A Strategy for Comparing the Contributions of Environmental Chemicals and Other Risk Factors to Neurodevelopment of Children

Bellinger, David C.

doi:10.1201/b18030-4

Cited by 13 publications

(18 citation statements)

References 62 publications

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“…Adapted from Bellinger. 15 for having a blood lead concentration in excess of 5 μg/dL (50 ppb); 15% of US children who lived in housing units built before 1950 had a blood lead concentration ≥5 μg/dL (≥50 ppb), whereas 4.2% of children who lived in housing built between 1950 and 1978 had a blood lead concentration ≥5 μg/dL (≥50 ppb), compared with 2.1% of children who lived in housing units built after 1978. 27 No treatments have been shown to be effective in ameliorating the permanent developmental effects of lead toxicity.…”

Section: Figurementioning

confidence: 99%

“…Despite the dramatic reductions in blood lead levels, lead toxicity accounts for an estimated total loss of 23 million IQ points among a 6-year cohort of contemporary US children. 15 Focusing efforts on children who have blood lead concentrations ≥5 μg/dL (≥50 ppb) is efficient but will fail to preserve the majority of lost IQ points in US children. The prevention paradox refers to the concept that most disease or disability occurs in low-to moderaterisk groups.…”

Section: Scope Of the Problemmentioning

confidence: 99%

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Prevention of Childhood Lead Toxicity

Lanphear¹,

Lowry²,

Ahdoot³

et al. 2016

Pediatrics

171

140

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Blood lead concentrations have decreased dramatically in US children over the past 4 decades, but too many children still live in housing with deteriorated lead-based paint and are at risk for lead exposure with resulting lead-associated cognitive impairment and behavioral problems. Evidence continues to accrue that commonly encountered blood lead concentrations, even those below 5 µg/dL (50 ppb), impair cognition; there is no identified threshold or safe level of lead in blood. From 2007 to 2010, approximately 2.6% of preschool children in the United States had a blood lead concentration ≥5 µg/dL (≥50 ppb), which represents about 535 000 US children 1 to 5 years of age. Evidence-based guidance is available for managing increased lead exposure in children, and reducing sources of lead in the environment, including lead in housing, soil, water, and consumer products, has been shown to be cost-beneficial. Primary prevention should be the focus of policy on childhood lead toxicity.

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Section: Figurementioning

confidence: 99%

Section: Scope Of the Problemmentioning

confidence: 99%

Prevention of Childhood Lead Toxicity

Lanphear¹,

Lowry²,

Ahdoot³

et al. 2016

Pediatrics

171

140

View full text Add to dashboard Cite

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“…Attention deficit hyperactivity disorder is diagnosed in mid-childhood and the prevalence declines with age, being 5-10% in childhood, 2.5-4% in adolescents and 2.5% in adults [152,153]. A recent pooled analysis suggested a global prevalence of 5.3% for attention deficit hyperactivity disorder in children and adolescents, although parental reports of symptoms consistent with attention deficit hyperactivity disorder often give higher estimates, with 7.2% of American children 4-17 years of age reported by parents to have a current diagnosis of attention deficit hyperactivity disorder [154]. By any measure neurocognitive disorders in children and adolescents impose a huge burden on society.…”

Section: Neurocognitive Disordersmentioning

confidence: 96%

“…There is less certainty over whether attention deficit hyperactivity disorder is associated with decreased cognitive function and lower intelligence quotient (IQ), although several of the environmental exposures associated with attention deficit hyperactivity disorder (see later), including lead [155], polychlorinated biphenyls [155], organochlorine pesticides [155], organophosphate pesticides and tobacco smoke [156], are associated with lower IQ. A recent meta-analysis that included 137 comparisons of full-scale IQ among children with attention deficit hyperactivity disorder and controls concluded that a reduction of 9 points was seen with attention deficit hyperactivity disorder [154].…”

Section: Neurocognitive Disordersmentioning

confidence: 99%

Early-life risk factors for chronic nonrespiratory diseases

et al. 2014

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We have witnessed a change in disease patterns contributing to the global burden of disease, with a shift from early childhood deaths due to the classic infectious communicable diseases to years lived with disability from chronic noncommunicable diseases. In both developing and developed countries, the years lived with disability attributable to chronic disease have increased: cardiovascular diseases by 17.7%; chronic respiratory disease by 8.5%; neurological conditions by 12.2%; diabetes by 30.0%; and mental and behavioural disorders by 5.0% over the past 20 years. Recognition of the contribution made by adverse environmental exposures in early life to noncommunicable diseases in later life is increasing. These earlylife exposures appear to contribute to both chronic respiratory and chronic nonrespiratory diseases. In this State of the Art article, we aim to examine early-life environmental exposures that have an epidemiological association with chronic nonrespiratory diseases, such as obesity and type II diabetes, cardiovascular disease, and neurocognitive and behavioural problems. We will highlight the potential overlap in environmental risks with respiratory diseases, and point out knowledge gaps and research opportunities. @ERSpublications Respiratory diseases are linked to obesity/diabetes/metabolic syndrome, CVD and neurocognitive/behavioural disorders

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“…It is not easy to discern a 5-point IQ difference between two children, but a 5-point downward shift in the population mean IQ, from 100 to 95 points, would result in a 57% increase in the number of children who have an IQ <70 points and a corresponding decrease in the number of children who have an IQ >130 points (Figure 2) (47). Bellinger calculated the population-wide impact of environmental toxins and other medical problems on IQ deficits in a contemporary six-year birth cohort of US children (10). The impacts of low-level exposures to lead, mercury, and organophosphate pesticides on decrements in IQ scores in US children were surprisingly large, even in comparison with clinical conditions, such as ADHD and preterm birth (10).…”

Section: Quantifying the Impact Of Toxins On Brain Developmentmentioning

confidence: 99%

The Impact of Toxins on the Developing Brain

Lanphear

2015

Annu. Rev. Public Health

141

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The impact of toxins on the developing brain is usually subtle for an individual child, but the damage can be substantial at the population level. Numerous challenges must be addressed to definitively test the impact of toxins on brain development in children: We must quantify exposure using a biologic marker or pollutant; account for an ever-expanding set of potential confounders; identify critical windows of vulnerability; and repeatedly examine the association of biologic markers of toxins with intellectual abilities, behaviors, and brain function in distinct cohorts. Despite these challenges, numerous toxins have been implicated in the development of intellectual deficits and mental disorders in children. Yet, too little has been done to protect children from these ubiquitous but insidious toxins. The objective of this review is to provide an overview on the population impact of toxins on the developing brain and describe implications for public health.

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A Strategy for Comparing the Contributions of Environmental Chemicals and Other Risk Factors to Neurodevelopment of Children

Cited by 13 publications

References 62 publications

Prevention of Childhood Lead Toxicity

Prevention of Childhood Lead Toxicity

Early-life risk factors for chronic nonrespiratory diseases

The Impact of Toxins on the Developing Brain

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