Bone lead levels in adjudicated delinquents: A case control study
Introduction
Most studies of childhood lead exposure have focused on cognitive function, using IQ tests as the outcome of interest. There are a number of reasons to believe that antisocial behavior may be a more sensitive and consequential outcome. This is not a new notion. Pediatricians who treat lead poisoning have frequently been told by parents that, after recovery, their offspring became oppositional, aggressive or violent. In 1943, Randolph Byers was stimulated to design the first follow-up study of lead-poisoned children. The precipitant was his discovery that children referred to him for evaluation of violent behavior were former patients who had been treated for lead poisoning. Of the 20 subjects he studied, 19 had severe behavior problems or were learning disordered [5].
Published controlled studies of the lead-delinquency hypothesis are limited to three. Denno [9] found that the strongest predictor of arrest in Philadelphia youths enrolled in the Collaborative Perinatal Project was a history of lead poisoning. In 1996, we studied a cohort of 301 boys in the Pittsburgh School System. Bone lead levels at 12 years of age were significantly related to parents' and teachers' Child Behavior Checklist ratings of aggression, attention and delinquency. The subjects' self-reports of delinquent acts were also positively associated with bone lead concentrations [19]. Dietrich et al. [10] have recently reported that prenatal exposure to lead was associated with increased parent reports of antisocial behavior and postnatal exposure with increased reports of delinquent acts by the subjects themselves.
To more directly examine the relationship between lead exposure and criminality, we conducted a case-control study of bone lead levels in 194 male youths arrested and adjudicated as delinquent by the court.
Section snippets
Subjects
Cases were youths who resided in Allegheny County, PA, who were arrested and adjudicated by the Juvenile Court as delinquent. Controls were nondelinquent youths attending high schools in Pittsburgh. Two programs of the Allegheny County Juvenile Court serve serious delinquents: the Community Intensive Supervision Program (CISP) and the Allegheny Academy. Both programs function either as alternatives to incarceration of serious offenders or provide aftercare following incarceration. Three CISP
Results
Table 2 shows the mean±S.D. bone lead concentrations for all cases and controls and stratified by race. Delinquents had significantly higher bone lead levels than controls (11.0±32.7 vs. 1.5±32.1 ppm; P=.007). Limiting subjects to those attending the same high schools and comparing bone lead levels, we found almost identical bone lead levels (11.1±27.6 vs. 1.5±32.1 ppm). White delinquents had higher bone lead levels than African American delinquents (20±27.5 vs. 9.0±33.6 ppm). Both White and
Discussion
These findings of higher concentrations of lead in delinquents and of an association of bone lead levels with delinquency after covariate adjustment support those we reported in 1996 on the relationship between bone lead and antisocial behavior [19], and are consistent with both Denno's [9] and Dietrich et al.'s findings [10]. The effect is substantial. With all subjects in the model, bone lead level was the second strongest risk factor, exceeded only by race. In the stratified models, with
Acknowledgements
This study was supported by the National Institute of Environmental Health Sciences, Grant no. ES 05015.
We thank Mr. Joseph Daugerdas, former Director of the Allegheny Juvenile Court, the staffs of the Community Intensive Supervision Program, the Allegheny Academy and the Pittsburgh Public School System for their assistance and support in providing access to subjects. Heather Schaner, Carolina Diaz-Peroza, Jennifer Skwarlo and Jennifer Bowser carefully evaluated the subjects. Loretta Kemp
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