Declining blood lead levels and cognitive changes in moderately lead-poisoned children
H. A. Ruff, P. E. Bijur, M. Markowitz, Y. C. Ma and J. F. Rosen
Department of Pediatrics, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.
OBJECTIVE--To determine whether chelation therapy or biochemical changes
during a lead-lowering intervention was associated with changes in
cognitive functioning of moderately lead-poisoned children. It was
hypothesized that cognitive performance would improve as blood lead level
declined over time. DESIGN--Short-term intervention study with measures
obtained before and after intervention. SETTING--Hospital specialty clinic
and university research center. PATIENTS--A total of 154 previously
untreated children referred to clinic with blood lead levels between 1.21
and 2.66 mumol/L (25 and 55 micrograms/dL) at time of enrollment. Ages
ranged from 13 to 87 months. INTERVENTION--Enrolled children were treated
with edetate calcium disodium (EDTA) if eligible and/or with orally
administered iron supplement if iron deficient. For all children, housing
inspections and abatement procedures were performed as necessary. MAIN
OUTCOME MEASURES--Score on Bayley Mental Development Scale or
Stanford-Binet Intelligence Scale (4th edition). RESULTS--There was no
effect of edetate calcium disodium treatment per se. In the short term (7
weeks), changes in blood lead levels were not related to changes in
cognitive scores. In the long term (6 months), however, changes in
performance were significantly related to changes in blood lead level, even
after controlling for confounding variables. The standardized score
increased 1 point for every decrease of 0.14 mumol/L (3 micrograms/dL) in
blood lead level. CONCLUSION--The results suggest an association between
decreases in blood lead level and cognitive improvements in moderately
lead-poisoned children.
Lead Exposure in Children: Prevention, Detection, and Management
Committee on Environmental Health
Pediatrics 2005;116:1036-1046.
ABSTRACT
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Effect of Chelation Therapy on the Neuropsychological and Behavioral Development of Lead-Exposed Children After School Entry
Dietrich et al.
Pediatrics 2004;114:19-26.
ABSTRACT
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A Randomized Trial of Calcium Supplementation for Childhood Lead Poisoning
Markowitz et al.
Pediatrics 2004;113:e34-39.
ABSTRACT
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Do Children With Falling Blood Lead Levels Have Improved Cognition?
Liu et al.
Pediatrics 2002;110:787-791.
ABSTRACT
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The Effect of Chelation Therapy with Succimer on Neuropsychological Development in Children Exposed to Lead
Rogan et al.
NEJM 2001;344:1421-1426.
ABSTRACT
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Declining Blood Lead Levels and Changes in Cognitive Function During Childhood: The Port Pirie Cohort Study
Tong et al.
JAMA 1998;280:1915-1919.
ABSTRACT
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A Computer Program For Managing Lead Poisoning in Children
Schindler and Torchia
CLIN PEDIATR 1995;34:619-620.
ABSTRACT
LEAD POISONING: TREATMENT AND PREVENTION
JWatch General 1993;1993:7-7.
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