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Should children with developmental and behavioural problems be routinely screened for lead?
G Lewendon1, S Kinra, R Nelder
1South & West Devon Health Authority, The Lescaze Offices, Dartington, Devon TQ9 6JE, UK. gill.lewendon@sw-devon-ha.swest.nhs.uk
Insights
Children with behavioral issues show higher blood lead levels than peers. Routine screening for lead exposure is recommended for these children to prevent further developmental harm.
Area of Science:
- Environmental Health
- Pediatrics
- Neurotoxicology
Background:
- Behavioral and developmental problems in children are a significant public health concern.
- Lead exposure is a known neurotoxin with potential to exacerbate developmental issues.
Purpose of the Study:
- To investigate if children with behavioral and/or developmental problems have elevated blood lead concentrations compared to the general child population.
- To determine the association between behavioral/developmental issues and blood lead levels.
Main Methods:
- Blood samples were collected from 69 children with behavioral/developmental problems and 136 controls.
- Blood lead levels were quantified using graphite furnace atomic absorption spectrometry.
- Statistical analyses, including multiple linear regression, were employed to assess differences and control for confounding factors.
Main Results:
- Children with behavioral and/or developmental problems exhibited significantly higher geometric mean blood lead concentrations (40.7 µg/L) compared to controls (29.2 µg/L).
- A higher proportion of children with behavioral/developmental problems had blood lead levels exceeding 100 µg/L (12%) versus controls (0.7%).
- These differences remained significant after adjusting for age, sex, and socioeconomic status.
Conclusions:
- Children experiencing behavioral and/or developmental problems are at a significantly higher risk for elevated blood lead concentrations.
- Routine screening for lead exposure in this vulnerable population is warranted to mitigate further neurodevelopmental impairment.
- Identifying and addressing lead exposure can be a critical step in managing behavioral and developmental challenges in children.
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 microg/l (12% (cases), 0.7% (controls); p < 0.001). Multiple linear regression suggested that this difference was not explained by differences 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 suffered by these children. We argue that this group of children should be routinely screened for lead.