Metal exposure is a public health hazard due to neurocognitive effects starting in early life. Poor socio-economic status, adverse home and family environment can enhance the neurodevelopmental toxicity due to chemical exposure. Disadvantaged socio-economic conditions are generally higher in environmentally impacted areas although the combined effect of these two factors has not been sufficiently studied. The effect of co-exposure to neurotoxic metals including arsenic, cadmium, manganese, mercury, lead, selenium, and to socio-economic stressors was assessed in a group of 299 children aged 6–12 years, residing at incremental distance from industrial emissions in Taranto, Italy. Exposure was assessed with biological monitoring and the distance between the home address and the exposure point source. Children’s cognitive functions were examined using the Wechsler Intelligence Scale for Children (WISC) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Linear mixed models were chosen to assess the association between metal exposure, socio-economic status and neurocognitive outcomes. Urinary arsenic, cadmium and hair manganese resulted inversely related to the distance from the industrial emission source (β − 0.04; 95% CI -0.06, − 0.01; β − 0.02; 95% CI -0.05, − 0.001; β − 0.02 95% CI -0.05, − 0.003) while the WISC intellectual quotient and its sub-scores (except processing speed index) showed a positive association with distance. Blood lead and urinary cadmium were negatively associated with the IQ total score and all sub-scores, although not reaching the significance level. Hair manganese and blood lead was positively associated with the CANTAB between errors of spatial working memory (β 2.2; 95% CI 0.3, 3.9) and the reaction time of stop signal task (β 0.05; 95% CI 0.02, 0.1) respectively. All the other CANTAB neurocognitive tests did not show to be significantly influenced by metal exposure. The highest socio-economic status showed about five points intellectual quotient more than the lowest level on average (β 4.8; 95% CI 0.3, 9.6); the interaction term between blood lead and the socio-economic status showed a significant negative impact of lead on working memory at the lowest socio-economic status level (β − 4.0; 95% CI -6.9, − 1.1). Metal exposure and the distance from industrial emission was associated with negative cognitive impacts in these children. Lead exposure had neurocognitive effect even at very low levels of blood lead concentration when socio-economic status is low, and this should further address the importance and prioritize preventive and regulatory interventions.

中文翻译：

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意大利塔兰托学童金属暴露和社会压力源对神经认知的影响。


由于从生命早期就开始产生神经认知影响，金属接触会危害公共健康。不良的社会经济地位、不利的家庭环境会增强化学物质暴露引起的神经发育毒性。尽管这两个因素的综合影响尚未得到充分研究，但受环境影响的地区社会经济条件较差的地区普遍较高。对 299 名 6-12 岁儿童共同暴露于神经毒性金属（包括砷、镉、锰、汞、铅、硒）和社会经济压力源的影响进行了评估，这些儿童居住在距离工业排放较远的地区。意大利塔兰托。通过生物监测以及家庭住址与暴露点源之间的距离来评估暴露情况。使用韦克斯勒儿童智力量表（WISC）和剑桥神经心理学自动测试系统（CANTAB）检查儿童的认知功能。选择线性混合模型来评估金属暴​​露、社会经济状况和神经认知结果之间的关联。尿砷、镉、发锰与距工业排放源的距离成反比（β − 0.04；95% CI -0.06，− 0.01；β − 0.02；95% CI -0.05，− 0.001；β − 0.02 95% CI -0.05，− 0.003），而 WISC 智商及其子分数（除处理速度指数外）与距离呈正相关。血铅和尿镉与智商总分和所有单项得分呈负相关，但未达到显着水平。头发锰和血铅与空间工作记忆误差之间的 CANTAB 呈正相关（β 2.2；95% CI 0.3, 3.9) 和停止信号任务的反应时间 (β 0.05; 95% CI 0.02, 0.1) 分别。所有其他 CANTAB 神经认知测试并未显示出受到金属暴露的显着影响。最高社会经济地位的智商平均比最低水平高出约 5 个百分点（β 4.8；95% CI 0.3，9.6）；血铅与社会经济地位之间的交互项显示，在最低社会经济地位水平下，铅对工作记忆有显着的负面影响（β − 4.0；95% CI -6.9，− 1.1）。金属接触和距工业排放的距离与这些儿童的负面认知影响有关。当社会经济地位较低时，即使血铅浓度非常低，铅暴露也会对神经认知产生影响，这应该进一步强调重要性并优先考虑预防和监管干预措施。