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Table 3 Neurodevelopmental outcomes of manganese exposure measured in drinking water

From: Biomarkers of environmental manganese exposure and associations with childhood neurodevelopment: a systematic review and meta-analysis

Author, Year Age (Years) Country/ Study Name Number (Girls/Boys) Sources Neurological Assessments Associations between Manganese in Drinking Water and Neurodevelopmental Outcomes Adjustment for Covariates Study Quality
Neurodevelopmental outcomes from cohort studies
Dion 2018 [20] 10.5–18 Canada 287 (151/136) Ground water WASI W-Mn and time-averaged W-Mn: ↓: IQ among girls Maternal IQ, education and income High
Rahman 2017 [69] 10 Bangladesh 1265 (609/656) Well water WISC-IV, SDQ Prenatal W-Mn: ↑: cognition in girls, W-Mn: ↓: behavior Maternal IQ, SES, child age, sex, education, height for age, Hb, school type, HOME, tester, number of siblings and arsenic High
Rodrigues 2016 [70] 1.6–3.3 Bangladesh 525 (264/261) Drinking water from well water BSID-III W-Mn: an inverse-U relationship with fine motor function, cognition: NS Maternal age, maternal education, passive smoking, child’s sex, HOME score, maternal IQ and child’s hematocrit levels High
Neurodevelopmental outcomes from cross-sectional studies
Bouchard 2011 [16] 6–13 Canada 362 (194/168) Ground water WASI W-Mn and estimated Mn intake from water consumption: ↓: IQ, estimated Mn intake from dietary: NS Maternal education and IQ, income, home stimulation score, family structure, sex and age of child, IQ testing session, source of water and level of iron in tap water High
Bouchard 2018 [8] 6–14 Canada 259 (132/127) Drinking water from ground water WISC-IV NS, possible beneficial effects in boys Child’s age, maternal IQ and education, income and IQ tester High
do Nascimento 2015 [49] 6–12 Brazil 69 (34/35) Drinking water from well water RCPM W-Mn: ↓: cognitive function Age, sex and parents’ education High
Khan 2011 [56] 8–11 Bangladesh 201 (100/101) Drinking water from well water CBCL W-Mn: ↓: behaviors (classroom behavioral problems) Arsenic, sex, BMI, maternal education and arm circumference High
Khan 2012 [71] 8–11 Bangladesh 840 (444/396) Well water AARES W-Mn > 400 μg/L: ↓: mathematics test School-grade, parental education and head circumference and controlling for within-teacher correlations in rating the children High
Nascimento 2016 [63] 6–12 Brazil 63 (31/32) Potential contamination from pesticide NEUPSILIN-Inf W-Mn: ↓: written language and executive functions IQ, age, sex and parents’ education High
Oulhote 2014 [15] 6–13 Canada 375 (200/175) Drinking water from ground water WASI, CPT-II, FT, SA W-Mn: ↓: memory, Mn intake from water:↓: motor function Child’s sex, age, maternal education and IQ, income, maternal depressive symptoms and tap water lead High
Wasserman 2006 [9] 10 Bangladesh 142 (72/70) Drinking water from well water WISC-III W-Mn: ↓: IQ Maternal education and IQ, house type, family ownership of a television, child height and head circumference High
  1. ↓: Negative association; ↑: Positive association; NS No significant association. Hb Hemoglobin; Mn Manganese. W-Mn Manganese in drinking water. BMI Body mass index; HOME score Home observation for measurement of the environment score; IQ Intelligence Quotient; SES Socioeconomic status