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Phthalates Exposure and Attention-Deficit/Hyperactivity Disorder in School-Age Children

  • Bung-Nyun Kim
    Affiliations
    Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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  • Soo-Churl Cho
    Affiliations
    Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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  • Yeni Kim
    Affiliations
    Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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  • Min-Sup Shin
    Affiliations
    Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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  • Hee-Jeong Yoo
    Affiliations
    Department of Psychiatry, Seoul National University Bundang Hospital, Seong-nam, Republic of Korea
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  • Jae-Won Kim
    Affiliations
    Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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  • Young Hee Yang
    Affiliations
    Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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  • Hyo-Won Kim
    Affiliations
    Division of Child & Adolescent Psychiatry, Department of Psychiatry and Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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  • Soo-Young Bhang
    Affiliations
    Department of Psychiatry, Ulsan University Hospital, Ulsan, Republic of Korea
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  • Yun-Chul Hong
    Correspondence
    Address correspondence to Yun-Chul Hong, M.D., Ph.D., Department of Preventive Medicine, Seoul National University College of Medicine and Institute of Environmental Medicine, SNUMRC, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Republic of Korea
    Affiliations
    Department of Preventive Medicine, Seoul National University College of Medicine and Institute of Environmental Medicine, SNUMRC, Seoul, Republic of Korea
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Published:September 14, 2009DOI:https://doi.org/10.1016/j.biopsych.2009.07.034

      Background

      Very few studies have examined the association between attention-deficit/hyperactivity disorder (ADHD) and phthalate exposure in humans. The aim of this study was to investigate the impact of phthalates on symptoms of ADHD in school-age children.

      Methods

      A cross-sectional examination of urine phthalate concentrations was performed, and scores on measures of ADHD symptoms and neuropsychological dysfunction with regard to attention and impulsivity were obtained from 261 Korean children, age 8–11 years.

      Results

      Mono-2-ethylheyl phthalate (MEHP) and mono-2-ethyl-5-oxohexylphthalate (MEOP) for metabolites of Di-2-ethylhexylphthalate (DEHP) and mono-n-butyl phthalate (MNBP) for metabolites of dibutyl phthalate (DBP) were measured in urine samples. The mean concentrations of MEHP, MEOP, and MNBP were 34.0 μg/dL (SD = 36.3; range: 2.1–386.7), 23.4 μg/dL (SD = 23.0; range: .75–244.8), and 46.7 μg/L (SD = 21.4; range: 13.2–159.3), respectively. After adjustment for covariates, teacher-rated ADHD scores were significantly associated with DEHP metabolites but not with DBP metabolites. We also found significant relationships between the urine concentrations of metabolites for DBP and the number of omission and commission errors in continuous performance tests (CPT) after adjustment for covariates.

      Conclusion

      The present study showed a strong positive association between phthalate metabolites in urine and symptoms of ADHD among school-age children.

      Key Words

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