Page 1 of 7

Health Impacts of Lead Poisoning

A preliminary listing of the health effects & symptoms of lead poisoning

by Vance Vella, Elizabeth O’Brien, Elisa Idris, Erik Wibowo, Dr Hugh Xin Xi Zhu and others - a work in progress by The

LEAD Group Inc, Australia

Updated by Emily Choong (Actuarial Intern) 11/04/18 and Elizabeth O’Brien (Lead Scientist) – 27/09/2020

he following list of the symptoms and effects of lead poisoning has been compiled to raise

awareness that more blood lead assessments must be done in time for further poisoning to be

prevented. After each symptom or effect, the numbers indicate the publications which refer to

that effect. So far, only 64 publications have been examined of the thousands published. More will be

reviewed and this list updated as time permits.

However, remember that most people who are lead poisoned present with no symptoms at all.

Children

Nervous system

 Encephalopathy [brain disease] (1,2,3,4,20,35)

 Acute encephalopathy (11)

 Alters function of developing brain (16)

 Alters electroencephalogram [EEG] (16)

 Convulsions (1, 2, 3, 4)

 Cerebral Palsy (1)

 Neurotransmitter release disrupted (11)

Peripheral nervous system

 Peripheral nerve disturbances [reduced touch

sensitivity] (2, 3, 4, 5, 6,18)

 Slowed nerve conduction velocity [decreased

reaction times] (2,14,18,35,39,58)

 Foot/ hand drop (1,3)

 Proprioreceptive pathways involved in balance

altered (2)

 Dizziness (1,4,38)

Growth & development

 Delayed neurodevelopment [e.g. in sitting up,

walking, talking] (2,58)

 Stature and growth rate reduction (1,2,3,18,35,39)

 Impaired pituitary-thyroid endocrine system

(18,21)

 Osteoporosis in later years (43)

 Weight loss (58. 60)

 Delayed Puberty (60)

 Reduced postnatal growth (60)

Cognitive development

 I.Q. levels decrease

(1,2,3,4,5,6,15,24,35,36,39,41,58, 60)

 Cognitive function deficits (2,26,33)

 Verbal function / linguistic deficits (2,14,15)

 Learning difficulties (11,15,35)

 Decreased educational performance (35, 60)

 Decreased reading, maths, non-verbal reasoning

ability & short term memory, even at blood lead

levels less than 10ug/dL (41)

 Autism (7) in genetically predisposed

individuals with metallothionein dysfunction (42)

Behaviour

 Aggression, violence, hostility, anti-social or

delinquent behaviour (8,26, 60)

 Attention problems; distractibility, restlessness

(8,12,15,21,38,58, 60)

 Externalising and internalising behaviours (8)

 Hyperactive behaviours, difficult to manage

(1,2,8)

 Inappropriate / uncontrolled behaviours similar to

ADD behaviours, increased frequency (2,11)

 Irritability (1,38)

 Lethargy (1)

 Increased school absenteeism (35)

Hearing

 Hearing impairment; auditory sensitivity

decreased (2,3,5,10,14,18,21,26,32,35,39,58, 60)

 Auditory evoked response patterns altered (2)

 Auditory processing altered (2,10)

Sight

 Retinal degeneration (6,10)

 Depressed sensitivity of rod photoreceptors (10)

 Perceptual function deficits (2,21)

 Visio-spatial skills deficit [eg difficulty doing

jigsaws] (15)

 Cataract (63)

Movement and muscular

 Visual-motor skills deficits [hand-eye

coordination] (2,3,15,26)

 Fine motor dysfunction (1, 2, 3)

 Motor function deficits (2)

 Impaired muscular strength and endurance (26)

Page 2 of 7

 Paralysis (3)

 Somatic complaints [aches and pains] (8,38)

Digestive system

 Impaired Vitamin D metabolism [affecting bone

remodelling, mineral absorption and calcium

uptake] (2,3,6,18,24,35,38,39,58)

 Colic (3,25,35)

 Loss of appetite (1,2)

 Vomiting (1,4)

 Constipation, diarrhoea, anorexia (38,58)

 Abdominal cramps (39,58)

Renal (kidneys), blood and circulation

 Renal disease – acute nephropathy

(14,21,35,38,58)

 Queensland nephritis (14)

 Anaemia (1,2,3,4,5,6,35,38,58)

Death (1,2, 3, 4,19,35,46,58)

Perinatal Development and

Reproductive Health Effects

Foetal

 Preimplantation loss (3)

 Miscarriage, still birth, neonatal death

(2,3,4,5,18,20,24,31,47)

 Reduced gestational age, preterm birth

(1,2,3,5,18,24,62)

 Reduced birth weight (1,2,3,4,5,6,18,19, 60,62)

 Minor congenital / chromosomal anomalies

(2,3,4,18,31)

 Reproductive abnormalities; disorders (5,13,38)

 Decreased placental functioning (19)

 Lead passed via placenta to foetus from mother

(39,58)

 Reduced foetal growth (60,62)

Maternal

 Pre-eclampsia (64)

 Increased risk of maternal death (due to

preeclampsia) (64)

Adults

 Altered testicular functioning (24)

 Hypospermia [low sperm count] (3,5,19,47, 60)

 Asthenospermia [sperm weakness] (3,5,20, 60)

 Teratospermia [sperm abnormalities] (3,5,31)

 Erectile dysfunction, impotence (3,40)

 Decreased serum testosterone (3)

 Lead presence in seminal fluid (31)

 Pituitary effects (31)

 Sterility, infertility (5,31,35,39,58)

 Effects on ovaries (19)

 Decreased libido / sex drive (2,21,31)

 Impotence (31)

 Delayed conception time (60)

Adults

Kidneys

 Renal damage

(2,3,5,13,14,21,23,24,28,30,34,39,58)

 Chronic lead nephropathy [kidney disease]

(2,3,14,21,22,24,38,58, 60)

 Death from nephritis [kidney inflammation]

(29,30)

 Fanconi Syndrome (14)

 Gout (2,3,14)

 Renal hypertension (17)

 Decrease in glomerular filtration rate and

Increase in creatinine concentration (23, 60)

Nervous system

 Encephalopathy [brain disease] (2,4,20,24,25,34)

 Cerebrovascular diseases, stroke, cerebral

haemorrhage (2,27,28,29,30)

 Psychomotor impairment (13,34)

 Peripheral nervous system (13,24,40,47)

 Peripheral Arterial Disease [PAD](53,54)

 Slowed nerve conduction velocity [slowed

reaction time] (2,34,58)

 Tremor (25,26,38,40,55, 60)

 Paresthesia, paralysis (25)

Cardiovascular and circulation

 Hypertension, elevated blood pressure

(2,14,17,22,35,38,40,58, 60)

 Increased systolic blood pressure in men (35)

 Cardio-toxic effects (14)

 Increased risk of cardiovascular disease (17, 61)

 Coronary artery disease (2)

 Anaemia; falling haemoglobin levels

(2,3,5,13,24,35,38,39,47,58)

 Platelet dysfunction (2)

 Increased erythrocyte [red blood cell]

protoporphyrin (35)

 Increased ALA in urine (34)

 Increased protoporphyrin in urine (34)

 Increased risk of early death from heart attack or

stroke (46,61)

 Left-ventricular hypertrophy (61)

 Peripheral arterial disease (61)

 Electrocardiographic abnormalities (61)

 Promotes development of atherosclerosis (plaque

build-up in arteries) and thrombosis (formation of

blood clots) (61)

 Ischaemic heart disease (61)

Intellectual and mental

 Depression (2,13,38)

 Anxiety (38)

 Personality changes (34)

Page 3 of 7

 Death from violence, suicide, accidents (29)

 Impaired concentration (19,25,34,38)

 Deficits in short term memory (2,13,19,34,38)

 Cognitive function deficit (58)

 Oxidative stress (61)

Behaviour

 Fatigue, muscular exhaustion (2,19,25,34,38, 47)

 Sleep disturbance, insomnia (19)

 Irritability, agitation, restlessness, aggression

(2,13,24,34,19, 47,58)

Sensory

 Abnormalities in visuomotor coordination (2)

 Abnormalities in fine motor control (2)

 Deficits in visual acuity (2)

 Hearing loss (18,35,39,47,58)

 Somatosensory dysfunction [eg deficits in

detection of vibration, changes in temperature]

(2,23)

Gastrointestinal / Digestive

 Effects on gastrointestinal tract (24)

 Loss of appetite (19,40)

 Nausea (19)

 Constipation, diarrhoea (25,38)

 Abdominal pain, cramps (25,34,40,47)

 Weight loss, anorexia (25,38)

Bone, muscle and joint

 Bone marrow alterations (21)

 Myalgia [muscle pain] (25,38,40,58)

 Pain in buttocks and cramps in the legs as early

stages of peripheral arterial diseases

[PAD](53,54)

 Muscular weakness (34,38,39,40,47)

 Arthralgia [joint pain] (25,38,40,47)

 Bone lead mobilisation during menopause leads

to decreased neurocognitive performance and

increased systolic blood pressure in post-

menopausal women (44)

 Wrist drop [the inability to hold the hand

extended] (47)

 Long term effect: linked to osteoporosis which

has symptoms of decline in bone density and

increase risk in fractures, also inhibit normal

fracture healing (48,49,50,51,52)

Other

 Headaches (2,19,21,40, 47)

 Decreased longevity (35,39)

 Adrenal dysfunction (38)

 Teeth with blue black-lines near gum base

(38,40)

 Pallor (40)

 Cell damage (at blood lead level between 20 to

30 g/dL for men and between 10 to 20 g/dL

for women) (39)

 Probable human carcinogen (56,57)

Death (2,4,19,39,46,61)

 Increased risk of early death from cancer and all

other causes (46)

Effects of lead from

animal studies

 Impaired attention, learning and short-term

memory in primates (12)

 Behavioural impairment; inflexibility in

behavioural change in primates (12)

 Elevated blood pressure at moderate levels (17)

 Impaired immune system in new-borns of rats

fed lead [greater susceptibility to asthma] (37,45)

 Increased incidence of tumors (cancer) in rats

born to mothers fed lead (45)

 Altered response to stimulant drugs; attenuation

of drug induced hyperactivity in rats (2)

 Teratogenic effect causing birth deformities (4)

 Low bone density in lab animals such as mice

and fractures due to lead-induced osteoporosis do

not heal properly (52)

References [LID = Library identification number in Global Lead Advice & Support Service (GLASS) Library]

1. Smith, M. A., Grant, L. D. & Sors, A. (1989). Lead exposure and child development: an

international assessment. Kleeven Academic Publishers. [LID 5279]

2. Silbergeld, E. K. (1992). Neurological perspective on lead toxicity. In Human Lead Exposure, ed

H. L. Needleman, CRC Press. [LID 756]

3. National Research Council (US). (1993). Measuring lead exposure in infants children and other

sensitive populations. National Academy Press, Washington DC. [LID 5042]

4. Chemwatch Database. (1996) Lead Arsenate. http://www.chemsw.com/ [LID 73]

5. Alperstein, G., Reznik, R. & Duggin, G. (1991). Lead: Subtle forms and new modes of poisoning.

The Medical Journal of Australia Vol 155 Sept 16. [LID 208]

Page 4



The LEAD Group Inc. LEAD Action News vol no 1997

6. Berry, M., Garrard, J. & Greene, D. (1994). Reducing Lead Exposure in Australia. Commonwealth

Department of Human Services and Health, Canberra. [LID 1208]

7. Clark, H. R. (1995). The cure for all diseases. Pro Motion Publishing, San Diego California.

http://drclarkia.com/books/The_Cure_For_All_Diseases.html . [LID 673]

8. Needleman, H. L., Riess, J. A., Tobin, M., Biesecker, G. & Greenhouse, J.B. (1996). Bone Lead

Levels and Delinquent Behavior. vol 275 No 5 JAMA. February 7. pp 363-369.

http://jama.jamanetwork.com/article.aspx?articleid=395592 Abstract. [LID 54]

9. F. Gil, A. Facio, E. Villanueva, M.L. Pérez, R. Tojo, A. Gil, The association of tooth lead content

with dental health factors, The science of the total environment. Volume 192, Issue 2, 2

December 1996, Pages 183–191.

http://www.sciencedirect.com/science/article/pii/S0048969796053132 Abstract.

10. Fox, D. A. (1992). Visual and Auditory System Alterations following Developmental or Adult

Lead Exposure: a critical review. In Human Lead Exposure, ed H. L. Needleman, CRC Press. [LID

4820]

11. Goldstein, G. W. (1992). Developmental neurobiology of lead toxicity. In Human Lead Exposure,

ed H. L. Needleman, CRC Press. [LID 1563]

12. Rice, D. C., (1992). Behavioural Impairment produced by developmental lead exposure:

Evidence from primate research. In Human Lead Exposure, ed H. L. Needleman, CRC Press. [LID

4822]

13. Matte, T. D., Landrigan P. J. & Baker E. L. (1992). Occupational Lead Exposure. In Human Lead

Exposure, ed H. L. Needleman, CRC Press. [LID 4806]

14. Wedeen R. P. (1992). Lead, the kidneys and hypertension. In Human Lead Exposure, ed H. L.

Needleman, CRC Press

15. Bellinger, D. & Needleman, H. L. (1992). Neurodevelopmental effects of low-level lead exposure

in children. In Human Lead Exposure, ed H. L. Needleman, CRC Press. [LID 4824]

16. Burchfile, J. L., Duffy, F. H., Bartels P. H., & Needleman, H. L. (1992). Low-level lead exposure:

Effect on quantitative electroencephalography and correlation with neuropsychologic

measures. In Human Lead Exposure, ed H. L. Needleman, CRC Press

17. Schwartz, J. (1992). Lead, blood pressure and cardio-vascular disease In Human Lead

Exposure, ed H. L. Needleman, CRC Press

18. Schwartz, J. (1992). Low level health effects of lead: Growth, developmental and neurological

disturbances. In Human Lead Exposure, ed H. L. Needleman, CRC Press. [LID 4827]

19. Rutter, M. & Jones, R. (ed) Lead versus health: Sources and effects of low level lead exposure.

Wiley medical Publications

20. National Academy of Sciences. (1980). Lead in the Human Environment. Washington DC.

21. Castellino, N., Castellino, P. & Sannolo, N. (ed). (1995). Inorganic lead exposure. Lewis Publishers

22. Hu, H., Pepper, L. & Goldman, R. Effect of repeated occupational exposure to lead, cessation

of exposure, and chelation on levels of lead in bone.. American Journal of Industrial Medicine

1991;20(6):723-35. http://www.ncbi.nlm.nih.gov/pubmed/1805610 Abstract.

23. Rokho Kim, MD, DrPH; Andrea Rotnitzky, PhD; David Sparrow, DSc; Scott T. Weiss, MD, MSc;

Carrie Wager, BSc; Howard Hu, MD, ScD . (1996). A Longitudinal Study of Low level lead

exposure and impairment of renal function. JAMA Vol 275 No 15 April 1996. p. 1177-1181.

http://jama.jamanetwork.com/article.aspx?articleid=400546 Abstract.

24. Fischbein, A. (1992). Occupational and environmental lead exposure. In Environmental and

Occupational Medicine, 2nd edn. Ed W.N. Rom. Little, Brown & Co. [LID 5136]

25. Rempel, D. MD. The Lead-Exposed Worker California occupational health program JAMA. 1989;

262(4): 532-534. http://jama.jamanetwork.com/article.aspx?articleid=378115 Abstract.

 
  Page 5 of 7 
26.  Repko, J. (1976). Behavioural toxicology of inorganic Lead. In Health Effects of Occupational 
Lead and Arsenic Exposure - a symposium, ed.B. W. Carnow, US Dept of Health, Education and 
Welfare Public Health Service Divn of Surveillance Hazard Evaluation and Field Studies, Feb.  
27.  Fanning, D. (1988). A mortality study of lead workers 1926 - 1985. In Archives of Environmental 
Health, Vol 43 No 3 May/June. pp. 247-251. http://www.ncbi.nlm.nih.gov/pubmed/3382250 Abstract.  
28.  D Malcolm, H A Barnett. (1982). A mortality study of lead workers 1925 - 76. In British Journal of 
Industrial Medicine 1982; Vol 39. pp. 404-410 http://oem.bmj.com/content/39/4/404.abstract  
29.  Davies, J. M. (1984). Long-term mortality study of chromate pigment workers who suffered 
lead poisoning. In British Journal of Industrial Medicine, Vol 41. pp. 170-178 
http://oem.bmj.com/content/41/2/170.abstract?sid=7a6b24e7-2419-4a15-ab25-5d78f48d25f8  
30.  McMichael, A. J. & Johnson, H. M. Long term mortality profile of heavily exposed lead smelter 
workers. In Journal of Occupational Health, Vol 24 No 5 May 1982. 
http://journals.lww.com/joem/Abstract/1982/24050/Long_term_Mortality_Profile_of_Heavily_Exposed
.8.aspx  
31.  Winder, C. (1989). Reproductive and chromosomal effects of occupational exposure to lead in 
the male. In Reproductive Toxicology Review. Vol 7. pp. 221-233. [LID 1479] 
32.  Schwartz, J. & Otto, D. (1987). Blood lead, hearing thresholds, and neurobehavioral 
development in children and youth. In Archives of Environmental Health Vol 42, No. 21 pp 153-
160, 1st May 1987. 
http://hero.epa.gov/index.cfm?action=reference.details&reference_id=57538    http://cfpub.epa.gov/si
/si_public_record_Report.cfm?dirEntryID=48404  
33.  Fergusson, D. M., Hurwood, L. J. & Lynskey, M. T. (1997). Early dentine lead levels and 
educational outcomes at 18 years. In Journal of Child Psychology and Psychiatry, Vol 38 No 4. pp. 
471-478. http://onlinelibrary.wiley.com/doi/10.1111/j.1469-
7610.1997.tb01532.x/abstract;jsessionid=4E242DD9F8439BE0BB0A5398 
1CAEB7B4.d03t02  
34.  NSW Workcover Authority. Occupational Medicine Handbook Ch 5 "Lead" p. 58  
35.  Royce, S. E. (1992). Lead toxicity. US Dept of Health and Human Services Agency for Toxic 
Substances and Disease Registry. Sept . 
http://wonder.cdc.gov/wonder/prevguid/p0000017/p0000017.asp  
36.  Gatsonis, C. A.. & Needleman, H. L. (1992). Recent epidemological studies of low-level lead 
exposure and the IQ of children: a meta-analytic review In Human Lead Exposure, ed H. L. 
Needleman, CRC Press. [LID 4828]  
37.  Day, M. (1998) Lead in the womb. New Scientist Magazine. 23 May 1998 p.7  
38.  Werbach, M. F. (1997). Foundations of nutritional medicine. Third Line press, Tarzana California.  
39.  Agency for Toxic Substances Disease Registrar. (1989). Toxicological profile of lead. US ATSDR. 
http://www.atsdr.cdc.gov/ToxProfiles/TP.asp?id=96&tid=22   
40.  Salome, F. & Gulson, B. (1996). Lead paint management. Grad School of the Environment, 
Macquarie University  
41.  Lanphear, Bruce P; Dietrich, Kim; Auinger, Peggy; Cox, Christopher. (2000) Cognitive Deficits 
Associated with Blood Lead Concentrations <10 µg/dL in US Children and Adolescents, 
Public Health Reports Nov 2000, Volume 115, 521-529; 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1308622/pdf/pubhealthrep00019-0027.pdf  
42.  Walsh, William J; Usman, Anju; Tarpey, Jeffrey; and Kelly, Tanika. (2001) Metallothionein And 
Autism Pfeiffer Treatment Center, Health Research Institute, Naperville, Illinois USA. The booklet 
can be ordered from info@HRIPTC.org or via the website www.hriptc.org for US$20 + postage but is 
not web-published. October 2001  
43.  Wentzel, Michael, Democrat & Chronicle, 25/2/02, UR [University of Rochester] links childhood 
lead to osteoporosis: http://www.mindfully.org/Health/Folder%20Settings/2002/Lead-Exposure-
Osteoporosis25feb02.htm  

 
Page 6       

 The LEAD Group Inc.    LEAD Action News vol no  1997 
44.  Silbergeld, Ellen, Menopause and Lead: Consequences and Determinants of Bone Lead 
Mobilization, Women's Environments & Women's Health Conference, Baltimore, Maryland, October 
22, 1999.  
45.  NBC News, Lead in Pregnancy Linked to Asthma, July 29 [1998?] re: study by Dr. Rodney R. 
Dietert, Cornell University in Ithaca, N.Y published in journal Toxicological Sciences. See 
http://www.cyber-nook.com/water/tbl_cont.html  [LID 6728] 
46.  Lustberg, M; Silbergeld, E, Blood Lead Levels And Mortality, in Arch Intern Med 2002 Nov 
25;162(21):2443-9, http://archinte.jamanetwork.com/article.aspx?articleid=214370  [LID 6921] 
47.  Government of Ontario, Canada, Ministry of Labour, Health and Safety, "Lead on Construction 
Projects - The Health Effects of Lead", http://www.labour.gov.on.ca/english/hs/pdf/gl_lead.pdf  
48.  Escribano, A., M. Revilla, E.R. Hernandez, C. Seco, J. Gonzalez-Riola, L.F. Villa, H. Rico. (1997), 
Effect of lead on bone development and bone mass: A morphometric, densitometric, and 
histomorphometric study in growing rats. Calcified Tissue International. 60(2): 200-203. 
http://www.springerlink.com/content/81u4pc2002ecgx54/ 
http://www.ncbi.nlm.nih.gov/pubmed/9056171  
49.  Gruber, H.E., H.C. Gonick, F. Khalil-Manesh, T.V. Sanchez, S. Motsinger, M. Meyer, C.F. Sharp. 
(1997). Osteopenia induced by long-term, low- and high-level exposure of the adult rat to 
lead. Mineral & Electrolyte Metabolism. 23(2): 645-73. 
http://www.ncbi.nlm.nih.gov/pubmed/9252971; http://cat.inist.fr/?aModele=afficheN&cpsidt=2781185  
50.  Katrina Smith Korfmacher, PhD, Long Term Costs of Lead Poisoning. How much can New York 
save by stopping lead? Environmental Health Sciences Center, University of Rochester. 
http://www.sehn.org/tccpdf/lead%20costs%20NY.pdf  
51.  Professor Brian Gulson, Macquarie University News, Good News for aging Bones, No longer 
online.  
52.  St. Louis Lead Prevention Coalition  - University of Rochester study links osteoporosis to 
childhood lead exposure, 
http://www.leadprevention.org/web/uploads/childhood_lead_&_osteoporosis.doc  
53.  AHA Journal News report (2004),"Safe' levels of lead, cadmium may raise risk of peripheral 
artery disease", 08/06/04. http://www.charitywire.com/charity8/05787.html [LID 7385] 
54.  Ana Navas-Acien, MD, MPH; Elizabeth Selvin, MPH; A. Richey Sharrett, MD, DrPH; Emma 
Calderon-Aranda, PhD, MD; Ellen Silbergeld, PhD; Eliseo Guallar, MD, DrPH. Lead, Cadmium, 
Smoking, and Increased Risk of Peripheral Arterial Disease (Circulation. 2004;109:3196-3201.) 
© 2004 American Heart Association, Inc. http://circ.ahajournals.org/content/109/25/3196.full  [LID 
7392]  
55.  Louis, ED, EC Jurewicz, LK Applegate, P Factor-Litvak, M Parides, L Andrews, V Slavkovich, JH 
Graziano, S Carroll and A Todd. (2003). "Association Between Essential Tremor and Blood Lead 
Concentration Environmental Health Perspectives", 3 July 2003 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241711/pdf/ehp0111-001707.pdf  [LID 7330]  
56.  International Agency for Research on Cancer (IARC), IARC Monographs on the Evaluation of 
Carcinogenic Risks to Humans Volume 87 (2006) Inorganic and Organic Lead Compounds 
http://monographs.iarc.fr/ENG/Monographs/vol87/index.php  [LID 7420]  
57.  National Toxicology Program (of the US department of Health and Human Services) Report on 
Carcinogens Twelfth Edition 2011 http://ntp-server.niehs.nih.gov/ntp/roc/twelfth/roc12.pdf  [LID 
7352]  
58.  Dr. Ben Balzer, Lead Poisoning Slide Show, 6 September 2000  www.lead.org.au/bblp/bblp.html 
[LID 4598] 
59.  Menke, A, Muntner, P, Batuman, V, Silbergeld, EK, and Guallar, E. 2004. Blood Lead Below 0.48 
µmol/L (10 µg/dL) and Mortality Among US Adults. Circulation - Journal of the American Heart 
Association 114:1388. http://circ.ahajournals.org/cgi/reprint/CIRCULATIONAHA.106.628321v1  [LID 
8599] 

Page 7 of 7

60. National Toxicology Program (NTP). NTP Monograph on Health Effects of Low-Level

Lead. U.S Department of Health and Services 2012 [LID 15884]

61. Lanphear B, Rauch S, Auinger P, Allen R, Hornung R, Low-level lead exposure and mortality

in US adults: a population-based cohort study. Lancet Public Health 2018

http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(18)30025-2/fulltext [LID

18948]

62. Felicia A. Rabito, Mehmet Kocak, Derek W. Werthmann, Frances A. Tylavsky, Christopher D.

Palmer, Patrick J. Parsons, Changes in low levels of lead over the course of pregnancy and

the association with birth outcomes. Reproductive Toxicology Volume 50, December 2014,

Pages 138-144, published online 22 Oct 2014, at

https://www.sciencedirect.com/science/article/abs/pii/S0890623814002597?via%3Dihub

63. Schaumberg DA, Mendes F, Balaram M, Dana MR, Sparrow D, Hu H. Accumulated lead

exposure and risk of age-related cataract in men. JAMA. 2004;292(22):2750-2754 - JAMA,

December 8, 2004 - Vol 292, No. 22. http://www.rima.org/web/medline_pdf/Jama_2750.pdf

64. Arthur E. Poropat, Mark A. S. Laidlaw, Bruce Lanphear, Andrew Ball, Howard W. Mielke

Blood lead and preeclampsia: A meta-analysis and review of implications.

Environmental Research Volume 160, January 2018, Pages 12-19, at

https://doi.org/10.1016/j.envres.2017.09.014