Neighborhood environmental exposures and incidence of attention deficit/hyperactivity disorder: A population-based cohort study

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• dc.contributor.author Yuchi, Weiran
• dc.contributor.author Brauer, Michael
• dc.contributor.author Czekajlo, Agatha
• dc.contributor.author Davies, Hugh W.
• dc.contributor.author Davis, Zoë
• dc.contributor.author Guhn, Martin
• dc.contributor.author Jarvis, Ingrid
• dc.contributor.author Jerrett, Michael
• dc.contributor.author Nesbitt, Lorien
• dc.contributor.author Oberlander, Tim F.
• dc.contributor.author Sbihi, Hind
• dc.contributor.author Su, Jason
• dc.contributor.author van den Bosch, Matilda A.
• dc.date.accessioned 2022-05-10T05:52:52Z
• dc.date.available 2022-05-10T05:52:52Z
• dc.date.issued 2022
• dc.description.abstract Background: Emerging studies have associated low greenspace and high air pollution exposure with risk of child attention deficit/hyperactivity disorder (ADHD). Population-based studies are limited, however, and joint effects are rarely evaluated. We investigated associations of ADHD incidence with greenspace, air pollution, and noise in a population-based birth cohort. Methods: We assembled a cohort from administrative data of births from 2000 to 2001 (N ∼ 37,000) in Metro Vancouver, Canada. ADHD was identified by hospital records, physician visits, and prescriptions. Cox proportional hazards models were applied to assess associations between environmental exposures and ADHD incidence adjusting for available covariates. Greenspace was estimated using vegetation percentage derived from linear spectral unmixing of Landsat imagery. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated using land use regression models; noise was estimated using a deterministic model. Exposure period was from birth until the age of three. Joint effects of greenspace and PM2.5 were analysed in two-exposure models and by categorizing values into quintiles. Results: During seven-year follow-up, 1217 ADHD cases were diagnosed. Greenspace was associated with lower incidence of ADHD (hazard ratio, HR: 0.90 [0.81-0.99] per interquartile range increment), while PM2.5 was associated with increased incidence (HR: 1.11 [1.06-1.17] per interquartile range increment). NO2 (HR: 1.01 [0.96, 1.07]) and noise (HR: 1.00 [0.95, 1.05]) were not associated with ADHD. There was a 50% decrease in the HR for ADHD in locations with the lowest PM2.5 and highest greenspace exposure, compared to a 62% increase in HR in locations with the highest PM2.5 and lowest greenspace exposure. Effects of PM2.5 were attenuated by greenspace in two-exposure models. Conclusions: We found evidence suggesting environmental inequalities where children living in greener neighborhoods with low air pollution had substantially lower risk of ADHD compared to those with higher air pollution and lower greenspace exposure.
• dc.description.sponsorship This work was supported by the Canadian Institutes of Health Research (grant number:156152) and by the European Union's Horizon 2020 research and innovation programme under a Marie Skłodowska-Curie Grant Agreement No 891538. Data were made accessible via Population Data BC. National air pollution estimates, Canadian Marginalization index, and NDVI metrics indexed to DMTI Spatial Inc. postal codes were provided by CANUE (Canadian Urban Environmental Health Research Consortium). We are grateful for the support of the Integrated Remote Sensing Studio (IRSS) at the University of British Columbia, and Nicholas Coops for development of the Landsat greenness time series. The data that support the findings of this study are available from the Medical Services Plan of British Columbia and other Data Stewards but restrictions apply to the availability of these data, which were used under agreement for the current study, and so are not openly available. Data are however accessible via Population Data BC and the relevant Data Stewards following approval of a Data Access Request and within the terms of Population Data BC access. All inferences, opinions, and conclusions drawn in this manuscript are those of the authors, and do not reflect the opinions or policies of the Data Steward(s).
• dc.format.mimetype application/pdf
• dc.identifier.citation Yuchi W, Brauer M, Czekajlo A, Davies HW, Davis Z, Guhn M, Jarvis I, Jerrett M, Nesbitt L, Oberlander TF, Sbihi H, Su J, van den Bosch M. Neighborhood environmental exposures and incidence of attention deficit/hyperactivity disorder: A population-based cohort study. Environ Int. 2022 Mar;161:107120. DOI: 10.1016/j.envint.2022.107120
• dc.identifier.doi http://dx.doi.org/10.1016/j.envint.2022.107120
• dc.identifier.issn 0160-4120
• dc.identifier.uri http://hdl.handle.net/10230/53031
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Environ Int. 2022 Mar;161:107120
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/891538
• dc.rights © 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword ADHD
• dc.subject.keyword Air pollution
• dc.subject.keyword Green space
• dc.subject.keyword Linear spectral unmixing
• dc.subject.keyword Satellite remote sensing
• dc.subject.keyword Vegetation percentage
• dc.title Neighborhood environmental exposures and incidence of attention deficit/hyperactivity disorder: A population-based cohort study
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion