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Exposure to fluoridated water and attention deficit hyperactivity disorder prevalence among children and adolescents in the United States: an ecological association.

Malin AJ, Till C - Environ Health (2015)

Bottom Line: Epidemiological and animal-based studies have suggested that prenatal and postnatal fluoride exposure has adverse effects on neurodevelopment.Parents reported higher rates of medically-diagnosed ADHD in their children in states in which a greater proportion of people receive fluoridated water from public water supplies.The relationship between fluoride exposure and ADHD warrants future study.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, York University, Keele St., 4700, Toronto, Canada. ashleyjs@yorku.ca.

ABSTRACT

Background: Epidemiological and animal-based studies have suggested that prenatal and postnatal fluoride exposure has adverse effects on neurodevelopment. The aim of this study was to examine the relationship between exposure to fluoridated water and Attention-Deficit Hyperactivity Disorder (ADHD) prevalence among children and adolescents in the United States.

Methods: Data on ADHD prevalence among 4-17 year olds collected in 2003, 2007 and 2011 as part of the National Survey of Children's Health, and state water fluoridation prevalence from the Centers for Disease Control and Prevention (CDC) collected between 1992 and 2008 were utilized.

Results: State prevalence of artificial water fluoridation in 1992 significantly positively predicted state prevalence of ADHD in 2003, 2007 and 2011, even after controlling for socioeconomic status. A multivariate regression analysis showed that after socioeconomic status was controlled each 1% increase in artificial fluoridation prevalence in 1992 was associated with approximately 67,000 to 131,000 additional ADHD diagnoses from 2003 to 2011. Overall state water fluoridation prevalence (not distinguishing between fluoridation types) was also significantly positively correlated with state prevalence of ADHD for all but one year examined.

Conclusions: Parents reported higher rates of medically-diagnosed ADHD in their children in states in which a greater proportion of people receive fluoridated water from public water supplies. The relationship between fluoride exposure and ADHD warrants future study.

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Related in: MedlinePlus

Artificial fluoridation prevalence predicting ADHD prevalence after adjusting for 1992 median household income, by state. The line with large dashes and triangles represent predicted values of ADHD prevalence in 2003. The line with small dashes and diamonds represent predicted values of ADHD prevalence in 2007. The solid line and circles represent predicted values of ADHD prevalence in 2011.
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Fig1: Artificial fluoridation prevalence predicting ADHD prevalence after adjusting for 1992 median household income, by state. The line with large dashes and triangles represent predicted values of ADHD prevalence in 2003. The line with small dashes and diamonds represent predicted values of ADHD prevalence in 2007. The solid line and circles represent predicted values of ADHD prevalence in 2011.

Mentions: The overall model was significant when predicting ADHD prevalence in 2003 (F (2, 48) = 8.71, p = 0.001), 2007 (F (2, 48) = 7.94, p = 0.001) and 2011 (F (2, 48) = 12.21, p = 0.000), accounting for 24%, 22% and 31% of the variance in ADHD prevalence respectively. In the final model, artificial fluoridation prevalence in 1992 significantly and independently predicted parent-reported health care provider-diagnosed ADHD in all three years examined, Wilks λ = .81, F (3, 46) = 3.64, p = 0.02, while the predictive relationship between median household income in 1992 and ADHD prevalence in all three years was reduced to that of a trend, Wilks λ = .86, F (3, 46) = 2.48, p = 0.07. After applying a Bonferroni correction, artificial fluoridation prevalence in 1992 significantly predicted ADHD prevalence in 2003, (B = 0.023, t (48) = 3.05, p = 0.004), 2007 (B = 0.031, t (48) = 2.64, p = 0.011), and 2011 (B = 0.042, t (48) = 3.20, p = 0.002). Thus, after adjusting for socioeconomic status, a 1% increase in artificial water fluoridation prevalence in 1992 was associated with a 0.023% increase in ADHD prevalence in 2003 (corresponding to approximately 67,000 additional diagnoses), a 0.031% increase in ADHD prevalence in 2007 (corresponding to approximately 93,000 additional diagnoses) and a 0.043% increase in ADHD prevalence in 2011 (corresponding to approximately 131,000 additional diagnoses). Median household income in 1992 (measured in hundreds of dollars) did not meet the threshold for significance in predicting ADHD prevalence in 2003 (p = 0.061) or 2007 (p = 0.035), but did so in 2011 (B = −.018, t = − 2.77, p = 0.008) (see Figure 1).Figure 1


Exposure to fluoridated water and attention deficit hyperactivity disorder prevalence among children and adolescents in the United States: an ecological association.

Malin AJ, Till C - Environ Health (2015)

Artificial fluoridation prevalence predicting ADHD prevalence after adjusting for 1992 median household income, by state. The line with large dashes and triangles represent predicted values of ADHD prevalence in 2003. The line with small dashes and diamonds represent predicted values of ADHD prevalence in 2007. The solid line and circles represent predicted values of ADHD prevalence in 2011.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389999&req=5

Fig1: Artificial fluoridation prevalence predicting ADHD prevalence after adjusting for 1992 median household income, by state. The line with large dashes and triangles represent predicted values of ADHD prevalence in 2003. The line with small dashes and diamonds represent predicted values of ADHD prevalence in 2007. The solid line and circles represent predicted values of ADHD prevalence in 2011.
Mentions: The overall model was significant when predicting ADHD prevalence in 2003 (F (2, 48) = 8.71, p = 0.001), 2007 (F (2, 48) = 7.94, p = 0.001) and 2011 (F (2, 48) = 12.21, p = 0.000), accounting for 24%, 22% and 31% of the variance in ADHD prevalence respectively. In the final model, artificial fluoridation prevalence in 1992 significantly and independently predicted parent-reported health care provider-diagnosed ADHD in all three years examined, Wilks λ = .81, F (3, 46) = 3.64, p = 0.02, while the predictive relationship between median household income in 1992 and ADHD prevalence in all three years was reduced to that of a trend, Wilks λ = .86, F (3, 46) = 2.48, p = 0.07. After applying a Bonferroni correction, artificial fluoridation prevalence in 1992 significantly predicted ADHD prevalence in 2003, (B = 0.023, t (48) = 3.05, p = 0.004), 2007 (B = 0.031, t (48) = 2.64, p = 0.011), and 2011 (B = 0.042, t (48) = 3.20, p = 0.002). Thus, after adjusting for socioeconomic status, a 1% increase in artificial water fluoridation prevalence in 1992 was associated with a 0.023% increase in ADHD prevalence in 2003 (corresponding to approximately 67,000 additional diagnoses), a 0.031% increase in ADHD prevalence in 2007 (corresponding to approximately 93,000 additional diagnoses) and a 0.043% increase in ADHD prevalence in 2011 (corresponding to approximately 131,000 additional diagnoses). Median household income in 1992 (measured in hundreds of dollars) did not meet the threshold for significance in predicting ADHD prevalence in 2003 (p = 0.061) or 2007 (p = 0.035), but did so in 2011 (B = −.018, t = − 2.77, p = 0.008) (see Figure 1).Figure 1

Bottom Line: Epidemiological and animal-based studies have suggested that prenatal and postnatal fluoride exposure has adverse effects on neurodevelopment.Parents reported higher rates of medically-diagnosed ADHD in their children in states in which a greater proportion of people receive fluoridated water from public water supplies.The relationship between fluoride exposure and ADHD warrants future study.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychology, York University, Keele St., 4700, Toronto, Canada. ashleyjs@yorku.ca.

ABSTRACT

Background: Epidemiological and animal-based studies have suggested that prenatal and postnatal fluoride exposure has adverse effects on neurodevelopment. The aim of this study was to examine the relationship between exposure to fluoridated water and Attention-Deficit Hyperactivity Disorder (ADHD) prevalence among children and adolescents in the United States.

Methods: Data on ADHD prevalence among 4-17 year olds collected in 2003, 2007 and 2011 as part of the National Survey of Children's Health, and state water fluoridation prevalence from the Centers for Disease Control and Prevention (CDC) collected between 1992 and 2008 were utilized.

Results: State prevalence of artificial water fluoridation in 1992 significantly positively predicted state prevalence of ADHD in 2003, 2007 and 2011, even after controlling for socioeconomic status. A multivariate regression analysis showed that after socioeconomic status was controlled each 1% increase in artificial fluoridation prevalence in 1992 was associated with approximately 67,000 to 131,000 additional ADHD diagnoses from 2003 to 2011. Overall state water fluoridation prevalence (not distinguishing between fluoridation types) was also significantly positively correlated with state prevalence of ADHD for all but one year examined.

Conclusions: Parents reported higher rates of medically-diagnosed ADHD in their children in states in which a greater proportion of people receive fluoridated water from public water supplies. The relationship between fluoride exposure and ADHD warrants future study.

Show MeSH
Related in: MedlinePlus