Fluoride exposure and intelligence in school-age children: evidence from different windows of exposure susceptibility
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RESEARCH ARTICLE
Open Access
Fluoride exposure and intelligence in school-age children: evidence from different windows of exposure susceptibility Kaihong Xu1,2†, Ning An1†, Hui Huang1,2, Leizhen Duan3, Jun Ma4, Jizhe Ding1, Tongkun He5, Jingyuan Zhu1, Zhiyuan Li1, Xuemin Cheng1,2, Guoyu Zhou2,6* and Yue Ba1,2,6*
Abstract Background: The intellectual loss induced by fluoride exposure has been extensively studied, but the association between fluoride exposure in different susceptibility windows and children’s intelligence is rarely reported. Hence, we conducted a cross-sectional study to explore the association between fluoride exposure in prenatal and childhood periods and intelligence quotient (IQ). Methods: We recruited 633 local children aged 7–13 years old randomly from four primary schools in Kaifeng, China in 2017. The children were divided into four groups, of which included: control group (CG, n = 228), only prenatal excessive fluoride exposure group (PFG, n = 107), only childhood excessive fluoride exposure group (CFG, n = 157), both prenatal and childhood excessive fluoride exposure group (BFG, n = 141). The concentrations of urinary fluoride (UF) and urinary creatinine (UCr) were determined by fluoride ion-selective electrode assay and a creatinine assay kit (picric acid method), respectively. The concentration of UCr-adjusted urinary fluoride (CUF) was calculated. IQ score was assessed using the second revision of the Combined Raven’s Test-The Rural in China (CRTRC2). Threshold and saturation effects analysis, multiple linear regression analysis and logistic regression analysis were conducted to analyze the association between fluoride exposure and IQ. Results: The mean IQ score in PFG was respectively lower than those in CG, CFG and BFG (P < 0.05). The odds of developing excellent intelligence among children in PFG decreased by 51.1% compared with children in CG (OR = 0.489, 95% CI: 0.279, 0.858). For all the children, CUF concentration of ≥1.7 mg/L was negatively associated with IQ scores (β = − 4.965, 95% CI: − 9.198, − 0.732, P = 0.022). In children without prenatal fluoride exposure, every 1.0 mg/ L increment in the CUF concentration of ≥2.1 mg/L was related to a reduction of 11.4 points in children’s IQ scores (95% CI: − 19.2, − 3.5, P = 0.005). (Continued on next page)
* Correspondence: [email protected]; [email protected] † Kaihong Xu and Ning An contributed equally to this work. 2 Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China 1 Department of Environmental Health, School of Public Health, Zhengzhou University, Zhengzhou 450001, Henan, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link
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