ArticleBMC pediatrics2016
Blood lead concentrations and attention deficit hyperactivity disorder in Korean children: a hospital-based case control study.
Article in BMC pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 6 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 6 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Neurodevelopmental Outcomes Associated with Early-Life Exposure to Heavy Metals: A Systematic Review.International journal of environmental research and public health · 2025Pooled it
- 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
- Dietary inflammatory index of mothers during pregnancy and Attention Deficit-Hyperactivity Disorder symptoms in the child at preschool age: a prospective investigation in the INMA and RHEA cohorts.European child & adolescent psychiatry · 2022Pooled 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
- Trial
- Adapting, piloting, and evaluating a pediatric lead screening and risk-reduction intervention in Nairobi: A hybrid implementation-effectiveness trial protocol.medRxiv : the preprint server for health sciences · 2026Article
- Attention-deficit/hyperactivity disorder in India: epidemiology, diagnostic inequities, treatment gaps, and public mental health implications.Frontiers in psychiatry · 2026Review
- Effects of Blood Lead Levels <10 µg/dL in School-Age Children and Adolescents: A Scoping Review.Pediatrics · 2024Article
- Higher rates of autism and attention deficit/hyperactivity disorder in American children: Are food quality issues impacting epigenetic inheritance?World journal of clinical pediatrics · 2023Review
- Canadian Airway Focus Group updated consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Article
- Connecting inorganic mercury and lead measurements in blood to dietary sources of exposure that may impact child development.World journal of methodology · 2021Review
- Particulate Matter and Associated Metals: A Link with Neurotoxicity and Mental Health.Atmosphere · 2021Article
- Preliminary Investigation of Association between Methylphenidate and Serum Growth Markers in Children with Attention-Deficit/Hyperactivity Disorder: A Cross-Sectional Case-Control Study.Soa--ch'ongsonyon chongsin uihak = Journal of child & adolescent psychiatry · 2020Article
- Environmental lead exposure is associated with neurocognitive dysfunction in children with chronic kidney disease.Pediatric nephrology (Berlin, Germany) · 2019Article
- Dynamical properties of elemental metabolism distinguish attention deficit hyperactivity disorder from autism spectrum disorder.Translational psychiatry · 2019Article
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBecause the developing brain of a child is vulnerable to environmental toxins, even very low concentration of neurotoxin can affect children's neurodevelopment. Lead is a neurotoxic heavy metal which has the harmful effect on the striatal-frontal circuit of brain. This area of the brain is known to be closely related to attention deficit hyperactivity disorder (ADHD) pathophysiology. The primary objective of the present study was to investigate whether elevated blood lead concentration is a risk factor for ADHD. The secondary objective was to examine the association between blood lead concentration and symptom severity.
methodsWe conducted a frequency-matched, hospital-based case-control study with 114 medically diagnosed ADHD cases and 114 controls. The participants were matched for age and sex. The diagnoses of ADHD were assessed with semi-structured diagnostic interviews. The participants completed the continuous performance test (CPT), and their parents completed the ADHD-rating scale (ADHD-RS). Blood lead concentrations were measured by using graphite furnace atomic absorption spectrometry featuring Zeeman background correction.
resultsChildren with ADHD exhibited blood lead concentrations that were significantly higher than those of the controls ( 1.90 ± 086 μg/dℓ vs. 1.59 ± 0.68 μg/dℓ, p = 0.003). The log transformed total blood lead concentration was associated with a higher risk of ADHD (OR: 1.60, 95 % CI: 1.04-2.45, p < 0.05). The analysis also revealed that the children with blood lead concentrations above 2.30 μg/dℓ were at a 2.5-fold (95 % CI: 1.09-5.87, p < 0.05) greater risk of having ADHD. After adjusting for covariates, our multivariate regression models indicated that blood lead concentrations were not significantly associated with ADHD-RS or CPT profiles among the ADHD cases.
conclusionEven low blood lead concentrations are a risk factor for ADHD in children. This study warrants primary prevention policies to reduce the environmental lead burden. Future studies may be required to ascertain the effects of lead on symptom severity in ADHD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.