RESUMO
BACKGROUND: Several reports indicate that drinking water arsenic (WAs) and manganese (WMn) are associated with children's intellectual function. Very little is known, however, about possible associations with other neurologic outcomes such as motor function. METHODS: We investigated the associations of WAs and WMn with motor function in 304 children in Bangladesh, 8-11 years of age. We measured As and Mn concentrations in drinking water, blood, urine, and toenails. We assessed motor function with the Bruininks-Oseretsky test, version 2, in four subscales-fine manual control (FMC), manual coordination (MC), body coordination (BC), and strength and agility-which can be summarized with a total motor composite score (TMC). RESULTS: Log-transformed blood As was associated with decreases in TMC [ß = -3.63; 95% confidence interval (CI): -6.72, -0.54; p < 0.01], FMC (ß = -1.68; 95% CI: -3.19, -0.18; p < 0.05), and BC (ß = -1.61; 95% CI: -2.72, -0.51; p < 0.01), with adjustment for sex, school attendance, head circumference, mother's intelligence, plasma ferritin, and blood Mn, lead, and selenium. Other measures of As exposure (WAs, urinary As, and toenail As) also were inversely associated with motor function scores, particularly TMC and BC. Square-transformed blood selenium was positively associated with TMC (ß = 3.54; 95% CI: 1.10, 6.0; p < 0.01), FMC (ß = 1.55; 95% CI: 0.40, 2.70; p < 0.005), and MC (ß = 1.57; 95% CI: 0.60, 2.75; p < 0.005) in the unadjusted models. Mn exposure was not significantly associated with motor function. CONCLUSION: Our research demonstrates an adverse association of As exposure and a protective association of Se on motor function in children.