Analysis of prospective epidemiologic studies on the neurobehavioural effects of lead

Abstract

High-level lead exposure can have serious effects on the intellectual and behavioural development of young children. There has been much controversy in the last decade concerning the possible impact of low-level lead exposure upon the neurobehavioural and psychomotor development of children. Five longitudinal studies (Boston, Cincinnati, Cleveland, Port Pirie and Sydney) examining lead effects on child development were initiated in the early 1980s. These studies share multiple design features and include data on blood lead and neurobehavioural measurements from birth, six months, or annual intervals to seven years. All the studies use multivariate analysis to take into account possible confounding covariates with outcome measures.The studies tend to have varying results based on the covariates used and type of subject population. An analysis of the results of the five studies with regard to effects associated with prenatal and postnatal lead exposure and pregnancy outcome has been carried out and reveals inconsistencies in the onset, stability, and nature of neurobehavioural effects correlated with different indices of lead exposure. it is possible that the variation in reported results may be due to the use of different covariates and analyses among studies. A common analysis should be carried out among ail studies to further determine consistency of results. Although individual studies may show some effects, taken as a whole, the current published data from the five studies in this review are inconsistent and do not lend support to the concept that low level lead exposure resulting in blood lead levels below 25 μg dL(-1) is associated with neurobehavioural deficits in children.