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110N10 Focus Focus KPT; Christopher G. Reuther/EHP KPT; A 574 VOLUME 110 || NUMBER 10 || October 2002 • Environmental Health Perspectives Focus • The Lead Effect? or years, mothers have been telling pediatricians that their children changed after being exposed to toxic lead, says Herbert Needleman, a professor of child psychiatry and pediatrics at the University of Pittsburgh. These mothers saw that their children became more fidgety, less compliant, and more aggressive. If frustrated, the children often became violent. Science has since proven what moms first observed—lead is now known to be associated with cognitive impairment, learning disabilities, and behaviors that contribute to the likelihood of drop- ping out of high school. Today, some environmental researchers are taking an even harder look at lead and are advancing the notion that widespread exposure of children to toxicants such as lead may have helped spark the crime waves that rocked the United States throughout the twentieth century. “Maybe the more important outcome from lead expo- sure is not cognition or psychometric intelligence; it’s that it interferes with social adjustment or your ability to control your impulses and plan ahead,” says Needleman. Moreover, these scientists posit, further reducing contin- uing exposures in the womb and during infancy and early childhood may prevent future crime. Environmental Health Perspectives • VOLUME 110 || NUMBER 10 || October 2002 A 575 Focus • The Lead Effect? Needleman has long been at the fore- nile delinquency among 195 inner-city in both cognitive and behavioral function, front of the debate over a possible relation- youth in Cincinnati. Blood lead levels were including aggressiveness, impulsiveness, and ship between childhood lead exposure and sampled before birth and through adoles- ability to pay attention,” says Ted Schettler, the development of juvenile delinquency and cence. Published in the November/ science director of the Science and a propensity to commit criminal acts. December 2001 issue of Neurotoxicology and Environmental Health Network, an envi- Evidence that lead poisoning induces severe Teratology, it’s the first long-term study to ronmental and public health policy think behavioral problems has been around for track lead exposure in children from womb tank. “Whether they translate into crime is decades. Today, however, Needleman and to mid-adolescence. another matter.” A History of Prior Bad Acts Today, the chief source of lead exposure for Adolescent boys with American children is through ingestion or inhalation of deteriorating lead paint in elevated lead levels older housing. Use of lead in house paint peaked in 1914 and was banned in 1978. were more likely to engage According to the Department of Housing and Urban Development (HUD), lead in acts of bullying, vandalism, paint coats surfaces in 39 million homes, or 40% of the nation’s entire housing stock. arson, shoplifting, and HUD estimates that, of those homes, lead paint hazards lurk in about 25 million, other delinquent behaviors. more than one-fifth of which are currently occupied by a child under the age of 6. Lead was first introduced to gasoline in the mid-1920s, after a General Motors sci- –Needleman study entist discovered its octane-boosting effects. Journal of the American Medical Association Tetraethyl lead may have been an inexpen- sive octane enhancer, but it also proved a particularly pernicious pollutant because of other researchers are building a stronger case “There appears to be a linear relation- its neurodevelopmental effects and its indef- for behavioral effects at relatively low levels ship between blood lead levels and the inite persistence in the environment. of exposure. The past decade has produced a number of reported delinquent acts from Before its phaseout under the Clean Air series of intriguing findings. the lowest levels of exposure to the highest,” Act beginning in the late 1970s, lead in A study of some 300 Pittsburgh stu- Dietrich says. Interestingly, the team found gasoline was the greatest source of exposure; dents, led by Needleman and published in no gender difference in the correlation. indeed, leaded gas made the toxicant essen- the 7 February 1996 issue of the Journal of Exposed girls were as likely as boys to com- tially ubiquitous in the environment. In the American Medical Association, first mit delinquent acts, despite the fact that 1976, nearly 90% of U.S. children aged revealed that adolescent boys with elevated male gender is almost always a risk factor for 1–5 had blood lead levels exceeding the 10 lead levels were more likely to engage in acts engagement in delinquent behavior. µg/dL guideline set by the Centers for of bullying, vandalism, arson, shoplifting, Intriguing as these findings are, there is Disease Control and Prevention (CDC). and other delinquent behaviors, according to still skepticism over whether lead exposure After lead’s phaseout from gasoline, the self and parental reports. really contributes to delinquency. “There’s mean concentration dropped across all In their latest work, presented at the no disagreement that lead can cause changes demographic groups in the entire popula- 2000 joint conference of the American Academy of Pediatrics and Pediatric Academic Societies in Boston, Needleman’s team used X-ray fluorescence technology to examine bone lead concentrations in rough- Variations in leaded gasoline ly 350 youngsters aged 12–18 in Allegheny County, Pennsylvania, to gauge past expo- sales from 1941 to 1986 sures. The team found significantly higher bone lead levels in children convicted of correlate with roughly delinquency than in those with no juvenile convictions. Among boys, convicted delin- 90% of the fluctuations quents were almost twice as likely to have higher bone lead concentrations, in violent crime rate Needleman reports, and four times as likely after adjusting for confounding factors. from 1960 to 1998. Last year, Kim Dietrich, a developmental psychologist and professor of environmental health and pediatrics at the University of –Nevin study Cincinnati College of Medicine, reported a Environmental Research significant link between prenatal and other early exposures to lead and self-reported juve- A 576 VOLUME 110 | NUMBER 10 | October 2002 • Environmental Health Perspectives Focus • The Lead Effect? tion uniformly from 16 µg/dL in 1976 to 2 much of the variance is attributable to University of Rochester, “The effect of lead µg/dL by 1999. By 1990, 90% of U.S. chil- genetics and how much to environment. is much greater on kids from lower-income dren aged 1–5 met the CDC guidelines, “Lead’s links with aggression, impulsive families. If you’re dealing with a disadvan- according to data from the National Health behavior, and attention loss are pretty clear, taged population that already has a lower and Nutrition Examination Survey. and that sets a kid up to have problems in mean IQ and you expose that population Even levels below the 10 µg/dL CDC school,” Schettler explains. Although such to a neurotoxicant, especially a develop- threshold are reported to still have health effects themselves add to the risk of running mental neurotoxicant, you will find the effects, including lowering IQ and causing into trouble with the law, struggling stu- effect amplified, which means you have to behavioral problems. A team led by Bruce dents tend to drop out or not pursue higher think about effect modification.” Lanphear at Children’s Hospital Medical education, making it tougher to land high- In many ways, says Weiss, by stripping Center in Cincinnati reported at the 2000 paying or interesting jobs, he says. “And you away confounding factors, what science joint conference of the American Academy start putting that together with all the other has done is to focus too intensely on one of Pediatrics and Pediatric Academic social factors, and it’s very possible there’s a set of risks when there are multiple risks Societies that cognitive defects in reading, link with delinquent behavior and crime at whose interactions might provoke even math, short-term memory, and visual con- some point that’s very plausible,” Schettler greater adverse effects. “It’s not just certain struction skills occur at levels as low as 2.5 says. “Who knows whether there are two, disadvantaged populations that suffer µg/dL. three, or more steps in that cascade.” higher exposures to lead, because we know Developmental exposures to lead, Philip Landrigan, chair of community that minority kids have higher levels,” he depending on the time and level of the and preventive medicine at Mount Sinai says. “But in general, because of their social exposure, have exhibited a variety of effects School of Medicine, points out that just and economic circumstances, they also are on the brain on a mechanistic level, includ- because a child is exposed to lead doesn’t exposed to other kinds of risks that might ing detectable structural changes. But researchers have yet to pin There’s no disagreement that lead down a direct mechanism that can cause changes in both might contribute to the development cognitive and behavioral function, of delinquent behavior. “Lead including aggressiveness, impulsiveness, does so much dam- age, it’s hard to and ability to pay attention. decide what is the important factor,” Whether they translate into crime N eedleman explains. Plus, neu- is another matter. rologists still don’t understand the neurophysiological –Ted Schettler basis for delinquent Science and Environmental Health Network behavior of any type. Some behav- iorists have suggested that lead’s adverse guarantee that the child will end up going add to or multiply the kinds of risks that effects on parts of the brain that control to jail or being a criminal, although it may are posed by lead exposure or other kinds behaviors such as aggressiveness may be a increase the risk. “That injury which is done of toxicant exposure.” possible route. For example, lead’s ability to to the brain of a child early in life by lead In such debates, proving a direct link impair function of the prefrontal lobe, sets the stage for the child possibly becom- remains a challenge.
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