Project: Metal exposure early in life and children’s health and development

A majority of our research is focused on health effects of metal exposure early in life, a particularly sensitive period to toxic insults. We have a global health approach and base our studies on mother-child cohorts in Asia, South America, and Europe. The largest cohort (n=2500) is located rural Bangladesh and it was initially nested within the MINIMat supplementation trial in pregnancy (2001-2003), which recruited mothers in early pregnancy. Maternal exposure to arsenic (mainly through well water and rice) and other pollutants, especially cadmium (mainly diet), lead (multiple sources), manganese (drinking water and food), and DDT (breast milk) has been determined (using ICP-MS) and the children have been followed up repeatedly concerning exposure, health (especially morbidity and immune function) and development (growth, cognitive function and behavior) until 10 years of age. Another mother-child cohort (n=200) has been established in the Andean part of northern Argentina, where we have long experience of research concerning arsenic exposure and metabolism. This was followed by the discovery of elevated water concentrations of lithium, boron and cesium, and we are now elucidating potential health effects of these exposures. We have recruited pregnant women in 10 villages and their children until 6 months of age. In particular we assess effects of the multiple exposures on pregnancy outcomes, thyroid function and calcium metabolism. Through collaboration with researchers at the University of Crete we also assess early life exposure to metals, in particular cadmium, in the Rhea cohort on Crete. We have measured maternal exposure in pregnancy and followed the children at birth (anthropometry) and at 4 years of age (growth and cognitive function). Follow-up at 6 years of age is ongoing. We also participate in a large, population-based mother-child cohort in northern Sweden, (NICE; Nutritional impact on Immunological maturation during Childhood in relation to the Environment), initiated by researchers at two Universities in Gothenburg and at Sunderby Hospital in Luleå, Sweden. The plan is to repeatedly assess the exposure to multiple metals and other trace elements (in pregnancy, at delivery, and childhood) and to relate that to pregnancy outcomes, and child growth, immune maturation and allergy, and neurodevelopment.

There are large individual differences in susceptibility to metal toxicity and we evaluate sensitivity factors such as gender, nutritional status, metabolism and genetics in the studied cohorts.

Contact persons

Marie Vahter and Maria Kippler


  • Swedish Research Council
  • Swedish Research Council Formas
  • The Swedish International Development Cooperation Agency
  • Karolinska Institutet

Recent publications

Prenatal lead exposure and childhood blood pressure and kidney function.
Skröder H, Hawkesworth S, Moore S, Wagatsuma Y, Kippler M, Vahter M
Environ. Res. 2016 Nov;151():628-634

Boron exposure through drinking water during pregnancy and birth size.
Igra A, Harari F, Lu Y, Casimiro E, Vahter M
Environ Int 2016 10;95():54-60


Impact of prenatal exposure to cadmium on cognitive development at preschool age and the importance of selenium and iodine.
Kippler M, Bottai M, Georgiou V, Koutra K, Chalkiadaki G, Kampouri M, et al
Eur. J. Epidemiol. 2016 11;31(11):1123-1134

Manganese exposure through drinking water during pregnancy and size at birth: A prospective cohort study.
Rahman S, Kippler M, Ahmed S, Palm B, El Arifeen S, Vahter M
Reprod. Toxicol. 2015 Jun;53():68-74

Environmental exposure to lithium during pregnancy and fetal size: a longitudinal study in the Argentinean Andes.
Harari F, Langeén M, Casimiro E, Bottai M, Palm B, Nordqvist H, et al
Environ Int 2015 Apr;77():48-54

Arsenic exposure and cell-mediated immunity in pre-school children in rural Bangladesh.
Ahmed S, Moore S, Kippler M, Gardner R, Hawlader M, Wagatsuma Y, et al
Toxicol. Sci. 2014 Sep;141(1):166-75

Environmental exposure to metals and children's growth to age 5 years: a prospective cohort study.
Gardner R, Kippler M, Tofail F, Bottai M, Hamadani J, Grandér M, et al
Am. J. Epidemiol. 2013 Jun;177(12):1356-67

Environmental exposure to arsenic and cadmium during pregnancy and fetal size: a longitudinal study in rural Bangladesh.
Kippler M, Wagatsuma Y, Rahman A, Nermell B, Persson L, Raqib R, et al
Reprod. Toxicol. 2012 Dec;34(4):504-11

Critical windows of exposure for arsenic-associated impairment of cognitive function in pre-school girls and boys: a population-based cohort study.
Hamadani J, Tofail F, Nermell B, Gardner R, Shiraji S, Bottai M, et al
Int J Epidemiol 2011 Dec;40(6):1593-604