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Blood lead values (PbB) from cord blood and maternal samples as well as present PbB from venous blood samples were available for 114 six- to seven-year-old children living in or near the city of Nordenham (FRG). These children represented 30% of all children born between July 1975 and August 1976 in the district hospital (N = 383). The range of cord blood PbB was 4-31 micrograms/100 ml (mean = 8.2 micrograms/100 ml) and of maternal PbB was 4-30 micrograms/100 ml (mean = 9.3 micrograms/100 ml), whereas the range for present PbB was 3.9-22.8 micrograms/100 ml (mean = 8.2 micrograms/100 ml). The degree of correlation between maternal and cord blood PbB was 0.79, despite the poor technical quality of many cord blood samples as compared to maternal blood samples (less coagulation). These children were given a battery of neurophysiological and neuropsychological tests. The present report is restricted to psychological performance measures. The test battery covered intelligence (reduced Wechsler Intelligence Scale for Children), visual-motor performance (Bender Test, GFT), serial reaction performance (Wiener Reaction Device), and cued as well as choice reaction times. After correction for confounding by means of stepwise multiple-regression analysis, few significant associations between blood lead levels and performance deficit occurred. In general the degree of association was somewhat stronger for present PbB than for perinatal PbB: With increasing present PbB there was a borderline drop of performance IQ (P less than 0.1), as well as a significant disruption of serial reactions, which was more pronounced for the difficult (P less than 0.01) than for the easier version of the Wiener Device (P less than 0.05). A similar but less pronounced pattern of associations was observed for maternal PbB but not for cord blood PbB. Some influence of perinatal lead exposure on later performance can, thus, still be detected if, in addition to cord blood PbB, maternal PbB is taken into account as well.

A structured problem-solving task was used to evaluate the effects of lead (Pb) exposure on the activity patterns and attention of 18-month-old infants. After statistically controlling for the influence of the caretaker's attempts to support and teach the infant during the task, multivariate techniques were used to examine the residual variances to detect any effects of prenatal or postnatal Pb exposure. Contrary to expectations, no relationship was found between Pb exposure and measures of attention. Activity level was found to be negatively related to blood Pb level. The suggested suppression of behavior was inconsistent with reports of hyperactivity found in school children with elevated Pb level, but is consistent with observations of lethargy in infants with iron deficiency. To examine this alternative, free erythrocyte protoporphyrin (FEP) levels, which are elevated both in the presence of elevated Pb and in iron deficiency, were incorporated into the regression model. FEP was the best predictor of room movement, as indicated by a backward elimination analysis that removed all Pb measures from the model. However, none of the other measures of hematopoietic status were related to behavior. The suppression of activity level, if a reliable effect, is very small, and only weakly though significantly related to FEP level.

The relationship between postnatal lead (Pb) exposure and early sensorimotor development was prospectively investigated in a group of infants born to parents residing in lead-hazardous areas of Cincinnati, Ohio. Few significant relationships were found between current or cumulative infant blood Pb levels and indices of sensorimotor development during the first year of life. When important developmental covariates such as birth weight and home environment were included in the analyses, no significant relationship between Pb exposure and development remained. To date, there appears to be no evidence in these data that postnatal low-level Pb exposure increases an infant's risk for delays in early sensorimotor development.

Initial evaluations of 104 low-socioeconomic status black children screened by the local community health departments in North Carolina showed significant effects of lead in the range 6-59 micrograms/dl on IQ after controlling for concomitant social factors, such as socioeconomic status, home environment, and maternal IQ. The main concomitant variable was socioeconomic status, which was multicolinear with other social factors. Five years later, when all blood lead levels were 30 micrograms/dl or less, lead effects on IQ were no longer significant. The correlation between maternal and child IQ, which had been suppressed initially in children with higher lead levels, returned to expected levels when decreases in blood lead level occurred, while concomitant variables remained stable over the 5-year period.

A model for understanding the effects of lead on child development, which focuses on the ecology of childhood is presented. The methods used in 10 prospective, longitudinal studies of the effects of lead are summarized and preliminary results presented. Differences between studies lead to a conclusion that there should be more interinvestigator collaboration to ensure greater comparability across studies.