Brominated Flame Retardant Exposure and Attention Deficient Hyperactivity Disorder in U.S. Youth

BACKGROUND:  Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children characterized by forgetfulness, excessive daydreaming, making careless mistakes, inability to take turns and excessive fidgeting. Children with ADHD have difficulty in school, peer relationships and are more likely to have major injuries compared to children who do not have ADHD. Polybrominated diphenyl ethers (PBDEs) are ubiquitous environmental contaminants that are believed to affect neurodevelopment, however little is known about PBDES and clinical developmental disorders. 

METHODS:  Data from the National Health and Nutrition Examination Survey (NHANES) 2003-2004 was used to examine the relationship between lipid adjusted serum PBDE concentrations,2’,4-tribromodiphenyl ether (BDE-28), 2,2’,4,4’-tetrabromodiphenylether (BDE-47), 2,2’,4,4’,5-pentabromodiphenyl ether (BDE-99), 2,2’,4,4’,5,5’-pentabromodiphenyl ether (BDE-100), 2,2’,4,4’,5,5’-hexbromodiphenyl ether, 2,2’,4,4’,5,5’-hexabromobiphenyl (BB-153), sum concentrations of all the brominated flame retardants and sum concentrations of all PBDEs) and parent reported diagnosis of ADHD by a health care provider or physician in youth 12 to 15 years of age (N=377 ). Multiple logistic regression models were used to evaluate the association between each congener, and the sum of all congners, dichotomized at the geometric mean and parent reported ADHD diagnosis by a doctor or health professional.

RESULTS:  The weighted prevalence of ADHD was 13.57 %. The adjusted odds ratios (AOR), 95% confidence interval (CI) for 2’,4-tribromodiphenyl ether (BDE-28), 2,2’,4,4’-tetrabromodiphenylether (BDE-47), 2,2’,4,4’,5-pentabromodiphenyl ether (BDE-99), 2,2’,4,4’,5,5’-pentabromodiphenyl ether (BDE-100), 2,2’,4,4’,5,5’-hexbromodiphenyl ether, 2,2’,4,4’,5,5’-hexabromobiphenyl (BB-153), sum concentrations of all the brominated flame retardants and sum concentrations of all the PBDEs are 1.350 (95% CI: 0.408, 4.467), 0.890 (95% CI: 0.287, 2.760), 1.246 (95% CI: 0.276, 5.622), 2.345 (95% CI: 0.618, 8.900), 4.120 (95% CI: 0.734, 23.414), 0.904 (95% CI: 0.033, 0.623), 1.161 (95% CI: 0.437, 3.081) and 2.127 (95% CI: 0.541, 8.359), respectively when adjusted for gender, health insurance status and birth weight.

CONCLUSIONS:  No association was found between the lipid adjusted serum concentrations of single PBDE congeners or the sum of all congeners and parent reported ADHD prevalence.