Neuropsychological Effects of Lead in Children: Interactions with Social Background Variables

Heinrich-Heine-Universität Düsseldorf, Düsseldorf, North Rhine-Westphalia, Germany
Neuropsychobiology (Impact Factor: 2.26). 02/1984; 11(3):195-202. DOI: 10.1159/000118077
Source: PubMed


Following a short and selective summary of findings from psychological studies on lead-induced cognitive dysfunction in man, our own studies in lead-exposed children are briefly described in more detail. These studies, run in the cities of Duisburg and Stolberg, were based on tooth lead levels as the principal indicator of long-term cumulative lead exposure. From a comprehensive sample of neuropsychological outcome measures, only few significant findings emerged, namely lead-related deficits of visual-motor integration and of reaction performance, but not of general intelligence. Without exception, the observed lead effects were small compared to those of social background. An interesting interaction was found between lead exposure and social background for visual-motor integration and for reaction performance: for both these measures, but not for intelligence, the degree of association between performance deficit and lead exposure was more pronounced in socially disadvantaged children than in those from a more middle-class background. This finding was tentatively discussed within a transactional model of development. The common practice of simply controlling the effects of confounding social factors by analysis of covariance or related techniques appears doubtful in this context.

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    • "Cumulative poverty and hardship in the first year of life were associated with negative effects on cognitive function in childhood (Schoon et al., 2012). The observed interaction between PAH (cord adducts) and material hardship is consistent with other reports that adverse social conditions can modify the neurotoxicity of environmental pollutants such as lead, traffic-related pollutants, and ETS (Bellinger, 2000; Clougherty et al., 2007; Dietrich et al., 1991; Rauh et al., 2004; Winneke and Kraemer, 1984) (see McEwen and Tucker, 2011 for review). A number of prior reports in other populations have indicated adverse neurodevelopmental effects of air pollution (Edwards et al., 2010; Perera et al., 2009; Sram et al., 1996; Tang et al., 2014). "
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    ABSTRACT: Polycyclic aromatic hydrocarbons are common carcinogenic and neurotoxic urban air pollutants. Toxic exposures, including air pollution, are disproportionately high in communities of color and frequently co-occur with chronic economic deprivation. We examined whether the association between child IQ and prenatal exposure to polycyclic aromatic hydrocarbons differed between groups of children whose mothers reported high vs. low material hardship during their pregnancy and through child age 5. We tested statistical interactions between hardships and polycyclic aromatic hydrocarbons, as measured by DNA adducts in cord blood, to determine whether material hardship exacerbated the association between adducts and IQ scores. Prospective cohort. Participants were recruited from 1998 to 2006 and followed from gestation through age 7 years. Urban community (New York City) PARTICIPANTS: A community-based sample of 276 minority urban youth EXPOSURE MEASURE: Polycyclic aromatic hydrocarbon-DNA adducts in cord blood as an individual biomarker of prenatal polycyclic aromatic hydrocarbon exposure. Maternal material hardship self-reported prenatally and at multiple timepoints through early childhood. Child IQ at 7 years assessed using the Wechsler Intelligence Scale for Children. Significant inverse effects of high cord PAH-DNA adducts on full scale IQ, perceptual reasoning and working memory scores were observed in the groups whose mothers reported a high level of material hardship during pregnancy or recurring high hardship into the child's early years, and not in those without reported high hardship. Significant interactions were observed between high cord adducts and prenatal hardship on working memory scores (β=-8.07, 95% CI (-14.48, -1.66) and between high cord adducts and recurrent material hardship (β=-9.82, 95% CI (-16.22, -3.42). The findings add to other evidence that socioeconomic disadvantage can increase the adverse effects of toxic physical "stressors" like air pollutants. Observed associations between high cord adducts and reduced IQ were significant only among the group of children whose mothers reported high material hardship. These results indicate the need for a multifaceted approach to prevention. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Apr 2015 · Neurotoxicology and Teratology
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    • "Children living in low socio-economic environment are more likely to be exposed to lead or other chemical hazards and the adverse effects of lead may be more pronounced in lower compared to higher socioeconomic groups. Studies carried out by Bellinger et al. [31] and Winneke et al. [32] suggest that social context modifies the effects of chemical neurotoxins. For example, material hardship has been demonstrated to modify the neurotoxic effects of tobacco smoke in children in the study done by Rauh et al [28]. "
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    ABSTRACT: The primary purpose of this study was to assess the relationship between very low-level of prenatal lead exposure measured in the cord blood (<5 microg/dL) and possible gender-specific cognitive deficits in the course of the first three years of life. The accumulated lead dose in infants over the pregnancy period was measured by the cord blood lead level (BLL) and cognitive deficits were assessed by the Bayley Mental Development Index (MDI). The study sample consisted of 457 children born to non-smoking women living in the inner city and the outlying residential areas of Krakow. The relationship between prenatal lead exposure and MDI scores measured at 12, 24 and 36 months of age and adjusted to a set of important covariates (gender of child, maternal education, parity, breastfeeding, prenatal and postnatal environmental tobacco smoke) was evaluated with linear multivariate regression, and the Generalized Estimating Equations (GEE) longitudinal panel model. The median of lead level in cord blood was 1.21 microg/dL with the range of values from 0.44 to 4.60 microg/dL. Neither prenatal BLL (dichotomized by median) nor other covariates affected MDI score at 12 months of age. Subsequent testing of children at 24 months of age showed a borderline significant inverse association of lead exposure and mental function (beta coefficient=-2.42, 95%CI: -4.90 to 0.03), but the interaction term (BLL x male gender) was not significant. At 36 months, prenatal lead exposure was inversely and significantly associated with cognitive function in boys (Spearman correlation coefficient=-0.239, p=0.0007) but not girls (r=-0.058, p=0.432) and the interaction between BLL and male gender was significant (beta coefficient=-4.46; 95%CI: -8.28 to -0.63). Adjusted estimates of MDI deficit in boys at 36 months confirmed very strong negative impact of prenatal lead exposure (BLL>1.67 microg/dL) compared with the lowest quartile of exposure (beta coefficient=-6.2, p=0.002), but the effect in girls was insignificant (beta coefficient=-0.74, p=0.720). The average deficit of cognitive function in the total sample over the first three years of life (GEE model) associated with higher prenatal lead exposure was also significant (beta coefficient=-3.00; 95%CI: -5.22 to -0.70). Beside prenatal lead exposure, presence of older siblings at home and prenatal environmental tobacco smoke had a negative impact on MDI score. Better maternal education showed a strong beneficial effect on the cognitive development of children. Conclusion: the study suggests that there might be no threshold for lead toxicity in children and provides evidence that 3-year old boys are more susceptible than girls to prenatal very low lead exposure. The results of the study should persuade policy makers to consider gender-related susceptibility to lead and possibly to other toxic hazards in setting environmental protection guidelines. To determine whether the cognitive deficit documented in this study persists to older ages, the follow-up of the children over the next several years is to be carried out.
    Full-text · Article · Jun 2009 · Early human development
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    • "Children living with lower socio-economic status are more likely to be exposed to lead and some evidence suggests that the adverse effects of lead may be more pronounced in lower compared to higher socio-economic groups (Bellinger et al., 1989; Tong et al., 2000; Winneke and Kraemer, 1984). Some other previous work supports the concept that social context modifies the effects of chemical neurotoxins. "
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    ABSTRACT: The notion that maternal personality characteristics influence cognitive development in their children has been grounded in stress moderation theory. Maternal personality traits, such as self-esteem, may buffer maternal stressors or lead to improved maternal-child interactions that directly impact neurodevelopment. This can be extended to suggest that maternal personality may serve to attenuate or exacerbate the effects of other neurotoxicants, although this has not been studied directly. We examined whether mothers' self-esteem had a direct or main effect on their children's cognitive outcomes. We also explored the modifying effects of maternal self-esteem on the association between exposure to lead and neurodevelopment in these children. Study participants included 379 mother-child pairs from Mexico City. Data included the Coopersmith Self-Esteem Scale in mothers, children's Bayley's Scale of Infant Development (BSID) scores, and sociodemographic information. Linear regression was used to model the relationship between maternal self-esteem and the Bayley's Mental Development Index (MDI) and Psychomotor Development Index (PDI) scores at age 24 months using models stratified by levels of maternal self-esteem. In adjusted models, each point increase in maternal self-esteem was associated with children having 0.2 higher score on the Bayley's MDI (p=0.04). Similar results were observed using the PDI outcome. Moreover, there was evidence that maternal self-esteem attenuated the negative effects of lead exposure, although the interaction fell short of conventional levels of statistical significance.
    Full-text · Article · Apr 2008 · NeuroToxicology
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