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American Academy of Pediatrics
Article

Attention-Deficit/Hyperactivity Disorder and Urinary Metabolites of Organophosphate Pesticides

Maryse F. Bouchard, David C. Bellinger, Robert O. Wright and Marc G. Weisskopf
Pediatrics June 2010, 125 (6) e1270-e1277; DOI: https://doi.org/10.1542/peds.2009-3058
Maryse F. Bouchard
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David C. Bellinger
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Robert O. Wright
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Marc G. Weisskopf
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Abstract

OBJECTIVE: The goal was to examine the association between urinary concentrations of dialkyl phosphate metabolites of organophosphates and attention-deficit/hyperactivity disorder (ADHD) in children 8 to 15 years of age.

METHODS: Cross-sectional data from the National Health and Nutrition Examination Survey (2000–2004) were available for 1139 children, who were representative of the general US population. A structured interview with a parent was used to ascertain ADHD diagnostic status, on the basis of slightly modified criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

RESULTS: One hundred nineteen children met the diagnostic criteria for ADHD. Children with higher urinary dialkyl phosphate concentrations, especially dimethyl alkylphosphate (DMAP) concentrations, were more likely to be diagnosed as having ADHD. A 10-fold increase in DMAP concentration was associated with an odds ratio of 1.55 (95% confidence interval: 1.14–2.10), with adjustment for gender, age, race/ethnicity, poverty/income ratio, fasting duration, and urinary creatinine concentration. For the most-commonly detected DMAP metabolite, dimethyl thiophosphate, children with levels higher than the median of detectable concentrations had twice the odds of ADHD (adjusted odds ratio: 1.93 [95% confidence interval: 1.23–3.02]), compared with children with undetectable levels.

CONCLUSIONS: These findings support the hypothesis that organophosphate exposure, at levels common among US children, may contribute to ADHD prevalence. Prospective studies are needed to establish whether this association is causal.

  • attention-deficit/hyperactivity disorder
  • pesticides
  • organophosphates
  • National Health and Nutrition Examination Survey
  • Accepted February 23, 2010.
  • Copyright © 2010 by the American Academy of Pediatrics
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Pediatrics
Vol. 125, Issue 6
1 Jun 2010
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Attention-Deficit/Hyperactivity Disorder and Urinary Metabolites of Organophosphate Pesticides
Maryse F. Bouchard, David C. Bellinger, Robert O. Wright, Marc G. Weisskopf
Pediatrics Jun 2010, 125 (6) e1270-e1277; DOI: 10.1542/peds.2009-3058

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Attention-Deficit/Hyperactivity Disorder and Urinary Metabolites of Organophosphate Pesticides
Maryse F. Bouchard, David C. Bellinger, Robert O. Wright, Marc G. Weisskopf
Pediatrics Jun 2010, 125 (6) e1270-e1277; DOI: 10.1542/peds.2009-3058
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  • What causes attention deficit hyperactivity disorder?
  • Reducing The Staggering Costs Of Environmental Disease In Children, Estimated At $76.6 Billion In 2008
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