ArticleEnvironmental health perspectives2020
Exposure to Manganese in Drinking Water during Childhood and Association with Attention-Deficit Hyperactivity Disorder: A Nationwide Cohort Study.
Article in Environmental health perspectives, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers.
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Who cites it
43 citing papers in PubMed, 88 citations in OpenAlex.
- Early-Life Manganese Overexposure Activates Microglial Phagocytosis through the YY1/TREM2 Axis Leading to Hippocampal Synaptic Remodeling in Mice.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Hydrochemical and health risk evaluation of the groundwater in Gonbad Kavus area, northeastern Iran.Scientific reports · 2026Article
- Fetal and postnatal metal metabolism-related changes in brain function are associated with childhood behavioral deficits.Science advances · 2026Article
- Manganese Exposure: Delayed Effects and Biomarkers in adult male and female Wistar rats.Molecular neurobiology · 2026Article
- Heavy Metals Like Aluminum, Arsenic, Cadmium, Chromium, Copper, Iron, Lead, Manganese, Mercury, Nickel, and Zinc Polluting the Drinking Water: Their Individual Health Hazards.International journal of molecular sciences · 2025Review
- Oral guanfacine treatment ameliorates the ADHD-like symptoms caused by developmental manganese exposure.Progress in neuro-psychopharmacology & biological psychiatry · 2025Article
- Mitochondrially Transcribed dsRNA Mediates Manganese-induced Neuroinflammation.bioRxiv : the preprint server for biology · 2025Article
- Associations between Maternal Urinary Metabolite Concentrations of Selected Volatile Organic Compounds and Child Neurocognitive Development at Two Years of Age.Environmental health perspectives · 2025Article
- Exposure to Manganese Induces Autophagy-Lysosomal Pathway Dysfunction-Mediated Tauopathy by Activating the cGAS-STING Pathway in the Brain.Environment & health (Washington, D.C.) · 2025Article
- Association between some environmental risk factors and attention-deficit hyperactivity disorder among children in Egypt: a case-control study.Italian journal of pediatrics · 2025Article
- Manganese-Induced Parkinsonism: A Review of Etiologies and Treatments.Degenerative neurological and neuromuscular disease · 2025Review
- Mixed contaminant exposure in tapwater and the potential implications for human-health in disadvantaged communities in California.Water research · 2024Article
- Increased risk of attention-deficit/hyperactivity disorder in adolescents with high salivary levels of copper, manganese, and zinc.European child & adolescent psychiatry · 2024Article
- A Mixed Methods Approach to Understanding the Public Health Impact of a School-Based Citizen Science Program to Reduce Arsenic in Private Well Water.Environmental health perspectives · 2024Article
- Perspectives on environment and health research in Denmark.Scandinavian journal of public health · 2024Article
- Manganese exposure from spring and well waters in the Shenandoah Valley: interplay of aquifer lithology, soil composition, and redox conditions.Environmental geochemistry and health · 2024Article
- Invited Perspective: Studying Metal Impacts on Neurobehavior during the Critical but Challenging Window of Adolescence.Environmental health perspectives · 2024Article
- An Industry-Relevant Metal Mixture, Iron Status, and Reported Attention-Related Behaviors in Italian Adolescents.Environmental health perspectives · 2024Article
- Manganese in residential drinking water from a community-initiated case study in Massachusetts.Journal of exposure science & environmental epidemiology · 2024Article
- Integrating different tools and technologies to advance drinking water quality exposure assessments.Journal of exposure science & environmental epidemiology · 2024Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundManganese (Mn) in drinking water may increase the risk of several neurodevelopmental outcomes, including attention-deficit hyperactivity disorder (ADHD). Earlier epidemiological studies on associations between Mn exposure and ADHD-related outcomes had small sample sizes, lacked spatiotemporal exposure assessment, and relied on questionnaire data (not diagnoses)-shortcomings that we address here.
objectiveOur objective was to assess the association between exposure to Mn in drinking water during childhood and later development of ADHD.
methodsIn a nationwide population-based registry study in Denmark, we followed a cohort of 643,401 children born 1992-2007 for clinical diagnoses of ADHD. In subanalyses, we classified cases into ADHD-Inattentive and ADHD-Combined subtypes based on hierarchical categorization of International Classification of Diseases (ICD)-10 codes. We obtained Mn measurements from 82,574 drinking water samples to estimate longitudinal exposure during the first 5 y of life with high spatiotemporal resolution. We modeled exposure as both peak concentration and time-weighted average. We estimated sex-specific hazard ratios (HRs) in Cox proportional hazards models adjusted for age, birth year, socioeconomic status (SES), and urbanicity.
resultsWe found that exposure to increasing levels of Mn in drinking water was associated with an increased risk of ADHD-Inattentive subtype, but not ADHD-Combined subtype. After adjusting for age, birth year, and SES, females exposed to high levels of Mn (i.e., DISCUSSION: Mn in drinking water was associated with ADHD, specifically the ADHD-Inattentive subtype. Our results support earlier studies suggesting a need for a formal health-based drinking water guideline value for Mn. Future Mn-studies should examine ADHD subtype-specific associations and utilize direct subtype measurements rather than relying on ICD-10 codes alone. https://doi.org/10.1289/EHP6391.
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