Developmental pbde exposure and IQ/ADHD in childhood

A systematic review and meta-analysis

Juleen Lam, Bruce P. Lanphear, David Bellinger, Daniel A. Axelrad, Jennifer McPartland, Patrice Sutton, Lisette Davidson, Natalyn Daniels, Saunak Sen, Tracey J. Woodruff

Research output: Contribution to journalReview article

46 Citations (Scopus)

Abstract

Background: In the United States, one in six children are affected by neurodevelopmental disorders, and polybrominated diphenyl ethers (PBDEs) in flame-retardant chemicals are measured ubiquitously in children. Objective: We conducted a systematic a systematic review regarding developmental exposure to PBDEs and intelligence or Attention Deficit/ Hyperactivity Disorder (ADHD) and attention-related behavioral conditions in humans. Methods: We searched articles published up to 26 September 2016, and included original studies that quantified exposures to PBDEs incurred any time in proximity to conception or during in utero, perinatal, or childhood time periods. We evaluated the risk of bias of individual studies and the overall quality and strength of the evidence according to the Navigation Guide systematic review methodology. We established criteria in advance to identify studies that could be combined using random effects meta-analyses (DerSimonian-Laird method). Results: Fifteen studies met the inclusion criteria; 10 studies met the criteria for intelligence and nine for attention-related problems. We rated studies generally with “low” to “probably low” risk of bias and rated the overall body of evidence as “moderate” quality with “sufficient” evidence for an association between Intelligence Quotient (IQ) and PBDEs. Our meta-analysis of four studies estimated a 10-fold increase (in other words, times 10) in PBDE exposure associated with a decrement of 3.70 IQ points (95% confidence interval: 0.83, 6.56). We concluded the body of evidence was of “moderate” quality for ADHD with “limited” evidence for an association with PBDEs, based on the heterogeneity of association estimates reported by a small number of studies and the fact that chance, bias, and confounding could not be ruled out with reasonable confidence. Conclusion: We concluded there was sufficient evidence supporting an association between developmental PBDE exposure and reduced IQ. Preventing developmental exposure to PBDEs could help prevent loss of human intelligence.

Original languageEnglish (US)
JournalEnvironmental Health Perspectives
Volume125
Issue number8
DOIs
StatePublished - Aug 1 2017

Fingerprint

Halogenated Diphenyl Ethers
Attention Deficit Disorder with Hyperactivity
Intelligence
Meta-Analysis
Flame Retardants
pentabromodiphenyl ether
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Lam, J., Lanphear, B. P., Bellinger, D., Axelrad, D. A., McPartland, J., Sutton, P., ... Woodruff, T. J. (2017). Developmental pbde exposure and IQ/ADHD in childhood: A systematic review and meta-analysis. Environmental Health Perspectives, 125(8). https://doi.org/10.1289/EHP1632

Developmental pbde exposure and IQ/ADHD in childhood : A systematic review and meta-analysis. / Lam, Juleen; Lanphear, Bruce P.; Bellinger, David; Axelrad, Daniel A.; McPartland, Jennifer; Sutton, Patrice; Davidson, Lisette; Daniels, Natalyn; Sen, Saunak; Woodruff, Tracey J.

In: Environmental Health Perspectives, Vol. 125, No. 8, 01.08.2017.

Research output: Contribution to journalReview article

Lam, J, Lanphear, BP, Bellinger, D, Axelrad, DA, McPartland, J, Sutton, P, Davidson, L, Daniels, N, Sen, S & Woodruff, TJ 2017, 'Developmental pbde exposure and IQ/ADHD in childhood: A systematic review and meta-analysis', Environmental Health Perspectives, vol. 125, no. 8. https://doi.org/10.1289/EHP1632
Lam, Juleen ; Lanphear, Bruce P. ; Bellinger, David ; Axelrad, Daniel A. ; McPartland, Jennifer ; Sutton, Patrice ; Davidson, Lisette ; Daniels, Natalyn ; Sen, Saunak ; Woodruff, Tracey J. / Developmental pbde exposure and IQ/ADHD in childhood : A systematic review and meta-analysis. In: Environmental Health Perspectives. 2017 ; Vol. 125, No. 8.
@article{9ae36c813f0d407680b9d42f7f0574c8,
title = "Developmental pbde exposure and IQ/ADHD in childhood: A systematic review and meta-analysis",
abstract = "Background: In the United States, one in six children are affected by neurodevelopmental disorders, and polybrominated diphenyl ethers (PBDEs) in flame-retardant chemicals are measured ubiquitously in children. Objective: We conducted a systematic a systematic review regarding developmental exposure to PBDEs and intelligence or Attention Deficit/ Hyperactivity Disorder (ADHD) and attention-related behavioral conditions in humans. Methods: We searched articles published up to 26 September 2016, and included original studies that quantified exposures to PBDEs incurred any time in proximity to conception or during in utero, perinatal, or childhood time periods. We evaluated the risk of bias of individual studies and the overall quality and strength of the evidence according to the Navigation Guide systematic review methodology. We established criteria in advance to identify studies that could be combined using random effects meta-analyses (DerSimonian-Laird method). Results: Fifteen studies met the inclusion criteria; 10 studies met the criteria for intelligence and nine for attention-related problems. We rated studies generally with “low” to “probably low” risk of bias and rated the overall body of evidence as “moderate” quality with “sufficient” evidence for an association between Intelligence Quotient (IQ) and PBDEs. Our meta-analysis of four studies estimated a 10-fold increase (in other words, times 10) in PBDE exposure associated with a decrement of 3.70 IQ points (95{\%} confidence interval: 0.83, 6.56). We concluded the body of evidence was of “moderate” quality for ADHD with “limited” evidence for an association with PBDEs, based on the heterogeneity of association estimates reported by a small number of studies and the fact that chance, bias, and confounding could not be ruled out with reasonable confidence. Conclusion: We concluded there was sufficient evidence supporting an association between developmental PBDE exposure and reduced IQ. Preventing developmental exposure to PBDEs could help prevent loss of human intelligence.",
author = "Juleen Lam and Lanphear, {Bruce P.} and David Bellinger and Axelrad, {Daniel A.} and Jennifer McPartland and Patrice Sutton and Lisette Davidson and Natalyn Daniels and Saunak Sen and Woodruff, {Tracey J.}",
year = "2017",
month = "8",
day = "1",
doi = "10.1289/EHP1632",
language = "English (US)",
volume = "125",
journal = "Environmental Health Perspectives",
issn = "0091-6765",
publisher = "Public Health Services, US Dept of Health and Human Services",
number = "8",

}

TY - JOUR

T1 - Developmental pbde exposure and IQ/ADHD in childhood

T2 - A systematic review and meta-analysis

AU - Lam, Juleen

AU - Lanphear, Bruce P.

AU - Bellinger, David

AU - Axelrad, Daniel A.

AU - McPartland, Jennifer

AU - Sutton, Patrice

AU - Davidson, Lisette

AU - Daniels, Natalyn

AU - Sen, Saunak

AU - Woodruff, Tracey J.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background: In the United States, one in six children are affected by neurodevelopmental disorders, and polybrominated diphenyl ethers (PBDEs) in flame-retardant chemicals are measured ubiquitously in children. Objective: We conducted a systematic a systematic review regarding developmental exposure to PBDEs and intelligence or Attention Deficit/ Hyperactivity Disorder (ADHD) and attention-related behavioral conditions in humans. Methods: We searched articles published up to 26 September 2016, and included original studies that quantified exposures to PBDEs incurred any time in proximity to conception or during in utero, perinatal, or childhood time periods. We evaluated the risk of bias of individual studies and the overall quality and strength of the evidence according to the Navigation Guide systematic review methodology. We established criteria in advance to identify studies that could be combined using random effects meta-analyses (DerSimonian-Laird method). Results: Fifteen studies met the inclusion criteria; 10 studies met the criteria for intelligence and nine for attention-related problems. We rated studies generally with “low” to “probably low” risk of bias and rated the overall body of evidence as “moderate” quality with “sufficient” evidence for an association between Intelligence Quotient (IQ) and PBDEs. Our meta-analysis of four studies estimated a 10-fold increase (in other words, times 10) in PBDE exposure associated with a decrement of 3.70 IQ points (95% confidence interval: 0.83, 6.56). We concluded the body of evidence was of “moderate” quality for ADHD with “limited” evidence for an association with PBDEs, based on the heterogeneity of association estimates reported by a small number of studies and the fact that chance, bias, and confounding could not be ruled out with reasonable confidence. Conclusion: We concluded there was sufficient evidence supporting an association between developmental PBDE exposure and reduced IQ. Preventing developmental exposure to PBDEs could help prevent loss of human intelligence.

AB - Background: In the United States, one in six children are affected by neurodevelopmental disorders, and polybrominated diphenyl ethers (PBDEs) in flame-retardant chemicals are measured ubiquitously in children. Objective: We conducted a systematic a systematic review regarding developmental exposure to PBDEs and intelligence or Attention Deficit/ Hyperactivity Disorder (ADHD) and attention-related behavioral conditions in humans. Methods: We searched articles published up to 26 September 2016, and included original studies that quantified exposures to PBDEs incurred any time in proximity to conception or during in utero, perinatal, or childhood time periods. We evaluated the risk of bias of individual studies and the overall quality and strength of the evidence according to the Navigation Guide systematic review methodology. We established criteria in advance to identify studies that could be combined using random effects meta-analyses (DerSimonian-Laird method). Results: Fifteen studies met the inclusion criteria; 10 studies met the criteria for intelligence and nine for attention-related problems. We rated studies generally with “low” to “probably low” risk of bias and rated the overall body of evidence as “moderate” quality with “sufficient” evidence for an association between Intelligence Quotient (IQ) and PBDEs. Our meta-analysis of four studies estimated a 10-fold increase (in other words, times 10) in PBDE exposure associated with a decrement of 3.70 IQ points (95% confidence interval: 0.83, 6.56). We concluded the body of evidence was of “moderate” quality for ADHD with “limited” evidence for an association with PBDEs, based on the heterogeneity of association estimates reported by a small number of studies and the fact that chance, bias, and confounding could not be ruled out with reasonable confidence. Conclusion: We concluded there was sufficient evidence supporting an association between developmental PBDE exposure and reduced IQ. Preventing developmental exposure to PBDEs could help prevent loss of human intelligence.

UR - http://www.scopus.com/inward/record.url?scp=85032834748&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032834748&partnerID=8YFLogxK

U2 - 10.1289/EHP1632

DO - 10.1289/EHP1632

M3 - Review article

VL - 125

JO - Environmental Health Perspectives

JF - Environmental Health Perspectives

SN - 0091-6765

IS - 8

ER -