Using the National Health and Nutrition Examination Survey to Explore the Relationship between Food Insecurity, Childhood Lead Poisoning, and Attention Deficit Hyperactivity Disorder in Children
Lead is a ubiquitous environmental toxin known to cause neurological deficits in children. There is no biological need for lead and no safe level of lead in the body has ever been identified. Despite dramatic decline in mean blood lead levels nationwide since the U.S. EPA’s ban on lead-based paint and leaded gasoline in the 1970s, there may be more than one million children under 6 years that have blood lead levels equal to or greater than the current public health action level of 5.0µg/dL. However, several studies have observed cognitive deficits and behavioral problems in children with blood lead levels below 5.0µg/dL and these observations have led to increased interest in further lowering the public health action level to 3.5µg/dL.
The first study explored the relationship between food insecurity and blood lead concentrations in children ages 1 to 5 years old. Using multivariate linear regression, multinomial regression, and logistic regression, we observed an association between food insecurity and blood lead concentrations. Interestingly, this relationship was only observed at blood lead concentrations at or above 3.5µg/dL and not at the current public health action level of 5.0µg/dL.
The second study further explored the relationship between blood lead concentrations and food insecurity by exploring whether food insecurity modified the relationship between blood lead concentrations and parent-reported ADHD in children 4 to 15 years old. No interaction between food insecurity and blood lead concentrations was observe. Still, associations between food insecurity and parent-reported ADHD and between blood lead concentrations and parent-reported ADHD were observed, and the latter association was observed at blood lead concentrations at or above the proposed public health action level of 3.5µg/dL.