Exposure to ambient PM10 and NO2 and the incidence of attention-deficit hyperactivity disorder in childhood

Jin young Min, Kyoung bok Min

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Background Epidemiological studies have implicated air pollution in the causation of neurodevelopmental disorders, including attention-deficit hyperactivity disorder (ADHD), but definitive evidence of this linkage is lacking. Objectives We examined the association between cumulative exposure to air pollutants from birth to diagnosis, particularly particulate matter of < 10 μm (PM10) and nitric dioxide (NO2), and childhood ADHD. Methods We used the National Health Insurance Service-National Sample Cohort (2002 − 2012), a population-wide health insurance claims dataset. A total of 8936 infants (age 0) born between January 2002 and December 2002 were followed-up for a 10-year period (2003 − 2012). ADHD was defined as per ICD-10 code F90.0. Exposure levels of PM10and NO2were extrapolated using geographic information systems and collated with the subjects' administrative district code, and individual exposure levels assigned. Hazard ratios (HRs) were calculated for the development of ADHD, after adjusting for gender, metropolitan area, income, and history of diseases. Results During the study period, ADHD occurred in 314 subjects (3.5%). With the increase in 1 μg/m3of air pollutants, the HRs of childhood ADHD were 1.18 (95% CI: 1.15–1.21) in case of PM10and 1.03 (95% CI: 1.02–1.04) in case of NO2. Compared with infants with the lowest tertile of PM10or NO2exposure, those with the highest tertile of PM10(HR = 3.88; 95% CI: 2.87–5.23) or NO2(HR = 2.10; 95% CI, 1.54–2.85) exposure had a 2 to 3 fold increased risk for ADHD. Conclusion Exposure to PM10and NO2was associated with the incidence of ADHD in childhood.

Original languageEnglish
Pages (from-to)221-227
Number of pages7
JournalEnvironment International
StatePublished - 2017


  • Children's health
  • Neurodevelopmental disorder
  • Nitric dioxide
  • Particulate matter

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