Smoke-Lead Combo Raises ADHD Risk

New research: lead plus tobacco smoke equals attention-deficit disorder for kids.

November 1, 2008

There's WHAT in my water?

RODALE NEWS, EMMAUS, PA—Protecting kids from cigarette smoke and lead exposure can drastically cut a child’s chance of developing attention-deficit/hyperactivity disorder (ADHD), according to new research from Cincinnati Children’s Hospital Medical Center researchers. The findings were released Oct. 20 at the Society for Developmental and Behavioral Pediatrics’ annual meeting.

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THE DETAILS: The study is based on information researchers collected between 2001 and 2004 in the National Health and Nutrition Examination Survey. The 2,588 samples were representative of the U.S. population, and focused on children and teens between 8 and 15 years old. Tobacco exposure was measured by mothers’ reports on how much they smoked during pregnancy, and lead was assessed using the children’s current blood lead levels. ADHD diagnosis followed guidelines laid out in the Diagnosis and Statistical Manual for Mental Disorders. The numbers showed that if children were exposed to cigarette smoke in the womb and to higher levels of lead during childhood, they were more than 8 times as likely to develop ADHD. Exposure to cigarette smoke or higher levels of lead alone more than doubled the risk.

WHAT IT MEANS: Both lead and cigarette smoke have been linked to ADHD before, but this study suggests that exposure to both makes the risk of ADHD skyrocket. Nearly 35,000 cases of ADHD in children between 8 and 15 years old could be erased if cigarette smoke and lead exposure were eliminated, says study author Tanya Froehlich, MD, professor of pediatrics, Cincinnati Children’s Hospital Medical Center. This means some cases of ADHD may be preventable, putting power in the hands of parents to make better decisions.

For parents or parents-to-be, the evidence is one more reason to stop smoking and give your home environment a good lead-check. Read on for some ways to keep these toxins away from your house and your family:

Before you have children:

• Contact your local water authority and verify that the pipes leading up to your home are lead-free. Note that if the pipes had repair work prior to 1986, the solder used might contain lead that could end up in your water.

• Test your tap water with an inexpensive kit—make sure the test includes first- and second-draw water. Edwards recommends the Clean Water Lead Testing kit. Or contact your state or local water authority to find a certified testing lab in your area. Testing costs between $20 and $100.

If your water has more lead than 5 parts per billion, invest in a lead-removing faucet filter certified by the National Sanitation Foundation. “You can have high confidence that all filters certified by NSF to remove lead will be highly protective,” says Marc Edwards, lead expert and professor of engineering at Virginia Tech University in Blacksburg. Change the filters according to the manufacturer’s directions. Look for the NSF seal on popular lead-removal filters like Brita and PUR.

If you have a lead problem and can’t afford filters, or are traveling and don’t trust the water, you can flush the water for several minutes before using it to cook or drink. This is especially important first thing in the morning, because water sits stagnant in pipes that could contain lead.

• Clean your faucet’s aerators (the mesh piece that’s screwed into the faucet) twice a month, especially if you suspect a lead problem. Test any dark particles found for lead with a lead-test kit. And remember, don’t use hot water from the tap for cooking or drinking—it’s more likely to contain leeched lead.

• If you have to let your water run, try to capture some in a watering can and use it to water indoor plants.

• If your home was built before 1978, have it assessed for lead hazards. Check out the National Lead Information Center for a list of experts in your area who can help you in your area.

• If you smoke and plan to have kids in your home, contact the government-sponsored 1-800-QUIT-NOW hotline for free coaching and a free quitting plan.

If you’re pregnant:

• Don’t smoke. Stay away from people who are smoking.

• If dining out, go to smoke-free restaurants.

• Avoid drinking water that might be from lead pipes.

If you have a child in daycare or school:

• Press the school to test its drinking water for lead.

• If they refuse, join a parent-teacher association to bring issue to the forefront. Schools are not required to test for lead in water.

• If they still refuse to test, or find unsafe levels, send your child to school with water in a stainless steel reusable water bottle and a packed lunch.

If your child has been diagnosed with ADHD:

• Make sure they get more green time. A 2004 study found that exposure to plants and the outdoors improved mental health and symptoms in children with ADHD. Instead of buying video games and gifts that will keep your kids indoors, spend more time with them on camping trips, outdoor gardening and playgrounds.

• Look into fish oil supplements. A 2007 study found nine patients with ADHD who took a daily dose of fish oil for a month experienced substantial improvement in concentration. We like Vital Choice’s Sockeye Salmon capsules because they are Marine Stewardship Council-approved—the wild Alaskan salmon are harvested responsibly and are healthy in numbers. Check with your doctor to make sure fish oil supplementation is right for your child.

• Reassess need for prescription pills with the rule of 10. "Every time your child's weight increases or decreases by 10%, get his condition—and his medication—reassessed," advises Robert Kuhn, PharmD, pediatric pharmacist at the University of Kentucky Children's Hospital. Once a year, Froehlich suggests parents should stop giving their children ADHD medication for a few days. “See what happens,” she says. “Do they do OK, or do they crash and burn?”