Developmental medicine and child neurology. Supplement最新文献

A study of the associations between level of tooth lead, behaviour, intelligence and a variety of other psychological skills was carried out in the child population aged six to seven years in three London boroughs. Tooth lead was estimated from the chemical analysis of shed teeth donated by children. 2663 (62.4 per cent) of the eligible children donated teeth. A study of the total population was carried out to see if those who donated teeth were representative of that population. There were small but consistent and statistically significant differences--tooth-givers being of slightly higher intelligence and showing fewer behaviour problems. 403 children, selected on the basis of their tooth-lead levels and social class, were studied more intensively. They were classified into six pre-arranged groups--high, medium and low tooth-lead levels, with each lead group divided into two social groups, manual and non-manual. The parents of these children were intensively interviewed in their homes regarding parental interest and attitudes to education, family characteristics and relationships, the early history of the child and the child's physical environment. The intelligence of the mother was measured. The child was then studied in school using tests of intelligence, educational attainment and other cognitive tasks. Teachers and parents completed standardised behaviour questionnaires. The results showed that intelligence and other psychological measures were strongly related to social factors, especially social grouping. Lead level was linked to a variety of factors in the home, especially the level of cleanliness, and to a lesser extent, maternal smoking. There was no significant link between lead level and behaviour, though when rated by teachers, but not by parents, there were small and reasonably consistent non-significant tendencies for high-lead children to show more difficult behaviour. Before social factors were controlled for, there were significant differences between the lead groups in measures of intelligence and two other psychological tests, the children in the high-lead groups performing worse. Once a number of social factors had been taken into account, the differences between the three lead groups (high, medium and low) became small and statistically nonsignificant, although they remained in the same direction.(ABSTRACT TRUNCATED AT 400 WORDS)

Research findings on the effects of raised lead levels on children's cognitive and behavioural functioning are reviewed. The results are considered separately with respect to clinic-type studies of children with high lead levels, studies of mentally retarded or behaviourally deviant children, chelation studies, smelter studies, and general population studies of dental lead. It is concluded that, although the findings are somewhat contradictory, the evidence suggests that persistently raised blood levels in the range above 40 microgram/100 ml may cause slight cognitive impairment (a reduction of one to five points on average) and less certainly may increase the risk of behavioural difficulties. There are pointers that there may also be psychological risks with lead levels below 40 microgram/100 ml, but the evidence on this point is inconclusive so far. Parallels are drawn with studies of other brain traumata and some suggestions are made with respect to both practical implications and the needs for further research.