Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies
<i>Background and objectives</i>: Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterized by two dimensions: inattentiveness and hyperactivity/impulsivity. ADHD may be the result of complex interactions between genetic, biological an...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/4/797 |
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| author | Gianluca Fiore Federica Veneri Rosaria Di Lorenzo Luigi Generali Marco Vinceti Tommaso Filippini |
| author_facet | Gianluca Fiore Federica Veneri Rosaria Di Lorenzo Luigi Generali Marco Vinceti Tommaso Filippini |
| author_sort | Gianluca Fiore |
| collection | DOAJ |
| description | <i>Background and objectives</i>: Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterized by two dimensions: inattentiveness and hyperactivity/impulsivity. ADHD may be the result of complex interactions between genetic, biological and environmental factors possibly including fluoride exposure. <i>Materials and methods</i>: A literature search was performed on 31 March 2023 in the following databases: PubMed, Embase and Web of Science. We defined the following inclusion criteria according to the PECOS statement: a healthy child and adolescent population (P), fluoride exposure of any type (E), comparison with low or null exposure (C), ADHD spectrum disorder (O), and ecological, cross-sectional, case–control and cohort studies (S). <i>Results</i>: We found eight eligible records corresponding to seven different studies investigating the effect of fluoride exposure on children and adolescents. One study had a cohort design and one a case–control one, while five were cross-sectional. Only three studies applied validated questionnaires for the purpose of ADHD diagnosis. As regards exposure assessment, levels of fluoride in urine and tap water were, respectively used in three and two studies, while two used both. Three studies reported a positive association with ADHD risk, all assessing exposure through fluoride levels. By using urinary fluoride, conversely, a positive correlation with inattention, internalizing symptoms, cognitive and psychosomatic problems was found in three studies, but no relation was found in the other one. <i>Conclusions</i>: The present review suggests that early exposure to fluoride may have neurotoxic effects on neurodevelopment affecting behavioral, cognitive and psychosomatic symptoms related to ADHD diagnosis. However, due to the heterogeneity of the studies included, current evidence does not allow to conclusively confirm that fluoride exposure is specifically linked to ADHD development. |
| first_indexed | 2024-03-11T04:45:21Z |
| format | Article |
| id | doaj.art-0f613744689f4b19adc0c694b463489e |
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| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T04:45:21Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-0f613744689f4b19adc0c694b463489e2023-11-17T20:22:14ZengMDPI AGMedicina1010-660X1648-91442023-04-0159479710.3390/medicina59040797Fluoride Exposure and ADHD: A Systematic Review of Epidemiological StudiesGianluca Fiore0Federica Veneri1Rosaria Di Lorenzo2Luigi Generali3Marco Vinceti4Tommaso Filippini5Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, ItalyUnit of Dentistry & Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, ItalyService of Psychiatric Diagnosis and Care (SPDC), Department of Mental Health and Drug Abuse, AUSL Modena, 41124 Modena, ItalyUnit of Dentistry & Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, ItalyEnvironmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, ItalyEnvironmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy<i>Background and objectives</i>: Attention deficit hyperactivity disorder (ADHD) is a childhood-onset neurodevelopmental disorder characterized by two dimensions: inattentiveness and hyperactivity/impulsivity. ADHD may be the result of complex interactions between genetic, biological and environmental factors possibly including fluoride exposure. <i>Materials and methods</i>: A literature search was performed on 31 March 2023 in the following databases: PubMed, Embase and Web of Science. We defined the following inclusion criteria according to the PECOS statement: a healthy child and adolescent population (P), fluoride exposure of any type (E), comparison with low or null exposure (C), ADHD spectrum disorder (O), and ecological, cross-sectional, case–control and cohort studies (S). <i>Results</i>: We found eight eligible records corresponding to seven different studies investigating the effect of fluoride exposure on children and adolescents. One study had a cohort design and one a case–control one, while five were cross-sectional. Only three studies applied validated questionnaires for the purpose of ADHD diagnosis. As regards exposure assessment, levels of fluoride in urine and tap water were, respectively used in three and two studies, while two used both. Three studies reported a positive association with ADHD risk, all assessing exposure through fluoride levels. By using urinary fluoride, conversely, a positive correlation with inattention, internalizing symptoms, cognitive and psychosomatic problems was found in three studies, but no relation was found in the other one. <i>Conclusions</i>: The present review suggests that early exposure to fluoride may have neurotoxic effects on neurodevelopment affecting behavioral, cognitive and psychosomatic symptoms related to ADHD diagnosis. However, due to the heterogeneity of the studies included, current evidence does not allow to conclusively confirm that fluoride exposure is specifically linked to ADHD development.https://www.mdpi.com/1648-9144/59/4/797ADHDfluorideattention deficit hyperactivity disorderneurobehavioralsystematic reviewepidemiology |
| spellingShingle | Gianluca Fiore Federica Veneri Rosaria Di Lorenzo Luigi Generali Marco Vinceti Tommaso Filippini Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies Medicina ADHD fluoride attention deficit hyperactivity disorder neurobehavioral systematic review epidemiology |
| title | Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies |
| title_full | Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies |
| title_fullStr | Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies |
| title_full_unstemmed | Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies |
| title_short | Fluoride Exposure and ADHD: A Systematic Review of Epidemiological Studies |
| title_sort | fluoride exposure and adhd a systematic review of epidemiological studies |
| topic | ADHD fluoride attention deficit hyperactivity disorder neurobehavioral systematic review epidemiology |
| url | https://www.mdpi.com/1648-9144/59/4/797 |
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