Exposure to Manganese in Drinking Water during Childhood and Association with Attention-Deficit Hyperactivity Disorder: A Nationwide Cohort Study.
Journal
Environmental health perspectives
ISSN: 1552-9924
Titre abrégé: Environ Health Perspect
Pays: United States
ID NLM: 0330411
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
entrez:
21
9
2020
pubmed:
22
9
2020
medline:
13
1
2021
Statut:
ppublish
Résumé
Manganese (Mn) in drinking water may increase the risk of several neurodevelopmental outcomes, including attention-deficit hyperactivity disorder (ADHD). Earlier epidemiological studies on associations between Mn exposure and ADHD-related outcomes had small sample sizes, lacked spatiotemporal exposure assessment, and relied on questionnaire data (not diagnoses)-shortcomings that we address here. Our objective was to assess the association between exposure to Mn in drinking water during childhood and later development of ADHD. In a nationwide population-based registry study in Denmark, we followed a cohort of 643,401 children born 1992-2007 for clinical diagnoses of ADHD. In subanalyses, we classified cases into ADHD-Inattentive and ADHD-Combined subtypes based on hierarchical categorization of International Classification of Diseases (ICD)-10 codes. We obtained Mn measurements from 82,574 drinking water samples to estimate longitudinal exposure during the first 5 y of life with high spatiotemporal resolution. We modeled exposure as both peak concentration and time-weighted average. We estimated sex-specific hazard ratios (HRs) in Cox proportional hazards models adjusted for age, birth year, socioeconomic status (SES), and urbanicity. We found that exposure to increasing levels of Mn in drinking water was associated with an increased risk of ADHD-Inattentive subtype, but not ADHD-Combined subtype. After adjusting for age, birth year, and SES, females exposed to high levels of Mn (i.e., Mn in drinking water was associated with ADHD, specifically the ADHD-Inattentive subtype. Our results support earlier studies suggesting a need for a formal health-based drinking water guideline value for Mn. Future Mn-studies should examine ADHD subtype-specific associations and utilize direct subtype measurements rather than relying on ICD-10 codes alone. https://doi.org/10.1289/EHP6391.
Sections du résumé
BACKGROUND
Manganese (Mn) in drinking water may increase the risk of several neurodevelopmental outcomes, including attention-deficit hyperactivity disorder (ADHD). Earlier epidemiological studies on associations between Mn exposure and ADHD-related outcomes had small sample sizes, lacked spatiotemporal exposure assessment, and relied on questionnaire data (not diagnoses)-shortcomings that we address here.
OBJECTIVE
Our objective was to assess the association between exposure to Mn in drinking water during childhood and later development of ADHD.
METHODS
In a nationwide population-based registry study in Denmark, we followed a cohort of 643,401 children born 1992-2007 for clinical diagnoses of ADHD. In subanalyses, we classified cases into ADHD-Inattentive and ADHD-Combined subtypes based on hierarchical categorization of International Classification of Diseases (ICD)-10 codes. We obtained Mn measurements from 82,574 drinking water samples to estimate longitudinal exposure during the first 5 y of life with high spatiotemporal resolution. We modeled exposure as both peak concentration and time-weighted average. We estimated sex-specific hazard ratios (HRs) in Cox proportional hazards models adjusted for age, birth year, socioeconomic status (SES), and urbanicity.
RESULTS
We found that exposure to increasing levels of Mn in drinking water was associated with an increased risk of ADHD-Inattentive subtype, but not ADHD-Combined subtype. After adjusting for age, birth year, and SES, females exposed to high levels of Mn (i.e.,
DISCUSSION
Mn in drinking water was associated with ADHD, specifically the ADHD-Inattentive subtype. Our results support earlier studies suggesting a need for a formal health-based drinking water guideline value for Mn. Future Mn-studies should examine ADHD subtype-specific associations and utilize direct subtype measurements rather than relying on ICD-10 codes alone. https://doi.org/10.1289/EHP6391.
Identifiants
pubmed: 32955354
doi: 10.1289/EHP6391
pmc: PMC7505135
doi:
Substances chimiques
Drinking Water
0
Manganese
42Z2K6ZL8P
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
97004Subventions
Organisme : NIEHS NIH HHS
ID : R01 ES026993
Pays : United States
Références
Neurotoxicology. 2018 Jan;64:126-133
pubmed: 28867366
Zhonghua Yu Fang Yi Xue Za Zhi. 1994 Jul;28(4):216-8
pubmed: 7842882
JAMA Psychiatry. 2020 Feb 1;77(2):155-164
pubmed: 31746968
Arch Toxicol. 2020 Mar;94(3):725-734
pubmed: 32180038
Environ Health Perspect. 2011 Oct;119(10):1501-6
pubmed: 21493178
Environ Res. 2013 Feb;121:39-44
pubmed: 23141434
Front Genet. 2014 Aug 04;5:265
pubmed: 25136353
Mol Psychiatry. 2019 Apr;24(4):562-575
pubmed: 29892054
Scand J Public Health. 2011 Jul;39(7 Suppl):54-7
pubmed: 21775352
Scand J Public Health. 2011 Jul;39(7 Suppl):22-5
pubmed: 21775345
Eur Child Adolesc Psychiatry. 2015 Feb;24(2):173-83
pubmed: 24796725
J Child Psychol Psychiatry. 2014 May;55(5):428-35
pubmed: 24111650
Neurotoxicology. 2014 Dec;45:201-7
pubmed: 24148923
Environ Health. 2014 Oct 24;13:87
pubmed: 25342305
Environ Health Perspect. 2017 May 26;125(5):057003
pubmed: 28564632
Environ Res. 2018 Feb;161:588-598
pubmed: 29247915
Psychol Assess. 2019 Aug;31(8):985-994
pubmed: 30958025
Environ Health Perspect. 2014 Dec;122(12):1343-50
pubmed: 25260096
Environ Health Perspect. 2007 Jul;115(7):1107-12
pubmed: 17637930
Environ Int. 2019 Sep;130:104908
pubmed: 31233999
Environ Health Perspect. 2007 Jan;115(1):122-7
pubmed: 17366831
Acta Paediatr. 2007 Sep;96(9):1269-74
pubmed: 17718779
Environ Health Perspect. 2017 Feb;125(2):230-237
pubmed: 27384154
Sci Total Environ. 2013 Jun 1;454-455:562-77
pubmed: 23570911
Eur Child Adolesc Psychiatry. 2001 Dec;10(4):230-9
pubmed: 11794548
Environ Health Perspect. 2011 Jan;119(1):138-43
pubmed: 20855239
Lancet Psychiatry. 2015 Aug;2(8):702-709
pubmed: 26249301
Nat Commun. 2016 May 27;7:11601
pubmed: 27231142
Br J Nutr. 1979 Mar;41(2):253-61
pubmed: 427078
Environ Health Perspect. 2006 Jan;114(1):124-9
pubmed: 16393669
Neurotoxicology. 2016 Dec;57:230-240
pubmed: 27737811
Int J Health Geogr. 2015 Aug 22;14:24
pubmed: 26297014
Environ Health Perspect. 2002 Jun;110(6):613-6
pubmed: 12055054
Environ Int. 2019 Sep;130:104889
pubmed: 31200154
Environ Int. 2017 Nov;108:299-308
pubmed: 28941415
Clin Epidemiol. 2015 Nov 23;7:491-508
pubmed: 26648756
Environ Res. 2017 Nov;159:458-465
pubmed: 28858760
Neurotoxicology. 2018 Jan;64:110-117
pubmed: 28716743
Dan Med Bull. 2006 Nov;53(4):441-9
pubmed: 17150149
Environ Health Perspect. 2007 Nov;115(11):1533-8
pubmed: 18007980
Neurotoxicology. 2018 Jan;64:118-125
pubmed: 28870865
Environ Health Perspect. 2010 Oct;118(10):1465-70
pubmed: 20936744
Eur Psychiatry. 2016 May;35:16-24
pubmed: 27061373
Environ Res. 2017 May;155:380-384
pubmed: 28282629
Neurotoxicology. 2018 Jan;64:1-4
pubmed: 29429640
Acta Paediatr. 2009 Jan;98(1):173-9
pubmed: 18764862