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August 18, 1993

Declining Blood Lead Levels and Cognitive Change in Children

JAMA. 1993;270(7):827. doi:10.1001/jama.1993.03510070049018

To the Editor.  —The recent contribution by Ruff et al1 demonstrates the benefits from treating lead poisoning with a chelating agent and iron. Ruff et al may have been unaware of a similar situation documented in Taiwan in which a decrease in blood lead level was associated with an improvement in IQ in a group of young children but at even lower lead levels and without medical treatment.2Children attending a kindergarten adjacent to a lead battery recycling factory were exposed to fugitive lead beginning near age 3 years and lasting for 1 to 2 years, until the kindergarten was closed. In September 1988, 32 children were examined while still exposed, and in March 1991, 2 years after the closing, 28 of them were reexamined. Venous blood lead level was determined and the Simon Binet, Chinese Fourth Edition, was administered along with questionnaires. Also, children from three other