. 2024 Jan 18;22(1):e8488. doi: 10.2903/j.efsa.2024.8488

TABLE 20.

Key epidemiological studies on As exposure and neurodevelopment. ^a

Reference study population design	Outcome definition	Population size (n), age	Arsenic exposure	Results	Additional information/confounders
Prenatal
von Ehrenstein et al. (2007) India Prospective mother–child cohort study	Wechsler Intelligence Scale for Children (no edition provided), Raven Coloured, Progressive Matrices test, Total Sentence Recall test, Purdue pegboard test	351 5–15 years	w‐As (μg/L) Mean (SD) Peak lifetime 147 (322) During pregnancy 110 (243) Tertiles < 10 10–49 50–99 > 100 < 10 10–49 50–99 > 100	B (95% CI) Full scale IQ Peak lifetime Ref 0.006 (−0.031, 0.33) −0.16 (−0.56, 0.23) −0.06 (−0.30, 0.18) During pregnancy Ref −0.047 (−0.38, 0.28) −0.007 (−0.36, 0.34) −0.002 (−0.24, 0.24)	Adjusted for age, sex, BMI, maternal and paternal education, father's occupation, number of rooms in the house, type of house building material, BMI and mother's age
Rodrigues et al. (2016) Bangladesh Prospective mother–child cohort study	Bayley Scales of Infant and Toddler Development, Third Edition (BSID‐III)	525 20–40 months Sirajdikhan (n = 239) Pabna (n = 286)	w‐As (μg/L) at 20–40 months Median (IQR) Sirajdikhan 1.5 (< 0.75, 21.6) Pabna 25.7 (4.4, 130) w‐As at 1st trimester pregnancy Sirajdikhan 1.3 (< LOD, 1.9) Pabna 26.5 (5.3, 81)	β (SE, p‐value) As 20–40 months Cognitive Sirajdikhan −0.002 (0.02, 0.93) Pabna −0.06 (0.03, 0.05) Fine motor Sirajdikhan −0.05 (0.03, 0.09) Pabna 0.02 (0.03, 0.48) As during pregnancy Cognitive Sirajdikhan 0.009 (0.03, 0.78) Pabna −0.09 (0.03, 0.006) Fine motor Sirajdikhan 0.07 (0.04, 0.10) Pabna 0.007 (0.03, 0.81)	Different exposure, scores and covariates between clinics and thus were results stratified by area. Adjusted for maternal age and education, child's gender, exposure to second‐hand smoke, HOME score, maternal Raven score and child haematocrit.
Vahter et al. (2020) Bangladesh Prospective mother–child cohort study, cross‐sectional at 5 and 10 years	Wechsler Intelligence Scale for Children 4th ed. (WISC‐IV)	1523 mother–child pairs 305 305 304 305 304 296 295 296 295 295 294 293 294 293 293	u‐tiAs (μg/L) children 10 years, Median (range) 22.6 (7.3–29.9) 36.7 (30.0–45.5) 57.3 (45.6–73.1) 104 (73.4–162) 265 (163–940) u‐tiAs children 5 years 21 (6–27) 34 (28–41) 53 (42–69) 100 (70–149) 236 (150–1020) u‐tiAs mothers week 8 23.8 (3.2–32.4) 43.5 (32.5–58.8) 83.5 (58.9–122) 174 (122–246) 381 (247–1287)	Β (95% CI) Full developmental score Ref −1.63 (−5.62; 2.36) −7.23 (−11.3, −3.18) −6.37 (−10.5, −2.22) −2.71 (−6.96, 1.54) Ref −1.53 (−5.63, 2.56) −3.30 (−7.41, 0.81) −2.57 (−6.78, 1.65) 0.59 (−3.67, 4.86) Ref −4.52 (−8.61, −0.43) −5.91 (−10.0, −1.77) −5.98 (−10.2, −1.77) −3.41 (−7.60, 0.77)	Adjusted for child gender, age at testing and tester, child BMI‐for‐age, type of school, school grade, number of children in the household, family, HOME score, father's level of education, mother's IQ, home stimulation, child, U‐cadmium and W‐manganese
Soler‐Blasco et al. (2022) Spain Prospective mother–child cohort study	McCarthy Scales of Children's Abilities	807 4–5 y	u‐tiAs mothers first trimester (μg/g creatinine) GM mean (95%CI) 7.78 (7.41–8.17)	Β (95% CI) General scale u‐tiAs continuous −0.49 (−1.53, 0.56)	Adjusted for area of study, creatinine, maternal and paternal educational level, parity, child's sex, attendance at nursery, maternal verbal intelligence quotienteason of sample collection and rice and seafood consumption during the first trimester of pregnancy.
Postnatal
Wasserman et al. (2004) Bangladesh Cross‐sectional study	Wechsler Intelligence Scale for Children, version III	201 9.5‐, 0.5 years	w‐As (μg/L) Mean (SD) 117.8 (145.2) w‐As (μg/L) Quartiles 0.1–5.5 5.6–50.0 50.1–176 177–790 u‐As (μg/g creatinine) 296.6 (277.2)	B (p‐value) Full‐Scale score w‐As continuous −1.64 (< 0.01) w‐As quartiles Ref Not provided −7.8 (< 0.05) −11.3 (< 0.01) u‐As continuous −2.9 (0.09)	Adjusted for maternal education, maternal intelligence, house type, television access, height, head circumference Speciated arsenic in urine but unclear if arsenobetaine and arsenocholine were subtracted from total urinary arsenic
Wasserman et al. (2007) Bangladesh Cross‐sectional study	Wechsler Preschool and Primary Scale of Intelligence, version III	301 6 years	w‐As (μg/L) Mean (SD) 120.1 (134.4) w‐As (μg/L) Quartiles 0.1–20.9 21–77.9 78–184.9 185–864	B (SE, p‐value) Full‐Scale IQ w‐As continuous −1.06 (0.57, < 0.07) w‐As quartiles Ref Not provided Not provided −5.70 (p = 0.09)	Adjusted for maternal education and intelligence, home stimulation, school attendance, height, head circumference, W‐manganese
Wasserman et al. (2018) Bangladesh Cross‐sectional study	Wechsler Intelligence Scale for Children‐Fourth Edition	694 14–16 years	u‐As (μg/g creatinine) Mean (SD) 157.79 (208.87)	B (SE, p‐value) Full‐Scale IQ, U‐As continuous −5.09 (1.38, < 0.001)	Adjusted for paternal education, maternal intelligence, house construction, head circumference, child education, w‐As of the mother at baseline, B‐selenium, B‐cadmium, B‐lead, B‐manganese. Speciated arsenic in urine but unclear if arsenobetaine and arsenocholine were subtracted from total urinary arsenic
Rosado et al. (2007) Mexico Cross‐sectional study	Weschsler Intelligence Scale for Children Revised Mexican Version (WISC‐RM), a test of number and letter sequencing, Cognitive Abilities Test, Math Achievement Test (MAT), Visual–Spatial Abilities with Figure Design, Peabody Picture Vocabulary Test (PPVT‐Spanish Edition)	557 6–8 years	u‐As (μg/L) Mean (SD) 58.1 (33.2)	Β (95% CI) Visual–spatial abilities −0.024 (−0.045, −0.004) Peabody picture vocabulary −0.064 (−0.115, −0.013) WISC‐RM digit span subscale −0.014 (−0.025, −0.002) Visual search −0.007 (−0.011, −0.002) OR (95% CI) Letter sequencing 0.992 (0.987, 0.996)	Adjusted for age, sex, mother's school level, haemoglobin, B‐lead and B‐lead × u‐As interaction when significant. They had further info on child anthropometry but this was not adjusted for
Parvez et al. (2011) Bangladesh Cross‐sectional study	Bruininks‐Oseretsky Test version 2. 4 subscales that are summarised into total motor composite score (TMC)	304 8–11 years	w‐As (μg/L) Mean (SD) 43.3 (73.6)	β (95% CI) TMC −1.18 (−2.13, −0.10)	Adjustment for sex, school attendance, head circumference, mother's intelligence, B‐manganese, B‐lead and B‐selenium
Hsieh et al. (2014) Taiwan Case–control study	Peabody Developmental Motor Scales, Gross Motor Function Measure, Preschool Language Evaluation Tool, Child Expression Evaluation Tool, Chinese Wechsler Intelligence Scale for Children (3rd ed.), Bayley III Scales of Infant and Toddler Development. Developmental delay defined as performance 2 SD below the mean on age‐appropriate, standardised, norm‐referenced tests	63/35 with and without develop‐mental delays; 5 years 7/12 21/11 35/12	u‐As (μg/g creatinine) Tertiles of the controls ≤ 13.56 13.57–24.71 > 24.71	OR (95% CI) Developmental delay 1.0 5.95 (0.64, 55.57) 11.83 (1.52, 91.82)	Adjusted for age, gender, birth weight of children, ethnicity of their mothers, gestational length, B‐lead or B‐mercury. Information about mothers' education but not different between delay groups and not included in the adjusted model
Wasserman et al. (2014) USA Cross‐sectional study	The Wechsler Intelligence Scale for Children IV ed	272 8–11 years 141 46 52 33	w‐As (μg/L) Mean (SD) 9.88 (15.06) Mean (SD) 1.24 (1.37) 7.37 (1.34) 14.80 (3.06) 42.55 (20.43)	B (SE, p‐value) Full Scale IQ Ref −6.09 (1.98, < 0.01) −3.15 (1.91, 0.05) −2.51 (2.29, < 0.10)	Adjustment for maternal IQ, maternal education, HOME score, school district, number of siblings
Desai et al. (2018) Uruguay Cross‐sectional study	Woodcock‐Muñoz cognitive battery: 7 subtests from which the general intellectual abilities (GIA) score was derived	328 5–8 years	u‐As (μg/L) children Median (range) 11.9 (1.4–93.9)	Β (95% CI) GIA score −0.05 (−1.91, 1.82)	Adjusted for school clusters at the design stage, child's sex, BMI for age, serum ferritin, B‐lead, haemoglobin, season, test administrator, mother's education, crowding at home, HOME score, parental smoking, source of drinking water, household possessions. No consistent effect modification by folate intake or %MMA
Signes‐Pastor et al. (2019) Spain Cross‐sectional study	McCarthy Scales of Children's Abilities (MSCA)	400 4–5 years	u‐As (μg/L) Median (IQR) 4.85 (2.74–7.54)	Β (95% CI) Motor functions global scores: −2.29 (−3.95, −0.63) gross scores: −1.92 (−3.52, −0.31) fine scores: −1.54 (−3.06, −0.03)	Adjusted for maternal education, child sex, BMI, age at testing, calorie adjusted consumption of rice and fish/seafood. In stratified analyses by sex, negative associations were observed with some scores only in boys
Desai, Barg, Vahter, Queirolo, Peregalli, Mañay, Millen, Yu, Browne, and Kordas (2020) Uruguay Cross‐sectional study	Woodcock‐Muñoz Cognitive Battery: 6 subtests from which Broad math score and Broad reading score were derived	239 5–8 years	u‐As (μg/L) children Median (range) 11.7 (2.6, 50.1)	OR (95% CI) Broad math score 1.01 (0.98, 1.04) Broad reading score 1.00 (0.98, 1.03)	Adjusted for season, sex, maternal education, household possessions, HOME score, haemoglobin, B‐lead, H‐manganese. No effect modification by %MMA or B‐vitamins
Desai, Barg, Vahter, Queirolo, Peregalli, Mañay, Millen, Yu, and Kordas (2020) Uruguay Cross‐sectional study	Tests from Cambridge Neuropsychological Test Automated Battery (CANTAB): Stockings of Cambridge (SOC), Intra‐dimensional/ extra‐dimensional shift task (IED) and Spatial Span (SSP)	255 5–8 years	u‐As (μg/L) children Median (range) 9.9 (2.2, 47.7) w‐As (μg/L) Median (range) 0.45 (0.1, 18.9)	Β (95% CI) IED Stages completed: −0.02 (−0.03, −0.002) IED Pre‐executive shift error: −0.07 (−0.13, −0.01) SSP Span length: −0.02 (−0.02, −0.01)	Adjusted for age, sex, maternal education, possessions score, HOME score, season, school clusters, B‐lead, haemoglobin, U‐cadmium and H‐manganese. No effect modification of B vitamin intake or %MMA

Reference study population design

Outcome definition

Population size (n), age

Arsenic exposure

Results

Additional information/confounders

Prenatal

von Ehrenstein et al. (2007)

India

Prospective mother–child cohort study

Wechsler Intelligence

Scale for Children (no edition provided), Raven Coloured, Progressive Matrices test, Total Sentence Recall test, Purdue pegboard test

351

5–15 years

w‐As (μg/L)

Mean (SD)

Peak lifetime

147 (322)

During pregnancy

110 (243)

Tertiles

< 10

10–49

50–99

> 100

< 10

10–49

50–99

> 100

B (95% CI)

Full scale IQ

Peak lifetime

Ref

0.006 (−0.031, 0.33)

−0.16 (−0.56, 0.23)

−0.06 (−0.30, 0.18)

During pregnancy

Ref

−0.047 (−0.38, 0.28)

−0.007 (−0.36, 0.34)

−0.002 (−0.24, 0.24)

Adjusted for age, sex, BMI, maternal and paternal education, father's occupation, number of rooms in the house, type of house building material, BMI and mother's age

Rodrigues et al. (2016)

Bangladesh

Prospective mother–child cohort study

Bayley Scales of Infant and Toddler Development, Third Edition (BSID‐III)

525

20–40 months

Sirajdikhan (n = 239)

Pabna (n = 286)

w‐As (μg/L) at 20–40 months

Median (IQR)

Sirajdikhan

1.5 (< 0.75, 21.6)

Pabna

25.7 (4.4, 130)

w‐As at 1st trimester pregnancy

Sirajdikhan

1.3 (< LOD, 1.9)

Pabna

26.5 (5.3, 81)

β (SE, p‐value)

As 20–40 months

Cognitive

Sirajdikhan

−0.002 (0.02, 0.93)

Pabna

−0.06 (0.03, 0.05)

Fine motor

Sirajdikhan

−0.05 (0.03, 0.09)

Pabna

0.02 (0.03, 0.48)

As during pregnancy

Cognitive

Sirajdikhan

0.009 (0.03, 0.78)

Pabna

−0.09 (0.03, 0.006)

Fine motor

Sirajdikhan

0.07 (0.04, 0.10)

Pabna

0.007 (0.03, 0.81)

Different exposure, scores and covariates between clinics and thus were results stratified by area. Adjusted for maternal age and education, child's gender, exposure to second‐hand smoke, HOME score, maternal Raven score and child haematocrit.

Vahter et al. (2020)

Bangladesh

Prospective mother–child cohort study, cross‐sectional at 5 and 10 years

Wechsler Intelligence Scale for Children 4th ed. (WISC‐IV)

1523 mother–child pairs

305

304

305

304

296

295

296

295

294

293

294

293

u‐tiAs (μg/L) children 10 years, Median (range)

22.6 (7.3–29.9)

36.7 (30.0–45.5)

57.3 (45.6–73.1)

104 (73.4–162)

265 (163–940)

u‐tiAs children 5 years

21 (6–27)

34 (28–41)

53 (42–69)

100 (70–149)

236 (150–1020)

u‐tiAs mothers week 8

23.8 (3.2–32.4)

43.5 (32.5–58.8)

83.5 (58.9–122)

174 (122–246)

381 (247–1287)

Β (95% CI)

Full developmental score

Ref

−1.63 (−5.62; 2.36)

−7.23 (−11.3, −3.18)

−6.37 (−10.5, −2.22)

−2.71 (−6.96, 1.54)

Ref

−1.53 (−5.63, 2.56)

−3.30 (−7.41, 0.81)

−2.57 (−6.78, 1.65)

0.59 (−3.67, 4.86)

Ref

−4.52 (−8.61, −0.43)

−5.91 (−10.0, −1.77)

−5.98 (−10.2, −1.77)

−3.41 (−7.60, 0.77)

Adjusted for child gender, age at testing and tester, child BMI‐for‐age, type of school, school grade, number of children in the household, family, HOME score, father's level of education, mother's IQ, home stimulation, child, U‐cadmium and W‐manganese

Soler‐Blasco et al. (2022)

Spain

Prospective mother–child cohort study

McCarthy Scales of Children's Abilities

807

4–5 y

u‐tiAs mothers first trimester (μg/g creatinine)

GM mean (95%CI)

7.78 (7.41–8.17)

Β (95% CI)

General scale

u‐tiAs continuous

−0.49 (−1.53, 0.56)

Adjusted for area of study, creatinine, maternal and paternal educational level, parity, child's sex, attendance at nursery, maternal verbal intelligence quotienteason of sample collection and rice and seafood consumption during the first trimester of pregnancy.

Postnatal

Wasserman et al. (2004)

Bangladesh

Cross‐sectional study

Wechsler Intelligence Scale for Children, version III

201

9.5‐, 0.5 years

w‐As (μg/L)

Mean (SD)

117.8 (145.2)

w‐As (μg/L)

Quartiles

0.1–5.5

5.6–50.0

50.1–176

177–790

u‐As (μg/g creatinine)

296.6 (277.2)

B (p‐value)

Full‐Scale score

w‐As continuous

−1.64 (< 0.01)

w‐As quartiles

Ref

Not provided

−7.8 (< 0.05)

−11.3 (< 0.01)

u‐As continuous

−2.9 (0.09)

Adjusted for maternal education, maternal intelligence, house type, television access, height, head circumference

Speciated arsenic in urine but unclear if arsenobetaine and arsenocholine were subtracted from total urinary arsenic

Wasserman et al. (2007)

Bangladesh

Cross‐sectional study

Wechsler Preschool and Primary Scale of Intelligence, version III

301

6 years

w‐As (μg/L)

Mean (SD)

120.1 (134.4)

w‐As (μg/L)

Quartiles

0.1–20.9

21–77.9

78–184.9

185–864

B (SE, p‐value)

Full‐Scale IQ

w‐As continuous

−1.06 (0.57, < 0.07)

w‐As quartiles

Ref

Not provided

−5.70 (p = 0.09)

Adjusted for maternal education and intelligence, home stimulation, school attendance, height, head circumference, W‐manganese

Wasserman et al. (2018)

Bangladesh

Cross‐sectional study

Wechsler Intelligence Scale for Children‐Fourth Edition

694

14–16 years

u‐As (μg/g creatinine)

Mean (SD)

157.79 (208.87)

B (SE, p‐value)

Full‐Scale IQ, U‐As continuous

−5.09 (1.38, < 0.001)

Adjusted for paternal education, maternal intelligence, house construction, head circumference, child education, w‐As of the mother at baseline, B‐selenium, B‐cadmium, B‐lead, B‐manganese.

Speciated arsenic in urine but unclear if arsenobetaine and arsenocholine were subtracted from total urinary arsenic

Rosado et al. (2007)

Mexico

Cross‐sectional study

Weschsler Intelligence Scale for Children Revised Mexican Version (WISC‐RM), a test of number and letter sequencing, Cognitive Abilities Test, Math Achievement Test (MAT), Visual–Spatial Abilities with Figure Design, Peabody Picture Vocabulary Test (PPVT‐Spanish Edition)

557

6–8 years

u‐As (μg/L)

Mean (SD)

58.1 (33.2)

Β (95% CI)

Visual–spatial abilities

−0.024

(−0.045, −0.004)

Peabody picture vocabulary

−0.064

(−0.115, −0.013)

WISC‐RM digit span subscale

−0.014

(−0.025, −0.002)

Visual search

−0.007

(−0.011, −0.002)

OR (95% CI)

Letter sequencing

0.992 (0.987, 0.996)

Adjusted for age, sex, mother's school level, haemoglobin, B‐lead and B‐lead × u‐As interaction when significant.

They had further info on child anthropometry but this was not adjusted for

Parvez et al.

(2011)

Bangladesh

Cross‐sectional study

Bruininks‐Oseretsky

Test version 2. 4 subscales that are summarised into total motor composite score (TMC)

304

8–11 years

w‐As (μg/L)

Mean (SD)

43.3 (73.6)

β (95% CI)

TMC

−1.18 (−2.13, −0.10)

Adjustment for sex, school attendance, head circumference, mother's intelligence, B‐manganese, B‐lead and B‐selenium

Hsieh et al. (2014)

Taiwan

Case–control study

Peabody Developmental Motor Scales, Gross Motor Function Measure, Preschool Language Evaluation Tool, Child Expression Evaluation Tool, Chinese Wechsler Intelligence Scale for Children (3rd ed.), Bayley III Scales of Infant and Toddler Development. Developmental delay defined as performance 2 SD below the mean on age‐appropriate, standardised, norm‐referenced tests

63/35 with and without develop‐mental delays; 5 years

7/12

21/11

35/12

u‐As (μg/g creatinine)

Tertiles of the controls

≤ 13.56

13.57–24.71

> 24.71

OR (95% CI)

Developmental delay

1.0

5.95 (0.64, 55.57)

11.83 (1.52, 91.82)

Adjusted for age, gender, birth weight of children, ethnicity of their mothers, gestational length, B‐lead or B‐mercury. Information about mothers' education but not different between delay groups and not included in the adjusted model

Wasserman et al. (2014)

USA

Cross‐sectional study

The Wechsler Intelligence Scale for Children IV ed

272

8–11 years

141

w‐As (μg/L)

Mean (SD)

9.88 (15.06)

Mean (SD)

1.24 (1.37)

7.37 (1.34)

14.80 (3.06)

42.55 (20.43)

B (SE, p‐value)

Full Scale IQ

Ref

−6.09 (1.98, < 0.01)

−3.15 (1.91, 0.05)

−2.51 (2.29, < 0.10)

Adjustment for maternal IQ, maternal education, HOME score, school district, number of siblings

Desai et al. (2018)

Uruguay

Cross‐sectional study

Woodcock‐Muñoz cognitive battery: 7 subtests from which the general intellectual abilities (GIA) score was derived

328

5–8 years

u‐As (μg/L) children

Median (range)

11.9 (1.4–93.9)

Β (95% CI)

GIA score

−0.05 (−1.91, 1.82)

Adjusted for school clusters at the design stage, child's sex, BMI for age, serum ferritin, B‐lead, haemoglobin, season, test administrator, mother's education, crowding at home, HOME score, parental smoking, source of drinking water, household possessions. No consistent effect modification by folate intake or %MMA

Signes‐Pastor et al. (2019)

Spain

Cross‐sectional study

McCarthy Scales of Children's Abilities (MSCA)

400

4–5 years

u‐As (μg/L) Median (IQR) 4.85 (2.74–7.54)

Β (95% CI)

Motor functions

global scores: −2.29 (−3.95, −0.63)

gross scores: −1.92 (−3.52, −0.31)

fine scores: −1.54 (−3.06, −0.03)

Adjusted for maternal education, child sex, BMI, age at testing, calorie adjusted consumption of rice and fish/seafood. In stratified analyses by sex, negative associations were observed with some scores only in boys

Desai, Barg, Vahter, Queirolo, Peregalli, Mañay, Millen, Yu, Browne, and Kordas (2020)

Uruguay

Cross‐sectional study

Woodcock‐Muñoz Cognitive Battery: 6 subtests from which Broad math score and Broad reading score were derived

239

5–8 years

u‐As (μg/L) children

Median (range) 11.7 (2.6, 50.1)

OR (95% CI)

Broad math score

1.01 (0.98, 1.04)

Broad reading score 1.00 (0.98, 1.03)

Adjusted for season, sex, maternal education, household possessions, HOME score, haemoglobin, B‐lead, H‐manganese. No effect modification by %MMA or B‐vitamins

Desai, Barg, Vahter, Queirolo, Peregalli, Mañay, Millen, Yu, and Kordas (2020)

Uruguay

Cross‐sectional study

Tests from Cambridge Neuropsychological Test Automated Battery (CANTAB): Stockings of Cambridge (SOC), Intra‐dimensional/

extra‐dimensional shift task (IED) and Spatial Span (SSP)

255

5–8 years

u‐As (μg/L) children

Median (range)

9.9 (2.2, 47.7)

w‐As (μg/L)

Median (range) 0.45 (0.1, 18.9)

Β (95% CI)

IED Stages completed: −0.02 (−0.03, −0.002)

IED Pre‐executive shift error: −0.07 (−0.13, −0.01)

SSP Span length: −0.02

(−0.02, −0.01)

Adjusted for age, sex, maternal education, possessions score, HOME score, season, school clusters, B‐lead, haemoglobin, U‐cadmium and H‐manganese. No effect modification of B vitamin intake or %MMA

Abbreviations: As, arsenic; b, blood; BMI, body mass index; BSID‐III, Bayley Scales of Infant and Toddler Development, Third Edition; CANTAB, Cambridge Neuropsychological Test Automated Battery; CI, confidence interval; GIA, general intellectual abilities; GM, geometric mean; HOME, Home Observation Measurement of the Environment score; IED, Intradimensional /extradimensional shift task; IQ, intelligence quotient; IQR, interquartile range; LOD, limit of detection; MAT, Math Achievement Test; MMA, sum of monomethylarsonous acid and monomethylarsonic acid; MSCA, McCarthy Scales of Children's Abilities; n nymber; OR, odds ratio; PPVT, Peabody Picture Vocabulary Test; ref, reference; SD, standard deviation; SE, standard error; SOC, Stockings of Cambridge; SSP, spatial span; TMC, Total Motor Composite score; u, urine; u‐As, urinary arsenic; USA, United States of America; w: water; w‐As, water arsenic; Weschsler Intelligence Scale for Children 4th edition; WISC‐RM, Weschsler Intelligence Scale for Children Revised Mexican Version; u‐tiAs, total urinary iAs (sum of iAs and its methylated metabolites MMA and DMA).

^{^a}

Due to space limitations, not all outcomes reported in the studies are included in the table. For studies using Wechsler scales, the full score is presented; for studies with many tests, only outcomes that were associated with arsenic are presented.