PEDIATRICS Vol. 87 No. 2 February 1991, pp. 219-227
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Low-Level Lead Exposure and Children's Cognitive Function in the Preschool Years

David Bellinger PhD1, Alan Leviton MD1, Jone Sloman PhD2, Michael Rabinowitz PhD3, Herbert L. Needleman 4, and Christine Waternaux PhD5

1 From The Children's Hospital, Harvard Medical School, Boston, Massachusetts
2 Wheelock College, Boston
3 Marine Biological Laboratory, Harvard Medical School, Boston, Massachusetts
4 Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
5 McLean Hospital Harvard Medical School, Boston, Massachusetts

In a cohort of 170 middle and upper-middle class children participating in a prospective study of child development and low-level lead exposure, higher blood lead levels at age 24 months were associated with lower scores at age 57 months on the McCarthy Scales of Children's Abilities. The mean blood lead level at age 24 months was 6.8 µg/dL (SD = 6.3; 75th, 90th, and 99th percentiles: 8.8, 13.7, 23.6, respectively) and for all but 1 child was less than 25 µg/dL, the current definition of an "elevated" level. After adjustment for confounding, scores on the General Cognitive Index decreased approximately 3 points (SE = 1.4) for each natural log unit increase in 24-month blood lead level. The inverse association between lead level and performance was especially prominent for visual-spatial and visual-motor integration skills. Higher prenatal exposures were not associated with lower scores at 57 months except in the subgroup of children with "high" concurrent blood lead levels (ie, ge10 µg/dL). The concentration of lead in the dentine of shed deciduous teeth was not significantly associated with children's performance after adjustment for confounding.

Key Words: lead • development • epidemiology • toxicology

Submitted on October 30, 1989
Accepted on January 18, 1990




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