Skip to main content
PMC home page
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 2001 Oct;85(4):286–288. doi: 10.1136/adc.85.4.286

Should children with developmental and behavioural problems be routinely screened for lead?

G Lewendon 1, S Kinra 1, R Nelder 1, T Cronin 1
PMCID: PMC1718950  PMID: 11567935

Abstract

AIM—To test the hypothesis that children with behavioural and/or developmental problems have significantly higher blood lead concentrations than the general childhood population.
METHODS—Blood samples were taken from 69 children with behavioural and/or developmental problems and 136 controls (children admitted for elective day case surgery under general anaesthetic). Blood lead estimations were carried out using graphite furnace atomic absorption
RESULTS—Children with behavioural and/or developmental problems had higher lead concentrations than controls, both in terms of their distribution across the group (meangeometric lead concentrations: 40.7 (cases), 29.2 (controls), ratio of the meansgeometric 1.35(95% CI 1.17, 1.58)) and the proportion of children with lead concentrations above those commonly defined as "toxic"—that is, 100 µg/l (12% (cases), 0.7% (controls); p < 0.001). Multiple linear regression suggested that this difference was not explained by differences in age, sex, or socioeconomic status of the two comparison groups.
CONCLUSIONS—Children with behavioural and/or developmental problems are more likely to have significantly higher blood lead concentrations than the general childhood population. Lead, a known and more importantly, a treatable neurotoxin, would further contribute to the impairment suffered by these children. We argue that this group of children should be routinely screened for lead.



Full Text

The Full Text of this article is available as a PDF (112.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Banks E. C., Ferretti L. E., Shucard D. W. Effects of low level lead exposure on cognitive function in children: a review of behavioral, neuropsychological and biological evidence. Neurotoxicology. 1997;18(1):237–281. [PubMed] [Google Scholar]
  2. Banks E. C., Ferretti L. E., Shucard D. W. Effects of low level lead exposure on cognitive function in children: a review of behavioral, neuropsychological and biological evidence. Neurotoxicology. 1997;18(1):237–281. [PubMed] [Google Scholar]
  3. Brody D. J., Pirkle J. L., Kramer R. A., Flegal K. M., Matte T. D., Gunter E. W., Paschal D. C. Blood lead levels in the US population. Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991) JAMA. 1994 Jul 27;272(4):277–283. doi: 10.1001/jama.272.4.277. [DOI] [PubMed] [Google Scholar]
  4. Charney E., Kessler B., Farfel M., Jackson D. Childhood lead poisoning. A controlled trial of the effect of dust-control measures on blood lead levels. N Engl J Med. 1983 Nov 3;309(18):1089–1093. doi: 10.1056/NEJM198311033091804. [DOI] [PubMed] [Google Scholar]
  5. Charney E., Sayre J., Coulter M. Increased lead absorption in inner city children: where does the lead come from? Pediatrics. 1980 Feb;65(2):226–231. [PubMed] [Google Scholar]
  6. Cohen D. J., Johnson W. T., Caparulo B. K. Pica and elevated blood lead level in autistic and atypical children. Am J Dis Child. 1976 Jan;130(1):47–48. doi: 10.1001/archpedi.1976.02120020049007. [DOI] [PubMed] [Google Scholar]
  7. David O., Clark J., Voeller K. Lead and hyperactivity. Lancet. 1972 Oct 28;2(7783):900–903. doi: 10.1016/s0140-6736(72)92534-2. [DOI] [PubMed] [Google Scholar]
  8. Hardan A., Sahl R. Psychopathology in children and adolescents with developmental disorders. Res Dev Disabil. 1997 Sep-Oct;18(5):369–382. doi: 10.1016/s0891-4222(97)00016-4. [DOI] [PubMed] [Google Scholar]
  9. Kahn C. A., Kelly P. C., Walker W. O., Jr Lead screening in children with attention deficit hyperactivity disorder and developmental delay. Clin Pediatr (Phila) 1995 Sep;34(9):498–501. doi: 10.1177/000992289503400909. [DOI] [PubMed] [Google Scholar]
  10. Kumar A., Dey P. K., Singla P. N., Ambasht R. S., Upadhyay S. K. Blood lead levels in children with neurological disorders. J Trop Pediatr. 1998 Dec;44(6):320–322. doi: 10.1093/tropej/44.6.320. [DOI] [PubMed] [Google Scholar]
  11. Lohiya G. S., Crinella F. M., Figueroa L. T., Caires S., Widman R. Lead exposure of people with developmental disabilities: success of control measures. Ment Retard. 1996 Aug;34(4):215–219. [PubMed] [Google Scholar]
  12. Lyngbye T., Hansen O. N., Trillingsgaard A., Beese I., Grandjean P. Learning disabilities in children: significance of low-level lead-exposure and confounding factors. Acta Paediatr Scand. 1990 Mar;79(3):352–360. doi: 10.1111/j.1651-2227.1990.tb11469.x. [DOI] [PubMed] [Google Scholar]
  13. Needleman H. L. Environmental lead and children's intelligence. Studies included in the meta-analysis are not representative. BMJ. 1995 May 27;310(6991):1408–1409. doi: 10.1136/bmj.310.6991.1408a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Needleman H. L. The current status of childhood low-level lead toxicity. Neurotoxicology. 1993 Summer-Fall;14(2-3):161–166. [PubMed] [Google Scholar]
  15. Pocock S. J., Smith M., Baghurst P. Environmental lead and children's intelligence: a systematic review of the epidemiological evidence. BMJ. 1994 Nov 5;309(6963):1189–1197. doi: 10.1136/bmj.309.6963.1189. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Schwartz J. Low-level lead exposure and children's IQ: a meta-analysis and search for a threshold. Environ Res. 1994 Apr;65(1):42–55. doi: 10.1006/enrs.1994.1020. [DOI] [PubMed] [Google Scholar]
  17. Silva P. A., Hughes P., Williams S., Faed J. M. Blood lead, intelligence, reading attainment, and behaviour in eleven year old children in Dunedin, New Zealand. J Child Psychol Psychiatry. 1988 Jan;29(1):43–52. doi: 10.1111/j.1469-7610.1988.tb00687.x. [DOI] [PubMed] [Google Scholar]
  18. Walkowiak J., Altmann L., Krämer U., Sveinsson K., Turfeld M., Weishoff-Houben M., Winneke G. Cognitive and sensorimotor functions in 6-year-old children in relation to lead and mercury levels: adjustment for intelligence and contrast sensitivity in computerized testing. Neurotoxicol Teratol. 1998 Sep-Oct;20(5):511–521. doi: 10.1016/s0892-0362(98)00010-5. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES