Autism spectrum disorder prevalence and associations with air concentrations of lead, mercury, and arsenic.
Lead, mercury, and arsenic are neurotoxicants with known effects on neurodevelopment. Autism spectrum disorder (ASD) is a neurodevelopmental disorder apparent by early childhood. Using data on 4486 children with ASD residing in 2489 census tracts in five sites of the Centers for Disease Control and Prevention's Autism and Developmental Disabilities Monitoring (ADDM) Network, we used multi-level negative binomial models to investigate if ambient lead, mercury, and arsenic concentrations, as measured by the US Environmental Protection Agency National-Scale Air Toxics Assessment (EPA-NATA), were associated with ASD prevalence. In unadjusted analyses, ambient metal concentrations were negatively associated with ASD prevalence. After adjusting for confounding factors, tracts with air concentrations of lead in the highest quartile had significantly higher ASD prevalence than tracts with lead concentrations in the lowest quartile (prevalence ratio (PR) = 1.36; 95 '% CI: 1.18, 1.57). In addition, tracts with mercury concentrations above the 75th percentile (>1.7 ng/m(3)) and arsenic concentrations below the 75th percentile (≤0.13 ng/m(3)) had a significantly higher ASD prevalence (adjusted RR = 1.20; 95 % CI: 1.03, 1.40) compared to tracts with arsenic, lead, and mercury concentrations below the 75th percentile. Our results suggest a possible association between ambient lead concentrations and ASD prevalence and demonstrate that exposure to multiple metals may have synergistic effects on ASD prevalence.
Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA. Aisha.S.Dickerson@uth.tmc.edu.
Aisha S
AS
Dickerson
Biostatistics/Epidemiology/Research Design (BERD) Core, Center for Clinical and Translational Sciences (CCTS), University of Texas Health Science Center at Houston, 6410 Fannin Street, UT Professional Building Suite 1100.05, Houston, TX, 77030, USA.|Division of Clinical and Translational Sciences, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston, Houston, TX, 77030, USA.|Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA.
Mohammad H
MH
Rahbar
Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.
Amanda V
AV
Bakian
Division of Child Psychiatry, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.
Deborah A
DA
Bilder
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
Rebecca A
RA
Harrington
Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, 85721, USA.
Sydney
S
Pettygrove
Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, 33612, USA.
Russell S
RS
Kirby
Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53726, USA.
Maureen S
MS
Durkin
Division of Epidemiology, Human Genetics, and Environmental Sciences (EHGES), University of Texas School of Public Health at Houston, University of Texas Health Science Center at Houston, Houston, TX, 77030, USA.
Inkyu
I
Han
Division of Biostatistics, University of Texas School of Public Health at Houston, Houston, TX, 77030, USA.
Lemuel A
LA
Moyé
Department of Psychiatry and Behavioral Sciences, University of Texas Medical School, Houston, TX, 77054, USA.
Deborah A
DA
Pearson
Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, 35205, USA.
Martha Slay
MS
Wingate
Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA.
Walter M
WM
Zahorodny
D000393:Air Pollutants / Q000032:analysis*; D001151:Arsenic / Q000032:analysis*; D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D004784:Environmental Monitoring / Q000379:methods*; D006801:Humans; D007854:Lead / Q000032:analysis*; D008297:Male; D008628:Mercury / Q000032:analysis*; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D014484:United States Environmental Protection Agency
D000393:Air Pollutants; D007854:Lead; D008628:Mercury; D001151:Arsenic
Air quality; Autism spectrum disorder; Environment; Metals; Pollution