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Do children with falling blood lead levels have improved cognition?

Xianchen Liu1, Kim N Dietrich, Jerilynn Radcliffe

  • 1Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709, USA.

Pediatrics
|October 3, 2002
PubMed

Insights

Cognitive improvements in children with elevated blood lead levels were observed in a study, but these gains were not directly linked to lead reduction via chelation therapy. Other factors appear to influence cognitive development.

Area of Science:

  • Environmental Health
  • Pediatric Neurology
  • Toxicology

Background:

  • Lead exposure in urban children is linked to impaired cognitive development.
  • Previous studies yielded conflicting results on the efficacy of chelation therapy for improving IQ in children with lead exposure.

Purpose of the Study:

  • To re-analyze data from a randomized clinical trial on chelation therapy for lead exposure.
  • To investigate the association between changes in blood lead levels and cognitive development in young children.

Main Methods:

  • A secondary analysis of a randomized trial involving 741 children (13-33 months old) with blood lead levels of 20-44 microg/dL.
  • Blood lead levels and cognitive test scores were measured at baseline, 6 months, and 36 months.
  • Change in blood lead level was used as the independent variable to assess its impact on cognitive test scores.

Main Results:

  • Blood lead levels decreased similarly in both chelation and placebo groups by 6 months.
  • No association was found between blood lead level reduction and cognitive score changes at 6 months.
  • In the placebo group, cognitive scores increased by 4.0-5.1 points per 10 microg/dL fall in blood lead level from baseline to 36 months.

Conclusions:

  • Cognitive improvements in children with lead exposure may be influenced by factors other than the direct effect of lead level reduction.
  • The active drug, succimer, is unlikely to be responsible for cognitive impairment, though it cannot be entirely ruled out.
Abstract

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