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Effects of Blood Lead Levels <10 µg/dL in School-Age Children and Adolescents: A Scoping Review

Audrey F Pennington1, Madison R Smith1, Stella O Chuke1

  • 1Lead Poisoning Prevention and Surveillance Branch, Division of Environmental Health Science and Practice, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta.

Pediatrics
|October 1, 2024
PubMed

Insights

Even low blood lead levels (BLLs) below 10 µg/dL in school-aged children may negatively impact development. This review found associations with cognitive and behavioral issues, underscoring the need for further research on childhood lead exposure.

Area of Science:

  • Environmental Health
  • Pediatric Public Health
  • Toxicology

Background:

  • Childhood lead exposure remains a significant public health concern.
  • While early-life lead exposure effects are known, impacts of low-level exposure in later childhood are less understood.
  • This review focuses on school-aged children and adolescents.

Purpose of the Study:

  • To synthesize evidence on the effects of blood lead levels (BLLs) below 10 µg/dL in school-aged children and adolescents.
  • To identify potential adverse outcomes associated with low-level lead exposure during later childhood.

Main Methods:

  • A systematic literature search was conducted across multiple databases (Medline, Embase, Global health, CINAHL, Scopus, Environmental Science Collection) from 2000 to 2023.
  • Peer-reviewed English-language articles reporting on BLLs <10 µg/dL in individuals aged 5–18 years were included.
  • Data extraction covered study characteristics, population, BLLs, and reported outcomes.

Main Results:

  • Out of 3180 screened articles, 115 met the inclusion criteria, with 85% reporting mean/median BLLs <5 µg/dL.
  • A significant majority (77%) of included studies indicated an association between BLLs <10 µg/dL and detrimental outcomes in school-aged children.
  • The strongest evidence linked low BLLs to reduced intelligence quotient (IQ) and increased attention-deficit/hyperactivity disorder (ADHD) diagnoses or behaviors.

Conclusions:

  • Low blood lead levels (<10 µg/dL) in school-aged children and adolescents may be associated with negative health and developmental outcomes.
  • A limitation is that few studies controlled for prior lead exposure in early childhood (<5 years).
  • Further research is needed to clarify the long-term effects of low-level lead exposure during later childhood and adolescence.
Abstract

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