Low-level lead exposure and the IQ of children. A meta-analysis of modern studies

We identified 24 modern studies of childhood exposures to lead in relation to IQ. From this population, 12 that employed multiple regression analysis with IQ as the dependent variable and lead as the main effect and that controlled for nonlead covariates were selected for a quantitative, integrated review or metaanalysis. The studies were grouped according to type of tissue analyzed for lead. There were 7 blood and 5 tooth lead studies. Within each group, we obtained jointPvalues by two different methods and average effect sizes as measured by the partial correlation coefficients. We also investigated the sensitivity of the results to any single study. The sample sizes ranged from 75 to 724. The sign of the regression coefficient for lead was negative in 11 of 12 studies. The negative partial r's for lead ranged from —.27 to —.003. The power to find an effect was limited, below 0.6 in 7 of 12 studies. The jointPvalues for the blood lead studies were r, —.15±.05), while for the tooth lead studies they were.0005 and.004, respectively (95% confidence interval for group partialr, —.08±.05). The hypothesis that lead impairs children's IQ at low dose is strongly supported by this quantitative review. The effect is robust to the impact of any single study. (JAMA. 1990;263:673-678)