Disparities in Toxic Chemical Exposures and Associated Neurodevelopmental Outcomes: A Scoping Review and Systematic Evidence Map of the Epidemiological Literature

dc.contributor.authorPayne-Sturges, Devon C.
dc.contributor.authorTaiwo, Tanya Khemet
dc.contributor.authorEllickson, Kristie
dc.contributor.authorMullen, Haley
dc.contributor.authorTchangalova, Nedelina
dc.contributor.authorAnderko, Laura
dc.contributor.authorChen, Aimin
dc.contributor.authorSwanson, Maureen
dc.description.abstractBACKGROUND: Children are routinely exposed to chemicals known or suspected of harming brain development. Targeting Environmental Neuro-Development Risks (Project TENDR), an alliance of more than 50 leading scientists, health professionals, and advocates, is working to protect children from these toxic chemicals and pollutants, especially the disproportionate exposures experienced by children from families with low incomes and families of color. OBJECTIVE: This scoping review was initiated to map existing literature on disparities in neurodevelopmental outcomes for U.S. children from population groups who have been historically economically/socially marginalized and exposed to seven exemplar neurotoxicants: combustion-related air pollution (AP), lead (Pb), mercury (Hg), organophosphate pesticides (OPs), phthalates (Phth), polybrominated diphenyl ethers (PBDEs), and polychlorinated biphenyls (PCBs). METHODS: Systematic literature searches for the seven exemplar chemicals, informed by the Population, Exposure, Comparator, Outcome (PECO) framework, were conducted through 18 November 2022, using PubMed, CINAHL Plus (EBSCO), GreenFILE (EBSCO), and Web of Science sources. We examined these studies regarding authors’ conceptualization and operationalization of race, ethnicity, and other indicators of sociodemographic and socioeconomic disadvantage; whether studies presented data on exposure and outcome disparities and the patterns of those disparities; and the evidence of effect modification by or interaction with race and ethnicity. RESULTS: Two hundred twelve individual studies met the search criteria and were reviewed, resulting in 218 studies or investigations being included in this review. AP and Pb were the most commonly studied exposures. The most frequently identified neurodevelopmental outcomes were cognitive and behavioral/psychological. Approximately a third (74 studies) reported investigations of interactions or effect modification with 69% (51 of 74 studies) reporting the presence of interactions or effect modification. However, less than half of the studies presented data on disparities in the outcome or the exposure, and fewer conducted formal tests of heterogeneity. Ninety-two percent of the 165 articles that examined race and ethnicity did not provide an explanation of their constructs for these variables, creating an incomplete picture. DISCUSSION: As a whole, the studies we reviewed indicated a complex story about how racial and ethnic minority and low-income children may be disproportionately harmed by exposures to neurotoxicants, and this has implications for targeting interventions, policy change, and other necessary investments to eliminate these health disparities. We provide recommendations on improving environmental epidemiological studies on environmental health disparities. To achieve environmental justice and health equity, we recommend concomitant strategies to eradicate both neurotoxic chemical exposures and systems that perpetuate social inequities.
dc.description.sponsorshipThis work was supported by Targeting Environmental Neurodevelopment Risks (Project TENDR), which has received grants from the John Merck Fund (ID0EMGAI36783, to M.S.), the Ceres Trust (ID0EWHAI36784, to M.S.), Passport Foundation, Forsythia Foundation, Park Foundation, Broad Reach Fund, and the Pediatric Epilepsy Research Foundation (ID0EAJAI36785, to M.S.). D.C.P.S. was supported by the National Institute of Environmental Health Sciences (K01ES028266). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.
dc.identifier.citationPayne-Sturges, D.C., Taiwo, T.K., Ellickson, K., Mullen, H., Tchangalova, N., Anderko, L., Chen, A., & Swanson, M. (2023). Health disparities in exposures to chemicals and pollutants affecting neurodevelopment: A scoping review and systematic evidence map of the epidemiological literature. Environmental Health Perspectives, 131(9). https://doi.org/10.1289/EHP11750
dc.relation.isAvailableAtSchool of Public Health
dc.relation.isAvailableAtMaryland Institute of Applied Environmental Health
dc.relation.isAvailableAtDigital Repository at the University of Maryland
dc.relation.isAvailableAtUniversity of Maryland (College Park, Md)
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.subjectNeurotoxicant Exposures
dc.subjectEnvironmental Justice
dc.subjectExposure Disparities
dc.subjectEnvironmental Pollutants
dc.titleDisparities in Toxic Chemical Exposures and Associated Neurodevelopmental Outcomes: A Scoping Review and Systematic Evidence Map of the Epidemiological Literature


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