{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T01:03:19Z","timestamp":1776128599407,"version":"3.50.1"},"reference-count":75,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Behavioral problems are multifactorial and includes perinatal, maternal, family, parenting, socio-economic and personal risk factors, but less is known about the association of postnatal heavy metals on children\u2019s behavioral problems in Pacific Island children. Methods: A cohort of eligible nine-year-old children within a Pacific Island Families longitudinal study were recruited for a cross-sectional study. Child behavior problems were assessed using the child behavior checklist. Heavy metals (including Ni, Cu, Pb, Al, Cr and Cd) were determined in toenails, after acid digestion and analyzed using inductively coupled plasma mass spectrometry. Other factors such as lifestyle (smoking in pregnancy), health outcomes (obesity, health status), demographics (gender, ethnicity, parents\u2019 marital status) and socioeconomic status (household income levels) were also collected. The statistical analysis included t-tests for independent sample and Mann\u2013Whitney U-test, and chi-square or Fisher\u2019s exact tests of independence for comparisons of the proportions. Regression models tested the hypothesized risk factors for behavior outcomes. Results: This observational study enrolled 278 eligible Pacific Island children living in Auckland, New Zealand. The prevalence of behavioral problems in the clinical range was high (22%) but there was no significant association between heavy metals in toenails and adverse behavioral outcomes. Conclusion: Regular monitoring and assessments of children for environmental risk factors, as well as social and lifestyle factors for behavior problems, continues. Alternative indicators of exposure to heavy metal should be evaluated.<\/jats:p>","DOI":"10.3390\/ijerph17114120","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T05:11:46Z","timestamp":1591765906000},"page":"4120","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Exposure to Toenail Heavy Metals and Child Behavior Problems in Nine-Year-Old Children: A Cross-Sectional Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7425-7229","authenticated-orcid":false,"given":"Shamshad","family":"Karatela","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Queensland, Herston, QLD 4006, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christin","family":"Coomarasamy","sequence":"additional","affiliation":[{"name":"Ko awatea, Counties Manukau Health, Private Bag 93311, Auckland 1640, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janis","family":"Paterson","sequence":"additional","affiliation":[{"name":"School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland 0627, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil I.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Chemistry FEPS, University of Surrey, Guildford, Surrey GU2 7XH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/08830738050200010201","article-title":"Developmental screening","volume":"20","author":"Rydz","year":"2005","journal-title":"J. Child Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1001\/archpediatrics.2012.793","article-title":"Social-emotional problems in preschool-aged children: Opportunities for prevention and early intervention","volume":"166","author":"Brown","year":"2012","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1542\/peds.2005-1784","article-title":"Do parenting and the home environment, maternal depression, neighborhood, and chronic poverty affect child behavioral problems differently in different racial-ethnic groups?","volume":"117","author":"Pachter","year":"2006","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.rasd.2012.09.006","article-title":"The relationship between family functioning and behavior problems in children with autism spectrum disorders","volume":"7","author":"Sikora","year":"2013","journal-title":"Res. Autism Spectr. Disord."},{"key":"ref_5","first-page":"151","article-title":"Special vulnerability of children to environmental exposures","volume":"27","author":"Carpenter","year":"2012","journal-title":"Rev. Environ. Health."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1016\/j.marpolbul.2007.09.020","article-title":"Interactions between climate change and contaminants","volume":"54","author":"Schiedek","year":"2007","journal-title":"Mar. Pollut. Bull."},{"key":"ref_7","unstructured":"Ministry of Health (2004). Living with Disability in New Zealand: A Descriptive Analysis of Results from the 2001 Household Disability Survey and the 2001 Disability Survey of Residential Facilities, Ministry of Health."},{"key":"ref_8","unstructured":"Ministry of Health (2011). The Health of Pacific Children and Young People with Chronic Conditions and Disabilities in New Zealand, University of Otago."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1071\/HC09126","article-title":"The Pacific primary health care workforce in New Zealand: What are the needs?","volume":"1","author":"Nosa","year":"2009","journal-title":"J. Prim. Health Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1289\/ehp.0901757","article-title":"Adverse effects of methylmercury: Environmental health research implications","volume":"118","author":"Grandjean","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"758","DOI":"10.1289\/ehp.1104152","article-title":"Cadmium exposure and neurodevelopmental outcomes in U.S. children","volume":"120","author":"Ciesielski","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.etap.2011.03.005","article-title":"Cadmium and exposure to stress increase aggressive behavior","volume":"32","author":"Almeida","year":"2011","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.scitotenv.2016.09.016","article-title":"Adverse associations between maternal and neonatal cadmium exposure and birth outcomes","volume":"575","author":"Guo","year":"2017","journal-title":"Sci. Total Environ."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.reprotox.2006.08.011","article-title":"Glycine reduces cadmium-induced teratogenic damage in mice","volume":"23","year":"2007","journal-title":"Reprod. Toxicol. (ElmsfordNy)"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1016\/j.chemosphere.2016.01.058","article-title":"Lead, mercury, and cadmium in umbilical cord serum and birth outcomes in Chinese fish consumers","volume":"148","author":"Tang","year":"2016","journal-title":"Chemosphere"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1080\/15287394.2015.1090939","article-title":"Systematic Review of Chromium and Nickel Exposure During Pregnancy and Impact on Child Outcomes","volume":"78","author":"McDermott","year":"2015","journal-title":"J. Toxicol. Environ. Health Part A."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1177\/1420326X06076670","article-title":"Respiratory Problems in Tannery Workers in Istanbul","volume":"16","author":"Issever","year":"2007","journal-title":"Indoor Built Environ."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1111\/j.0105-1873.2006.00824.x","article-title":"Cr(III) and Cr(VI) in leather and elicitation of eczema","volume":"54","author":"Hansen","year":"2006","journal-title":"Contact Dermat."},{"key":"ref_19","unstructured":"International Agency for Research on Cancer (IARC) (2012). The Evaluation of Carcinogenic Risks to Humans. Arsenic, Metals, Fibres and Dust. Chromium (VI) Compounds, IARC."},{"key":"ref_20","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (1993). Toxicological Profile for Nickel, U.S. Department of Health and Human Services."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1056\/NEJM199705293362203","article-title":"Aluminum neurotoxicity in preterm infants receiving intravenous-feeding solutions","volume":"336","author":"Bishop","year":"1997","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e20193148","DOI":"10.1542\/peds.2019-3148","article-title":"Aluminum Effects in Infants and Children","volume":"144","author":"Corkins","year":"2019","journal-title":"Pediatrics"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"96","DOI":"10.5864\/d2014-006","article-title":"Investigating elevated copper and lead levels in school drinking water","volume":"56","author":"Barn","year":"2013","journal-title":"Environ. Health Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0048-9697(00)00531-3","article-title":"Application of double focusing sector field ICP-MS for multielemental characterization of human hair and nails. Part II. A study of the inhabitants of northern Sweden","volume":"262","author":"Rodushkin","year":"2000","journal-title":"Sci. Total Environ."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.envpol.2004.07.015","article-title":"Mercury contamination in human hair and fish from Cambodia: Levels, specific accumulation and risk assessment","volume":"134","author":"Agusa","year":"2005","journal-title":"Environ. Pollut."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Liang, G., Pan, L., and Liu, X. (2017). Assessment of Typical Heavy Metals in Human Hair of Different Age Groups and Foodstuffs in Beijing, China. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14080914"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.eclnm.2009.01.012","article-title":"Trace element status in obese children: Relationship with metabolic risk factor","volume":"4","author":"Bougle","year":"2009","journal-title":"Eur. J. Clin. Nutr. Metab."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/ajcn\/84.4.762","article-title":"Selenium and coronary heart disease: A meta-analysis","volume":"84","author":"Guallar","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/BF02703706","article-title":"Fingernails as biological indices of metal exposure","volume":"30","author":"Mehra","year":"2005","journal-title":"J. Biosci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1289\/ehp.1002805","article-title":"Associations of toenail arsenic, cadmium, mercury, manganese, and lead with blood pressure in the normative aging study","volume":"120","author":"Mordukhovich","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1080\/07315724.2005.10719472","article-title":"Toenail selenium and cardiovascular disease in men with diabetes","volume":"24","author":"Rajpathak","year":"2005","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/s12011-010-8878-8","article-title":"Trace Elements in Obese Turkish Children","volume":"143","author":"Tascilar","year":"2010","journal-title":"Biol. Trace Elem Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Karatela, S., Ward, N., and Paterson, J. (2019). Mercury Exposure in Mother-Children Pairs in A Seafood Eating Population: Body Burden and Related Factors. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16122238"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1093\/ije\/dym171","article-title":"Cohort Profile: The Pacific Islands Families (PIF) Study","volume":"37","author":"Paterson","year":"2008","journal-title":"Int. J. Epidemiol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Karatela, S., Coomarasamy, C., Paterson, J., and Ward, N.I. (2019). Household Smoking Status and Heavy Metal Concentrations in Toenails of Children. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16203871"},{"key":"ref_36","unstructured":"Achenbach, T.M., and Rescorla, L.A. (2001). Manual for the ASEBA School-Age Forms & Profiles, University of Vermont 2001."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1080\/15374416.2011.563472","article-title":"International Comparisons of Behavioral and Emotional Problems in Preschool Children: Parents\u2019 Reports From 24 Societies","volume":"40","author":"Rescorla","year":"2011","journal-title":"J. Clin. Child Adolesc. Psychol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1038\/sj.ejcn.1602090","article-title":"What is the best measure of adiposity change in growing children: BMI, BMI %, BMI z-score or BMI centile?","volume":"59","author":"Cole","year":"2005","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_39","unstructured":"Ward, N.I. (2008). Trace Element Nail Report: ICP-MS Facility, Chemistry, University of Surrey."},{"key":"ref_40","unstructured":"Auckland Council (2015). Exploring Pacific Economies: Wealth Practices and Debt Management Working Report, WR2015\/002, Auckland Council."},{"key":"ref_41","unstructured":"Statistics New Zealand (2016). Changes in Home-Ownership Patterns 1986\u20132013: Focus on M\u0101ori and Pacific People, Tatauranga Aotearoa Wellington, New Zealand Statistics."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/1753-6405.12717","article-title":"Pacific Islands Families (PIF) Study: Housing and psychological distress among Pacific mothers","volume":"42","author":"Paterson","year":"2018","journal-title":"Aust. N. Z. J. Public Health."},{"key":"ref_43","unstructured":"Statistics New Zealand (2014). 2013 Census QuickStats about Culture and Identity, Statistics New Zealand."},{"key":"ref_44","unstructured":"Statistics New Zealand and Ministry of Pacific Island Affairs (2011). Health and Pacific Peoples in New Zealand, Statistics New Zealand and Ministry of Pacific Island Affairs."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.socscimed.2010.04.027","article-title":"Poverty and common mental disorders in low and middle income countries: A systematic review","volume":"71","author":"Lund","year":"2010","journal-title":"Soc. Sci. Med. (1982)"},{"key":"ref_46","unstructured":"Statistics New Zealand (2010). The New Zealand General Social Survey, Statistics New Zealand."},{"key":"ref_47","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2004). Toxicological Profile for Copper, Department of Health and Human Services, Public Health Service."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"98","DOI":"10.3923\/pjn.2003.98.101","article-title":"Effect of Environmental Pollution on Quality of Meat in District Bagh, Azad Kashmir","volume":"2","author":"Sabir","year":"2003","journal-title":"Pak. J. Nutr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s12011-008-8230-8","article-title":"Zinc, manganese, calcium, copper, and cadmium level in scalp hair samples of schizophrenic patients","volume":"127","author":"Rahman","year":"2009","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4137\/NMI.S6349","article-title":"Decreased zinc and increased copper in individuals with anxiety","volume":"4","author":"Russo","year":"2011","journal-title":"Nutr. Metab. Insights"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4103\/2277-9175.178788","article-title":"Assessing of plasma levels of iron, zinc and copper in Iranian Parkinson\u2019s disease","volume":"5","author":"Meamar","year":"2016","journal-title":"Adv. Biomed. Res."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Pavesi, T., and Moreira, J.C. (2020). Mechanisms and individuality in chromium toxicity in humans. J. Appl. Toxicol. JAT.","DOI":"10.1002\/jat.3965"},{"key":"ref_53","unstructured":"Agency for Toxic Substances and Disease Registry (ATSDR) (2012). Toxicological Profile for Chromium, Department of Health and Human Services, Public Health Service."},{"key":"ref_54","first-page":"38","article-title":"Occupational Risk and Relationship between Chromium and Nickel in Metal Working Fluid with Chromium and Nickel Levels in Blood and Urine among Machinists in Negeri Sembilan, Malaysia","volume":"21","author":"Hashim","year":"2015","journal-title":"Int. J. Sci. Basic Appl. Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/j.envpol.2019.06.084","article-title":"Childhood chromium exposure and neuropsychological development in children living in two polluted areas in southern Spain","volume":"252","author":"Alguacil","year":"2019","journal-title":"Environ. Pollut."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1529-1006.2005.00024.x","article-title":"Neurotoxicants, Micronutrients, and Social Environments: Individual and Combined Effects on Children\u2019s Development","volume":"6","author":"Nation","year":"2005","journal-title":"Psychol. Sci. Public Interest"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1111\/bcpt.13162","article-title":"Timescales of developmental toxicity impacting on research and needs for intervention","volume":"125","author":"Grandjean","year":"2019","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1093\/aje\/kwn348","article-title":"Aluminum and silica in drinking water and the risk of Alzheimer\u2019s disease or cognitive decline: Findings from 15-year follow-up of the PAQUID cohort","volume":"169","author":"Rondeau","year":"2009","journal-title":"Am J Epidemiol."},{"key":"ref_59","first-page":"38","article-title":"Toxic Metals and Essential Elements in Hair and Severity of Symptoms among Children with Autism","volume":"7","author":"Amin","year":"2012","journal-title":"Maedica"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"6027","DOI":"10.3390\/ijerph10116027","article-title":"Assessment of infantile mineral imbalances in autism spectrum disorders (ASDs)","volume":"10","author":"Yasuda","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.etap.2018.08.013","article-title":"Exposure of cadmium via smoking and drinking water on zinc levels of biological samples of malnutrition pregnant women: A prospective cohort study","volume":"63","author":"Ali","year":"2018","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Bao, Q.S., Lu, C.Y., Song, H., Wang, M., Ling, W., Chen, W.-Q., Deng, X.-Q., Hao, Y.-T., and Rao, S. (2009). Behavioural development of school-aged children who live around a multi-metal sulphide mine in Guangdong province, China: A cross-sectional study. BMC Public Health, 9.","DOI":"10.1186\/1471-2458-9-217"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1289\/ehp.1104431","article-title":"Early-life cadmium exposure and child development in 5-year-old girls and boys: A cohort study in rural Bangladesh","volume":"120","author":"Kippler","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.neuro.2005.10.001","article-title":"Neuropsychological correlates of hair arsenic, manganese, and cadmium levels in school-age children residing near a hazardous waste site","volume":"27","author":"Wright","year":"2006","journal-title":"Neurotoxicology"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s12011-009-8391-0","article-title":"Effects of gestational cadmium exposure on pregnancy outcome and development in the offspring at age 4.5 years","volume":"132","author":"Tian","year":"2009","journal-title":"Biol. Trace Elem. Res."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Guo, H., Chen, L., Cui, H., Peng, X., Fang, J., Zuo, Z., Deng, J., Wang, X., and Wu, B. (2016). Research Advances on Pathways of Nickel-Induced Apoptosis. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17010010"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"169","DOI":"10.3402\/ijch.v63i2.17703","article-title":"Elements in placenta and pregnancy outcome in arctic and subarctic areas","volume":"63","author":"Odland","year":"2004","journal-title":"Int. J. Circumpolar Health"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"327","DOI":"10.2478\/v10001-007-0034-0","article-title":"Small-for-gestational-age newborns of female refinery workers exposed to nickel","volume":"20","author":"Vaktskjold","year":"2007","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1093\/ije\/dyn163","article-title":"Maternal smoking during pregnancy and child behaviour problems: The Generation R Study","volume":"38","author":"Roza","year":"2009","journal-title":"Int. J. Epidemiol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.earlhumdev.2003.09.001","article-title":"Effect of antenatal exposure to maternal smoking on behavioural problems and academic achievement in childhood: Prospective evidence from a Dutch birth cohort","volume":"75","author":"Batstra","year":"2003","journal-title":"Early Hum. Dev."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1289\/ehp.0901209","article-title":"Prenatal and postnatal tobacco exposure and behavioral problems in 10-year-old children: Results from the GINI-plus prospective birth cohort study","volume":"118","author":"Ruckinger","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1017\/S0033291718001344","article-title":"Aggressive behaviour in childhood and adolescence: The role of smoking during pregnancy, evidence from four twin cohorts in the EU-ACTION consortium","volume":"49","author":"Malanchini","year":"2019","journal-title":"Psychol. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"12579","DOI":"10.1038\/s41598-017-11836-3","article-title":"Maternal Smoking in Pregnancy and Offspring Depression: A cross cohort and negative control study","volume":"7","author":"Taylor","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1353\/cpr.2016.0002","article-title":"Engaging Pacific Islanders in Research: Community Recommendations","volume":"10","author":"Look","year":"2016","journal-title":"Prog. Community Health Partn."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Bacchetti, P. (2010). Current sample size conventions: Flaws, harms, and alternatives. BMC Med., 8.","DOI":"10.1186\/1741-7015-8-17"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/11\/4120\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:37:09Z","timestamp":1760175429000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/11\/4120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,9]]},"references-count":75,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["ijerph17114120"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17114120","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,9]]}}}