Background Heavy metals can cause health problems by affecting the biological structure even at very low concentrations. Asymptomatic heavy metal poisoning causes non-specific symptoms such as behavioral disorders, difficulty in learning, and aggressive behaviors. There is also a great concern about the incidence of aggressive behavior among adolescents. A few research studies have concluded that a complex interaction or combination of factors leads to an increased risk of aggressive behavior in adolescents. This study aims to determine the correlation between the heavy metal levels in blood, plasma, and urine and the aggression level in adolescents. Materials and methods Two hundred twenty-eight adolescents between the ages of 13 and 19 were enrolled in the study. Blood, plasma, and urine heavy metal levels of the participants were measured by an inductively coupled plasma mass spectrometer (ICP-MS) device (Model 7700x; Agilent, Santa Clara, CA, USA). Buss and Perry's aggression questionnaire was used to investigate the correlation between heavy metals and aggressive behaviors in adolescents. Results Lead blood (r=0.34, p<.01), lead plasma (r=0.22, p<0.01), lead urine (r=0.31, p<.01), mercury blood (r=0.35, p<0.01), mercury urine (r=0.21, p<0.01), manganese blood (r=0.34, p<0.01), manganese plasma (r=0.33, p<0.01) and manganese urine (r=0.39, p<0.01) were positively correlated with tendency to aggression whereas no significant relationship was found between cadmium in blood, plasma, urine and mercury in plasma with aggression. Conclusion The study showed valuable data to associate a significant relationship between adolescents' aggression levels and heavy metals. There is an undeniable relationship between the health of adolescents and environmental pollution caused by heavy metals. Therefore, taking the necessary measures to prevent environmental heavy metal pollution is crucial for adolescent health.
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