Preprint / Version 1

Lead Exposure and Visual-Motor Abilities in Children from Chennai, India

Authors

  • Kavitha Palaniappan Department of Environmental Health and Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, India
  • Ananya Roy Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ
  • Kalpana Balakrishnan Department of Environmental Health and Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, India
  • Lakshmi Krishnan Department of Environmental Health and Engineering, Sri Ramachandra Medical College and Research Institute, Chennai, India
  • Bhramar Mukherjee Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
  • Howard Hu Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI
  • David Bellinger Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA

Keywords:

Lead levels, visual motor abilities, children

Abstract

Lead exposure poses a major environmental hazard in India, but little information is available on the impact of lead exposure on neurobehavioral development in Indian children. We hypothesize that higher blood lead levels are associated with poorer visual-motor, visual-spatial and fine motor functioning among children. We conducted a cross-sectional study of 814 school children, aged 3–7 years. Lead in whole blood was measured using the LeadCare Analyzer. The Wide Range of Visual Motor Abilities Test (WRAVMA) was administered to each child by trained examiners. The mean blood lead level was 11.4 ± 5.3 μg//dL. In multivariate analyses adjusting for mother’s education level, fathers education level, average monthly income, hemoglobin and sex, WRAVMA scores were inversely related to blood lead level. An increase of 10 μg/dL was associated with a decrease of 2.6 points (95% CI: −4.5 to −0.7, P=0.006) in the Visual Motor Composite score and a decrease of 2.9 points (95% CI: −5.1 to −0.7, P=0.011) in the Drawing subtest. Exploration of the shape of the dose-effect relationships using spline functions indicated some non-linearities, with the steepest declines in visual-motor skills occurring at higher blood lead levels. Among urban Indian children, higher blood lead levels are associated with decreased visual-motor abilities, particularly visual-motor integration. Keywords: Lead levels, visual motor abilities, children

Author Biographies

Howard Hu, Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI

Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA

David Bellinger, Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA

Department of Neurology, Children’s Hospital, Harvard Medical School, Boston, MA, USA

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