title: Childhood Blood Lead Levels and Symptoms of Attention Deficit Hyperactivity Disorder (ADHD): A Cross-Sectional Study of Mexican Children.
abstract: Previous studies suggest that blood lead levels are positively associated with attention deficit/hyperactivity disorder (ADHD) and ADHD-symptoms in children. However, the associations between lead exposure and ADHD subtypes are inconsistent and understudied.
  
  
  
  The objective of this study was to explore the association of low-level concurrent lead exposure with subtypes of ADHD symptoms in 578 Mexican children 6-13 years of age.
  
  
  
  We measured concurrent blood lead levels using inductively coupled plasma mass spectrometry (ICPMS). We administered the Conners' Rating Scales-Revised (CRS-R) to mothers to evaluate their children's ADHD symptoms. We used imputation to fill missing values in blood lead levels and used segmented regression models adjusted for relevant covariates to model the nonlinear relationship between blood lead and ADHD symptoms.
  
  
  
  Mean ± SD blood lead levels were 3.4 ± 2.9 μg/dL. In adjusted models, a 1-μg/dL increase in blood lead was positively associated with Hyperactivity and Restless-Impulsivity scores on the CRS-R scale and Hyperactivity-Impulsivity scores on the CRS-R scale of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, but only in children with blood lead level ≤ 5 μg/dL. Blood lead was not associated with Inattentive symptoms or overall ADHD behavior.
  
  
  
  In this population of Mexican children, current blood lead level among children with low exposure (≤ 5 μg/dL) was positively associated with hyperactive/impulsive behaviors, but not with inattentiveness. These results add to the existing evidence of lead-associated neurodevelopmental deficits at low levels of exposure.
  
  
  
  Huang S, Hu H, Sánchez BN, Peterson KE, Ettinger AS, Lamadrid-Figueroa H, Schnaas L, Mercado-García A, Wright RO, Basu N, Cantonwine DE, Hernández-Avila M, Téllez-Rojo MM. 2016. Childhood blood lead levels and symptoms of attention deficit hyperactivity disorder (ADHD): a cross-sectional study of Mexican children. Environ Health Perspect 124:868-874; http://dx.doi.org/10.1289/ehp.1510067.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Siying
authors.initials: S
authors.lastname: Huang
authors.forename: Howard
authors.initials: H
authors.lastname: Hu
authors.forename: Brisa N
authors.initials: BN
authors.lastname: Sánchez
authors.forename: Karen E
authors.initials: KE
authors.lastname: Peterson
authors.forename: Adrienne S
authors.initials: AS
authors.lastname: Ettinger
authors.forename: Héctor
authors.initials: H
authors.lastname: Lamadrid-Figueroa
authors.forename: Lourdes
authors.initials: L
authors.lastname: Schnaas
authors.forename: Adriana
authors.initials: A
authors.lastname: Mercado-García
authors.forename: Robert O
authors.initials: RO
authors.lastname: Wright
authors.forename: Niladri
authors.initials: N
authors.lastname: Basu
authors.forename: David E
authors.initials: DE
authors.lastname: Cantonwine
authors.forename: Mauricio
authors.initials: M
authors.lastname: Hernández-Avila
authors.forename: Martha María
authors.initials: MM
authors.lastname: Téllez-Rojo
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology*; D002648:Child; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood*; D008297:Male; D008800:Mexico / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D007854:Lead