Citation: Dellefratte K, Stingone JA, Claudio L. Combined association of BTEX and material hardship on ADHD-suggestive behaviours among a nationally representative sample of US children. Paediatr Perinat Epidemiol. 2019 Nov;33(6):482-489. doi: 10.1111/ppe.12594. Epub 2019
Previous research shows that environmental and social factors contribute to the development of attention-deficit/hyperactivity disorder (ADHD). Many questions arise from these observations, including: Are there particular air pollutants that may contribute to ADHD? How does exposure to air pollutants interact with socioeconomic factors? Can you see this effect in very young children before a definitive diagnosis of ADHD can be determined?
We set out to determine the relationship between early-life exposure to common ambient air pollutants (benzene, toluene, ethylbenzene, and xylene, also known as BTEX), household material hardship (a measure of socio-economic status), and ADHD-suggestive behaviours in kindergarten-age children. We chose to assess BTEX partly because these are air toxins that are known to potentially cause effects on the brain.
To do this, we used estimated pollutant exposure from the 2002 National Air Toxics Assessment at each child's residential ZIP code at enrollment. These data were linked to the Early Childhood Longitudinal Study Birth Cohort (which had been following 4650 children). Material hardship was assigned as a composite score of access to food, health care, and housing. Kindergarten teachers rated children's behaviours and activity in the classroom using a five-point Likert scale. Children with summary scores in the bottom decile were classified as displaying ADHD-suggestive behaviours.
We showed that both, early life exposure to toxic chemicals in the ambient air and material hardship were independently associated with ADHD-suggestive behaviours at school entry.
These associations were stronger in children who lived in urban areas. There was no evidence of interaction between early life BTEX exposure and material hardship, although the effects of BTEX exposure were slightly greater in magnitude among those with higher material hardship scores.
We concluded that children exposed to air toxics, material hardship, or both early in life are more likely to display signs of ADHD-suggestive behaviours as assessed by their kindergarten teachers. The associations between exposures to air pollution and to socio-economic hardship were observed in all children but were particularly strong in those living in urban areas. This work adds to the evidence of the detrimental effects of exposure of air pollution on the developing brain.
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Dr. Luz Claudio is an environmental health scientist, mother and consultant, originally from Puerto Rico. She is a tenured professor of environmental medicine and public health. Luz recently published her first book: How to Write and Publish a Scientific Paper: The Step-by-Step Guide. Dr. Claudio has internship programs and resources for young scientists. Opinions expressed in this blog are solely her own and may not reflect her employer's views.