title: Environmental exposure to metals and children's growth to age 5 years: a prospective cohort study.
abstract: In this prospective cohort study, based on 1,505 mother-infant pairs in rural Bangladesh, we evaluated the associations between early-life exposure to arsenic, cadmium, and lead, assessed via concentrations in maternal and child urine, and children's weights and heights up to age 5 years, during the period 2001-2009. Concurrent and prenatal exposures were evaluated using linear regression analysis, while longitudinal exposure was assessed using mixed-effects linear regression. An inverse association was found between children's weight and height, age-adjusted z scores, and growth velocity at age 5 years and concurrent exposure to cadmium and arsenic. In the longitudinal analysis, multivariable-adjusted attributable differences in children's weight at age 5 years were -0.33 kg (95% confidence interval (CI): -0.60, -0.06) for high (≥95th percentile) arsenic exposure and -0.57 kg (95% CI: -0.88, -0.26) for high cadmium exposure, in comparison with children with the lowest exposure (≤5th percentile). Multivariable-adjusted attributable differences in height were -0.50 cm (95% CI: -1.20, 0.21) for high arsenic exposure and -1.6 cm (95% CI: -2.4, -0.77) for high cadmium exposure. The associations were apparent primarily among girls. The negative effects on children's growth at age 5 years attributable to arsenic and cadmium were of similar magnitude to the difference between girls and boys in terms of weight (-0.67 kg, 95% CI: -0.82, -0.53) and height (-1.3 cm, 95% CI: -1.7, -0.89).
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Renee M
authors.initials: RM
authors.lastname: Gardner
authors.forename: Maria
authors.initials: M
authors.lastname: Kippler
authors.forename: Fahmida
authors.initials: F
authors.lastname: Tofail
authors.forename: Matteo
authors.initials: M
authors.lastname: Bottai
authors.forename: Jena
authors.initials: J
authors.lastname: Hamadani
authors.forename: Margaretha
authors.initials: M
authors.lastname: Grandér
authors.forename: Barbro
authors.initials: B
authors.lastname: Nermell
authors.forename: Brita
authors.initials: B
authors.lastname: Palm
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Rasmussen
authors.forename: Marie
authors.initials: M
authors.lastname: Vahter
mesh_terms: D001151:Arsenic / Q000633:toxicity / Q000652:urine; D001459:Bangladesh / Q000453:epidemiology; D001827:Body Height; D001835:Body Weight; D002104:Cadmium / Q000633:toxicity / Q000652:urine; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis / Q000706:statistics & numerical data; D004785:Environmental Pollutants / Q000633:toxicity* / Q000652:urine; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007854:Lead / Q000633:toxicity / Q000652:urine; D016014:Linear Models; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D008670:Metals / Q000633:toxicity* / Q000652:urine; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors
chemical_list: D004785:Environmental Pollutants; D008670:Metals; D002104:Cadmium; D007854:Lead; D001151:Arsenic
keywords: arsenic; body height; body weight; cadmium; child, preschool; growth; lead; prenatal exposure delayed effects