title: Cognitive deficits associated with blood lead concentrations <10 microg/dL in US children and adolescents.
abstract: OBJECTIVE
  Lead is a confirmed neurotoxicant, but the lowest blood lead concentration associated with deficits in cognitive functioning and academic achievement is poorly defined. The purpose of the present study was to examine the relationship of relatively low blood lead concentrations-especially concentrations <10 micrograms per deciliter (microg/dL)--with performance on tests of cognitive functioning in a representative sample of US children and adolescents.
  
  
  METHODS
  The authors used data from the Third National Health and Nutrition Examination Survey (NHANES III), conducted from 1988 to 1994, to assess the relationship between blood lead concentration and performance on tests of arithmetic skills, reading skills, nonverbal reasoning, and short-term memory among 4,853 children ages 6-16 years.
  
  
  RESULTS
  The geometric mean blood lead concentration for children n the study sample was 1.9 microg/dL; 172 (2.1%) had blood lead concentrations > or =10 microg/dL. After adjustment for gender, race/ethnicity, poverty, region of the country, parent or caregiver's educational level, parent or caregiver's marital status parent, serum ferritin level, and serum cotinine level, the data showed an inverse relationship between blood lead concentration and scores on four measures of cognitive functioning. For every 1 microg/dL increase in blood lead concentration, there was a 0.7-point decrement in mean arithmetic scores, an approximately 1-point decrement in mean reading scores, a 0.1-point decrement in mean scores on a measure of nonverbal reasoning, and a 0.5-point decrement in mean scores on a measure of short-term memory. An inverse relationship between blood lead concentration and arithmetic and reading scores was observed for children with blood lead concentrations lower than 5.0 microg/dL.
  
  
  CONCLUSIONS
  Deficits in cognitive and academic skills associated with lead exposure occur at blood lead concentrations lower than 5 microg/dL.
authors.affiliation: Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. bruce.lanphear@chmcc.org
authors.forename: B P
authors.initials: BP
authors.lastname: Lanphear
authors.forename: K
authors.initials: K
authors.lastname: Dietrich
authors.forename: P
authors.initials: P
authors.lastname: Auinger
authors.forename: C
authors.initials: C
authors.lastname: Cox
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D003072:Cognition Disorders / Q000097:blood* / Q000139:chemically induced / Q000453:epidemiology; D004522:Educational Status; D004781:Environmental Exposure / Q000032:analysis*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007854:Lead / Q000009:adverse effects / Q000097:blood*; D020264:Lead Poisoning, Nervous System, Childhood / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D008452:Maximum Allowable Concentration; D014481:United States / Q000453:epidemiology
chemical_list: D007854:Lead