ArticleNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2017
Secondhand Smoke Exposure and Low Blood Lead Levels in Association With Attention-Deficit Hyperactivity Disorder and Its Symptom Domain in Children: A Community-Based Case-Control Study.
Article in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 6 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 6 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- Association between heavy metals exposure and risk of attention deficit hyperactivity disorder (ADHD) in children: a systematic review and meta-analysis.European child & adolescent psychiatry · 2025Pooled it
- Exploring the link between toxic metal exposure and ADHD: a systematic review of pb and hg.Journal of neurodevelopmental disorders · 2024Pooled it
- Association between postnatal second-hand smoke exposure and ADHD in children: a systematic review and meta-analysis.Environmental science and pollution research international · 2021Pooled it
- A Systematic Review and Meta-Analysis Investigating the Relationship between Exposures to Chemical and Non-Chemical Stressors during Prenatal Development and Childhood Externalizing Behaviors.International journal of environmental research and public health · 2020Pooled it
- A systematic review and meta-analysis examining the interrelationships between chemical and non-chemical stressors and inherent characteristics in children with ADHD.Environmental research · 2020Pooled it
- The Association between Lead and Attention-Deficit/Hyperactivity Disorder: A Systematic Review.International journal of environmental research and public health · 2019Pooled it
- Early childhood exposure to secondhand smoke and behavioural problems in preschoolers.Scientific reports · 2018Trial
- Association between some environmental risk factors and attention-deficit hyperactivity disorder among children in Egypt: a case-control study.Italian journal of pediatrics · 2025Article
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- Effects of Blood Lead Levels <10 µg/dL in School-Age Children and Adolescents: A Scoping Review.Pediatrics · 2024Article
- Prenatal and Childhood Smoke Exposure Associations with Cognition, Language, and Attention-Deficit/Hyperactivity Disorder.The Journal of pediatrics · 2023Article
- Passive smoking and urinary oxidative biomarkers: A pilot study of healthy travelers from Los Angeles to Beijing.International journal of hygiene and environmental health · 2022Article
- Shortened Infant Telomere Length Is Associated with Attention Deficit/Hyperactivity Disorder Symptoms in Children at Age Two Years: A Birth Cohort Study.International journal of molecular sciences · 2022Article
- Menthol Flavor in E-Cigarette Vapor Modulates Social Behavior Correlated With Central and Peripheral Changes of Immunometabolic Signalings.Frontiers in molecular neuroscience · 2022Article
- Environmental Tobacco Smoke and Early Language Difficulties among U.S. Children.International journal of environmental research and public health · 2021Article
- Association of Prenatal, Early Postnatal, or Current Exposure to Secondhand Smoke With Attention-Deficit/Hyperactivity Disorder Symptoms in Children.JAMA network open · 2021Article
- LPHN3 gene variations and susceptibility to ADHD in Chinese Han population: a two-stage case-control association study and gene-environment interactions.European child & adolescent psychiatry · 2019Article
- Blood lead, bone lead and child attention-deficit-hyperactivity-disorder-like behavior.The Science of the total environment · 2019Article
- Prenatal Tobacco Exposure Modulated the Association of Genetic variants with Diagnosed ADHD and its symptom domain in children: A Community Based Case-Control Study.Scientific reports · 2019Article
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimSecondhand smoke (SHS) is a major indoor pollutant. We examined the possible association between exposure to both SHS and low levels of lead and attention-deficit-hyperactivity disorder (ADHD) and its symptom domain in children.
methodsThis case-control study was based on the results of a community survey using the ADHD rating scale conducted in 49 elementary schools. Both cases and control subjects were confirmed by a child psychiatrist. Each case was matched with one control subject according to gender, school, and grade in school. Using a multivariate conditional logistic regression model, we analyzed 214 case-control pairs of children who ranged in age from 6 to 10 years. Urine and blood levels of cotinine and of lead were determined, and information pertaining to SHS exposure was obtained by means of a questionnaire.
resultsExposure to low levels of lead (geometric mean = 1.65 µg/dL) was related to ADHD, particularly inattention (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.07-2.59), whereas SHS exposure was associated mainly with hyperactivity/impulsivity (OR = 3.85, 95% CI = 1.55-9.56). In the pathway from blood lead to hyperactivity/impulsivity, children's SHS exposure mediated and indirectly accounted for about 73% of this relationship. The combined exposure to lead and SHS synergistically increased the risk of ADHD, evident as both inattention and hyperactivity/impulsivity.
conclusionSHS, which is associated with hyperactivity/impulsivity in particular, combined with exposure to low blood levels of lead synergistically increased the risk of ADHD. Therefore, the exposure of children to both SHS and lead needs to be reduced. IMPLICATIONS: Although exposure to low levels of lead has been shown to be associated with ADHD, there is little evidence of symptom domain specificity. In our study, low blood lead levels were related to inattention. In addition, prenatal or postnatal exposure to SHS increased the risk of ADHD, particularly hyperactivity/impulsivity. Combined exposure to lead and SHS synergistically increased the risk for both these ADHD symptom domains. To protect children from environmental risk factors related to ADHD, it is necessary to further reduce children's exposure to SHS and lead, even in those with low blood lead levels.
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