Intellectual Impairment in Children with Blood Lead Concentrations below 10 μg per Deciliter
Open accessAbstract
BACKGROUND: Despite dramatic declines in children's blood lead concentrations and a lowering of the Centers for Disease Control and Prevention's level of concern to 10 microg per deciliter (0.483 micromol per liter), little is known about children's neurobehavioral functioning at lead concentrations below this level. METHODS: We measured blood lead concentrations in 172 children at 6, 12, 18, 24, 36, 48, and 60 months of age and administered the Stanford-Binet Intelligence Scale at the ages of 3 and 5 years. The relation between IQ and blood lead concentration was estimated with the use of linear and nonlinear mixed models, with adjustment for maternal IQ, quality of the home environment, and other potential confounders. RESULTS: The blood lead concentration was inversely and significantly associated with IQ. In the linear model, each increase of 10 microg per deciliter in the lifetime average blood lead concentration was associated with a 4.6-point decrease in IQ (P=0.004), whereas for the subsample of 101 children whose maximal lead concentrations remained below 10 microg per deciliter, the change in IQ associated with a given change in lead concentration was greater. When estimated in a nonlinear model with the full sample, IQ declined by 7.4 points as lifetime average blood lead concentrations increased from 1 to 10 microg per deciliter. CONCLUSIONS: Blood lead concentrations, even those below 10 microg per deciliter, are inversely associated with children's IQ scores at three and five years of age, and associated declines in IQ are greater at these concentrations than at higher concentrations. These findings suggest that more U.S. children may be adversely affected by environmental lead than previously estimated.
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Prior studies document a significant correlation between childhood lead levels less than 10 ug/ml and cognitive and behavioral outcomes including ADHD and hyperactivity.
“Chandramouli, Ellis, and Emond (2009); Canfield et al. (2003); Lanphear et al. (2005); Nigg et al. (2010); and Wasserman et al. (1997) all document a significant correlation between lead levels less than 10 milograms per deciliter (ug/ml) during childhood and cognitive and behavioral outcomes including ADHD and hyperactivity.”
From Do Low Levels of Blood Lead Reduce Children's Future Test Scores? (2018) · cites this paper as Canfield et al. (2003)
The Abstract reports a significant inverse association between blood lead concentration and IQ, including among children whose concentrations remained below 10 µg per deciliter. It does not report associations with ADHD or hyperactivity. The cited threshold is in µg per deciliter, not µg per milliliter as printed in the citing sentence. (LLM, conf=0.89)
Experimental — accuracy not yet measuredLead is an established neurotoxicant that has been implicated in ASD.
“Our primary focus was on lead, an established neurotoxicant that has been implicated in ASD20, and manganese, an essential nutrient with emerging evidence of neurotoxicity21.”
From Fetal and postnatal metal dysregulation in autism (2017) · cites this paper as [20]
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- Authors
- Canfield, R. L., Henderson, C. R., Cory-Slechta, D. A., Cox, C., Jusko, T. A., & Lanphear, B. P.
- Affiliations
- Cornell University (US)
- National Institutes of Health (US)
- University of Washington (US)
- Cincinnati Children's Hospital Medical Center (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2003-04-17
- Volume
- 348
- Issue
- 16
- Pages
- 1517-1526
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC4046839
- OpenAlex
- W2146334297
- Cited by
- 2,081
- References
- 50
- Citations by year
- 2026: 37 · 2025: 33 · 2024: 46 · 2023: 55 · 2022: 77 · 2021: 73 · 2020: 121 · 2019: 68 · 2018: 96 · 2017: 96 · 2016: 109 · 2015: 101 · 2014: 99 · 2013: 108 · 2012: 104
- FWCI
- 80.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Psychological Association
- University of Rochester
- Strong
- Cornell University Agricultural Experiment Station
- National Institute of Environmental Health Sciences (ES-01247, R01ES008388, R01 ES08388, P30ES001247)
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Heavy Metal Exposure and Toxicity
- Physical Sciences › Environmental Science › Pollution › Heavy metals in environment
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Mercury impact and mitigation studies
- Keywords
- blood lead levels, childhood lead exposure, IQ, neurobehavioral development, low-level lead exposure, environmental lead, nonlinear dose-response relationship, maternal IQ, family environment
- MeSH terms
- Child, Preschool, Environmental Exposure, Female, Humans, Infant, Intelligence, Lead, Lead Poisoning, Male, Regression Analysis, Stanford-Binet Test, United States, Cohort Studies, Multivariate Analysis
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