Lead (Pb), mercury (Hg), and fluoride (F) exposure during childhood is of concern owing to their toxicity. Also, evidence suggests that high and low exposure levels to manganese (Mn) and selenium (Se) during this vulnerable period are associated with an increased risk of adverse health effects. A reduced growth is associated with high Pb and F exposure; however, little is known about their impact on children’s body size, and there is a lack of consensus on the effects of Hg, Mn, and Se exposure on children’s anthropometric measures. This is particularly true for childhood metal co-exposures at levels relevant to the general population. We investigated the joint effects of exposure to a metal mixture (Pb, Mn, Hg, and Se in blood and F in plasma) on 6–11-year-old US children’s anthropometry (n = 1634). Median F, Pb, Mn, Hg, and Se concentrations were 0.3 µmol/L, 0.5 µg/dL, 10.2 µg/L, 0.3 µg/L, and 178.0 µg/L, respectively. The joint effects of the five metals were modeled using Bayesian kernel machine and linear regressions. Pb and Mn showed opposite directions of associations with all outcome measured, where Pb was inversely associated with anthropometry. For body mass index and waist circumference, the effect estimates for Pb and Mn appeared stronger at high and low concentrations of the other metals of the mixture, respectively. Our findings suggest that metal co-exposures may influence children’s body mass and linear growth indicators, and that such relations may differ by the exposure levels of the components of the metal mixture.

儿童时期接触铅 (Pb)、汞 (Hg) 和氟化物 (F) 因其毒性而备受关注。此外，有证据表明，在这个脆弱时期，锰 (Mn) 和硒 (Se) 的高和低接触水平都与不良健康影响的风险增加有关。生长减缓与高铅和氟暴露有关；然而，人们对其对儿童体型的影响知之甚少，并且对于汞、锰和硒暴露对儿童人体测量指标的影响也缺乏共识。对于与一般人群相关水平的儿童期金属共同暴露尤其如此。我们研究了接触金属混合物（血液中的 Pb、Mn、Hg 和 Se 以及血浆中的 F）对 6-11 岁美国儿童人体测量的联合影响 ( n = 1634)。 F、Pb、Mn、Hg 和 Se 浓度中位数分别为 0.3 µmol/L、0.5 µg/dL、10.2 µg/L、0.3 µg/L 和 178.0 µg/L。使用贝叶斯核机和线性回归对五种金属的联合效应进行建模。 Pb 和 Mn 与所有测量结果的关联方向相反，其中 Pb 与人体测量呈负相关。对于体重指数和腰围，Pb 和 Mn 的效应估计在混合物中其他金属的高浓度和低浓度下分别显得更强。我们的研究结果表明，金属共同暴露可能会影响儿童的体重和线性生长指标，并且这种关系可能因金属混合物成分的暴露水平而异。