We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Association of Exposure to Endocrine-Disrupting Chemicals During Adolescence With Attention-Deficit/Hyperactivity Disorder–Related Behaviors.
- Authors
Shoaff, Jessica R.; Coull, Brent; Weuve, Jennifer; Bellinger, David C.; Calafat, Antonia M.; Schantz, Susan L.; Korrick, Susan A.
- Abstract
Key Points: Question: Is exposure to endocrine-disrupting chemicals during adolescence a risk factor for behaviors associated with attention-deficit/hyperactivity disorder (ADHD)? Findings: In this cross-sectional analysis of data from 205 adolescents participating in a prospective birth cohort study, exposure to select phthalates was associated with an increased risk of ADHD-related behaviors. Associations were strongest for phthalates with antiandrogenic activity. Meaning: These findings support the potential importance of exposures to endocrine-disrupting chemicals, especially phthalates, during adolescence as correlates of ADHD-related behaviors. Importance: Attention-deficit/hyperactivity disorder (ADHD) is the most common childhood neurobehavioral disorder. Studies suggest that prenatal and early childhood exposure to endocrine-disrupting chemicals may be associated with ADHD, but the association during adolescence has not been studied to date. Objective: To evaluate the association between exposure to select endocrine-disrupting chemicals during adolescence and ADHD-related behaviors. Design, Setting, and Participants: For this cross-sectional analysis, data were collected from 205 adolescents in the New Bedford Cohort, an ongoing prospective birth cohort, between June 18, 2011, and June 10, 2014. The adolescents provided spot urine samples and underwent neurodevelopmental testing. Statistical analyses performed from January 15 to December 31, 2019, used a repeated-measures analysis with multivariate modified Poisson models to estimate the adjusted relative risk of ADHD-related behaviors associated with exposure to endocrine-disrupting chemicals. Exposures: Urinary biomarker concentrations of endocrine-disrupting chemicals or their metabolites, including phthalates, parabens, phenols, and triclocarban, were quantified. Summary exposure measures were created, combining biomarker concentrations of chemicals with a shared mechanism of action, exposure pathway, or chemical class. Main Outcomes and Measures: Behaviors related to ADHD were assessed with up to 14 indices from self-, parent-, and teacher-completed behavioral checklists using validated and standardized instruments; specifically, the Conners Attention Deficit Scale and the Behavior Assessment System for Children, Second Edition. Scores on each index were dichotomized to identify those with evidence of a significant behavioral problem, defined by each scale's interpretive guidelines. Results: Among the 205 participants, the mean (SD) age at assessment was 15.3 (0.7) years, with 112 girls (55%) and 124 non-Hispanic White participants (61%). The median urine concentrations were 0.45 μmol/L of Σantiandrogenic phthalates, 0.13 μmol/L of ΣDEHP metabolites, 0.49 μmol/L of Σpersonal care product phthalates, 0.35 μmol/L of Σparabens, 0.02 μmol/L of Σbisphenols, and 0.02 μmol/L of Σdichlorophenols. A total of 82 (40%) had scores consistent with a significant behavioral problem, whereas 39 (19%) had an ADHD diagnosis. Each 2-fold increase in the sum of antiandrogenic phthalate concentrations was associated with a 1.34 (95% CI, 1.00-1.79) increase in the risk of significant ADHD-related behavior problems, whereas a 2-fold increase in the sum of dichlorophenols was associated with a 1.15 (95% CI, 1.01-1.32) increased risk. These associations tended to be stronger in male participants, but comparisons of sex-specific differences were imprecise. Conclusions and Relevance: Endocrine-disrupting chemicals are used in a wide variety of consumer products resulting in ubiquitous exposure. The study findings suggest that exposure to some of these chemicals, particularly certain phthalates, during adolescence may be associated with behaviors characteristic of ADHD. This cross-sectional analysis evaluates the association between exposure to select endocrine-disrupting chemicals during adolescence and attention-deficit/hyperactivity (ADHD)–related behaviors.
- Subjects
MASSACHUSETTS; BEHAVIORAL assessment; RISK factors of attention-deficit hyperactivity disorder; ANDROGENS; ANTHROPOMETRY; ATTENTION-deficit hyperactivity disorder; PERSONAL beauty; BIOMARKERS; NEURAL development; CONFIDENCE intervals; STATISTICAL correlation; INGESTION; LONGITUDINAL method; NEUROPSYCHOLOGICAL tests; METABOLISM; METABOLITES; MULTIVARIATE analysis; ORGANIC compounds; PLASTICIZERS; POISSON distribution; QUESTIONNAIRES; RESEARCH funding; RISK assessment; SCALE analysis (Psychology); SELF-evaluation; TEENAGERS' conduct of life; URINALYSIS; ENDOCRINE system; PARENT attitudes; REPEATED measures design; CROSS-sectional method; COLLEGE teacher attitudes; DATA analysis software; DIARY (Literary form); DESCRIPTIVE statistics; PRENATAL exposure delayed effects; ADOLESCENCE
- Publication
JAMA Network Open, 2020, Vol 3, Issue 8, pe2015041
- ISSN
2574-3805
- Publication type
Academic Journal
- DOI
10.1001/jamanetworkopen.2020.15041