Attention-deficit/hyperactivity disorder and urinary metabolites of organophosphate pesticides
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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.
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A tenfold rise in DMAP organophosphate metabolite is linked to 55% higher probability of ADHD.
“a tenfold increase in the organophosphate metabolite dimethyl alkylphosphate (DMAP) was associated with 55% increase in the probability of having ADHD”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Bouchard et al., 2010
The Abstract Results and Results ('Any Subtype of ADHD') report an adjusted odds ratio of 1.55 for ADHD with a tenfold increase in urinary DMAP concentration. That is 55% higher odds, not necessarily a 55% higher probability, as the citing sentence states. (LLM, conf=0.90)
Experimental — accuracy not yet measuredChildren with detectable levels of the most common DMAP metabolite have twice the likelihood of ADHD as those with undetectable levels.
“Children with detectable levels of the most-commonly detected DMAP metabolite were twice as likely to have ADHD compared with those with undetectable levels”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Bouchard et al., 2010
The Results (Any Subtype of ADHD) identify dimethylthiophosphate as the most commonly detected DMAP metabolite and report approximately double the odds of ADHD for children above the median of detectable concentrations versus those below the detection limit. The claim extends that finding to all children with detectable levels, which the paper does not establish. (LLM, conf=0.92)
Experimental — accuracy not yet measured
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- Authors
- Bouchard, M. F., Bellinger, D. C., Wright, R. O., & Weisskopf, M. G.
- Affiliations
- Université de Montréal (CA)
- Environmental Health (GB)
- Brigham and Women's Hospital (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2010-06-01
- Volume
- 125
- Issue
- 6
- Pages
- e1270-e1277
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC3706632
- OpenAlex
- W2126941269
- Cited by
- 457
- References
- 34
- Citations by year
- 2026: 10 · 2025: 19 · 2024: 20 · 2023: 25 · 2022: 18 · 2021: 18 · 2020: 33 · 2019: 18 · 2018: 17 · 2017: 33 · 2016: 36 · 2015: 42 · 2014: 36 · 2013: 30 · 2012: 45
- FWCI
- 50.25
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Centers for Disease Control and Prevention
- National Institute of Environmental Health Sciences (P42ES016454, P30ES000002, P30-ES00002, K01ES012653, R01ES013744)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Plant Science › Pesticide Exposure and Toxicity
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
- Keywords
- attention deficit hyperactivity disorder, organophosphorus pesticides, dialkyl phosphate metabolites, urinary biomarkers, pesticide exposure, children, neurodevelopmental disorders
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Creatinine, Cross-Sectional Studies, Environmental Exposure, Female, Humans, Male, Nutrition Surveys, Pesticides, Organophosphates, United States, Prevalence
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