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August 18, 1993

Declining Blood Lead Levels and Cognitive Change in Children

JAMA. 1993;270(7):828. doi:10.1001/jama.1993.03510070049021

To the Editor.  —In study by Ruff et al1 of the effect of declining lead levels on the cognitive abilities of children, some children in the study sample were found to be developmentally delayed during testing performed at the time of entrance into the study. And an even larger number of children were found to be in the range where they might be described as being at "high risk" for developmental delay.Perhaps the majority of children in this study were of the age range, socioeconomic status, and cognitive performance level where they were likely to be eligible for early childhood education programs, and I would suspect that some study children were enrolled in such programs between the time they were enrolled in the lead study and their 6-month follow-up.For those who are enrolled in such childhood enrichment programs, these children are being removed to a more relatively