Behavioral indicators of lead neurotoxicity: Results of a clinical field survey

Abstract

Central nervous system dysfunction in workers occupationally exposed to lead was investigated by means of performance tests. The test scores of lead-exposed workers were compared with those of control groups (steel workers, papermill workers and farmers). It was found that secondary lead smelter workers showed significantly poorer performance scores than the nonexposed, control groups. The group differences between steel workers and lead workers in test scores were not attributable to differences in age or education. In the lead-exposed workers correlations between test scores and indicators of lead absorption (particularly blood lead and zinc protophyrin levels) were analyzed. Increases in zinc protoporphyrin levels were found to be highly correlated with decreases in test scores. Lower performance test scores were consistent with a sizeable prevalence of central nervous system symptoms among secondary lead smelter workers. Moreover, lead workers without central nervous system symptoms also showed decrements in performance test scores which were also correlated with elevated zinc protoporphyrin levels. The data indicate that certain behavioral tests might be important tools for studying subclinical central nervous system dysfunction due to lead toxicity; significant correlations between zinc protoporphyrin levels and behavioral test scores are considered to be consistent with an etiologic relationship between decrement in performance scores and lead effects on the central nervous system.