@article{ref1,
title="Manganese in drinking water and cognitive abilities and behavior at 10 years of age: a prospective cohort study",
journal="Environmental health perspectives",
year="2016",
author="Rahman, Syed Moshfiqur and Kippler, Maria and Tofail, Fahmida and Bölte, Sven and Hamadani, Jena Derakhshani and Vahter, Marie",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Cross-sectional studies have indicated impaired neurodevelopment by elevated drinking water manganese concentrations (W-Mn), but potential susceptible exposure windows are unknown. <br><br>OBJECTIVE: To prospectively evaluate effects of W-Mn, from fetal life to school-age, on children's cognitive abilities and behavior. <br><br>METHODS: We assessed cognitive abilities using Wechsler Intelligence Scale for Children (WISC-IV) and behavior using Strengths and Difficulties Questionnaire (SDQ) in 1,265 ten-year-old children in rural Bangladesh. Manganese in drinking water, used during pregnancy and by the children at 5 and 10 years, was measured using inductively coupled plasma mass spectrometry. <br><br>RESULTS: Median W-Mn was 0.20 mg/L (range 0.001-6.6) during pregnancy and 0.34 mg/L (<0.001-8.7) at 10 years. In multivariable-adjusted linear regression analyses, restricted to children with low arsenic exposure, none of the W-Mn exposures were associated with the children's cognitive abilities. Stratifying by gender (p for interaction in general <0.081) showed that prenatal W-Mn (<3 mg/L) was positively associated with cognitive ability measures in girls, but not in boys. W-Mn at all time-points was associated with increased risk of conduct problems, especially in boys (range 24-43% per mg/L). At the same time, the prenatal W-Mn was associated with a decreased risk of emotional problems (OR: 0.39, 95% CI 0.19, 0.82) in the boys. In girls, W-Mn was mainly associated with low prosocial scores (prenatal W-Mn: OR 1.48, 95% CI 1.06, 1.88). <br><br>CONCLUSIONS: Elevated prenatal W-Mn exposure was positively associated with cognitive function in girls, while boys appeared unaffected. However, early-life W-Mn exposure appeared to adversely affect children's behavior.<p /> <p>Language: en</p>",
language="en",
issn="0091-6765",
doi="10.1289/EHP631",
url="http://dx.doi.org/10.1289/EHP631"
}