TY - JOUR
T1 - Independent effects of lead exposure and iron deficiency anemia on developmental outcome at age 2 years
AU - Wasserman, G.
AU - Graziano, J. H.
AU - Factor-Litvak, P.
AU - Popovac, D.
AU - Morina, N.
AU - Musabegovic, A.
AU - Vrenezi, N.
AU - Capuni-Paracka, S.
AU - Lekic, V.
AU - Preteni-Redjepi, E.
AU - Hadzialjevic, S.
AU - Slavkovich, V.
AU - Kline, J.
AU - Shrout, P.
AU - Stein, Z.
N1 - Funding Information:
Retrospective and cross-sectional studies have reported that children with an increased lead burden performed less well Supported by National Institute of Environmental Health Science grant ES 03460, the U.S. Environmental Protection Agency, the National Academy of Sciences (Eastern Europe) Interacademy Exchange Program, and the Lucille P. Markey Charitable Trust. Submitted for publication Oct. 25, 1991; accepted June 5, 1992. Reprint requests: Gail Wasserman, PhD, Department of Child Psychiatry, New York State Psychiatric Institute, 722 West 168th St. New York, NY 10032. 9/20/39988 than their peers in both standardized intelligence tests and academic functioning. 1-5 Numerous reviews (e.g., Yule and Rutter 6) have indicated that interpretation of these obser-
PY - 1992/11
Y1 - 1992/11
N2 - For a prospective study of lead exposure, iron status, and infant development, we recruited infants living in a smelter town and a non-lead-exposed town in Kosovo, Yugoslavia. Among 392 infants assessed at age 2 years, the mean Mental Development Index (MDI), Bayley Scales of infant Development, was 105.2. At age 2 years, geometric mean blood lead concentrations were 35.5 and 8.4 μg/dl, respectively, among infants from the exposed and nonexposed towns. After controlling for variables associated with MDI, we found significant independent associations for both blood lead and hemoglobin concentrations. For example, a rise in blood lead concentration at age 2 years from 10 to 30 μg/dl was associated with an estimated 2.5 point decrement in MDI (p=0.03); statistically nonsignificant decrements were associated with blood lead levels measured at birth and at 6, 12, and 18 months of age. A decrease in hemoglobin concentration at 18 months of age from 12 to 10 gm/dl was associated with an estimated 3.4 point decrement in MDI (p=0.02); the latter association was present in both towns, suggesting that it was due to iron deficiency anemia independent of lead exposure. The findings suggest that the brain is vulnerable to the effects of both lead exposure and anemia before 2 years of age. On a global basis, the developmental consequences of anemia may exceed those of lead exposure.
AB - For a prospective study of lead exposure, iron status, and infant development, we recruited infants living in a smelter town and a non-lead-exposed town in Kosovo, Yugoslavia. Among 392 infants assessed at age 2 years, the mean Mental Development Index (MDI), Bayley Scales of infant Development, was 105.2. At age 2 years, geometric mean blood lead concentrations were 35.5 and 8.4 μg/dl, respectively, among infants from the exposed and nonexposed towns. After controlling for variables associated with MDI, we found significant independent associations for both blood lead and hemoglobin concentrations. For example, a rise in blood lead concentration at age 2 years from 10 to 30 μg/dl was associated with an estimated 2.5 point decrement in MDI (p=0.03); statistically nonsignificant decrements were associated with blood lead levels measured at birth and at 6, 12, and 18 months of age. A decrease in hemoglobin concentration at 18 months of age from 12 to 10 gm/dl was associated with an estimated 3.4 point decrement in MDI (p=0.02); the latter association was present in both towns, suggesting that it was due to iron deficiency anemia independent of lead exposure. The findings suggest that the brain is vulnerable to the effects of both lead exposure and anemia before 2 years of age. On a global basis, the developmental consequences of anemia may exceed those of lead exposure.
UR - http://www.scopus.com/inward/record.url?scp=0026499246&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0026499246&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(05)81895-5
DO - 10.1016/S0022-3476(05)81895-5
M3 - Article
C2 - 1432416
AN - SCOPUS:0026499246
SN - 0022-3476
VL - 121
SP - 695
EP - 703
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
IS - 5 PART 1
ER -