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Early childhood lead exposure and the persistence of educational consequences into adolescence.

ABSTRACT: BACKGROUND:There is consensus that early childhood lead exposure causes adverse cognitive and behavioral effects, even at blood lead levels (BLL) below 5??g/dL. What has not been established is to what extent the effects of childhood lead exposure persist across grades. OBJECTIVE:To measure the effects of early childhood lead exposure (BLL 1-10??g/dL) on educational performance from grades 3-8; to determine if effects in lower grades persist as a child progresses through school; and if so, to characterize the pattern of persistence. METHODS:We examine data from 560,624 children living in North Carolina between 2000 and 2012 with a BLL ?10??g/dL measured between age 0-5 years. Children are matched to their standardized math and reading scores for grades 3-8, creating an unbalanced panel of 2,344,358 student-year observations. We use socio-economic, demographic, and school information along with matching techniques to control for confounding effects. RESULTS:We find that early childhood exposure to low lead levels caused persistent deficits in educational performance across grades. In each grade (3-8), children with higher blood lead levels had, on average, lower percentile scores in both math and reading than children with lower blood lead levels. In our primary model, we find that children with BLL?=?5??g/dL in early childhood ranked 0.90-1.20 (1.35-1.55) percentiles lower than children with BLL???1??g/dL on math (reading) tests during grades 3-8. As children progressed through school, the average percentile deficit in their test scores remained stable. CONCLUSIONS:Our study shows that the adverse effects of early childhood exposure to low lead levels persist through early adolescence, and that the magnitude of the test-score percentile deficit remains steady between grades 3-8.

SUBMITTER: Shadbegian R

PROVIDER: S-EPMC7038535 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Early childhood lead exposure and the persistence of educational consequences into adolescence.

Shadbegian Ron R Guignet Dennis D Klemick Heather H Bui Linda L

Environmental research 20190810

<h4>Background</h4>There is consensus that early childhood lead exposure causes adverse cognitive and behavioral effects, even at blood lead levels (BLL) below 5 μg/dL. What has not been established is to what extent the effects of childhood lead exposure persist across grades.<h4>Objective</h4>To measure the effects of early childhood lead exposure (BLL 1-10 μg/dL) on educational performance from grades 3-8; to determine if effects in lower grades persist as a child progresses through school; a ...[more]

PMID: 31473504

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Project description:BackgroundLead (Pb) exposure is associated with adverse neurological development. Most notably, it has been observed through externalizing behavior symptoms, as observed among Inuit children from northern Québec. Evidence for a persistent neurological impact of early Pb exposure later in life is however scarce. Pb exposure may initiate a developmental cascade that increases the risk of long-term behavior problems.ObjectivesTesting for direct associations between childhood Pb concentrations and adolescent externalizing symptoms and substance use, as well as indirect associations through childhood behavior assessments.MethodsThe study sample is a longitudinal cohort of Inuit children (n = 212) followed since birth. Blood Pb concentrations were measured during childhood (median age = 11.4 years) and adolescence (median age = 18.5 years). Externalizing/inattentive behavior were teacher-assessed through the Teacher Report Form and the Disruptive Behavior Disorders Rating Scale for children. At the adolescence follow-up, behavior problems were self-reported by filling Achenbach's Youth Self-Report, the Barkley Adult ADHD-IV Rating Scale, and the Diagnostics Interview Schedule for Children. Adolescent substance use was also self-assessed through the DEP-ADO. Direct and indirect associations of child Pb concentrations with adolescent outcomes were tested through mediation models.ResultsChild blood Pb concentrations were not directly associated with any adolescent outcomes. On the contrary, childhood Pb exposure was indirectly associated, through childhood externalizing behavior assessments, with adolescent externalizing behaviors, binge drinking, and cannabis use. These indirect associations held after controlling for adolescents' concurrent Pb blood concentrations.DiscussionOur results highlight the indirect but lasting effects of child Pb exposure on adolescent behavior problems, and the importance of childhood externalizing behavior in this relationship. Adverse early-life environment put children on a riskier developmental trajectory, increasing their likelihood of lifelong psychological, social and health problems.

Project description:BackgroundPsychotic experiences predict adverse health outcomes, particularly if they are persistent. However, it is unclear what distinguishes persistent from transient psychotic experiences.AimsIn a large population-based cohort, we aimed to (a) describe the course of hallucinatory experiences from childhood to adolescence, (b) compare characteristics of youth with persistent and remittent hallucinatory experiences, and (c) examine prediction models for persistence.MethodYouth were assessed longitudinally for hallucinatory experiences at mean ages of 10 and 14 years (n = 3473). Multi-informant-rated mental health problems, stressful life events, self-esteem, non-verbal IQ and parental psychopathology were examined in relation to absent, persistent, remittent and incident hallucinatory experiences. We evaluated two prediction models for persistence with logistic regression and assessed discrimination using the area under the curve (AUC).ResultsThe persistence rate of hallucinatory experiences was 20.5%. Adolescents with persistent hallucinatory experiences had higher baseline levels of hallucinatory experiences, emotional and behavioural problems, as well as lower self-esteem and non-verbal IQ scores than youth with remittent hallucinatory experiences. Although the prediction model for persistence versus absence of hallucinatory experiences demonstrated excellent discriminatory power (AUC-corrected = 0.80), the prediction model for persistence versus remittance demonstrated poor accuracy (AUC-corrected = 0.61).ConclusionsThis study provides support for the dynamic expression of childhood hallucinatory experiences and suggests increased neurodevelopmental vulnerability in youth with persistent hallucinatory experiences. Despite the inclusion of a wide array of psychosocial parameters, a prediction model discriminated poorly between youth with persistent versus remittent hallucinatory experiences, confirming that persistent hallucinatory experiences are a complex multifactorial trait.

Project description:Background: Exposure to lead (Pb) during the early life stages has been associated with the development of metabolic syndrome (MetS). Longitudinal studies of Pb exposure in critical developmental windows in children are limited. Methods: Our study included 601 mother-child dyads from the PROGRESS (Programming Research in Obesity, Growth, Environment and Social Stressors) birth cohort. Blood lead levels (BLLs) were assessed during the second and third gestational trimesters, in cord blood at delivery, and at ages 1, 2, and 4 years. Bone lead levels in the patella and tibia were assessed at 1 month postpartum and evaluated in separate models. To account for cumulative exposure (prenatal, postnatal, and cumulative), we dichotomized the BLLs at each stage visit and determined the following: "higher" if a BLL was at least once above the median (HPb) and "lower" if all BLLs were below the median (LPb). We analyzed fasting glucose, HbA1c, triglycerides (TGs), total cholesterol (TC), high-density lipoprotein cholesterol (cHDL), low-density lipoprotein cholesterol (cLDL), body mass index, waist circumference (WC), body fat percentage, and systolic (SBP) and diastolic blood pressure (DBP) at two study visits between 6 and 12 years of age and created cutoff points based on the clinical guidelines for each indicator. Mixed effects models were used to analyze each outcome longitudinally for each BLL score, adjusting for child's sex, size for gestational age, child's age, maternal parity, mother's age, and socioeconomic status. Results: We observed associations for HPb exposure and TC in all stages (OR = 0.53, 95%CI = 0.32-0.86) and postnatally (OR = 0.59, 95%CI = 0.36-0.94) and for prenatal HPb and TGs (OR = 0.65, 95%CI = 0.44-0.95). HPb at all stages was associated with WC (OR = 0.27, 95%CI = 0.08-0.86), BMI (OR = 0.33, 95%CI = 0.11-0.99), SBP (OR = 0.53, 95%CI = 0.32-0.85), and DBP (OR = 0.57, 95%CI = 0.34-0.95). Pb levels in the patella were associated with cHDL (OR = 1.03, 95%CI = 1.00-1.07) and those in the tibia with TGs (OR = 0.95, 95%CI = 0.91-0.99). Conclusion: Early life exposure to Pb may alter early indicators of MetS. A follow-up of these children will allow for more definition on the impact of longer-term exposures.

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Early childhood lead exposure and the persistence of educational consequences into adolescence.

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Early childhood lead exposure and the persistence of educational consequences into adolescence.

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