Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study.
Low-level lead exposure, intelligence and academic achievement: a long-term follow-up study.
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DOI：
10.1542/peds.90.6.855
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发表时间：
1992-12
期刊：
影响因子：
8
通讯作者：
D. Bellinger;K. M. Stiles;H. Needleman
中科院分区：
文献类型：
--
作者：
D. Bellinger;K. M. Stiles;H. Needleman
低水平铅暴露对学龄期儿童智力和学业表现的影响尚不确定。这一问题在一项对低终生铅暴露的中产阶级和中上层阶级儿童的前瞻性研究中进行了调查。在10岁时对148名儿童进行了一系列神经心理测试，这些儿童的铅暴露和认知功能先前在6、12、18、24和57个月时进行了评估。主要终点是韦氏儿童智力量表（WISC-R）和考夫曼教育成就测验（K-TEA）。在校正潜在混杂因素后，24个月时较高的血铅水平与较低的WISC-R和K-TEA总体得分显著相关，而其他年龄段的血铅水平则没有升高。在大约0到25微克/分升的范围内，24个月时血铅增加0.48 μ mol/L（10微克/分升）与WISC-R全尺寸智商下降5.8分（95%置信区间：1.7到9.9,P = 0.007）和K-TEA电池综合评分下降8.9分（95%置信区间：4.2到13.6,P = 0.0003）相关。24月龄平均血铅水平为0.31 μ mol/L（6.5微克/分升；标准差：4.9,90%百分位数：12.5）。24个月左右血铅水平的轻微升高与10岁时智力和学业表现的缺陷有关。
The implications of low-level lead exposure for children's intellectual and academic performance at school age are uncertain. This issue was investigated in a prospective study of middle-class and upper-middle-class children with low lifetime exposures to lead. A battery of neuropsychological tests was administered at age 10 years to 148 children whose lead exposure and cognitive function had been previously assessed at ages 6, 12, 18, 24, and 57 months. Primary endpoints were Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Kaufman Test of Educational Achievement (K-TEA). Higher levels of blood lead at age 24 months, but not at other ages, were significantly associated with lower global scores on both the WISC-R and the K-TEA after adjustment for potential confounders. Over the range of approximately 0 to 25 micrograms/dL, a 0.48-mumol/L (10 micrograms/dL) increase in blood lead at 24 months was associated with a 5.8-point decline in WISC-R Full-Scale IQ (95% confidence interval: 1.7 to 9.9, P = .007) and an 8.9-point decline in K-TEA Battery Composite score (95% confidence interval: 4.2 to 13.6, P = .0003). Mean blood lead level at age 24 months was 0.31 mumol/L (6.5 micrograms/dL; SD: 4.9, 90% percentile: 12.5). Slightly elevated blood lead levels around the age of 24 months are associated with intellectual and academic performance deficits at age 10 years.