Air Pollutants and Attention Deficit Hyperactivity Disorder Medication
Administration in Elementary Schools
Introduction. Air pollution is considered a risk factor for several
diseases, including respiratory and cardiovascular. However, the effects
of air pollution on neurobehavioral disorders is not confirmed yet.
Thus, this study aimed at determining the association of seven air
pollutants with ADHD medication administration (ADHD-MA) in
Pennsylvania-located elementary schools over a three-year period.
Methods. An ecological study design involving records of 168,825
children from elementary schools in 49 Pennsylvania counties was used.
The number of children with ADHD-MA was extracted from an online
software specifically designed for allowing nurses to record health
conditions in schools. Daily measurements of air pollutants were gained
from the U.S Environmental Protection Agency. Results. The mean number
of ADHD-MA significantly increased over the 3-year period [163.9 (+
70.1) in 2008, 317.2 (+ 84.4) in 2009, and 427 (+ 101.4) in 2010]. The
difference in the number of ADHD-MA among the three years and among the
four seasons, for all years, were statistically significant
(P<0.001). Three air pollutants (SO2, CO, and PM2.5) were
significantly associated with ADHD-MA; no interactions among air
pollutants were significant. Conclusion. Air pollution is likely
associated with both ADHD incidence and ADHD-MA. Prospective
epidemiological and biomedical studies could examine the relationship
between air pollution and ADHD symptoms.