| Arsenic and Fluoride Exposure in Drinking Water: Children's IQ and Growth in Shanyin County, Shanxi Province, China San-Xiang Wang,1 Zheng-Hui Wang,1 Xiao-Tian Cheng,1 Jun Li,1 Zhi-Ping Sang,1 Xiang-Dong Zhang,1 Ling-Ling Han,1 Xiao-Yan Qiao,1 Zhao-Ming Wu,1 and Zhi-Quan Wang2 1Shanxi Institute for Prevention and Treatment of Endemic Disease, Linfen, Shanxi Province, People's Republic of China; 2Shanyin Center for Disease Control and Prevention, Shanyin, Shanxi Province, People's Republic of China Abstract
Background: Recently, in a cross-sectional study of 201 children in Araihazar, Bangladesh, exposure to arsenic (As) in drinking water has been shown to lower the scores on tests that measure children's intellectual function before and after adjustment for sociodemographic features. Objectives: We investigated the effects of As and fluoride exposure on children's intelligence and growth. Methods: We report the results of a study of 720 children between 8 and 12 years of age in rural villages in Shanyin county, Shanxi province, China. The children were exposed to As at concentrations of 142 ± 106 µg/L (medium-As group) and 190 ± 183 µg/L (high-As group) in drinking water compared with the control group that was exposed to low concentrations of As (2 ± 3 µg/L) and low concentrations of fluoride (0.5 ± 0.2 mg/L) . A study group of children exposed to high concentrations of fluoride (8.3 ± 1.9 mg/L) but low concentrations of As (3 ± 3 µg/L) was also included because of the common occurrence of elevated concentrations of fluoride in groundwater in our study area. A standardized IQ (intelligence quotient) test was modified for children in rural China and was based on the classic Raven's test used to determine the effects of these exposures on children's intelligence. A standardized measurement procedure for weight, height, chest circumference, and lung capacity was used to determine the effects of these exposures on children's growth. Results: The mean IQ scores decreased from 105 ± 15 for the control group, to 101 ± 16 for the medium-As group (p < 0.05) , and to 95 ± 17 for the high-As group (p < 0.01) . The mean IQ score for the high-fluoride group was 101 ± 16 and significantly different from that of the control group (p < 0.05) . Children in the control group were taller than those in the high-fluoride group (p < 0.05) ; weighed more than the those in the high-As group (p < 0.05) ; and had higher lung capacity than those in the medium-As group (p < 0.05) . Conclusions: Children's intelligence and growth can be affected by high concentrations of As or fluoride. The IQ scores of the children in the high-As group were the lowest among the four groups we investigated. It is more significant that high concentrations of As affect children's intelligence. It indicates that arsenic exposure can affect children's intelligence and growth. Key words: arsenic, children, fluoride, growth, IQ, water. Environ Health Perspect 115:643–647 (2006) . doi:10.1289/ehp.9270 available via http://dx.doi.org/ [Online 9 January 2007]
This article is part of the mini-monograph "Occurrence and Health Effects of Arsenic in China." Address correspondence to S-X. Wang, Institute for Prevention and Treatment of Endemic Disease, Linfen, Shanxi 041000, China. Telephone (86 357-2313118) . Fax (86 357-2313118) . E-mail: sxdb@public.lf.sx.cn We thank Y. Zheng, the guest-editor of this mini-monograph, for her critical comments and contributions regarding this manuscript. This work was supported by Shanxi Natural Science Foundation grant 20031093. The authors declare they have no competing financial interests. Received 17 April 2006 ; accepted 3 October 2006.
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