Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Prenatal Cadmium Exposure on Attention-deficit/Hyperactivity Disorder in 6-Year-old Children in Korea

  • Kim, Woosung (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Jang, Yoonyoung (Department of Preventive Medicine, Seoul National University College of Medicine) ;
  • Lim, Youn-Hee (Institute of Environmental Medicine, Seoul National University Medical Research Center) ;
  • Kim, Bung-Nyun (Division of Children and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • Shin, Choong Ho (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Lee, Young Ah (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Kim, Johanna Inhyang (Division of Children and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital) ;
  • Hong, Yun-Chul (Department of Preventive Medicine, Seoul National University College of Medicine)
  • Received : 2019.06.29
  • Accepted : 2019.11.06
  • Published : 2020.01.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: Prenatal cadmium (Cd) exposure may be associated with attention-deficit/hyperactivity disorder (ADHD) in children. Therefore, the objective of this study was to examine the relationship between Cd exposure during gestation and ADHD at 6 years of age. Methods: As part of an ongoing cohort study (the Environment and Development of Children study), 479 mother-child pairs from Seoul, Korea were included for analysis between 2008 and 2011. The whole blood concentration of Cd was analyzed using atomic absorption spectrophotometry. The parents were surveyed about ADHD behaviors in their children at age 6. Multivariable linear regression models were used to investigate the relationship between prenatal exposure to Cd and ADHD at 6 years of age. Results: Increased prenatal Cd concentrations were associated with increased scores for ADHD for girls, but not for boys, at age 6. A 2-fold increase in the prenatal Cd level was significantly associated with a 22.3% (95% confidence interval, 11.6 to 34.1) increase in ADHD in girls at 6 years of age, as indicated by the linear regression model. Conclusions: Our results identified significant associations between prenatal Cd exposure and ADHD scores in 6-year-old girls.

Keywords

References

  1. Agency for Toxic Substances and Disease Registry. Toxicological profile for cadmium; 2012 [cited 2019 Jun 1]. Available from: https://www.atsdr.cdc.gov/ToxProfiles/tp5.pdf.
  2. Jarup L, Akesson A. Current status of cadmium as an environmental health problem. Toxicol Appl Pharmacol 2009;238(3): 201-208. https://doi.org/10.1016/j.taap.2009.04.020
  3. European Food Safety Authority (EFSA). Cadmium in food-scientific opinion of the Panel on Contaminants in the Food Chain. EFSA J 2009;7(3):980.
  4. Ali MM, Murthy RC, Chandra SV. Developmental and longterm neurobehavioral toxicity of low level in-utero cadmium exposure in rats. Neurobehav Toxicol Teratol 1986;8(5):463-468.
  5. Desi I, Nagymajtenyi L, Schulz H. Behavioural and neurotoxicological changes caused by cadmium treatment of rats during development. J Appl Toxicol 1998;18(1):63-70. https://doi.org/10.1002/(SICI)1099-1263(199801/02)18:1<63::AID-JAT475>3.0.CO;2-Z
  6. Lehotzky K, Ungvary G, Polinak D, Kiss A. Behavioral deficits due to prenatal exposure to cadmium chloride in CFY rat pups. Neurotoxicol Teratol 1990;12(2):169-172. https://doi.org/10.1016/0892-0362(90)90130-5
  7. Nagymajtenyi L, Schulz H, Desi I. Behavioural and functional neurotoxicological changes caused by cadmium in a three-generational study in rats. Hum Exp Toxicol 1997;16(12):691-699. https://doi.org/10.1177/096032719701601201
  8. Nation JR, Bourgeois AE, Clark DE, Baker DM, Hare MF. The effects of oral cadmium exposure on passive avoidance performance in the adult rat. Toxicol Lett 1984;20(1):41-47. https://doi.org/10.1016/0378-4274(84)90180-2
  9. Jiang HM, Han GA, He ZL. Clinical significance of hair cadmium content in the diagnosis of mental retardation of children. Chin Med J (Engl) 1990;103(4):331-334.
  10. Marlowe M, Errera J, Jacobs J. Increased lead and cadmium burdens among mentally retarded children and children with borderline intelligence. Am J Ment Defic 1983;87(5):477-483.
  11. Thatcher RW, Lester ML, McAlaster R, Horst R. Effects of low levels of cadmium and lead on cognitive functioning in children. Arch Environ Health 1982;37(3):159-166. https://doi.org/10.1080/00039896.1982.10667557
  12. Capel ID, Pinnock MH, Dorrell HM, Williams DC, Grant EC. Comparison of concentrations of some trace, bulk, and toxic metals in the hair of normal and dyslexic children. Clin Chem 1981; 27(6):879-881. https://doi.org/10.1093/clinchem/27.6.879
  13. Ely DL, Mostardi RA, Woebkenberg N, Worstell D. Aerometric and hair trace metal content in learning-disabled children. Environ Res 1981;25(2):325-339. https://doi.org/10.1016/0013-9351(81)90035-9
  14. Pihl RO, Parkes M. Hair element content in learning disabled children. Science 1977;198(4313):204-206. https://doi.org/10.1126/science.905825
  15. Thatcher RW, McAlaster R, Lester ML, Cantor DS. Comparisons among EEG, hair minerals and diet predictions of reading performance in children. Ann N Y Acad Sci 1984;433:87-96. https://doi.org/10.1111/j.1749-6632.1984.tb14761.x
  16. Marlowe M, Cossairt A, Moon C, Errera J, MacNeel A, Peak R, et al. Main and interaction effects of metallic toxins on classroom behavior. J Abnorm Child Psychol 1985;13(2):185-198. https://doi.org/10.1007/BF00910641
  17. Cao Y, Chen A, Radcliffe J, Dietrich KN, Jones RL, Caldwell K, et al. Postnatal cadmium exposure, neurodevelopment, and blood pressure in children at 2, 5, and 7 years of age. Environ Health Perspect 2009;117(10) :1580-1586. https://doi.org/10.1289/ehp.0900765
  18. Gillberg C, Noren JG, Wahlstrom J, Rasmussen P. Heavy metals and neuropsychiatric disorders in six-year-old children. Aspects of dental lead and cadmium. Acta Paedopsychiatr 1982;48(5): 253-263.
  19. Lee DH, Jacobs DR, Porta M. Association of serum concentrations of persistent organic pollutants with the prevalence of learning disability and attention deficit disorder. J Epidemiol Community Health 2007;61(7):591-596. https://doi.org/10.1136/jech.2006.054700
  20. Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics 2012;9(3):490-499. https://doi.org/10.1007/s13311-012-0135-8
  21. Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006;36(2):159-165. https://doi.org/10.1017/S003329170500471X
  22. Fayyad J, Sampson NA, Hwang I, Adamowski T, Aguilar-Gaxiola S, Al-Hamzawi A, et al. The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys. Atten Defic Hyperact Disord 2017;9(1):47-65. https://doi.org/10.1007/s12402-016-0208-3
  23. Faraone SV, Biederman J, Mick E. The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 2006;36(2):159-165. https://doi.org/10.1017/S003329170500471X
  24. Biederman J, Petty CR, Clarke A, Lomedico A, Faraone SV. Predictors of persistent ADHD: an 11-year follow-up study. J Psychiatr Res 2011;45(2):150-155. https://doi.org/10.1016/j.jpsychires.2010.06.009
  25. Biederman J, Petty CR, O'Connor KB, Hyder LL, Faraone SV. Predictors of persistence in girls with attention deficit hyperactivity disorder: results from an 11-year controlled follow-up study. Acta Psychiatr Scand 2012;125(2):147-156. https://doi.org/10.1111/j.1600-0447.2011.01797.x
  26. DuPaul GJ, Reid R, Anastopoulos AD, Lambert MC, Watkins MW, Power TJ. Parent and teacher ratings of attention-deficit/hyperactivity disorder symptoms: factor structure and normative data. Psychol Assess 2016;28(2):214-225. https://doi.org/10.1037/pas0000166
  27. Bao QS, Lu CY, Song H, Wang M, Ling W, Chen WQ, et al. Behavioural development of school-aged children who live around a multi-metal sulphide mine in Guangdong province, China: a cross-sectional study. BMC Public Health 2009;9:217. https://doi.org/10.1186/1471-2458-9-217
  28. Ciesielski T, Weuve J, Bellinger DC, Schwartz J, Lanphear B, Wright RO. Cadmium exposure and neurodevelopmental outcomes in U.S. children. Environ Health Perspect 2012;120(5): 758-763. https://doi.org/10.1289/ehp.1104152
  29. Sioen I, Den Hond E, Nelen V, Van de Mieroop E, Croes K, Van Larebeke N, et al. Prenatal exposure to environmental contaminants and behavioural problems at age 7-8 years. Environ Int 2013;59:225-231. https://doi.org/10.1016/j.envint.2013.06.014
  30. Singhal RL, Merali Z, Hrdina PD. Aspects of the biochemical toxicology of cadmium. Fed Proc 1976;35(1):75-80.
  31. Stowe HD, Wilson M, Goyer RA. Clinical and morphologic effects of oral cadmium toxicity in rabbits. Arch Pathol 1972; 94(5):389-405.
  32. Faraone SV, Perlis RH, Doyle AE, Smoller JW, Goralnick JJ, Holmgren MA, et al. Molecular genetics of attention-deficit/hyperactivity disorder. Biol Psychiatry 2005;57(11):1313-1323. https://doi.org/10.1016/j.biopsych.2004.11.024
  33. Andersson H, Petersson-Grawe K, Lindqvist E, Luthman J, Oskarsson A, Olson L. Low-level cadmium exposure of lactating rats causes alterations in brain serotonin levels in the offspring. Neurotoxicol Teratol 1997;19(2):105-115. https://doi.org/10.1016/S0892-0362(96)00218-8
  34. Provias JP, Ackerley CA, Smith C, Becker LE. Cadmium encephalopathy: a report with elemental analysis and pathological findings. Acta Neuropathol 1994;88(6):583-586. https://doi.org/10.1007/BF00296497
  35. Goodlad JK, Marcus DK, Fulton JJ. Lead and attention-deficit/hyperactivity disorder (ADHD) symptoms: a meta-analysis. Clin Psychol Rev 2013;33(3):417-425. https://doi.org/10.1016/j.cpr.2013.01.009
  36. Park JI, Shim SH, Lee M, Jung YE, Park TW, Park SH, et al. The validities and efficiencies of Korean ADHD rating scale and Korean child behavior checklist for screening children with ADHD in the community. Psychiatry Investig 2014;11(3):258-265. https://doi.org/10.4306/pi.2014.11.3.258

Cited by

  1. Associations Between Thyroid Hormone Levels and Urinary Concentrations of Bisphenol A, F, and S in 6-Year-old Children in Korea vol.54, pp.1, 2020, https://doi.org/10.3961/jpmph.20.310
  2. ADHD: Reviewing the Causes and Evaluating Solutions vol.11, pp.3, 2020, https://doi.org/10.3390/jpm11030166
  3. Metal and essential element concentrations during pregnancy and associations with autism spectrum disorder and attention-deficit/hyperactivity disorder in children vol.152, 2020, https://doi.org/10.1016/j.envint.2021.106468