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Particulate Matter Exposure and Attention-Deficit/Hyperactivity Disorder in Children: A Systematic Review of Epidemiological Studies

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  • Gabriele Donzelli

    (Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine, School of Pharmacy, University of Valencia, Avenida Vicente Andres Estellés s/n, Burjassot, 46100 Valencia, Spain)

  • Agustin Llopis-Gonzalez

    (Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine, School of Pharmacy, University of Valencia, Avenida Vicente Andres Estellés s/n, Burjassot, 46100 Valencia, Spain
    Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Avenida Monforte de Lemos, 3-5, Pabellón 11, Planta 0 28029 Madrid, Spain)

  • Agustin Llopis-Morales

    (Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine, School of Pharmacy, University of Valencia, Avenida Vicente Andres Estellés s/n, Burjassot, 46100 Valencia, Spain)

  • Lorenzo Cioni

    (Scuola Normale Superiore, Piazza dei Cavalieri, 7-56126 Pisa, Italy)

  • María Morales-Suárez-Varela

    (Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine, School of Pharmacy, University of Valencia, Avenida Vicente Andres Estellés s/n, Burjassot, 46100 Valencia, Spain
    Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Avenida Monforte de Lemos, 3-5, Pabellón 11, Planta 0 28029 Madrid, Spain)

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is the most common cognitive and behavioural disorder affecting children, with a worldwide-pooled prevalence of around 5%. Exposure to particulate matter (PM) air pollution is suspected to be associated with autism spectrum disorders and recent studies have investigated the relationship between PM exposure and ADHD. In the absence of any synthesis of the relevant literature on this topic, this systematic review of epidemiological studies aimed to investigate the relationship between the exposure of children to PM and ADHD and identify gaps in our current knowledge. In December 2018, we searched the PubMed and EMBASE databases. We only included epidemiological studies carried out on children without any age limit, measuring PM exposure and health outcomes related to ADHD. We assessed the quality of the articles and the risk of bias for each included article using the Newcastle–Ottawa Scale and the Office of Health Assessment and Translation (OHAT) approach, respectively. The keyword search yielded 774 results. Twelve studies with a total number of 181,144 children met our inclusion criteria, of which 10 were prospective cohort studies and 2 were cross-sectional studies. We subsequently classified the selected articles as high or good quality studies. A total of 9 out of the 12 studies reported a positive association between PM exposure to outdoor air pollution and behavioral problems related to attention. Despite these results, we found a significant degree of heterogeneity among the study designs. Furthermore, 11 studies were judged to be at a probably high risk of bias in the exposure assessment. In conclusion, we opine that further high quality studies are still needed in order to clarify the association between PM exposure and ADHD diagnosis

Suggested Citation

  • Gabriele Donzelli & Agustin Llopis-Gonzalez & Agustin Llopis-Morales & Lorenzo Cioni & María Morales-Suárez-Varela, 2019. "Particulate Matter Exposure and Attention-Deficit/Hyperactivity Disorder in Children: A Systematic Review of Epidemiological Studies," IJERPH, MDPI, vol. 17(1), pages 1-16, December.
    • Handle: RePEc:gam:jijerp:v:17:y:2019:i:1:p:67-:d:300110
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    References listed on IDEAS

    as
    1. Gabriele Donzelli & Annalaura Carducci & Agustin Llopis-Gonzalez & Marco Verani & Agustin Llopis-Morales & Lorenzo Cioni & María Morales-Suárez-Varela, 2019. "The Association between Lead and Attention-Deficit/Hyperactivity Disorder: A Systematic Review," IJERPH, MDPI, vol. 16(3), pages 1-14, January.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    3. Mike Z. He & Xiange Zeng & Kaiyue Zhang & Patrick L. Kinney, 2017. "Fine Particulate Matter Concentrations in Urban Chinese Cities, 2005–2016: A Systematic Review," IJERPH, MDPI, vol. 14(2), pages 1-14, February.
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    Cited by:

    1. Jung-Im Shim & Garam Byun & Jong-Tae Lee, 2022. "Exposure to Particulate Matter as a Potential Risk Factor for Attention-Deficit/Hyperactivity Disorder in Korean Children and Adolescents (KNHANES 2008–2018)," IJERPH, MDPI, vol. 19(21), pages 1-11, October.
    2. Tian Wang & Jie Zhang & Yi Xu, 2020. "Epigenetic Basis of Lead-Induced Neurological Disorders," IJERPH, MDPI, vol. 17(13), pages 1-23, July.
    3. Johannes Boettcher & Michael Boettcher & Silke Wiegand-Grefe & Holger Zapf, 2021. "Being the Pillar for Children with Rare Diseases—A Systematic Review on Parental Quality of Life," IJERPH, MDPI, vol. 18(9), pages 1-13, May.

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