Association between exposure to polycyclic aromatic hydrocarbons and attention deficit hyperactivity disorder in children: a systematic review and meta-analysis.

Some studies have shown that exposure to polycyclic aromatic hydrocarbons (PAHs) is a dangerous factor for attention deficit hyperactivity disorder (ADHD). This systematic review and meta-analysis aimed to clarify this relationship, and to collect and analyze all the relevant evidences in published reports of epidemiologic studies. PubMed, Science Direct, Web of Science, Scopus, and Google Scholar databases were searched through September 31, 2018. The study quality was evaluated using the Newcastle-Ottawa Scale. Moreover, fixed- and random-effect models were used. The data in this meta-analysis were presented as adjusted odds ratio (AOR). From 959 articles, six articles were included in the systematic review, and for meta-analysis, one study (that was not AOR) was excluded. The participants included in the studies were 2799 with the age range of 5-15 years old, and 93.6% were living in America. Four of the studies were placed in one group, due to having a common author (Perera). Moreover, a significant association was found between PAH exposure and ADHD in these studies (odds ratio = 2.57, 95% CI = 1.75-3.78); however, in all studies, there was no significant association between PAH exposure and ADHD for children (overall odds ratio = 1.99, 95% CI = 0.96-4.11) with low heterogeneity (I2 = 28.73%; P value < 0.001). This study provided a systematic review and meta-analytic evidence for the association between PAH exposure and ADHD by a small number of studies. Further research study can be conducted in various countries. Graphical Abstract.