Until a reservoir of lead-safe housing is created, programs that educate families to reduce environmental exposure are needed. Although providing families with quantitative information regarding lead contamination may have a role in short-term efforts to prevent lead exposure, these null findings suggest that it has little benefit once BLLs are elevated.

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WHAT'S KNOWN ON THIS SUBJECT: Blood lead levels well below 10 mg/dL are now recognized as causing adverse cognitive effects, including lower scores on standardized reading and math tests. WHAT THIS STUDY ADDS:This is the first study to show that reading readiness early in kindergarten is independently associated with blood lead levels well below 10 mg/dL. Results suggest that lead exposure may have a larger impact on urban education than national estimates suggest. abstract OBJECTIVE: To evaluate the relationship between blood lead levels (BLLs) and reading readiness at kindergarten entry, an early marker of school performance, in a diverse urban school population. METHODS:Kindergarten reading readiness test scores for children attending public kindergarten in Providence, Rhode Island, were linked to state health department records of blood lead testing by using individual identifiers. The study population (N = 3406) was 59% Hispanic. For each child, the geometric mean BLL was estimated by using all previously reported BLLs. Analyses were adjusted for gender, age, year enrolled, race, child language, and free/reduced lunch status as a measure of socioeconomic status. RESULTS:The median geometric mean BLL was 4.2 mg/dL; 20% of children had at least 1 venous BLL $10 mg/dL. Compared with children with BLLs ,5 mg/dL, the adjusted prevalence ratios (95% confidence interval [CI]) for failing to achieve the national benchmark for reading readiness were 1.21 (1.19 to 1.23) and 1.56 (1.51 to 1.60) for children with BLLs of 5 to 9 and $10 mg/dL, respectively. On average, reading readiness scores decreased by 4.5 (95% CI: 22.9 to 26.2) and 10.0 (95% CI: 27.0 to 213.3) points for children with BLLs of 5 to 9 and $10 mg/dL, respectively, compared with BLLs ,5 mg/dL. CONCLUSIONS: BLLs well below 10 mg/dL were associated with lower reading readiness at kindergarten entry.

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