The neuromotor assessment of 245 six-year-old urban inner-city children enrolled in the Cincinnati Lead Study is reported from the Departments of Environmental Health and Pediatrics, University of Cincinnati College of Medicine, and the Children’s Hospital Medical Center, Cincinnati, OH. Quarterly measures of blood lead and development since birth showed that neonatal, but not prenatal blood lead levels were associated with impaired coordination, hand speed and dexterity. Postnatal blood lead levels were associated with similar impairments of coordination, and poorer scores on visual-motor control. Low to moderate lead exposure is associated with moderate deficits in gross and especially fine-motor development. Blood lead levels peaked at 2 years of age and then slowly declined; 87 children (35%) had levels of 25 mcg/dL or greater during the first 5 years of life, while 195 (80%) had at least one level at or above 15 mcg/dL during this period. Only 5% were chelated therapeutically. [1]

COMMENT. The cerebellum is particularly sensitive to lead intoxication in neonatal rats, and glial cell development and brain histogenesis are affected. In children of low socioeconomic status, motor development and coordination may be more sensitive indicators of the adverse effects of lead on the central nervous system than tests of intelligence and academic achievement. Lead poisoning is now defined as a blood lead level greater than or equal to 10 mcg/dL Children aged 6 months to 6 years and those living in older housing are the highest priority for screening, mandatory in many States.