The influence of low level pre- and perinatal exposure to PCDD/Fs, PCBs, and lead on attention performance and attention-related behavior among German school-aged children: results from the Duisburg Birth Cohort Study

Int J Hyg Environ Health. 2015 Jan;218(1):153-62. doi: 10.1016/j.ijheh.2014.09.005. Epub 2014 Oct 5.


Background: Prenatal exposure to polychlorinated biphenyls (PCBs) and lead are thought to be risk factors for attention-deficit hyperactivity disorder (ADHD), whereas the prenatal influence of polychlorinated dibenzo-p-dioxins and -furans (PCDD/Fs) on attention performance has been less studied.

Objectives: Within the Duisburg Birth Cohort Study, we investigated low-level exposure to these compounds in relation to children's attention.

Methods: We measured blood levels of PCDD/Fs, PCBs and lead from pregnant mothers (32(nd) week of pregnancy) and PCDD/Fs and PCBs in breast milk (2 weeks after delivery). The attention of school-aged children (N=117) was investigated with a computer-based test battery of attention performance (KITAP) and a parent rating questionnaire of behaviors related to ADHD (FBB-ADHS). Influences of the exposure on attention were analyzed by multiple regression analyses.

Results: Increasing prenatal PCDD/F and PCB concentrations were significantly (p<0.05) associated with a higher number of omission errors in the subtest Divided Attention (47% and 42%; 95% confidence intervals (95%-CI): 1.08-2.00 and 1.07-1.89, respectively). Prenatal lead concentrations had few significant associations with attention performance (e.g., a 23% higher number of omission errors in the subtest Distractibility; 95%-CI: 1.00-1.51), whereas ADHD-related behavior (questionnaire based) was increased with increasing lead exposure (Overall-ADHD: 9%; 95%-CI: 1.01-1.17). ADHD-related behavior was negatively associated with prenatal PCDD/F or PCB exposures (e.g., for PCB exposure: -10%; 95%-CI: 0.82-0.99).

Conclusions: Pre- and perinatal PCDD/F and PCB exposure may have subtle influences on attention performance in healthy children at low environmental levels, while behavior changes are negatively associated. Furthermore, we provide additional evidence for the impact of prenatal lead exposure on attention deficits.

Keywords: Attention performance; Attention-deficit hyperactivity disorder; Children; Dioxin; Lead; PCB.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attention Deficit and Disruptive Behavior Disorders / etiology*
  • Benzofurans / toxicity*
  • Child
  • Cohort Studies
  • Dibenzofurans, Polychlorinated
  • Environmental Pollutants / toxicity*
  • Female
  • Germany
  • Humans
  • Intelligence Tests
  • Lead / toxicity*
  • Male
  • Polychlorinated Biphenyls / toxicity*
  • Polychlorinated Dibenzodioxins / analogs & derivatives*
  • Polychlorinated Dibenzodioxins / toxicity
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Regression Analysis


  • Benzofurans
  • Dibenzofurans, Polychlorinated
  • Environmental Pollutants
  • Polychlorinated Dibenzodioxins
  • Lead
  • Polychlorinated Biphenyls