title: Patterns of exposure to multiple metals and associations with neurodevelopment of preschool children from Montevideo, Uruguay.
abstract: While it is known that toxic metals contribute individually to child cognitive and behavioral deficits, we still know little about the effects of exposure to multiple metals, particularly when exposures are low. We studied the association between children's blood lead and hair arsenic, cadmium, and manganese and their performance on the Bayley Scales of Infant Development III. Ninety-two preschool children (age 13-42 months) from Montevideo, Uruguay, provided a hair sample and 78 had a blood lead level (BLL) measurement. Using latent class analysis (LCA), we identified four groups of exposure based on metal concentrations: (1) low metals, (2) low-to-moderate metals, (3) high lead and cadmium, and (4) high metals. Using the four-group exposure variable as the main predictor, and fitting raw scores on the cognitive, receptive vocabulary, and expressive vocabulary scales as dependent variables, both complete-case and multiple imputation (MI) analyses were conducted. We found no association between multiple-metal exposures and neurodevelopment in covariate-adjusted models. This study demonstrates the use of LCA together with MI to determine patterns of exposure to multiple toxic metals and relate these to child neurodevelopment. However, because the overall study population was small, other studies with larger sample sizes are needed to investigate these associations.
authors.affiliation: Department of Nutritional Sciences, Pennsylvania State University, University Park, PA 16802, USA ; School of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, UK.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Kordas
authors.affiliation: Faculty of Psychology, Catholic University of Uruguay, 16000 Montevideo, Uruguay.
authors.forename: Graciela
authors.initials: G
authors.lastname: Ardoino
authors.affiliation: The Methodology Center, Pennsylvania State University, University Park, PA 16802, USA.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Coffman
authors.affiliation: Center for Research, Catholic University of Uruguay, 16000 Montevideo, Uruguay.
authors.forename: Elena I
authors.initials: EI
authors.lastname: Queirolo
authors.affiliation: Faculty of Psychology, Catholic University of Uruguay, 16000 Montevideo, Uruguay.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ciccariello
authors.affiliation: Faculty of Chemistry, University of the Republic of Uruguay, 18000 Montevideo, Uruguay.
authors.forename: Nelly
authors.initials: N
authors.lastname: Mañay
authors.affiliation: Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale Schools of Public Health and Medicine, New Haven, CT 06510, USA.
authors.forename: Adrienne S
authors.initials: AS
authors.lastname: Ettinger
mesh_terms: D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D004781:Environmental Exposure; D004784:Environmental Monitoring; D004785:Environmental Pollutants / Q000097:blood / Q000378:metabolism*; D005260:Female; D006197:Hair / Q000737:chemistry; D006801:Humans; D007223:Infant; D008297:Male; D008670:Metals / Q000097:blood / Q000378:metabolism*; D009483:Neuropsychological Tests; D014583:Uruguay
chemical_list: D004785:Environmental Pollutants; D008670:Metals