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Journal of Environmental and Public Health
Volume 2014, Article ID 628508, 10 pages
Research Article

Urinary Polycyclic Aromatic Hydrocarbon Metabolites and Attention/Deficit Hyperactivity Disorder, Learning Disability, and Special Education in U.S. Children Aged 6 to 15

1Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06520, USA
2Department of Chronic Disease Epidemiology, Yale School Public Health, New Haven, CT 06520, USA
3Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY 10032, USA
4Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, 1 Church Street, 6th floor, New Haven, CT 06510, USA

Received 28 June 2013; Accepted 16 December 2013; Published 30 January 2014

Academic Editor: Brian Buckley

Copyright © 2014 Zaynah Abid et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Exposure to polycyclic aromatic hydrocarbons (PAHs) adversely affects child neurodevelopment, but little is known about the relationship between PAHs and clinically significant developmental disorders. We examined the relationship between childhood measures of PAH exposure and prevalence of attention deficit/hyperactivity disorder (ADHD), learning disability (LD), and special education (SE) in a nationally representative sample of 1,257 U.S. children 6–15 years of age. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2001–2004. PAH exposure was measured by urinary metabolite concentrations. Outcomes were defined by parental report of (1) ever doctor-diagnosed ADHD, (2) ever doctor- or school representative-identified LD, and (3) receipt of SE or early intervention services. Multivariate logistic regression accounting for survey sampling was used to determine the associations between PAH metabolites and ADHD, LD, and SE. Children exposed to higher levels of fluorine metabolites had a 2-fold increased odds (95% C.I. 1.1, 3.8) of SE, and this association was more apparent in males (OR 2.3; 95% C.I. 1.2, 4.1) than in females (OR 1.8; 95% C.I. 0.6, 5.4). No other consistent pattern of developmental disorders was associated with urinary PAH metabolites. However, concurrent exposure to PAH fluorine metabolites may increase use of special education services among U.S. children.