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dc.contributor.authorChoi, Anna L.
dc.contributor.authorSun, Guifan
dc.contributor.authorZhang, Ying
dc.contributor.authorGrandjean, Philippe
dc.date.accessioned2013-04-23T18:31:21Z
dc.date.issued2012
dc.identifier.citationChoi, Anna L., Guifan Sun, Ying Zhang, and Philippe Grandjean. 2012. Developmental fluoride neurotoxicity: a systematic review and meta-analysis. Environmental Health Perspectives 120(10): 1362-1368.en_US
dc.identifier.issn0091-6765en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10579664
dc.description.abstractBackground: Although fluoride may cause neurotoxicity in animal models and acute fluoride poisoning causes neurotoxicity in adults, very little is known of its effects on children’s neurodevelopment. Objective: We performed a systematic review and meta-analysis of published studies to investigate the effects of increased fluoride exposure and delayed neurobehavioral development. Methods: We searched the MEDLINE, EMBASE, Water Resources Abstracts, and TOXNET databases through 2011 for eligible studies. We also searched the China National Knowledge Infrastructure (CNKI) database, because many studies on fluoride neurotoxicity have been published in Chinese journals only. In total, we identified 27 eligible epidemiological studies with high and reference exposures, end points of IQ scores, or related cognitive function measures with means and variances for the two exposure groups. Using random-effects models, we estimated the standardized mean difference between exposed and reference groups across all studies. We conducted sensitivity analyses restricted to studies using the same outcome assessment and having drinking-water fluoride as the only exposure. We performed the Cochran test for heterogeneity between studies, Begg’s funnel plot, and Egger test to assess publication bias, and conducted meta-regressions to explore sources of variation in mean differences among the studies. Results: The standardized weighted mean difference in IQ score between exposed and reference populations was –0.45 (95% confidence interval: –0.56, –0.35) using a random-effects model. Thus, children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas. Subgroup and sensitivity analyses also indicated inverse associations, although the substantial heterogeneity did not appear to decrease. Conclusions: The results support the possibility of an adverse effect of high fluoride exposure on children’s neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment.en_US
dc.language.isoen_USen_US
dc.publisherNational Institute of Environmental Health Sciencesen_US
dc.relation.isversionofdoi:10.1289/ehp.1104912en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491930/pdf/en_US
dash.licenseLAA
dc.subjectfluorideen_US
dc.subjectintelligenceen_US
dc.subjectneurotoxicityen_US
dc.titleDevelopmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysisen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalEnvironmental Health Perspectivesen_US
dash.depositing.authorGrandjean, Philippe
dc.date.available2013-04-23T18:31:21Z
dc.identifier.doi10.1289/ehp.1104912*
dash.contributor.affiliatedChoi, Anna Lai
dash.contributor.affiliatedGrandjean, Philippe
dc.identifier.orcid0000-0003-4046-9658


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