Association of Bisphenol A exposure and Attention-Deficit/Hyperactivity Disorder in a national sample of U.S. children.
BACKGROUND
Bisphenol A (BPA) has been linked to changes in the dopamine system and development of an Attention-Deficit/Hyperactivity Disorder (ADHD) phenotype in animal models, with differing effects in males compared to females. We examined the association between urinary BPA concentrations and ADHD in a national sample of U.S. children, and whether this association differs by child sex.


METHODS
We used data from the 2003-2004 National Health and Nutrition Examination Survey, a cross-sectional, nationally representative sample of the U.S.


POPULATION
Participants were 8-15 years of age (N=460). Using a diagnostic interview to ascertain the presence of ADHD in the past year, multivariable logistic regression examined the link between concurrent urinary BPA concentrations and ADHD status.


RESULTS
Of the 460 participants, 7.1% [95% CI: 4.4-11.3] met Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) criteria for ADHD. Children who had BPA concentrations at or above the median of the sample had higher prevalence of meeting criteria for ADHD (11.2% [95% CI: 6.8-17.8]) than those with BPA concentrations below the median (2.9% [95% CI: 1.1-7.2]). Higher urinary BPA concentrations were associated with ADHD (adjusted odds ratio [aOR]: 5.68 [95% CI: 1.6-19.8] for BPA concentrations above vs. below the median). In sex-stratified analyses, these associations were stronger in boys (aOR=10.9 [95% CI: 1.4-86.0]) than in girls (aOR=2.8 [95% CI: 0.4-21.3]), although the BPA by sex interaction term was not significant (p=0.25).


CONCLUSION
We found evidence that higher urinary BPA concentrations were associated with ADHD in U.S. children; these associations were stronger in boys than in girls. Considering the widespread use of BPA and growing literature on neurobehavioral effects of BPA in children, further study is warranted to determine if reducing exposure to BPA may represent an important avenue for ADHD prevention.
['Tewar|Shruti|S|', 'Auinger|Peggy|P|', 'Braun|Joseph M|JM|', 'Lanphear|Bruce|B|', 'Yolton|Kimberly|K|', 'Epstein|Jeffery N|JN|', 'Ehrlich|Shelley|S|', 'Froehlich|Tanya E|TE|']
D000293:Adolescent D001289:Attention Deficit Disorder with Hyperactivity D001559:Benzhydryl Compounds D002648:Child D003430:Cross-Sectional Studies D004781:Environmental Exposure D004785:Environmental Pollutants D005260:Female D006801:Humans D008297:Male D009749:Nutrition Surveys D010636:Phenols D015995:Prevalence D012737:Sex Factors D014481:United States
Bisphenol A Hyperactivity ADHD Attention Behavior Endocrine disruptor Environmental exposure