Blood lead concentrations and children's behavioral and emotional problems: a cohort study.

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TitleBlood lead concentrations and children's behavioral and emotional problems: a cohort study.
Publication TypeJournal Article
Year of Publication2014
AuthorsLiu, J, Liu, X, Wang, W, McCauley, L, Pinto-Martin, J, Wang, Y, Li, L, Yan, C, Rogan, WJ
JournalJAMA Pediatr
Volume168
Issue8
Pagination737-45
Date Published2014 Aug
ISSN2168-6211
KeywordsChild Behavior Disorders, Child, Preschool, China, Female, Humans, Lead, Male, Prospective Studies, Risk Factors, Spectrophotometry, Atomic, Surveys and Questionnaires
Abstract

IMPORTANCE: The association between lead exposure and children's IQ has been well studied, but few studies have examined the effects of blood lead concentrations on children's behavior.OBJECTIVE: To evaluate the association between blood lead concentrations and behavioral problems in a community sample of Chinese preschool children with a mean blood lead concentration of less than 10 µg/dL.DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted at 4 preschools in Jintan, Jiangsu province of China. Participants included 1341 children aged 3 to 5 years.EXPOSURES: Lead.MAIN OUTCOMES AND MEASURES: Blood lead concentrations were measured in children aged 3 to 5 years. Behavioral problems were assessed using Chinese versions of the Child Behavior Checklist and Caregiver-Teacher Report Form when children were aged 6 years.RESULTS: The mean (SD) blood lead concentration was 6.4 (2.6) µg/dL, with the 75th and 90th percentiles being 7.5 and 9.4 µg/dL, respectively. General linear modeling showed significant associations between blood lead concentrations and increased scores for teacher-reported behavioral problems. A 1-µg/dL increase in the blood lead concentration resulted in a 0.322 (95% CI, 0.058 to 0.587), 0.253 (95% CI, 0.016 to 0.500), and 0.303 (95% CI, 0.046 to 0.560) increase of teacher-reported behavior scores on emotional reactivity, anxiety problems, and pervasive developmental problems, respectively (P < .05), with adjustment for parental and child variables. Spline modeling showed that mean teacher-reported behavior scores increased with blood lead concentrations, particularly for older girls.CONCLUSIONS AND RELEVANCE: Blood lead concentrations, even at a mean concentration of 6.4 µg/dL, were associated with increased risk of behavioral problems in Chinese preschool children, including internalizing and pervasive developmental problems. This association showed different patterns depending on age and sex. As such, continued monitoring of blood lead concentrations, as well as clinical assessments of mental behavior during regular pediatric visits, may be warranted.

DOI10.1001/jamapediatrics.2014.332
Alternate JournalJAMA Pediatr
PubMed ID25090293
PubMed Central IDPMC4152857
Grant ListK02-ES019878 / ES / NIEHS NIH HHS / United States
K01-ES015877 / ES / NIEHS NIH HHS / United States
K01 ES015877 / ES / NIEHS NIH HHS / United States
ZIA ES043011-20 / / Intramural NIH HHS / United States
R01 ES018858 / ES / NIEHS NIH HHS / United States
P30 ES013508 / ES / NIEHS NIH HHS / United States
ZIA ES043011-19 / / Intramural NIH HHS / United States
R01-ES018858 / ES / NIEHS NIH HHS / United States
P30-ES013508 / ES / NIEHS NIH HHS / United States
K02 ES019878 / ES / NIEHS NIH HHS / United States
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