We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Early Life Exposure to Perfluoroalkyl Substances (PFAS) and ADHD: A Meta-Analysis of Nine European Population-Based Studies.
- Authors
Forns, Joan; Verner, Marc-Andre; Iszatt, Nina; Nowack, Nikola; Carlsen Bach, Cathrine; Vrijheid, Martine; Costa, Olga; Andiarena, Ainara; Sovcikova, Eva; Bjerre Høyer, Birgit; Wittsiepe, Jürgen; Lopez-Espinosa, Maria-Jose; Ibarluzea, Jesus; Hertz-Picciotto, Irva; Toft, Gunnar; Stigum, Hein; Guxens, Mònica; Liew, Zeyan; Eggesbø, Merete
- Abstract
INTRODUCTION: To date, the evidence for an association between perfluoroalkyl substances (PFAS) exposure and attention deficit and hyperactivity disorder (ADHD) is inconclusive. OBJECTIVE: We investigated the association between early life exposure to perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA), and ADHD in a collaborative study including nine European population-based studies, encompassing 4,826 mother–child pairs. METHODS: Concentrations of PFOS and PFOA were measured in maternal serum/plasma during pregnancy, or in breast milk, with different timing of sample collection in each cohort. We used a validated pharmacokinetic model of pregnancy and lactation to estimate concentrations of PFOS and PFOA in children at birth and at 3, 6, 12, and 24 months of age. We classified ADHD using recommended cutoff points for each instrument used to derive symptoms scores. We used multiple imputation for missing covariates, logistic regression to model the association between PFAS exposure and ADHD in each study, and combined all adjusted study-specific effect estimates using random-effects meta-analysis. RESULTS: A total of 399 children were classified as having ADHD, with a prevalence ranging from 2.3% to 7.3% in the studies. Early life exposure to PFOS or PFOA was not associated with ADHD during childhood [odds ratios (ORs) ranging from 0.96 (95% CI: 0.87, 1.06) to 1.02 (95% CI: 0.93, 1.11)]. Results from stratified models suggest potential differential effects of PFAS related to child sex and maternal education. CONCLUSION: We did not identify an increased prevalence of ADHD in association with early life exposure to PFOS and PFOA. However, stratified analyses suggest that there may be an increased prevalence of ADHD in association with PFAS exposure in girls, in children from nulliparous women, and in children from low-educated mothers, all of which warrant further exploration.
- Subjects
AGE distribution; ATTENTION-deficit hyperactivity disorder; BLOOD collection; BREAST milk; CONFIDENCE intervals; FLUOROCARBONS; HEALTH education; LACTATION; MATERNAL age; MATHEMATICAL models; META-analysis; PREGNANT women; SEX distribution; TIME; LOGISTIC regression analysis; THEORY; ENVIRONMENTAL exposure; DISEASE prevalence; SULFUR acids; DESCRIPTIVE statistics; ODDS ratio; FETUS; PREGNANCY
- Publication
Environmental Health Perspectives, 2020, Vol 128, Issue 5, p057002-1
- ISSN
0091-6765
- Publication type
Article
- DOI
10.1289/EHP5444