Evidence map›Paper›PMID 39875928›Full record

ArticleItalian journal of pediatrics2025

Association between some environmental risk factors and attention-deficit hyperactivity disorder among children in Egypt: a case-control study.

Riham Abdelhamid Hussein, Rania Hussein Refai, Aleya Hanafy El-Zoka, Hanan Galal Azouz, Mohamed Fakhry Hussein

Abstract read
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Article in Italian journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
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  4. Human hair as a diagnostic tool in medicine.Biochemistry and biophysics reports · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Riham Abdelhamid HusseinAlexandria University, Alexandria, Egypt.
Rania Hussein RefaiAlexandria University, Alexandria, Egypt. hiph.rattia@alexu.edu.eg.ORCID http://orcid.org/0000-0002-9524-1346
Aleya Hanafy El-ZokaHigh Institute of Public Health, Alexandria University, Alexandria, Egypt.
Hanan Galal AzouzAlexandria University, Alexandria, Egypt.
Mohamed Fakhry HusseinHigh Institute of Public Health, Alexandria University, Alexandria, Egypt.ORCID http://orcid.org/0000-0003-3775-6226

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAttention-Deficit Hyperactivity Disorder (ADHD) is a complex disease that negatively impacts the social and academic/occupational activities of children and is more common in boys than in girls.

methodsThis case-control study aimed to assess the association between some environmental risk factors and ADHD among children in Alexandria, Egypt. It was carried out at the outpatient clinics of El Shatby Pediatric University Hospital in Alexandria, Egypt, with 252 children (126 cases and 126 controls). Hair samples were collected for analysis of lead and manganese levels using Atomic Absorption Spectrophotometer. A pre-designed interview questionnaire was used to determine the important environmental risk factors that may be related to ADHD.

resultsChildren from parents with low levels of education, living in crowded houses, and occupational exposure to chemical agents were found to be risk factors for ADHD. The mean ± SD hair lead level in ADHD children was 2.58 ± 1.95, while in controls was 1.87 ± 0.92, with a statistically significant difference (p < 0.001). The mean ± SD hair manganese level in ADHD children was 2.10 ± 1.54, while in controls was 1.11 ± 0.69, with a statistically significant difference (p < 0.001). The logistic regression model revealed that six factors had a significant association with ADHD: using of newspapers to wrap food 3 or more times a week (adjusted odds ratio (AOR) = 105.11, 95% CI: 11.18-988.26), daily TV watching by child for more than 5 h (AOR = 63.96, 95% CI: 2.56-1601.32), child's eating commercially packed noodles 3 times or more per week (AOR = 57.73, 95% CI: 3.77-593.93), using unpackaged flour in cooking (AOR = 44.47, 95% CI: 1.83-629.80), eating sweets daily by child (AOR = 6.82, 95% CI: 1.23-37.94), and lastly elevated hair Manganese level (AOR = 3.57, 95% CI: 1.24-10.29).

conclusionsADHD is a multi-factorial disorder, where many environmental risk factors contribute to its development. Future efforts to determine the best preventive strategy in Egypt must be based on a better knowledge of the role of environmental risk factors in the etiology of the disorder. Eliminating non-essential uses of lead and providing public education regarding the importance of safe disposal of lead-acid batteries and computers are necessary.

Indexed as

Attention Deficit Disorder with HyperactivityEnvironmental ExposureCase-Control StudiesChildEgyptFemaleHairHumansLeadLogistic ModelsMaleManganeseRisk FactorsSurveys and QuestionnairesLeadManganeseAttention-deficit hyperactivity disorderEgyptEnvironmental risk factorsLeadManganese

Identifiers

PMID39875928
PMCPMC11776284

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.