title: Cadmium exposure and neuropsychological development in school children in southwestern Spain.
abstract: This study assessed the association between cadmium exposure and neuropsychological development in children from a region with high industrial and mining activities in southwestern Spain. We conducted a cross-sectional study with 261 children aged 6-9 years between January and March 2012. Cadmium exposure was measured in urine and hair of children, and neuropsychological development was assessed with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and with three computerized tests from the Behavioral Assessment and Research System (BARS): Reaction Time Test (RTT), Continuous Performance Test (CPT) and Selective Attention Test (SAT). Multivariate linear regression models, adjusted for potential confounders, were used to estimate the association between neuropsychological development and cadmium exposure measured in urine and hair samples. Geometric means of urine and hair cadmium levels were 0.75 μg/g creatinine and 0.01 μg/g, respectively. We observed that doubling of levels of cadmium in urine was associated with a reduction of two points (95% CI: -3.8 to -0.4) in the Full-Scale intelligence quotient (IQ) in boys. By domains, association was statistically significant for Verbal Comprehension (β=-2.0; p=0.04) and close to the significance level for Perceptual Reasoning (β=-1.8; p=0.06). Among girls, only Verbal Comprehension showed suggestive associations with cadmium exposure (β=-1.7; p=0.06). Cadmium exposure is associated with cognitive delays in boys in our region. Our results provide additional evidence of the neurotoxic effect of low-level postnatal cadmium exposure among children, and support the hypothesis of differences between sexes in the neurotoxic effect of metals on children.
authors.affiliation: Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, c/Cuesta del Observatorio 4, 18080 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodríguez-Barranco
authors.affiliation: Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, c/Cuesta del Observatorio 4, 18080 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain. Electronic address: marina.lacasana.easp@juntadeandalucia.es.
authors.forename: Marina
authors.initials: M
authors.lastname: Lacasaña
authors.affiliation: Department of Legal Medicine and Toxicology, University of Granada, Granada, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Gil
authors.affiliation: Department of Clinical, Experimental and Social Psychology, University of Huelva, Huelva, Spain.
authors.forename: Andres
authors.initials: A
authors.lastname: Lorca
authors.affiliation: Research Center on Health and Environment (CYSMA), University of Huelva, Huelva, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Alguacil
authors.affiliation: Center for Research on Occupational and Environmental Toxicology, Oregon Health and Science University, USA; Occupational and Environmental Health, University of Iowa, USA.
authors.forename: Diane S
authors.initials: DS
authors.lastname: Rohlman
authors.affiliation: Andalusian School of Public Health (EASP), Campus Universitario de Cartuja, c/Cuesta del Observatorio 4, 18080 Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: González-Alzaga
authors.affiliation: Department of Legal Medicine and Toxicology, University of Granada, Granada, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Molina-Villalba
authors.affiliation: Department of Developmental and Educational Psychology, University of Huelva, Huelva, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Mendoza
authors.affiliation: Center for Public Health Research (CSISP-FISABIO), Valencia, Spain.
authors.forename: Clemente
authors.initials: C
authors.lastname: Aguilar-Garduño
mesh_terms: D002104:Cadmium / Q000032:analysis / Q000633:toxicity* / Q000652:urine; D002648:Child; D002657:Child Development / Q000187:drug effects*; D004781:Environmental Exposure; D005260:Female; D006197:Hair / Q000737:chemistry; D006801:Humans; D007360:Intelligence / Q000187:drug effects*; D008297:Male; D009483:Neuropsychological Tests; D013030:Spain; D013054:Spectrophotometry, Atomic
chemical_list: D002104:Cadmium
keywords: Biomonitoring; Cadmium; Child; Gender; Intelligence; Neuropsychological development