Attention-deficit/hyperactivity symptoms in preschool children from an e-waste recycling town: assessment by the parent report derived from DSM-IV.
BACKGROUND
To investigate the attention-deficit/hyperactivity disorder (ADHD) status among preschool-aged children in Guiyu, an electronic waste (e-waste) recycling town in Guangdong, China.


METHODS
Two hundred and forty-three parents were surveyed regarding ADHD behaviors in their children (aged 3-7 years) based solely on the DSM-IV criteria. The peripheral blood samples were taken from these children to measure blood lead levels (BLLs) and blood cadmium levels (BCLs).


RESULTS
12.8% of children met the criteria for ADHD, of which the inattentive, hyperactive/impulsive and combined subtypes were 4.5%, 5.3% and 2.9% respectively. Of all children, 28.0% had BLLs ≥ 10 ug/dL and only 1.2% had BCLs ≥ 2 ug/L, levels conventionally considered high. Either modeled by univariate or multivariable analysis, the three ADHD scores (inattentive, hyperactive/impulsive and total scores) calculated from the Parent Rating Scale showed strong positive correlations with BLLs but not with BCLs. Furthermore, children with high BLLs had 2.4 times higher risk of ADHD than those with low BLLs (OR: 2.4 [95% CI: 1.1-5.2]). When each of the 18 categories on the Parent Rating Scale was separately analyzed, children with high BLLs had significant higher risks for positive ADHD symptoms than those with low BLLs in 12 of the 18 categories (ORs ranged from 2.1 [95% CI: 1.1-3.9] to 3.6 [95% CI: 1.7-7.5]).


CONCLUSIONS
This study suggests that environmental lead contamination due to e-waste recycling has an impact on neurobehavioral development of preschool children in Guiyu.
Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China. shanyizrb@163.com.
Ruibiao
R
Zhang
Analytical Cytology Laboratory and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, People's Republic of China. xhuo@stu.edu.cn.
Xia
X
Huo
Translational Medicine Center, Shantou University Medical College, Shantou, Guangdong, People's Republic of China. guyuh@yahoo.com.
Guyu
G
Ho
Analytical Cytology Laboratory and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, People's Republic of China. 506084313@qq.com.
Xiaojuan
X
Chen
Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China. wanghongwu-1998@hotmail.com.
Hongwu
H
Wang
Department of Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China. Wangty999@sohu.com.
Tianyou
T
Wang
Department of Pediatrics, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, People's Republic of China. malian8965@sina.com.|Shenzhen Pingshan Maternal and Child Health Hospital, Shenzhen, Guangdong, People's Republic of China. malian8965@sina.com.|Shenzhen University Women's and Children's Hospital, Shenzhen, Guangdong, People's Republic of China. malian8965@sina.com.
Lian
L
Ma
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology; D002104:Cadmium / Q000009:adverse effects / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004781:Environmental Exposure / Q000009:adverse effects; D004785:Environmental Pollutants / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007854:Lead / Q000009:adverse effects* / Q000097:blood; D008297:Male; D015995:Prevalence; D064091:Waste Disposal Facilities
D004785:Environmental Pollutants; D002104:Cadmium; D007854:Lead