title: Postnatal arsenic exposure and attention impairment in school children.
abstract: Over the last few decades there has been an increased concern about the health risks from exposure to metallic trace elements, including arsenic, because of their potential neurotoxic effects on the developing brain. This study assessed whether urinary arsenic (UA) levels are associated with attention performance and Attention-Deficit/Hyperactivity Disorder (ADHD) in children living in an area with high industrial and mining activities in Southwestern Spain. A cross-sectional study was conducted on 261 children aged 6-9 years. Arsenic levels were determined in urine samples. Attention was measured by using 4 independent tools: a) tests from the Behavioral Assessment and Research System (BARS) designed to measure attention function: Simple Reaction Time Test (RTT), Continuous Performance Test (CPT) and Selective Attention Test (SAT); b) AULA Test, a virtual reality (VR)-based test that evaluates children's response to several stimuli in an environment simulating a classroom; c) Child Behavior Checklist (CBCL), administered to parents; and d) Teacher's Report Form (TRF), administered to teachers. Multivariate linear and logistic regression models, adjusted for potential confounders, were used to estimate the magnitude of the association between UA levels and attention performance scores. Higher UA levels were associated with an increased latency of response in RTT (β = 12.3; 95% confidence interval (CI): 3.5-21.1) and SAT (β = 3.6; 95% CI: .4-6.8) as well as with worse performance on selective and focalized attention in the AULA test (β for impulsivity = .6; 95% CI: .1-1.1; β for inattention = .5; 95% CI: .03-1.0). A dose-response relationship was observed between UA levels and inattention and impulsivity scores. In contrast, results from the CBCL and TRF tests failed to show a significant association with UA levels. In conclusion, UA levels were associated with impaired attention/cognitive function, even at levels considered safe. These results provide additional evidence that postnatal arsenic exposure impairs neurological function in children.
authors: Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs), Granada, University Hospitals of Granada/University of Granada, Granada, Spain.
authors: Miguel
authors: M
authors: Rodríguez-Barranco
authors: Department of Legal Medicine and Toxicology, University of Granada School of Medicine, Granada, Spain.
authors: Fernando
authors: F
authors: Gil
authors: Department of Legal Medicine and Toxicology, University of Granada School of Medicine, Granada, Spain. Electronic address: ajerez@ugr.es.
authors: Antonio F
authors: AF
authors: Hernández
authors: Research Center on Health and Environment (CYSMA), University of Huelva, Huelva, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors: Juan
authors: J
authors: Alguacil
authors: Department of Clinical, Experimental and Social Psychology, University of Huelva, Huelva, Spain.
authors: Andres
authors: A
authors: Lorca
authors: Department of Developmental and Educational Psychology, University of Huelva, Huelva, Spain.
authors: Ramón
authors: R
authors: Mendoza
authors: Department of Psychology, University of Almería, Almería, Spain.
authors: Inmaculada
authors: I
authors: Gómez
authors: Department of Legal Medicine and Toxicology, University of Granada School of Medicine, Granada, Spain.
authors: Isabel
authors: I
authors: Molina-Villalba
authors: Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs), Granada, University Hospitals of Granada/University of Granada, Granada, Spain.
authors: Beatriz
authors: B
authors: González-Alzaga
authors: Center for Public Health Research (CSISP-FISABIO), Valencia, Spain.
authors: Clemente
authors: C
authors: Aguilar-Garduño
authors: Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, USA; Oregon Institute for Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA.
authors: Diane S
authors: DS
authors: Rohlman
authors: Andalusian School of Public Health (EASP), Granada, Spain; Instituto de Investigación Biosanitaria (ibs), Granada, University Hospitals of Granada/University of Granada, Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors: Marina
authors: M
authors: Lacasaña
mesh_terms: D001151:Arsenic / Q000633:toxicity* / Q000652:urine; D001288:Attention / Q000187:drug effects*; D001289:Attention Deficit Disorder with Hyperactivity / Q000139:chemically induced*; D002648:Child; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000187:drug effects; D008297:Male; D011930:Reaction Time / Q000187:drug effects; D012574:Schools
chemical_list: D001151:Arsenic
keywords: ADHD; Arsenic; Attention; Children; Neurobehavioral disorder; Neurotoxicity