Early postnatal and concurrent exposure to metals and neurobehavioral outcomes at 5 years: Associations with individual environmental exposures and mixtures

Sui-Ling Liao; Shen-Hao Lai; Yuan-Ting Hsu; Li-Chen Chen; Ming-Han Tsai; Man-Chin Hua; Tsung-Chieh Yao; Kuan-Wen Su; Kuo-Wei Yeh; Chih-Yung Chiu; Shau-Ku Huang; Jing-Long Huang

doi:10.1016/j.neuro.2024.08.006

Early postnatal and concurrent exposure to metals and neurobehavioral outcomes at 5 years: Associations with individual environmental exposures and mixtures

Neurotoxicology. 2024 Aug 29:105:58-66. doi: 10.1016/j.neuro.2024.08.006. Online ahead of print.

Authors

Affiliations

¹ Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Chang Gung University, College of Medicine, Taoyuan, Taiwan.
² Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Division of Pulmonology, Department of Pediatric, Chang Gung Memorial Hospital, Taiwan; Chang Gung University, College of Medicine, Taoyuan, Taiwan.
³ National Institute of Environmental Health Sciences, National Health Research Institutes, Chunan, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Chunan, Taiwan.
⁴ Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taiwan; Chang Gung University, College of Medicine, Taoyuan, Taiwan.
⁵ National Institute of Environmental Health Sciences, National Health Research Institutes, Chunan, Taiwan; Johns Hopkins University, School of Medicine, Baltimore, USA. Electronic address: skhuang@nhri.org.tw.
⁶ Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan; Department of Pediatrics, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, Tucheng, Taiwan; Chang Gung University, College of Medicine, Taoyuan, Taiwan. Electronic address: long@cgmh.org.tw.

PMID: 39214502
DOI: 10.1016/j.neuro.2024.08.006

Abstract

Background: Little is known about the effect of postnatal exposure to heavy metals on children's behavior problems. This study aimed to investigate the association between metal exposure during different stages of postnatal life and neurobehavioral outcomes in preschool children.

Methods: Urinary concentrations of six metals (arsenic, cadmium, chromium, lead, manganese, and vanadium) were measured using inductively coupled plasma mass spectrometry in 220 participants at two time points: before 1 year and at 5 years of age. Mothers completed the Child Behavior Checklist when the children were 5 years old. Multivariable linear and logistic regression analyses were used to evaluate the association between metal concentrations and behavioral outcomes. We employed Bayesian kernel machine regression (BKMR) to assess possible joint effects and potential interactions between metal mixtures and behavioral outcomes.

Results: Concentrations of urinary arsenic (As) in infants were associated with higher scores for anxious/shy behavior problems (β ranging from 0.03 to 0.23). Further analyses showed that As exposure increased the odds of scores falling into the borderline or clinical range on anxious/depressed, affective, and pervasive developmental problems (ORs: 2.45-3.40). Stratification by sex indicated significance in girls but not in boys. BKMR analysis showed that, among the metal mixtures, As displayed a major effect on behavior scores. Concentrations of urinary cadmium in infants were also associated with higher behavioral scores but did not increase the risk of clinical problems. A cross-sectional survey in 5-year-olds did not show a significant association between concurrent metal exposure and behavioral outcome.

Conclusion: Our results showed that exposure to As and Cd during infancy was associated with emotional problems in children. The effect of arsenic exposure was more pronounced among female infants. We suggest reducing exposure to toxic metals during early postnatal life to prevent behavioral problems in children."

Keywords: arsenic; cadmium; chromium; metal mixtures; neurobehavioral disorders; urinary biomarkers.