed the statistical analysis. Ruixue Huang and Jianjun He wrote the initial manuscript. Ruixue Huang critically revised the manuscript and polish the English language.

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Correspondence to Ruixue Huang.

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Responsible editor: Philippe Garrigues

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He, J., Ning, H. & Huang, R. Low blood lead levels and attention-deficit hyperactivity disorder in children: a systematic review and meta-analysis. Environ Sci Pollut Res 26, 17875–17884 (2019). https://doi.org/10.1007/s11356-017-9799-2

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