SynthesisPloS one2022
Heavy metals and neurodevelopment of children in low and middle-income countries: A systematic review.
Synthesis in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 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
52 citing papers in PubMed, 2 syntheses or guidelines pooled it, 108 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
- Pesticides and neurodevelopment of children in low and middle-income countries: A systematic review.PloS one · 2025Pooled it
- Potentially Toxic Metal Levels in Breast Milk and Their Determinants Among Lactating Mothers of the DSAN-12 M Birth Cohort in the Reconcavo Baiano, Brazil.Biological trace element research · 2026Article
- Review
- Peripheral and central auditory impairment linked to heavy metal exposure in Nicaraguan children from artisanal mining communities.Journal of global health · 2026Article
- Nutritional Profile of Children, Adolescents, and Women Living in Areas Potentially Affected by Heavy Metal Pollutants from the Revuè River in the Manica Province, Mozambique.Epidemiologia (Basel, Switzerland) · 2026Article
- Maternal Anemia and Pediatric Neurodevelopment in Children from Mothers Exposed to Mixed Heavy Metals in Suriname.Journal of xenobiotics · 2026Article
- Adaptation and test-retest reliability of a mobile neurocognitive battery for assessing neurotoxicity in rural children in Bangladesh.Neurotoxicology · 2026Article
- Hair biomonitoring reveals spatial heterogeneity of multielement exposure in Bogotá schoolchildren.Environmental geochemistry and health · 2026Article
- Prenatal urinary biomarkers of metal and metalloid exposure and child neurodevelopmental outcomes in Puerto Rico.Environmental research · 2026Article
- Prenatal metal exposures in urban and suburban New York, and a scoping review to compare metal concentrations in meconium across studies.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Towards learning and memory risk assessment with human brain organoids: barriers and opportunities.Frontiers in toxicology · 2026Review
- Impact of prenatal environmental exposure on offspring neurodevelopment and susceptibility to neurodegenerative diseases: mechanisms and perspectives.Frontiers in public health · 2026Review
- Reframing air pollution as a cognitive and socioeconomic risk.NPJ clean air · 2026Review
- DNA methylation as a biomarker of prenatal exposures: current challenges and opportunities.Environmental epigenetics · 2026Review
- Impact of a prenatal exposure mixture of metals on DNA methylation-derived cell-type composition in cord blood.Environmental epigenetics · 2026Article
- Article
- Prenatal and childhood exposures to heavy metals and their associations with child cognition, motor skills, behaviour and mental health.Essays in biochemistry · 2025Review
- Essential and non-essential metals in children's intellectual functioning: A multi-media biomarker approach from a Mexico City birth cohort.Environmental research · 2025Article
- Distribution of Hematologic Parameters of Complete Blood Count in Anemic and Nonanemic Children in a Mining-Exposed Highland Peruvian Community.International journal of environmental research and public health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe presence of harmful environmental exposures, which disproportionately affects low-and-middle income countries (LMICs), contributes to >25% of deaths and diseases worldwide and detrimentally affects child neurodevelopment. Few resources succinctly summarize the existing literature on this topic. Our objective is to systematically review and characterize the evidence regarding the relationship between heavy metals and neurodevelopment of children in LMICs.
methodsWe conducted a medical librarian-curated search on multiple online databases to identify articles that included individuals <18 years living in a LMIC, quantitatively measured exposure to a heavy metal (either prenatal or postnatal), and used a standardized measurement of neurodevelopment (i.e. cognitive, language, motor, and behavior). Reviews, editorials, or case studies were excluded. Results were analyzed qualitatively, and quality was assessed.
resultsOf the 18,043 screened articles, 298 full-text articles were reviewed, and 100 articles met inclusion criteria. The included studies represented data from 19 LMICs, only one of which was classified as a low-income country. Ninety-four percent of postnatal lead and all postnatal manganese studies showed a negative association with metal exposure and neurodevelopment, which were the strongest relationships among the metals studied. Postnatal exposure of mercury was associated with poor neurodevelopment in only half of studies. Limited data on postnatal arsenic and cadmium suggests an association with worse neurodevelopment. Findings were mixed for prenatal arsenic and lead, although some evidence supports that the neurotoxicity of lead was amplified in the presence of manganese. CONCLUSIONS AND POTENTIAL IMPACT: We found that lead and manganese appear to consistently have a detrimental effect on the neurodevelopment of children, and more evidence is needed for mercury, arsenic, and cadmium. Better characterization of these effects can motivate and inform prioritization of much needed international policies and programs to reduce heavy metal exposures for young children within LMICs.
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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.