title: Blood lead, parental marital status and the risk of attention-deficit/hyperactivity disorder in elementary school children: A longitudinal study.
abstract: The aim of this study was to investigate the blood lead level and parental marital status that might influence the development of attention-deficit/hyperactivity disorder (ADHD) symptoms in school-aged children. The participants in the survey included elementary school children, and they were followed up biennially. The participants' parents or caregivers were administered a questionnaire including ADHD rating scale. Among 2967 who were not suspected to have ADHD at baseline survey, 2195 children who took follow-up test for ADHD were evaluated. The incidence rate of suspected ADHD was 5.0% (107 cases) during the two years of the follow-up period. The geometric mean blood lead level was 1.56μg/dL. Relative risk ratio for ADHD was estimated using logistic regression analysis. After adjustment for potential confounders, ADHD developed more frequently in children with blood lead levels of >2.17μg/dL (highest quartile) (RR 1.552, 95% CI 1.002-2.403) and in children with a single parent (RR 1.805, 95% CI 1.002-3.254). The RR was 3.567 (95% CI 1.595-7.980) in children with relatively high blood lead levels (>2.17μg/dL) from single-parent families, compared with those with low blood lead and a two-parent family. The ADHD risk in association with blood lead level was modified by family status.
authors.affiliation: Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Won-Jun
authors.initials: WJ
authors.lastname: Choi
authors.affiliation: Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea. Electronic address: hojang@dankook.ac.kr.
authors.forename: Ho-Jang
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Department of Psychology, Dankook University College of Social Sciences, Cheonan, Republic of Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Lim
authors.affiliation: Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
authors.forename: Ji-Ae
authors.initials: JA
authors.lastname: Lim
authors.affiliation: Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea.
authors.forename: Mina
authors.initials: M
authors.lastname: Ha
mesh_terms: D001288:Attention / Q000502:physiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000097:blood / Q000209:etiology* / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D007854:Lead / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D010290:Parents / Q000523:psychology*; D012307:Risk Factors
chemical_list: D007854:Lead
keywords: Attention-deficit/hyperactivity disorder; Interaction; Lead; Longitudinal; Parental marital status