Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Health Effects of Lead at Low Exposure Levels: Expert Consensus and Rationale for Lowering the Definition of Childhood Lead Poisoning

Health Effects of Lead at Low Exposure Levels: Expert Consensus and Rationale for Lowering the... Abstract Since the Centers for Disease Control (CDC) 1985 Statement on Preventing Lead Poisoning in Young Children1 was published, an extensive database has provided a direct link between low-level lead exposure during early development and deficits in neurobehavioral-cognitive performance evident later in childhood through adolescence.2-17 These consistent and conclusive studies, based on the strength of the science, have demonstrated the presence of a constellation of neurotoxic and other adverse effects of lead at blood lead (BPb) levels at least as low as 0.48 μmol/L (10 μg/dL). Accordingly, federal agencies and advisory groups have redefined childhood lead poisoning as a BPb level of 0.48 μmol/L (10 μg/dL).18-23 These agencies arrived at this finding through consensus among informed lead experts and preparation of scientific documents evaluated through the peer review process. Furthermore, according to the CDC, no threshold for the lead-IQ relationship has been established.18 Before discussing some of References 1. Statement on Preventing Lead Poisoning in Young Children . Atlanta, Ga: Centers for Disease Control; 1985. 2. Fulton M, Raab G, Thompson C, Laxen D, Hunter R, Hepburn W. Influence of blood lead on the ability and the attainment of children in Edinburgh . Lancet . 1987;1:1221-1226.Crossref 3. Hansen ON, Trillingsgaard A, Beesel, Lyngbye T, Grandjean P. A neuropsychological study of children with elevated dentine lead level: assessment of the effect of lead in different socioeconomic groups . Neurotoxicol Teratol . 1989; 11:205-213.Crossref 4. Hatzakis A, Kokkevi A, Maravelias C, et al. Psychometric intelligence deficits in lead-exposed children . In: Smith M, Grant L, Sors A, eds. Lead Exposure and Child Development: An International Assessment . Dordrecht, the Netherlands: Kluwer Academic Publishers; 1989:211-223. 5. Hawk BA, Schroeder SR, Robinson G, et al. Relation of lead and social factors to IQ of low-SES children: a partial replication . Am J Ment Def . 1986;91:178-183. 6. Landsdown R, Yule W, Urbanowicz MA, Hunter J. The relationship between blood-lead concentrations, intelligence, attainment and behaviour in a school population: the second study . Int Arch Occup Environ Health . 1986;57:225-235.Crossref 7. Lyngbye T, Hansen ON, Trillingsgaard A, Beese I, Grandjean P. Learning disabilities in children: significance of low-level lead exposure and confounding effects . Acta Pediatr Scand . 1990;79:352-360.Crossref 8. Schroeder SR, Hawk B, Otto DA, Mushak P, Hicks RE. Separating the effects of lead and social factors on IQ . Environ Res . 1985;38:144-154.Crossref 9. Winneke G, Brockhaus A, Ewers U, Kramer U, Neuf M. Results from the European multicenter study on lead neurotoxicity in children: implications for risk assessment . Neurotoxicity Teratol . 1990;12:553-559.Crossref 10. Yule W, Landsdown R, Miller I, Urbanowicz M. The relationship between blood lead concentrations, intelligence, and attainment in a school population: a pilot study . Dev Med Child Neurol . 1981;23:567-576.Crossref 11. Needleman HL, Schell A, Bellinger D, Leviton A, Allred EN. The long-term effects of exposure to low doses of lead in childhood: an 11 -year follow-up report . N Engl J Med . 1990;322: 83-88.Crossref 12. McMichael AJ, Baghurst PA, Wigg NR, Vimpani GV, Robertson EF, Roberts RJ. Port Pirie cohort study: environmental exposure to lead and children's abilities at four years . N Engl J Med . 1988;319:468-475.Crossref 13. Bellinger D, Leviton A, Waternaux C, Needleman H, Rabinowitz M. Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development . N Engl J Med . 1987;316:1037-1043.Crossref 14. Bellinger D, Sloman J, Leviton A, Rabinowitz M, Needleman H, Waternaux C. Low-level exposure and children's cognitive function in the preschool years . Pediatrics . 1991;87:219-227. 15. Dietrich KN, Grafft KM, Bier M, Berger O, Succop PA, Bornschein RL. Neurobehavioral effect of fetal lead exposure: the first year of life . In: Smith M, Grand LD, eds. Lead Exposure and Child Development: An International Assessment . Lancaster, England: MTP Press Ltd; 1989: 320-331. 16. Bellinger DC, Stiles KM, Needleman HL. Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study. Pediatrics. In press. 17. Schwartz J. Beyond Loel's, p values and vote counting: methods for looking at the shapes and strengths of associations. Neurotoxicology. In press. 18. Preventing Lead Poisoning in Young Children: A Statement by The Centers for Disease Control . Atlanta, Ga: Centers for Disease Control; 1991. 19. Centers for Disease Control. Strategic Plan for the Elimination of Childhood Lead Poisoning . Washington DC: Dept of Health and Human Services; (February) 1991. 20. Clean Air Scientific Advisory Committee . Washington, DC: US Environmental Protection Agency; (January) 1990. 21. Agency for Toxic Substances and Disease Registry . The Nature and Extent of Lead Poisoning in Children in the United States: A Report to Congress . Atlanta, Ga: ATSDR; 1988. 22. US Environmental Protection Agency. Air Quality Criteria for Lead . Research Triangle Park, NC: US Environmental Protection Agency; 1986. EPA Report No. EPA-6700/8-83/027af-df. 23. US Environmental Protection Agency. Supplement to the 1986 Air Quality Criteria for Lead Addendum . Research Triangle Park, NC: Environmental Criteria and Assessment Office; 1990. Report No. EPA/600/8-89/049a. 24. Mushak P, Davis JM, Crochetti AF, Grant LD. Prenatal and postnatal effects of low level lead exposure: integrated summary of a report to the US Congress on childhood lead poisoning . Environ Res. 1989;50:11-36.Crossref 25. Comprehensive and Workable Plan for the Abatement of Lead-Based Paint in Privately Owned Housing: Report to Congress . Washington, DC: US Dept of Housing and Urban Development; 1990:xix. 26. Needleman HL, Gunnoe C, Leviton A, et al. Deficits in psychologic and classroom performance of children with elevated dentine lead levels . N Engl J Med . 1979;300:689-695.Crossref 27. Ernhart CB, Morrow-Tlucak M, Marler MR, Wolf AW. Low level lead exposure in the prenatal and early preschool periods: early preschool development . Neurotoxicol Teratol . 1987;9:259-270.Crossref 28. Needleman HL, Gatsonis CA. Low-level lead exposure and the IQ of children . JAMA . 1990;263:673-678.Crossref 29. Needleman HL. Low level lead exposure and children's intelligence: a quantitative and critical review of modern studies. In: Lindberg SE, Hutchinson TC, eds. International Conference: Heavy Metals in the Environment. Edinburgh, Scotland: CEP Consultants Ltd; 1987;1:1-8. 30. Grant LD, Davis JM. Effect of low-level lead exposure on pediatric neurobehavioral and physical development: current findings and future directions . In: Smith M, Grant LD, Sors A, eds. Lead Exposure and Child Development: An International Assessment . Lancaster, England: MTP Press Ltd; 1989:49-115. 31. Cost and Benefits of Reducing Lead in Gasoline: Final Regulatory Impact Analysis . Washington DC: Office of Policy Analysis, Environmental Protection Agency; 1985. 32. Crocetti AF, Mushak P, Schwartz J. Determination of numbers of lead-exposed US children by areas of the United States: an integrated summary of a report to the U.S. Congress . Environ Health Perspect . 1989;89:109-120.Crossref 33. Mushak P. The US Agency for Toxic Substances and Disease Registry's report to Congress on childhood lead poisoning: overview and update. In: Proceedings of the First National Conference: Laboratory Issues in Childhood Lead Poisoning. Washington, DC: Association of State and Territorial Public Health Laboratory Directors. In press. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Health Effects of Lead at Low Exposure Levels: Expert Consensus and Rationale for Lowering the Definition of Childhood Lead Poisoning

American Journal of Diseases of Children , Volume 146 (11) – Nov 1, 1992

Loading next page...
 
/lp/american-medical-association/health-effects-of-lead-at-low-exposure-levels-expert-consensus-and-YswHMgwCub

References (31)

Publisher
American Medical Association
Copyright
Copyright © 1992 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1992.02160230036011
Publisher site
See Article on Publisher Site

Abstract

Abstract Since the Centers for Disease Control (CDC) 1985 Statement on Preventing Lead Poisoning in Young Children1 was published, an extensive database has provided a direct link between low-level lead exposure during early development and deficits in neurobehavioral-cognitive performance evident later in childhood through adolescence.2-17 These consistent and conclusive studies, based on the strength of the science, have demonstrated the presence of a constellation of neurotoxic and other adverse effects of lead at blood lead (BPb) levels at least as low as 0.48 μmol/L (10 μg/dL). Accordingly, federal agencies and advisory groups have redefined childhood lead poisoning as a BPb level of 0.48 μmol/L (10 μg/dL).18-23 These agencies arrived at this finding through consensus among informed lead experts and preparation of scientific documents evaluated through the peer review process. Furthermore, according to the CDC, no threshold for the lead-IQ relationship has been established.18 Before discussing some of References 1. Statement on Preventing Lead Poisoning in Young Children . Atlanta, Ga: Centers for Disease Control; 1985. 2. Fulton M, Raab G, Thompson C, Laxen D, Hunter R, Hepburn W. Influence of blood lead on the ability and the attainment of children in Edinburgh . Lancet . 1987;1:1221-1226.Crossref 3. Hansen ON, Trillingsgaard A, Beesel, Lyngbye T, Grandjean P. A neuropsychological study of children with elevated dentine lead level: assessment of the effect of lead in different socioeconomic groups . Neurotoxicol Teratol . 1989; 11:205-213.Crossref 4. Hatzakis A, Kokkevi A, Maravelias C, et al. Psychometric intelligence deficits in lead-exposed children . In: Smith M, Grant L, Sors A, eds. Lead Exposure and Child Development: An International Assessment . Dordrecht, the Netherlands: Kluwer Academic Publishers; 1989:211-223. 5. Hawk BA, Schroeder SR, Robinson G, et al. Relation of lead and social factors to IQ of low-SES children: a partial replication . Am J Ment Def . 1986;91:178-183. 6. Landsdown R, Yule W, Urbanowicz MA, Hunter J. The relationship between blood-lead concentrations, intelligence, attainment and behaviour in a school population: the second study . Int Arch Occup Environ Health . 1986;57:225-235.Crossref 7. Lyngbye T, Hansen ON, Trillingsgaard A, Beese I, Grandjean P. Learning disabilities in children: significance of low-level lead exposure and confounding effects . Acta Pediatr Scand . 1990;79:352-360.Crossref 8. Schroeder SR, Hawk B, Otto DA, Mushak P, Hicks RE. Separating the effects of lead and social factors on IQ . Environ Res . 1985;38:144-154.Crossref 9. Winneke G, Brockhaus A, Ewers U, Kramer U, Neuf M. Results from the European multicenter study on lead neurotoxicity in children: implications for risk assessment . Neurotoxicity Teratol . 1990;12:553-559.Crossref 10. Yule W, Landsdown R, Miller I, Urbanowicz M. The relationship between blood lead concentrations, intelligence, and attainment in a school population: a pilot study . Dev Med Child Neurol . 1981;23:567-576.Crossref 11. Needleman HL, Schell A, Bellinger D, Leviton A, Allred EN. The long-term effects of exposure to low doses of lead in childhood: an 11 -year follow-up report . N Engl J Med . 1990;322: 83-88.Crossref 12. McMichael AJ, Baghurst PA, Wigg NR, Vimpani GV, Robertson EF, Roberts RJ. Port Pirie cohort study: environmental exposure to lead and children's abilities at four years . N Engl J Med . 1988;319:468-475.Crossref 13. Bellinger D, Leviton A, Waternaux C, Needleman H, Rabinowitz M. Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development . N Engl J Med . 1987;316:1037-1043.Crossref 14. Bellinger D, Sloman J, Leviton A, Rabinowitz M, Needleman H, Waternaux C. Low-level exposure and children's cognitive function in the preschool years . Pediatrics . 1991;87:219-227. 15. Dietrich KN, Grafft KM, Bier M, Berger O, Succop PA, Bornschein RL. Neurobehavioral effect of fetal lead exposure: the first year of life . In: Smith M, Grand LD, eds. Lead Exposure and Child Development: An International Assessment . Lancaster, England: MTP Press Ltd; 1989: 320-331. 16. Bellinger DC, Stiles KM, Needleman HL. Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study. Pediatrics. In press. 17. Schwartz J. Beyond Loel's, p values and vote counting: methods for looking at the shapes and strengths of associations. Neurotoxicology. In press. 18. Preventing Lead Poisoning in Young Children: A Statement by The Centers for Disease Control . Atlanta, Ga: Centers for Disease Control; 1991. 19. Centers for Disease Control. Strategic Plan for the Elimination of Childhood Lead Poisoning . Washington DC: Dept of Health and Human Services; (February) 1991. 20. Clean Air Scientific Advisory Committee . Washington, DC: US Environmental Protection Agency; (January) 1990. 21. Agency for Toxic Substances and Disease Registry . The Nature and Extent of Lead Poisoning in Children in the United States: A Report to Congress . Atlanta, Ga: ATSDR; 1988. 22. US Environmental Protection Agency. Air Quality Criteria for Lead . Research Triangle Park, NC: US Environmental Protection Agency; 1986. EPA Report No. EPA-6700/8-83/027af-df. 23. US Environmental Protection Agency. Supplement to the 1986 Air Quality Criteria for Lead Addendum . Research Triangle Park, NC: Environmental Criteria and Assessment Office; 1990. Report No. EPA/600/8-89/049a. 24. Mushak P, Davis JM, Crochetti AF, Grant LD. Prenatal and postnatal effects of low level lead exposure: integrated summary of a report to the US Congress on childhood lead poisoning . Environ Res. 1989;50:11-36.Crossref 25. Comprehensive and Workable Plan for the Abatement of Lead-Based Paint in Privately Owned Housing: Report to Congress . Washington, DC: US Dept of Housing and Urban Development; 1990:xix. 26. Needleman HL, Gunnoe C, Leviton A, et al. Deficits in psychologic and classroom performance of children with elevated dentine lead levels . N Engl J Med . 1979;300:689-695.Crossref 27. Ernhart CB, Morrow-Tlucak M, Marler MR, Wolf AW. Low level lead exposure in the prenatal and early preschool periods: early preschool development . Neurotoxicol Teratol . 1987;9:259-270.Crossref 28. Needleman HL, Gatsonis CA. Low-level lead exposure and the IQ of children . JAMA . 1990;263:673-678.Crossref 29. Needleman HL. Low level lead exposure and children's intelligence: a quantitative and critical review of modern studies. In: Lindberg SE, Hutchinson TC, eds. International Conference: Heavy Metals in the Environment. Edinburgh, Scotland: CEP Consultants Ltd; 1987;1:1-8. 30. Grant LD, Davis JM. Effect of low-level lead exposure on pediatric neurobehavioral and physical development: current findings and future directions . In: Smith M, Grant LD, Sors A, eds. Lead Exposure and Child Development: An International Assessment . Lancaster, England: MTP Press Ltd; 1989:49-115. 31. Cost and Benefits of Reducing Lead in Gasoline: Final Regulatory Impact Analysis . Washington DC: Office of Policy Analysis, Environmental Protection Agency; 1985. 32. Crocetti AF, Mushak P, Schwartz J. Determination of numbers of lead-exposed US children by areas of the United States: an integrated summary of a report to the U.S. Congress . Environ Health Perspect . 1989;89:109-120.Crossref 33. Mushak P. The US Agency for Toxic Substances and Disease Registry's report to Congress on childhood lead poisoning: overview and update. In: Proceedings of the First National Conference: Laboratory Issues in Childhood Lead Poisoning. Washington, DC: Association of State and Territorial Public Health Laboratory Directors. In press.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1992

There are no references for this article.