Tổng quan bằng chứng hiện tại về tác động của thuốc trừ sâu, polychlorinated biphenyls và một số kim loại chọn lọc đến rối loạn thiếu tập trung/hiếu động ở trẻ em
Tóm tắt
Mục tiêu của bài tổng quan này là điều tra mối liên hệ giữa rối loạn thiếu tập trung/hiếu động (ADHD) hoặc các triệu chứng liên quan đến ADHD và các hóa chất công nghiệp, chẳng hạn như các chất phospho hữu cơ và thuốc trừ sâu hữu cơ clo, polychlorinated biphenyls (PCBs), chì, thủy ngân và mangan. Các tìm kiếm trên Medline, PubMed và EBSCO đã được thực hiện để xác định các nghiên cứu phân tích mối liên hệ giữa sự phơi nhiễm trẻ em trước và sau sinh đối với các chất độc này và ADHD hoặc các triệu chứng liên quan đến ADHD. Bài tổng quan này chỉ giới hạn trong các nghiên cứu trên con người được xuất bản bằng tiếng Anh trong các tạp chí đã được kiểm duyệt kể từ năm 2000. Hầu hết các nghiên cứu được trình bày tập trung vào thuốc trừ sâu, PCB và chì. Tác động của thủy ngân và mangan ít được điều tra hơn. Các phát hiện cho thấy sự phơi nhiễm của trẻ em đối với thuốc trừ sâu phốt phát hữu cơ có thể gây ra các triệu chứng nhất quán với rối loạn phát triển lan tỏa, ADHD hoặc các vấn đề về sự chú ý. Sự phơi nhiễm với thuốc trừ sâu hữu cơ clo và PCBs có liên quan đến các hành vi giống như ADHD như sự tỉnh táo, chất lượng phản ứng cảnh giác, và chi phí của sự chú ý. Các nghiên cứu đã cung cấp bằng chứng rằng nồng độ chì trong máu dưới 10 μg/dl có liên quan đến ADHD hoặc các triệu chứng liên quan đến ADHD. Thông tin về mối liên hệ giữa sự phơi nhiễm với thủy ngân và độc tính thần kinh còn hạn chế và cần được xác nhận thêm trong các nghiên cứu tương lai. Hai nghiên cứu cho thấy rằng sự phơi nhiễm với mangan có liên quan đến ADHD; sự phơi nhiễm này và tác động của nó đến sự phát triển thần kinh của trẻ em cần được điều tra thêm. Các nghiên cứu trong tương lai nên sử dụng thiết kế theo dõi với nhiều mẫu sinh học được thu thập theo thời gian để đánh giá chính xác hơn về sự phơi nhiễm và các khoảng thời gian quan trọng của nó. Thêm vào đó, việc bao gồm các yếu tố gây nhiễu tiềm năng và sự phơi nhiễm đồng thời là rất quan trọng.
Từ khóa
Tài liệu tham khảo
Polanczyk G, Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: A systematic review and metaregression analysis. Am J Psychiatry 2007;164:942–948.
Aguiar A, Eubig PA, Schantz SL. Attention deficit/hyperactivity disorder: A focused overview for children’s environmental health researchers. Environ Health Perspect 2010;118(12):1646–1653.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Diseases (DSM-IV). 4th ed. Washington, DC: American Psychiatric Publishing; 1994.
World Health Organization. The ICD-10 Classification on Mental and Behavioral Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization; 1993.
Smith AK, Mick S, Faraone SV. Advances in genetic studies of attention-deficit/hyperactivity disorder. Curr Psychiatry Rep 2009;11(2):143–148.
Braun JM, Kahn RS, Froehlich T, Auinger P, Lanphear BP. Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children. Environ Health Perspect 2006;114(12):1904–1909.
Jokanovic M. Medical treatment of acute poisoning with organophosphorus and carbamate pesticides. Toxicol Lett 2009;190(2):107–115.
Timofeeva OA, Sanders D, Seemann K, Yang L, Hermanson D, Regenbogen S, et al. Persistent behavioral alterations in rats neonatally exposed to low doses of the organophosphate pesticide, parathion. Brain Res Bull 2008;77(6):404–411.
Furlong CE, Holland N, Richter RJ, Bradman A, Ho A, Eskenazi B. PON1 status of farmworker mothers and children as a predictor of organophosphate sensitivity. Pharmacogenet Genomics 2006;16(3):183–190.
Holland N, Furlong C, Bastaki M, Richter R, Bradman A, Huen K, et al. Paraoxonase polymorphisms, haplotypes, and enzyme activity in Latino mothers and newborns. Environ Health Perspect 2006;114:985–991.
Sultatos LG. Mammalian toxicology of organophosphorus pesticides. J Toxicol Environ Health 1994;43(3):271–289.
Coccini T, Crevani A, Rossi G, Assandri F, Balottin U, Nardo RD, et al. Reduced platelet monoamine oxidase type B activity and lymphocyte muscarinic receptor binding in unmedicated children with attention deficit hyperactivity disorder. Biomarkers 2009;14(7):513–522. DOI: 10.3109/13547500903144436.
Verma SK, Kumar V, Gill KD. An acetylcholinesterase-independent mechanism for neurobehavioral impairments after chronic low level exposure to dichlorvos in rats. Pharmacol Biochem Behav 2009;92(1):173–181.
Slotkin TA, Seidler FJ. Comparative developmental neurotoxicity of organophosphates in vivo: transcriptional responses of pathways for brain cell development, cell signaling, cytotoxicity and neurotransmitter systems. Brain Res Bull 2007;72(4–6):232–274.
Heath CJ, Picciotto MR. Nicotine-induced plasticity during development: modulation of the cholinergic system and long-term consequences for circuits involved in attention and sensory processing. Neuropharmacology 2009;56(Suppl 1):254–262.
Slotkin TA. Cholinergic systems in brain development and disruption by neurotoxicants: nicotine, environmental tobacco smoke, organophosphates. Toxicol Appl Pharmacol 2004;198(2):132–151.
Rauh VA, Garfinkel R, Perera FP, Andrews HF, Hoepner L, Barr DB, et al. Impact of prenatal chlorpyrifos exposure on neurodevelopment in the first 3 years of life among inner-city children. Pediatrics 2006;118(6):1845–1859.
Eskenazi B, Marks AR, Bradman A, Harley K, Barr DB, Johnson C. Organophosphate pesticide exposure and neurodevelopment in young Mexican-American children. Environ Health Perspect 2007;115(5):792–798.
Bouchard MF, Bellinger DC, Wright RO, Weisskopf MG. Attention-deficit/hyperactivity disorder and urinary metabolites of organophosphate pesticides. Pediatrics 2010;125:1270. DOI 10.1542/peds.2009-3058
Marks AR, Harley K, Bradman A, Kogut K, Barr DB, Johnson C, et al. Organophophate pesticide exposure and attention in young Mexican-American children: the CHAMACOS study. Environ Health Perspect 2010;118(12):1768–1774.
Sánchez Lizard P, O’Rourke MK, Morris RJ. The effects of organophosphate pesticide exposure on hispanic children’s cognitive and behavioral functioning. J Pediatr Psychol 2008;33(1):91–101.
Berger DF, Lombardo JP, Jeffers PM, Hunt AE, Bush B, Casey A, et al. Hyperactivity and impulsiveness in rats fed diets supplemented with either Aroclor 1248 or PCB — contaminated St. Lawrence river fish. Behav Brain Res 2001;126(1–2):1–11.
Holene E, Nafstad I, Skaare JU, Sagvolden T. Behavioural hyperactivity in rats following postnatal exposure to subtoxic doses of polychlorinated biphenyl congeners 153 and 126. Behav Brain Res 1998;94(1):213–224.
Rice DC. Parallels between attention deficit hyperactivity disorder and behavioral deficits produced by neurotoxic exposure in monkeys. Environ Health Perspect 2000;108(Suppl 3):405–408.
Sagiv SK, Nugent JK, Brazelton TB, Choi AL, Tolbert PE, Altshul LM, et al. Prenatal organochlorine exposure and measures of behavior in infancy using the Neonatal Behavioral Assessment Scale (NBAS). Environ Health Perspect 2008;116(5):666–673.
Seegal RF, Brosch KO, Okoniewski RJ. Effects of in utero and lactational exposure of the laboratory rat to 2,4,2′,4′- and 3,4,3′,4′-tetrachlorobiphenyl on dopamine function. Toxicol Appl Pharmacol 1997;146(1):95–103.
Seegal RF, Okoniewski RJ, Brosch KO, Bemis JC. Polychlorinated biphenyls alter extraneuronal but not tissue dopamine concentrations in adult rat striatum: An in vivo microdialysis study. Environ Health Perspect 2002;110:1113–1117.
Faraone SV, Biederman J. Neurobiology of attention-deficit hyperactivity disorder. Biol Psychiatry 1998;44(10):951–958.
Vreugdenhil HJI, Mulder PGH, Emmen HH, Weisglas-Kuperus N. Effects of perinatal exposure to PCBs on neuropsychological functions in the Rotterdam cohort at 9 years of age. Neuropsychology 2004;18:185–193.
Jacobson JL, Jacobson SW. Prenatal exposure to polychlorinated biphenyls and attention at school age. J Pediatr 2003;143:700–788.
Stewart P, Fitzgerald S, Reihman J, Gump B, Lonky E, Darvill T, et al. Prenatal PCB exposure, the corpus callosum, and response inhibition. Environ Health Perspect 2003;111(13):1670–1677.
Stewart P, Reihman J, Gump B, Lonky E, Darvill T, Pagano J. Response inhibition at 8 and 9 1/2 years of age in children prenatally exposed to PCBs. Neurotoxicol Teratol 2005;27(6):771–780.
Stewart PW, Sargent DM, Reihman J, Gump BB, Lonky E, Darvill T, et al. Response inhibition during Differential Reinforcement of Low Rates (DRL) schedules may be sensitive to low-level polychlorinated biphenyl, methylmercury, and lead exposure in children. Environ Health Perspect 2006;114(12):1923–1929.
Grandjean P, Weihe P, Burse VW, Needham LL, Storr-Hansen E, Heinzow B, et al. Neurobehavioral deficits associated with PCB in 7-year-old children prenatally exposed to seafood neurotoxicants. Neurotoxicol Teratol 2001. 23:305–317.
Lee DH., Jacobs DR., Porta M. Association of serum concentrations of persistent organic pollutants with the prevalence of learning disability and attention deficit disorder. J Epidemiol Community Health 2007;61:591–596.
Sagiv SK, Thurston SW, Bellinger DC, Tolbert PE, Altshul LM, Korrick SA. Prenatal Organochlorine Exposure and Behaviors Associated With Attention Deficit Hyperactivity Disorder in School-Aged Children. Am J Epidemiol 2010;171(5):593–601.
Cheuk DKL, Wong V. Attention-deficit hyperactivity disorder and blood mercury level: A case-control study in Chinese children. Neuropediatrics 2006;37:234–240.
Sager PR. Selectivity of methylmercury effects on cytoskeleton and mitotic progression in cultured cells. Toxicol Appl Pharm 1988;94(3):473–486.
Sager PR, Matheson DW. Mechanisms of neurotoxicity related to selective disruption of microtubules and intermediate filaments. Toxicology 1988;49(2–3):479–492.
Nicolescu R, Petcu C, Cordeanu A, Fabritius K, Schlumpf M, Krebs R, et al. Environmental exposure to lead, but not other neurotoxic metals, relates to core elements of ADHD in Romanian children: performance and questionnaire data. Environ Res 2010;110:476–483.
Ha M, Kwon HJ, Lim MH, Jee YK, Hong YC, Leem JH, et al. Low blood levels of lead and mercury and symptoms of attention deficit hyperactivity in children: A report of the Children’s Health and Environment Research (CHEER). Neurotoxicology 2009;30:31–36.
Debesa F, Budtz-Jørgensen E, Weihea P, Whited RF, Grandjean P. Impact of prenatal methylmercury exposure on neurobehavioral function at age 14 years. Neurotoxicol Teratol 2006;28(3):363–375.
Julvez J, Debes F, Weihe P, Choi A, Grandjean P. Sensitivity of continuous performance test (CPT) at age 14 years to developmental methylmercury exposure. Neurotoxicol Teratol 2010;32:627–632.
Myers GJ, Davidson PW, Cox C, Shamlaye CF, Palumbo D, Cernichiari E, et al. Prenatal methylmercury exposure from ocean fish consumption in Seychelles child development study. Lancet 2003;17(361):1686–1692.
Centers for Disease Control and Prevention (CDC). Preventing lead poisoning in young children. Atlanta: CDC; 2005.
Bellinger DC. Very low lead exposures and children’s neurodevelopment. Curr Opin Pediatr 2008;20(2):172–177.
Solon O, Riddell TJ, Quimbo SA, Butrick E, Aylward GP, Lou Bacate M, et al. Associations between cognitive function, blood lead concentration, and nutrition among children in the Central Philippines. J Pediatr 2008;152:237–243.
Nigg JT, Casey BJ. An integrative theory of attention-deficit/hyperactivity disorder based on the cognitive and affective neurosciences. Dev Psychopathol 2005;17:785–806.
Castellanos FX, Sonuga-Barke EJ, Milham MP, Tannock R. Characterizing cognition in ADHD: Beyond executive dysfunction. Trends Cogn Sci 2006;10:117–123.
Froehlich TE, Lanphear BP, Auinger P, Hornung R, Epstein JN, Braun J, et al. Association of tobacco and lead exposures with attention-deficit/hyperactivity disorder. Pediatrics 2009;124(6):1054–1063.
Wang HL, Chen XT, Yang B, Ma FL, Wang S, Tang ML, et al. Case-control study of blood lead levels and attention deficit hyperactivity disorder in Chinese children. Environ Health Perspect 2008;116:1401–1406.
Roy A, Bellinger D, Hu H, Schwartz J, Ettinger AS, Wright RO, et al. Lead exposure and behavior among young children in Chennai, India. Environ Health Perspect 2009;117:1607–1611.
Chiodo LM, Covington C, Sokol RJ, Hannigan JH, Jannise J, Ager J, et al. Blood lead levels and specific attention effects in young children. Neurotoxicol Teratol 2007;29(5):538–546.
Nigg JT, Knottnerus GM, Martel MM, Nikolas M, Cavanagh K, Karmaus W, et al. Low blood lead levels associated with clinically diagnosed attention-deficit/hyperactivity disorder and mediated by weak cognitive control. Biol Psychiatry 2008;63(3):325–331.
Nigg JT, Nikolas M, Knottnerus GM, Cavanagh K, Friderici K. Confirmation and extension of association of blood lead with attention-deficit/hyperactivity disorder (ADHD) and ADHD symptom domains at population — typical exposure levels. J Child Psychol Psychiatry 2010;51(1):58–65.
Cho SC, Kim BN, Hong YC, Shin MS, Yoo HJ, Kim JW, et al. Effect of environmental exposure to lead and tobacco smoke on inattentive and hyperactive symptoms and neurocognitive performance in children. J Child Psychol Psychiatry 2010;51(9):1050–1057.
Kim Y, Cho SC, Kim BN, Hong YC, Shin MS, Yoo HJ. Association between blood lead levels (< 5 μg/dl) and inattention-hyperactivity and neurocognitive profiles in school-aged Korean children. Sci Total Environ 2010;408(23):5737–5743.
Bouchard M, Laforest F, Vandelac L, Bellinger D, Mergler D. Hair manganese and hyperactive behaviors: pilot study of school-age children exposed through tap water. Environ Health Perspect 2007;115(1):122–127.
Rodier J. Manganese poisoning in Moroccan miners. Br J Ind Med 1955;12:21–35.
Iregren A. Manganese neurotoxicity in industrial exposures: proof of effects, critical exposure level, and sensitive tests. Neurotoxicology 1999;20:315–323.
Levy BS, Nassetta WJ. Neurologic effects of manganese in humans: a review. Int J Occup Environ Health 2003;9:153–163.