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The Association between Lead and Attention-Deficit/Hyperactivity Disorder: A Systematic Review

1
Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Legal Medicine, School of Pharmacy, Universitat de Valencia. Avenida Vicente Andres Estellés s/n, Burjassot, 46100 Valencia, Spain
2
Department of Biology, University of Pisa, Via Luca Ghini, 13-56126 Pisa, Italy
3
Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Avenida Monforte de Lemos, 3-5. Pabellón 11. Planta 0 28029 Madrid, Spain
4
Scuola Normale Superiore, Piazza dei Cavalieri, 7-56126 Pisa, Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(3), 382; https://doi.org/10.3390/ijerph16030382
Received: 8 January 2019 / Revised: 25 January 2019 / Accepted: 27 January 2019 / Published: 29 January 2019
(This article belongs to the Section Children Health)
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Abstract

The etiology of Attention-Deficit/Hyperactivity Disorder (ADHD) is complex and multifactorial. Although the development of ADHD symptoms remains to be elucidated, in recent years, epigenetic processes have emerged as candidate mechanisms. Lead is one of the most dangerous environmental pollutants, and it is suspected to be associated with ADHD. The aim of the present study was to review the epidemiological literature currently available on the relation between lead exposure and the diagnosis of ADHD. The PubMed and EMBASE databases were searched from 1 July 2018 up to 31 July 2018. The authors included observational studies (cohort, case–control and cross-sectional studies) published in English carried out on children within the last 5 years, measuring lead exposure and health outcomes related to ADHD. Seventeen studies met the inclusion criteria: 5 of these studies found no association between lead exposure and ADHD whereas the remaining 12 studies showed positive associations, even though not all of them were homogeneous in terms of exposure periods considered or ADHD diagnosis. To conclude, the evidence from the studies allowed us to establish that there is an association between lead and ADHD and that even low levels of lead raise the risk. However, there is still a lack of longitudinal studies about the relationship between lead exposure and the development of ADHD. Given the potential importance for public health, further research that includes the entire potential risk factors for ADHD in children must be encouraged. View Full-Text
Keywords: Lead; Attention-Deficit/Hyperactivity Disorder; ADHD; environmental pollutants; observational studies analysis; systematic review Lead; Attention-Deficit/Hyperactivity Disorder; ADHD; environmental pollutants; observational studies analysis; systematic review
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Donzelli, G.; Carducci, A.; Llopis-Gonzalez, A.; Verani, M.; Llopis-Morales, A.; Cioni, L.; Morales-Suárez-Varela, M. The Association between Lead and Attention-Deficit/Hyperactivity Disorder: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16, 382.

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