Mireille Desrochers-Couture1, Yohann Courtemanche1, Nadine Forget-Dubois1, Richard E Bélanger2, Olivier Boucher3, Pierre Ayotte4, Sylvaine Cordier5, Joseph L Jacobson6, Sandra W Jacobson6, Gina Muckle7. 1. Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada. 2. Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada; Département de Pédiatrie, Université Laval, Québec, Québec, Canada. 3. Département de Psychologie, Université de Montréal, Montréal, Québec, Canada; Service de Psychologie, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada. 4. Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada; Centre de Toxicologie du Québec, Institut National de Santé Publique du Québec, Québec, Québec, Canada; Département de Médecine Sociale et Préventive, Université Laval, Québec, Québec, Canada. 5. Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada; Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S1085, F-35000 Rennes, France. 6. Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, USA. 7. Centre de Recherche du CHU de Québec-Université Laval, Québec, Québec, Canada; École de Psychologie, Université Laval, Québec, Québec, Canada. Electronic address: gina.muckle@psy.ulaval.ca.
Abstract
BACKGROUND: Lead (Pb) exposure is associated with adverse neurological development. Most notably, it has been observed through externalizing behavior symptoms, as observed among Inuit children from northern Québec. Evidence for a persistent neurological impact of early Pb exposure later in life is however scarce. Pb exposure may initiate a developmental cascade that increases the risk of long-term behavior problems. OBJECTIVES: Testing for direct associations between childhood Pb concentrations and adolescent externalizing symptoms and substance use, as well as indirect associations through childhood behavior assessments. METHODS: The study sample is a longitudinal cohort of Inuit children (n = 212) followed since birth. Blood Pb concentrations were measured during childhood (median age = 11.4 years) and adolescence (median age = 18.5 years). Externalizing/inattentive behavior were teacher-assessed through the Teacher Report Form and the Disruptive Behavior Disorders Rating Scale for children. At the adolescence follow-up, behavior problems were self-reported by filling Achenbach's Youth Self-Report, the Barkley Adult ADHD-IV Rating Scale, and the Diagnostics Interview Schedule for Children. Adolescent substance use was also self-assessed through the DEP-ADO. Direct and indirect associations of child Pb concentrations with adolescent outcomes were tested through mediation models. RESULTS: Child blood Pb concentrations were not directly associated with any adolescent outcomes. On the contrary, childhood Pb exposure was indirectly associated, through childhood externalizing behavior assessments, with adolescent externalizing behaviors, binge drinking, and cannabis use. These indirect associations held after controlling for adolescents' concurrent Pb blood concentrations. DISCUSSION: Our results highlight the indirect but lasting effects of child Pb exposure on adolescent behavior problems, and the importance of childhood externalizing behavior in this relationship. Adverse early-life environment put children on a riskier developmental trajectory, increasing their likelihood of lifelong psychological, social and health problems.
BACKGROUND: Lead (Pb) exposure is associated with adverse neurological development. Most notably, it has been observed through externalizing behavior symptoms, as observed among Inuit children from northern Québec. Evidence for a persistent neurological impact of early Pb exposure later in life is however scarce. Pb exposure may initiate a developmental cascade that increases the risk of long-term behavior problems. OBJECTIVES: Testing for direct associations between childhood Pb concentrations and adolescent externalizing symptoms and substance use, as well as indirect associations through childhood behavior assessments. METHODS: The study sample is a longitudinal cohort of Inuit children (n = 212) followed since birth. Blood Pb concentrations were measured during childhood (median age = 11.4 years) and adolescence (median age = 18.5 years). Externalizing/inattentive behavior were teacher-assessed through the Teacher Report Form and the Disruptive Behavior Disorders Rating Scale for children. At the adolescence follow-up, behavior problems were self-reported by filling Achenbach's Youth Self-Report, the Barkley Adult ADHD-IV Rating Scale, and the Diagnostics Interview Schedule for Children. Adolescent substance use was also self-assessed through the DEP-ADO. Direct and indirect associations of childPb concentrations with adolescent outcomes were tested through mediation models. RESULTS:Child blood Pb concentrations were not directly associated with any adolescent outcomes. On the contrary, childhood Pb exposure was indirectly associated, through childhood externalizing behavior assessments, with adolescent externalizing behaviors, binge drinking, and cannabis use. These indirect associations held after controlling for adolescents' concurrent Pb blood concentrations. DISCUSSION: Our results highlight the indirect but lasting effects of childPb exposure on adolescent behavior problems, and the importance of childhood externalizing behavior in this relationship. Adverse early-life environment put children on a riskier developmental trajectory, increasing their likelihood of lifelong psychological, social and health problems.
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