ArticleEnvironmental health perspectives2017
The Joint Effect of Prenatal Exposure to Metal Mixtures on Neurodevelopmental Outcomes at 20-40 Months of Age: Evidence from Rural Bangladesh.
Article in Environmental health perspectives, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 147 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
147 citing papers in PubMed, 2 syntheses or guidelines pooled it, 313 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
- Heavy metals and neurodevelopment of children in low and middle-income countries: A systematic review.PloS one · 2022Pooled it
- Review
- Association of exposure to organophosphate pesticides with reproductive lifespan.BMC women's health · 2026Article
- Zebrafish parental co-exposure to environmentally relevant levels of inorganic arsenic + methylmercury impacts neurobehavior in parents and progeny.Environmental toxicology and pharmacology · 2026Article
- Toenail metal concentrations and kidney health among young people at risk of chronic kidney disease of uncertain etiology.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- The association of multiple whole blood metals with hypertension prevalence and blood pressure among general Chinese adults.Nutrition journal · 2026Article
- Prenatal urinary biomarkers of metal and metalloid exposure and child neurodevelopmental outcomes in Puerto Rico.Environmental research · 2026Article
- Association between plasma metal element profiles and cognitive impairment in occupationally aluminum-exposed workers at a large aluminum plant in northern China.The journal of prevention of Alzheimer's disease · 2026Article
- Effects of Prenatal Essential and Toxic Metal Exposure on Children's Neurodevelopment: A Multi-Method Approach.Toxics · 2025Article
- Impact of manganese and metal mixtures in blood, hair, and soil on child adaptive behaviors in Southeast Side Chicago.Environmental research · 2025Article
- The associations between mixed blood heavy metal exposure and depressive symptom: a cross-sectional study in Shandong, China.BMC public health · 2025Article
- The relationship between self-reported adverse experiences and depressive symptoms among middle-aged and elderly individuals: A longitudinal study based on the CHARLS database.Brain, behavior, & immunity - health · 2025Article
- Applications of mixture methods in epidemiological studies investigating the health impact of persistent organic pollutants exposures: a scoping review.Journal of exposure science & environmental epidemiology · 2025Article
- Review
- Suppression effect of folate on poly- and perfluoroalkyl substance-induced alterations in lipids and the atherogenic index of plasma in adolescents.Lipids in health and disease · 2025Article
- Exposure to Multiple Metal(loid)s and Hypertension in Chinese Older Adults.Biological trace element research · 2025Article
- Neurobehavioral effects of low dose exposure to chemical mixtures: a review.Archives of toxicology · 2025Review
- IMPACT OF REAL-LIFE ENVIRONMENTAL EXPOSURES ON REPRODUCTION: Phthalates disrupt female reproductive health: a call for enhanced investigation into mixtures.Reproduction (Cambridge, England) · 2025Review
- Article
87 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundExposure to chemical mixtures is recognized as the real-life scenario in all populations, needing new statistical methods that can assess their complex effects.
objectivesWe aimed to assess the joint effect of in utero exposure to arsenic, manganese, and lead on children's neurodevelopment.
methodsWe employed a novel statistical approach, Bayesian kernel machine regression (BKMR), to study the joint effect of coexposure to arsenic, manganese, and lead on neurodevelopment using an adapted Bayley Scale of Infant and Toddler Development™. Third Edition, in 825 mother-child pairs recruited into a prospective birth cohort from two clinics in the Pabna and Sirajdikhan districts of Bangladesh. Metals were measured in cord blood using inductively coupled plasma-mass spectrometry.
resultsAnalyses were stratified by clinic due to differences in exposure profiles. In the Pabna district, which displayed high manganese levels [interquartile range (IQR): 4.8, 18 μg/dl], we found a statistically significant negative effect of the mixture of arsenic, lead, and manganese on cognitive score when cord blood metals concentrations were all above the 60th percentile (As≥0.7 μg/dl, Mn≥6.6 μg/dl, Pb≥4.2 μg/dl) compared to the median (As=0.5 μg/dl, Mn=5.8 μg/dl, Pb=3.1 μg/dl). Evidence of a nonlinear effect of manganese was found. A change in log manganese from the 25th to the 75th percentile when arsenic and manganese were at the median was associated with a decrease in cognitive score of −0.3 (−0.5, −0.1) standard deviations. Our study suggests that arsenic might be a potentiator of manganese toxicity.
conclusionsEmploying a novel statistical method for the study of the health effects of chemical mixtures, we found evidence of neurotoxicity of the mixture, as well as potential synergism between arsenic and manganese. https://doi.org/10.1289/EHP614.
Indexed as
Identifiers
What OpenQuestion holds
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.