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Airborne Lead Exposure and Childhood Cognition: The Environmental Influences on Child Health Outcomes (ECHO) Cohort
Lisa M Gatzke-Kopp1, Michael Willoughby1, Amii M Kress1
1Lisa M. Gatzke-Kopp is with the Department of Human Development and Family Studies, Pennsylvania State University, University Park. Michael Willoughby is with the Department of Education and Workforce Development, RTI International, Raleigh, NC. Amii M. Kress, Kristen McArthur, and Cara Wychgram are with the Department of General Epidemiology and Methodology, Johns Hopkins University, Baltimore, MD. David C. Folch is with the Department of Geography, Planning and Recreation, Northern Arizona University, Flagstaff. Steve Brunswasser is with the Department of Psychology, Rowan University, Glassboro, NJ. Dana Dabelea is with the Colorado School of Public Health, University of Colorado Anshutz Medical Campus, Aurora. Amy J. Elliott is with the Avera Research Institute, Sioux Falls, SD. Tina Hartert is with the Center for Health Services Research, Vanderbilt University, Nashville, TN. Margaret Karagas is with the Department of Epidemiology, Dartmouth Geisel School of Medicine, Lebanon, NH. Cindy T. McEvoy is with the Department of Pediatrics, Oregon Health Sciences University, Portland. James A. VanDerslice is with the Department of Public Health, University of Utah School of Medicine, Salt Lake City. Robert O. Wright and Rosalind J. Wright are with the Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY.
Abstract:
Objectives. To examine whether a previously reported association between airborne lead exposure and children's cognitive function replicates across a geographically diverse sample of the United States. Methods. Residential addresses of children (< 5 years) were spatially joined to the Risk-Screening Environmental Indicators model of relative airborne lead toxicity. Cognitive outcomes for children younger than 8 years were available for 1629 children with IQ data and 1476 with measures of executive function (EF; inhibitory control, cognitive flexibility). We used generalized linear models using generalized estimating equations to examine the associations of lead, scaled by interquartile range (IQR), accounting for individual- and area-level confounders. Results. An IQR increase in airborne lead was associated with a 0.74-point lower mean IQ score (b = -0.74; 95% confidence interval = -1.00, -0.48). The association between lead and EF was nonlinear and was modeled with a knot at the 97.5th percentile of lead in our sample. Lead was significantly associated with lower mean inhibitory control but not with cognitive flexibility. This effect was stronger among males for both IQ and inhibitory control. Conclusions. Early-life exposure to airborne lead is associated with lower cognitive functioning. (Am J Public Health. 2024;114(3):309-318. https://doi.org/10.2105/AJPH.2023.307519).
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