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Introduction <p>Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with rising global prevalence. Beyond genetics, environmental exposures—particularly heavy metals—are increasingly implicated.</p> Methods <p>Following PRISMA guidelines, PubMed, Scopus, and Web of Science were searched (2000–2024) for observational human studies on heavy metal exposure in children (0–18 years) with clinically diagnosed ASD. Data on study design, population, exposure measurement, and outcomes were narratively synthesized.</p> Results <p>Fifty-seven studies met inclusion. Most reported elevated lead, mercury, and cadmium levels in children with ASD, especially in hair and urine, with some linking higher concentrations to greater symptom severity. However, biomarker variability, diagnostic differences, and geographic diversity limited comparability. Proposed mechanisms include oxidative stress, mitochondrial dysfunction, and neuroinflammation.</p> Conclusion <p>The results indicate an association between heavy metals exposure and ASD risk and severity, but no causal relation can be established. Standardized, longitudinal studies are needed to guide prevention.</p>

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Heavy Metal Exposure and Autism Spectrum Disorder in Children: a Systematic Review of Epidemiological and Biological Evidence

  • 期刊论文

  • 发表日期：

    2025年11月29日

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  • Asmaa Hammooz,
  • Abdulameer Kareem Leelo Al-Obaidy,
  • Marwa Ibrahim Mahfouz Khalil,
  • Ahmed Dahshan

摘要

Introduction

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with rising global prevalence. Beyond genetics, environmental exposures—particularly heavy metals—are increasingly implicated.

Methods

Following PRISMA guidelines, PubMed, Scopus, and Web of Science were searched (2000–2024) for observational human studies on heavy metal exposure in children (0–18 years) with clinically diagnosed ASD. Data on study design, population, exposure measurement, and outcomes were narratively synthesized.

Results

Fifty-seven studies met inclusion. Most reported elevated lead, mercury, and cadmium levels in children with ASD, especially in hair and urine, with some linking higher concentrations to greater symptom severity. However, biomarker variability, diagnostic differences, and geographic diversity limited comparability. Proposed mechanisms include oxidative stress, mitochondrial dysfunction, and neuroinflammation.

Conclusion

The results indicate an association between heavy metals exposure and ASD risk and severity, but no causal relation can be established. Standardized, longitudinal studies are needed to guide prevention.