Volume 28, Issue 3 (Iran South Med J 2025)
Iran South Med J 2025, 28(3): 724-743 |
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Mazarei Z, Hamidi A, Ravanipour M, Omrani A, Ravanipour M. Endocrine Disruptors and Attention Deficit Hyperactivity Disorder: A Systematic Re-view of Environmental Monitoring Exposure Studies. Iran South Med J 2025; 28 (3) :724-743
URL: http://ismj.bpums.ac.ir/article-1-2345-en.html
URL: http://ismj.bpums.ac.ir/article-1-2345-en.html
1- Department of Medicine, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
2- Department of Medical Library & Information Sciences, School of Paramedicine, Bushehr University of Medical Sciences, Bushehr, Iran
3- Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
4- Department of Pediatrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
5- Department of Environmental Health Engineering, School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran ,ravan.mas@gmail.com
2- Department of Medical Library & Information Sciences, School of Paramedicine, Bushehr University of Medical Sciences, Bushehr, Iran
3- Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran
The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
4- Department of Pediatrics, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
5- Department of Environmental Health Engineering, School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran ,
Abstract: (14 Views)
Background: Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children, with a multifactorial and complex etiology. Recent evidence suggests a combined role of factors, especially endocrine-disrupting chemicals (EDCs), as effective environmental factors in the development of this disorder by disrupting hormonal regulatory pathways and neurodevelopment. Despite the growth of studies in this field, there is still insufficient evidence about the relationship between environmental exposure to EDCs (based on environmental monitoring) and the development of ADHD. Therefore, this systematic review was conducted to determine the existing evidence about the relationship between exposure through environmental monitoring to EDCs and the development of ADHD symptoms.
Materials and Methods: The present study is a systematic review conducted in accordance with the PRISMA checklist. All research articles in English without publication time limit until September 22, 2024 were searched in three databases: Scopus, Web of Science, and PubMed using keywords related to the topic and based on MeSH terms. All stages of screening of articles were performed based on inclusion and exclusion criteria. Finally, the required data were extracted from the final retrieved articles.
Results: Out of 9045 search results, 3495 duplicates were removed and after a complete review of the literature, 8 articles were finally selected for the final analysis. The largest publication range of the selected articles was in the last 10 years and in terms of exposure sources, air, food and drinking water were the most common sources examined, respectively, while no studies were found for soil and sediment. The most frequently evaluated pollutants included PAHs, benzene, and BTEX. About half of the studies reported a positive and significant association between exposure to some EDCs and the occurrence of ADHD symptoms, while other studies did not find such an association.
Conclusion: The findings of this review indicate that although there is growing evidence of a potential association between environmental exposure to EDCs and an increased risk of ADHD, the limited number of studies and the presence of some heterogeneity prevent definitive
conclusions. This study highlights the need for future longitudinal research designs and multi-source exposure assessments that control for confounding variables. Also, focusing on less studied sources such as soil and sediments may contribute to a more comprehensive understanding of the actual exposure pathways and neurodevelopmental outcomes in children.
Materials and Methods: The present study is a systematic review conducted in accordance with the PRISMA checklist. All research articles in English without publication time limit until September 22, 2024 were searched in three databases: Scopus, Web of Science, and PubMed using keywords related to the topic and based on MeSH terms. All stages of screening of articles were performed based on inclusion and exclusion criteria. Finally, the required data were extracted from the final retrieved articles.
Results: Out of 9045 search results, 3495 duplicates were removed and after a complete review of the literature, 8 articles were finally selected for the final analysis. The largest publication range of the selected articles was in the last 10 years and in terms of exposure sources, air, food and drinking water were the most common sources examined, respectively, while no studies were found for soil and sediment. The most frequently evaluated pollutants included PAHs, benzene, and BTEX. About half of the studies reported a positive and significant association between exposure to some EDCs and the occurrence of ADHD symptoms, while other studies did not find such an association.
Conclusion: The findings of this review indicate that although there is growing evidence of a potential association between environmental exposure to EDCs and an increased risk of ADHD, the limited number of studies and the presence of some heterogeneity prevent definitive
conclusions. This study highlights the need for future longitudinal research designs and multi-source exposure assessments that control for confounding variables. Also, focusing on less studied sources such as soil and sediments may contribute to a more comprehensive understanding of the actual exposure pathways and neurodevelopmental outcomes in children.
Keywords: Attention Deficit Hyperactivity Disorder, Endocrine Disruptor, Environmental Monitoring, Exposure, Systematic Review
Type of Study: Review Systematic and Meta Analysis |
Subject:
Nervous System
Received: 2025/12/27 | Accepted: 2025/12/27 | Published: 2025/12/27
Received: 2025/12/27 | Accepted: 2025/12/27 | Published: 2025/12/27
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