ArticleJAMA pediatrics2014
Blood lead concentrations and children's behavioral and emotional problems: a cohort study.
Article in JAMA pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 2 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 2 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- Lead exposure and antisocial behavior: A systematic review of human and animal evidence.Environment international · 2025Pooled it
- A systematic review and meta-analysis examining the interrelationships between chemical and non-chemical stressors and inherent characteristics in children with ADHD.Environmental research · 2020Pooled it
- Effect of Residential Lead-Hazard Interventions on Childhood Blood Lead Concentrations and Neurobehavioral Outcomes: A Randomized Clinical Trial.JAMA pediatrics · 2018Trial
- Prenatal and Early Postnatal Lead Exposure, Sensitive Periods, and Later Adult Mental Health.JAMA psychiatry · 2025Article
- Impact of early adolescent lead exposure on brain function and response: Findings from a Chinese cohort.Neurotoxicology · 2025Article
- Developmental lead exposure and aggression in male rats: Influences of maternal care and environmental enrichment.Toxicology reports · 2025Article
- Persistent Aggressive Behaviour From Childhood to Adolescence: The Influence of Environmental Tobacco Exposure and the Protective Role of Fish Consumption.Criminal behaviour and mental health : CBMH · 2025Article
- Prevalence and risk factors of elevated blood lead levels in 0-6-year-old children: a national cross-sectional study in China.Frontiers in public health · 2025Article
- Childhood lead exposure and sleep problems in adolescents: a longitudinal cohort study.International archives of occupational and environmental health · 2024Article
- IEUBK Modeling of Children's Blood Lead Levels in Homes Served by Private Domestic Wells in Three Illinois Counties.International journal of environmental research and public health · 2024Article
- Involvement of Nrf2 Signaling in Lead-induced Toxicity.Current medicinal chemistry · 2024Review
- Article
- Heavy Metal(loid) Body Burden in Environmentally Exposed Children With and Without Internalizing Behavior Problems.Exposure and health · 2022Article
- Prenatal lead (Pb) exposure is associated with differential placental DNA methylation and hydroxymethylation in a human population.Epigenetics · 2022Article
- Exposure to coal ash and depression in children aged 6-14 years old.Environmental research · 2022Article
- Early childhood lead exposure and adolescent heart rate variability: A longitudinal cohort study.Environmental research · 2022Article
- Parental Lead Exposure Promotes Neurobehavioral Disorders and Hepatic Dysfunction in Mouse Offspring.Biological trace element research · 2022Article
- Blood lead levels mediate the relationship between social adversity and child externalizing behavior.Environmental research · 2022Article
- Longitudinal association of early childhood lead exposure and adolescent heart rate variability: influence of parental education.Journal of environmental science and health. Part C, Toxicology and carcinogenesis · 2022Article
- Firearm licenses associated with elevated pediatric blood lead levels in Massachusetts.Environmental research · 2021Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
importanceThe association between lead exposure and children's IQ has been well studied, but few studies have examined the effects of blood lead concentrations on children's behavior.
objectiveTo evaluate the association between blood lead concentrations and behavioral problems in a community sample of Chinese preschool children with a mean blood lead concentration of less than 10 µg/dL. DESIGN, SETTING, AND
participantsA prospective cohort study was conducted at 4 preschools in Jintan, Jiangsu province of China. Participants included 1341 children aged 3 to 5 years. EXPOSURES: Lead. MAIN OUTCOMES AND MEASURES: Blood lead concentrations were measured in children aged 3 to 5 years. Behavioral problems were assessed using Chinese versions of the Child Behavior Checklist and Caregiver-Teacher Report Form when children were aged 6 years.
resultsThe mean (SD) blood lead concentration was 6.4 (2.6) µg/dL, with the 75th and 90th percentiles being 7.5 and 9.4 µg/dL, respectively. General linear modeling showed significant associations between blood lead concentrations and increased scores for teacher-reported behavioral problems. A 1-µg/dL increase in the blood lead concentration resulted in a 0.322 (95% CI, 0.058 to 0.587), 0.253 (95% CI, 0.016 to 0.500), and 0.303 (95% CI, 0.046 to 0.560) increase of teacher-reported behavior scores on emotional reactivity, anxiety problems, and pervasive developmental problems, respectively (P < .05), with adjustment for parental and child variables. Spline modeling showed that mean teacher-reported behavior scores increased with blood lead concentrations, particularly for older girls. CONCLUSIONS AND RELEVANCE: Blood lead concentrations, even at a mean concentration of 6.4 µg/dL, were associated with increased risk of behavioral problems in Chinese preschool children, including internalizing and pervasive developmental problems. This association showed different patterns depending on age and sex. As such, continued monitoring of blood lead concentrations, as well as clinical assessments of mental behavior during regular pediatric visits, may be warranted.
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