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Very low lead exposures and children's neurodevelopment.
Curr Opin Pediatr. 2008 Apr; 20(2):172-7.CO

Abstract

PURPOSE OF REVIEW

We remain far from achieving the goal of eliminating lead-associated neurodevelopmental morbidities in children. New evidence regarding the blood lead levels at which morbidities occur have led to calls for the Centers for Disease Control and Prevention to reduce the current screening guideline of 10 microg/dl. The review evaluates the basis for these calls.

RECENT FINDINGS

Adverse outcomes, such as reduced intelligence quotient and academic deficits, occur at levels below 10 microg/dl. Some studies suggest that the rate of decline in performance is greater at levels below 10 microg/dl than above 10 microg/dl, although a plausible mechanism has not been identified. Increased exposure is also associated with neuropsychiatric disorders such as attention deficit hyperactivity disorder and antisocial behavior. Functional imaging studies are beginning to provide insight into the neural substrate of lead's neurodevelopmental effects. Current protocols for chelation therapy appear ineffective in preventing such effects, although environmental enrichment might do so.

SUMMARY

No level of lead exposure appears to be 'safe' and even the current 'low' levels of exposure in children are associated with neurodevelopmental deficits. Primary prevention of exposure provides the best hope of mitigating the impact of this preventable disease.

Authors+Show Affiliations

Children's Hospital Boston, Harvard Medical School, Harvard School of Public Health, Boston, Massachusetts 02115, USA. david.bellinger@childrens.harvard.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18332714

Citation

Bellinger, David C.. "Very Low Lead Exposures and Children's Neurodevelopment." Current Opinion in Pediatrics, vol. 20, no. 2, 2008, pp. 172-7.
Bellinger DC. Very low lead exposures and children's neurodevelopment. Curr Opin Pediatr. 2008;20(2):172-7.
Bellinger, D. C. (2008). Very low lead exposures and children's neurodevelopment. Current Opinion in Pediatrics, 20(2), 172-7. https://doi.org/10.1097/MOP.0b013e3282f4f97b
Bellinger DC. Very Low Lead Exposures and Children's Neurodevelopment. Curr Opin Pediatr. 2008;20(2):172-7. PubMed PMID: 18332714.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Very low lead exposures and children's neurodevelopment. A1 - Bellinger,David C, PY - 2008/3/12/pubmed PY - 2008/8/30/medline PY - 2008/3/12/entrez SP - 172 EP - 7 JF - Current opinion in pediatrics JO - Curr. Opin. Pediatr. VL - 20 IS - 2 N2 - PURPOSE OF REVIEW: We remain far from achieving the goal of eliminating lead-associated neurodevelopmental morbidities in children. New evidence regarding the blood lead levels at which morbidities occur have led to calls for the Centers for Disease Control and Prevention to reduce the current screening guideline of 10 microg/dl. The review evaluates the basis for these calls. RECENT FINDINGS: Adverse outcomes, such as reduced intelligence quotient and academic deficits, occur at levels below 10 microg/dl. Some studies suggest that the rate of decline in performance is greater at levels below 10 microg/dl than above 10 microg/dl, although a plausible mechanism has not been identified. Increased exposure is also associated with neuropsychiatric disorders such as attention deficit hyperactivity disorder and antisocial behavior. Functional imaging studies are beginning to provide insight into the neural substrate of lead's neurodevelopmental effects. Current protocols for chelation therapy appear ineffective in preventing such effects, although environmental enrichment might do so. SUMMARY: No level of lead exposure appears to be 'safe' and even the current 'low' levels of exposure in children are associated with neurodevelopmental deficits. Primary prevention of exposure provides the best hope of mitigating the impact of this preventable disease. SN - 1040-8703 UR - https://www.unboundmedicine.com/medline/citation/18332714/Very_low_lead_exposures_and_children's_neurodevelopment_ L2 - http://dx.doi.org/10.1097/MOP.0b013e3282f4f97b DB - PRIME DP - Unbound Medicine ER -