title: Environmental exposure to polychlorinated biphenyls and quality of the home environment: effects on psychodevelopment in early childhood.
abstract: BACKGROUND
  There is uncertainty whether environmental levels of exposure to polychlorinated biphenyls (PCBs) adversely affect mental and motor development in early childhood. We aimed to establish whether such an effect is of only prenatal or additional postnatal origin, and if a favourable home environment can counteract this effect.
  
  
  METHODS
  Between 1993 and 1995 we recruited 171 healthy mother-infant pairs and prospectively measured psychodevelopment in newborn infants aged 7, 18, 30, and 42 months. We estimated prenatal and perinatal PCB exposure of newborn babies in cord blood and maternal milk. At 42 months we measured postnatal PCB concentrations in serum. At 18 months the quality of the home environment was assessed using the Home Observation for Measurement of the Environment scale. Mental and psychomotor development of the children were assessed using the Bayley Scales of Infant Development until 30 months and the Kaufman Assessment Battery for Children at 42 months.
  
  
  RESULTS
  Negative associations between milk PCB and mental/motor development were reported at all ages, becoming significant from 30 months onwards. Over 30 months, for a PCB increase from 173 (5th percentile) to 679 ng/g lipids in milk (95th percentile) there was a decrease of 8.3 points (95% CI -16.5 to 0.0) in the Bayley Scales of Infant Development mental scores, and a 9.1 point decrease (95% CI -17.2 to -1.02) in the Bayley Scales of Infant Development motor scores. There was also a negative effect of postnatal PCB exposure via breastfeeding at 42 months. Home environment had a positive effect from 30 months onwards (Bayley Scales of Infant Development mental score increase of 9.4 points [95% CI 2.2-16.7]).
  
  
  CONCLUSIONS
  Prenatal PCB exposure at current European background levels inhibits, and a favourable home environment supports, mental and motor development until 42 months of age. PCB exposure also has an effect postnatally.
authors.affiliation: Division of Analytical Chemistry, Medical Institute of Environmental Hygiene, Flintbeck, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Walkowiak
authors.forename: J A
authors.initials: JA
authors.lastname: Wiener
authors.forename: A
authors.initials: A
authors.lastname: Fastabend
authors.forename: B
authors.initials: B
authors.lastname: Heinzow
authors.forename: U
authors.initials: U
authors.lastname: Krämer
authors.forename: E
authors.initials: E
authors.lastname: Schmidt
authors.forename: H J
authors.initials: HJ
authors.lastname: Steingrüber
authors.forename: S
authors.initials: S
authors.lastname: Wundram
authors.forename: G
authors.initials: G
authors.lastname: Winneke
mesh_terms: D016902:Air Pollution, Indoor; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D004781:Environmental Exposure; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008895:Milk, Human / Q000737:chemistry; D011078:Polychlorinated Biphenyls / Q000009:adverse effects* / Q000097:blood; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011597:Psychomotor Performance / Q000187:drug effects*
chemical_list: D011078:Polychlorinated Biphenyls