Abstract
The etiology of Attention-Deficit/Hyperactivity Disorder (ADHD) is complex and multifactorial. Although the development of ADHD symptoms remains to be elucidated, in recent years, epigenetic processes have emerged as candidate mechanisms. Lead is one of the most dangerous environmental pollutants, and it is suspected to be associated with ADHD. The aim of the present study was to review the epidemiological literature currently available on the relation between lead exposure and the diagnosis of ADHD. The PubMed and EMBASE databases were searched from 1 July 2018 up to 31 July 2018. The authors included observational studies (cohort, case–control and cross-sectional studies) published in English carried out on children within the last 5 years, measuring lead exposure and health outcomes related to ADHD. Seventeen studies met the inclusion criteria: 5 of these studies found no association between lead exposure and ADHD whereas the remaining 12 studies showed positive associations, even though not all of them were homogeneous in terms of exposure periods considered or ADHD diagnosis. To conclude, the evidence from the studies allowed us to establish that there is an association between lead and ADHD and that even low levels of lead raise the risk. However, there is still a lack of longitudinal studies about the relationship between lead exposure and the development of ADHD. Given the potential importance for public health, further research that includes the entire potential risk factors for ADHD in children must be encouraged.
Highlights
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental disorders affecting children [1]
The chosen studies were analyzed according to the following characteristics: location, sample size, birth years or range of age, study design, ADHD measurement criteria, exposure measurement, results, level of evidence and grade of recommendation
Several studies showed that human exposures to environmental pollutants can represent a risk factor for ADHD
Summary
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental disorders affecting children [1]. ADHD affects many adults [2]. Symptoms of ADHD are divided into two categories of inattention and hyperactivity and impulsivity that include behaviors like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations [3]. Res. Public Health 2019, 16, 382; doi:10.3390/ijerph16030382 www.mdpi.com/journal/ijerph
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