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Environmental Science and Pollution Research

, Volume 26, Issue 18, pp 17875–17884 | Cite as

Low blood lead levels and attention-deficit hyperactivity disorder in children: a systematic review and meta-analysis

  • Jianjun He
  • Huacheng Ning
  • Ruixue HuangEmail author
Environmental Pollution and Energy Management

Abstract

Attention-deficit hyperactivity disorder (ADHD) of children is one of the most common neurodevelopmental diseases; the etiology remains unclear. We reviewed and meta-analyzed case-control studies to assess the effects of blood lead levels in children on ADHD symptoms. Relevant studies were identified by searching electronic databases. A meta-analysis was performed using the fixed model of Review Manager 5.3 software. Seven relevant studies were identified. The case groups exhibited significant increases in ADHD symptoms [mean difference (MD), 0.59; 95% confidence interval (CI), 0.50–0.68; p < 0.0001]. Subgroup assessment showed that even children with blood lead levels <3 μg/dL exhibited significant increases in ADHD symptoms (MD, 0.47; 95% CI, 0.39–0.56; p < 0.0001). Subgroup assessment also showed that children aged 5–12 years exhibited more significant increases in ADHD symptoms (MD, 1.35; 95% CI, 0.28–2.41; p < 0.0001) than children aged >12 years. Our findings suggest that low blood lead levels may be associated with ADHD symptoms in children. However, caution is needed when interpreting the results because among-study heterogeneity was in play. Primary interventions should focus on children with low blood lead levels.

Keywords

ADHD Children Lead Systematic review Meta-analysis Blood level 

Notes

Author’s contribution

Ruixue Huang conceived and designed the study. Ruixue Huang, Huacheng Ning performed eligibility screening and data extraction. Jianjun He analyzed the data and performed the statistical analysis. Ruixue Huang and Jianjun He wrote the initial manuscript. Ruixue Huang critically revised the manuscript and polish the English language.

Compliance with ethical standards

Conflicts of interest

The authors declare that they have no conflicts of interest.

Supplementary material

11356_2017_9799_MOESM1_ESM.doc (64 kb)
ESM 1 (DOC 64 kb)

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Changsha Medical UniversityChangshaChina
  2. 2.Department of Occupational and Environmental Health, Xiangya School of Public HealthCentral South UniversityChangshaChina

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