Identifying periods of heightened susceptibility to lead exposure in relation to behavioral problems

ABSTRACT BACKGROUND Lead exposure is associated with behavioral problems in children, but the age(s) of greatest susceptibility to low-level lead exposure is unknown. OBJECTIVE We evaluated

the association of repeated blood lead concentrations with parent-reported behaviors to identify periods of heightened susceptibility during infancy and childhood (HOME Study; Cincinnati,

OH; 2003–2006; _n_ = 244). METHODS We quantified lead in whole blood samples (ages 1, 2, 3, 4, 5, and 8 years) and assessed behavior using the Behavioral Assessment System for Children-2

(BASC-2; ages 2, 3, 4, 5, and 8 years). We used multiple informant models and modified Poisson regression to estimate covariate-adjusted associations of ln-transformed blood lead

concentrations with continuous BASC-2 T-scores and the relative risk of behavior scores classified as at-risk or clinically significant, respectively. RESULTS We observed trends indicating

that higher blood lead concentrations at all ages were adversely associated with scores on behavioral scales. On the Externalizing Problems and Adaptive Skills scales, these associations

were strongest for blood lead concentrations at age 8 years (_β_ = 3.1-point; 95% CI = 0.7, 5.4 and _β_ = −2.2-point; 95% CI = −4.9, 0.5, respectively) compared with other ages. Overall,

higher blood lead concentrations were associated with elevated risk of behavior scores classified as at-risk or clinically significant on the Adaptive Skills, Behavioral Symptom Index, and

Externalizing Problems scales. SIGNIFICANCE Contemporary levels of lead exposure during the first 8 years of life were associated with ADHD-related behaviors, specifically aggression,

hyperactivity, and conduct problems. IMPACT STATEMENT Our results highlight the importance of primary lead prevention across childhood. Access through your institution Buy or subscribe This

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THE EXPOSURE TO NEUROTOXIC ELEMENTS ON ITALIAN SCHOOLCHILDREN BEHAVIOR Article Open access 10 May 2021 PRENATAL EXPOSURE TO PERSISTENT ORGANIC POLLUTANTS AND METALS AND PROBLEMATIC CHILD

BEHAVIOR AT 3–5 YEARS OF AGE: A GREENLANDIC COHORT STUDY Article Open access 12 November 2021 DRINKING AND SMOKING POLYGENIC RISK IS ASSOCIATED WITH CHILDHOOD AND EARLY-ADULTHOOD PSYCHIATRIC

AND BEHAVIORAL TRAITS INDEPENDENTLY OF SUBSTANCE USE AND PSYCHIATRIC GENETIC RISK Article Open access 13 November 2021 DATA AVAILABILITY Data are available upon reasonable request. The HOME

Study Principal Investigators welcome new collaborations with other investigators and have actively engaged in collaborative data sharing projects. Interested investigators should contact

Drs. JMB (joseph_ braun_ 1@brown. edu) and KY (kimberly. yolton@ cchmc. org) to obtain additional information about The HOME Study, discuss collaborative opportunities, and request a project

proposal form. The HOME Study Protocol Review Committee reviews proposed research projects to ensure that they do not overlap with extant projects and are an efficient use of scarce

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Brain Cogn. 2010;72:46–55. PubMed  Google Scholar  Download references ACKNOWLEDGEMENTS The authors would like to acknowledge David E. Jacobs, Sherry Dixon, Jonathan Wilson, and Kofi Berko

for their contribution to this research. The authors and publisher are solely responsible for the accuracy of the statements and interpretations contained in this publication. Such

interpretations do not necessarily reflect the views of the US Government. The HOME Study and this research was supported by the National Institutes of Environmental Health Sciences grants

P01ES011261, R01ES014575, and R01ES020349. Additional support for this research was received through a grant (MDLTS0008-18) from the United States Department of Housing and Urban

Development. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Department of Epidemiology, Brown University, Providence, RI, USA Clara G. Sears & Joseph M. Braun * Division of Environmental

Medicine, Department of Medicine, University of Louisville, Louisville, KY, USA Clara G. Sears * Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada Bruce P. Lanphear *

Division of General and Community Pediatrics, Cincinnati Children’s Hospital, Cincinnati, OH, USA Yingying Xu * Department of Biostatistics, Epidemiology and Informatics, University of

Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Aimin Chen * Department of Pediatrics, Cincinnati Children’s Hospital, University of Cincinnati College of Medicine,

Cincinnati, OH, USA Kimberly Yolton Authors * Clara G. Sears View author publications You can also search for this author inPubMed Google Scholar * Bruce P. Lanphear View author publications

You can also search for this author inPubMed Google Scholar * Yingying Xu View author publications You can also search for this author inPubMed Google Scholar * Aimin Chen View author

publications You can also search for this author inPubMed Google Scholar * Kimberly Yolton View author publications You can also search for this author inPubMed Google Scholar * Joseph M.

Braun View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS CGS was responsible for methodology, investigation, writing- original draft; BPL was

responsible for methodology, investigation, writing—review & editing, project administration, funding acquisition; YX was responsible for data management and analysis, writing—review

& editing, AC was responsible for methodology, investigation, writing- review & editing, project administration, funding acquisition; KY was responsible for methodology,

investigation, writing—review & editing, project administration, funding acquisition; JMB was responsible for methodology, investigation, writing—review & editing, supervision,

project administration, funding acquisition. CORRESPONDING AUTHOR Correspondence to Clara G. Sears. ETHICS DECLARATIONS COMPETING INTERESTS JMB’s institution was financially compensated for

his services as an expert witness for plaintiffs in litigation related to PFAS-contaminated drinking water; these funds were not paid to JMB directly. BPL has served as an expert witness for

plaintiffs in litigation related to lead poisoning prevention cases, but he received no personal payments for his services. His institution was financially compensated for some of those

cases. The other authors declare they have no actual or potential competing financial interests. ETHICAL APPROVAL The institutional review boards (IRB) of Cincinnati Children’s Hospital

Medical Center (CCHMC) and the participating prenatal clinics and delivery hospitals approved the HOME Study. Brown University deferred to the CCHMC IRB as the IRB of record. Women provided

written informed consent for themselves and their children after research assistants explained study protocols during face-to-face visits. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer

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and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Sears, C.G., Lanphear, B.P., Xu, Y. _et al._ Identifying periods of heightened susceptibility to lead exposure in relation to behavioral

problems. _J Expo Sci Environ Epidemiol_ 32, 1–9 (2022). https://doi.org/10.1038/s41370-021-00389-3 Download citation * Received: 25 May 2021 * Revised: 13 September 2021 * Accepted: 15

September 2021 * Published: 02 November 2021 * Issue Date: January 2022 * DOI: https://doi.org/10.1038/s41370-021-00389-3 SHARE THIS ARTICLE Anyone you share the following link with will be

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