Association between potential lead exposure assessed using a screening questionnaire and aggressive behaviour among...

The association between lead exposure and aggressive behaviour has been documented internationally. However, evidence among adolescents in low- and middle-income countries-particularly using non-blood-based exposure screening tools-remains limited.

This cross-sectional study investigates the relationship between potential lead exposure and aggressive behaviour in adolescents. The study subjects were middle and high school students aged 13-18 years residing in Jakarta. Data on the potential lead exposure were obtained using a lead exposure risk questionnaire from the Ministry of Health of the Republic of Indonesia, while data on aggressive behaviour were collected using the Buss Perry Aggression Questionnaire Scale. The likelihood of aggressive behaviour was analysed using logistic regression.

The study, conducted between June and October 2024, involved 488 high school students from five municipalities in Jakarta. 76 students (15.6%) exhibited aggressive behaviour. It did not differ significantly by sex (p=0.817), parental education (p=0.916) or socioeconomic status (p=0.162). Potential lead exposure was significantly associated with aggressive behaviour (p=0.001), with a higher prevalence observed among participants reporting multiple exposure sources (p<0.001). Subjects with a potential lead exposure had a significantly higher likelihood of exhibiting aggressive behaviour (adjusted OR=10.0; 95% CI 1.32 to 77.3) compared with those not exposed. Residing in older buildings with deteriorating wall paint or furniture emerged as the sole significant source of potential lead exposure associated with elevated aggressive behaviour (adjusted OR=2.98; 95% CI 1.66 to 5.38). Additional risk factors included prior traumatic experiences, inadequate parental attention and frequent exposure to violent media.

This study demonstrates a significant relationship between the potential lead exposure and aggressive behaviour. Improved policies for preventing lead exposure are necessary to protect the health of adolescents in Jakarta and the community from the long-term impacts of lead exposure.