Should children with developmental and behavioural problems be routinely screened for lead?

Abstract

Aim-To test the hypothesis that children with behavioural and/or developmental problems have significantly higher blood lead concentrations than the general childhood population. Methods-Blood samples were taken from 69 children with behavioural and/or developmental problems and 136 controls (children admitted for elective day case surgery under general anaesthetic). Blood lead estimations were carried out using graphite furnace atomic absorption Results-Children with behavioural and/or developmental problems had higher lead concentrations than controls, both in terms of their distribution across the group (mean geometric lead concentrations: 40.7 (cases), 29.2 (controls), ratio of the means geometric 1.35 (95% CI 1.17, 1.58)) and the proportion of children with lead concentrations above those commonly defined as "toxic"-that is, 100 µg/l (12% (cases), 0.7% (controls); p < 0.001). Multiple linear regression suggested that this diVerence was not explained by diVerences in age, sex, or socioeconomic status of the two comparison groups. Conclusions-Children with behavioural and/or developmental problems are more likely to have significantly higher blood lead concentrations than the general childhood population. Lead, a known and more importantly, a treatable neurotoxin, would further contribute to the impairment suVered by these children. We argue that this group of children should be routinely screened for lead. (Arch Dis Child 2001;85:286-288)

The effects of metallothionein 2A polymorphism on lead metabolism: are pregnant women with a heterozygote genotype for metallothionein 2A polymorphism and their newborns at risk of having higher blood lead levels?

“…In general, the mean blood lead level is estimated to be below 5 g/dl in Western European countries and between 5 and 10 g/dl in Eastern ones. Lewendon et al report that up to 5% of the children in England have blood lead levels >10 g/dl (Lewendon et al 2001). Other studies showed that average concentrations of cord blood from healthy children were between 2.02 g/dl and 3.83 g/dl in Poland, 4.82 g/dl in Czechoslovakia, 4.09 g/dl in Taiwan and 2.49 g/dl in our study (Durska et al 2002;Truska et al 1989;Soong et al 1991).…”

Practice parameter: Evaluation of the child with global developmental delay [RETIRED]

“…88 However, in a study of children drawn from a population at low risk for lead exposure, a series of 43 children with either developmental delay or attention deficit hyperactivity disorder did not demonstrate elevated lead levels compared to controls (class II study). 89 Current consensus guidelines with respect to lead testing in children recommend a strategy of targeted screening of all children with identifiable risk factors.…”

Effects of blood lead level on biochemical and hematological parameters in children with neurological diseases of Western Maharashtra, India

“…Currently, about 3% of children in the US have elevated blood levels of lead (more than 10 μg/dL); however, recent data show that the effect on cognitive skill in children could occur at lower levels, even as low as 5 μg/dL. Children absorb over three times as much as adults and are at greatly increased risk through increased activity such as chewing objects and sucking their fingers [22]. Blood lead levels in children with neurological disorders is on the higher side due to excessive hand-to-mouth activity, poor nutritional status consequent to feeding difficulties, poor appetite, and social neglect.…”