Lead and cognitive function in adults: A questions and answers approach to a review of the evidence for cause, treatment, and prevention

Abstract

Lead has been extensively used worldwide in gasoline, consumer products, commercial applications, and industrial settings. Its use in gasoline and paint has been particularly hazardous to public health leading to widespread population exposure and substantial lifetime cumulative doses in most Americans over age 40 years. Cumulative lead dose can be estimated by measuring the current concentration of lead in tibia bone by X-ray fluorescence. A growing literature has documented that tibia lead levels are associated with decrements in cognitive function and declines in cognitive function over time. Furthermore, there are several interesting lines of biochemical and epidemiological investigation that have demonstrated potential links of lead to neurodegenerative diseases. These studies support the inference that a proportion of what has been termed 'normal' age-related cognitive decline may, in fact, be due to exposure to neurotoxicants such as lead. Well-designed studies of cumulative lead dose and Alzheimer's disease risk should be conducted to follow-up on these leads. The strong and compelling body of literature on lead and cognitive dysfunction and decline also supports a need for intervention studies to prevent lead-related cognitive decline.

Lead Bullet Fragments in Venison from Rifle-killed Deer: Potential for Human Dietary Exposure

“…Release of lead stores from bone exposes fetuses during pregnancy [9], and adults late in life [10,11]. Lead is implicated in reduced somatic growth [12], decreased brain volume [5], spontaneous abortion [13], nephropathy [14], cancer, and cardiovascular disease [15,16].…”

Health hazard evaluation report: evaluation of lead exposure at an indoor law enforcement firing range.

“…The OSHA PEL, NIOSH REL, and ACGIH TLV may prevent overt symptoms of lead poisoning, but do not protect workers from lead's contributions to conditions such as hypertension, renal dysfunction, or reproductive and cognitive effects [Brown-Williams et al 2009;Holland and Cawthorn 2016;Institute of Medicine 2012;Schwartz and Hu 2007;Schwartz and Stewart 2007]. Generally, acute lead poisoning with symptoms has been documented in persons having BLLs above 70 µg/dL.…”

Health hazard evaluation report: evaluation of employees' exposures to lead, noise, and heat at an automotive lead-acid battery recycling company.

“…The PEL, REL, and TLV may prevent overt symptoms of lead poisoning, but do not protect workers from lead's contributions to conditions such as hypertension, renal dysfunction, reproductive, and cognitive effects Schwartz and Stewart 2007;Brown-Williams et al 2009;IOM 2012]. Generally, acute lead poisoning with symptoms has been documented in persons having BLLs above 70 µg/dL.…”