Cincinnati Lead Study

The Cincinnati Lead Study:  Sub-clinical Markers of Neurotoxicity in Children Exposed to Lead (1979-2020)

Purpose: The Cincinnati Lead Study (CLS) is a prospective longitudinal examination of the effects of low to moderate prenatal and postnatal lead exposure on the health and development of urban inner-city infants, children, adolescents and adults.  The CLS was initiated in 1979 by researchers and clinicians at the University of Cincinnati College of Medicine and the Cincinnati Children’s Hospital Medical Center.  The study was designed to examine the impact of low to moderate lead exposure on children’s health, with a special emphasis on the developing nervous system.  Subjects were recruited prenatally from urban, inner-city areas of Cincinnati where there has been historically a high incidence of lead poisoning. The principal source of exposure in this cohort was lead paint residues in dust and soil.  The CLS is the longest, continuously active prospective study of lead exposure and child development in the world.  Since its inception, the CLS has collected data on lead exposure (blood lead concentrations), neurobehavioral and neuromotor outcomes, child health, nutrition, environmental nurture, and sociodemographic variables on a quarterly to yearly basis from the first trimester of pregnancy to adulthood.  The study has been funded for the last 40 years through grants from the National Institute of Environmental Health Sciences (NIEHS) and the United States Environmental Protection Agency (USEPA).  Studies generated by CLS investigators have contributed substantially to USEPA, United States Centers for Disease Control (USCDC), and World Health Organization (WHO) regulatory and clinical care policies with respect to the prevention of environmental lead exposure and the medical management of lead-exposed children.

From National Geographic: Finally, the end of leaded gas

09/1/2021 - After decades of international pressure by a UN group, leaded gasoline is no longer being produced.

An article from National Geographic highlights the Cincinnati Lead Study cohort, the world's longest-running birth cohort research since 1979 at UC's Department of Environmental and Public Health Sciences.

Read National Geographic Article: Finally, the end of leaded gas

CLS Study Results of Effect of Lead on Neuromotor Function: Postural Stability and Gait Function

Schematic showing roles of various afferents associated with the four postural sway test conditions. 

Postural Balance testing on a compliant (foam pad) surface.

Postural Sway results for eyes closed, firm surface by blood lead quartile.

Comparison of postural sway stabilogram patterns from two children representing lowest (Q1) and highest (Q4) exposure quartiles for eyes closed, compliant surface condition (FC).

Publications: Bhattacharya, A., Shukla, R., Bornschein, R., Dietrich, K. and Kopke, J. "Postural disequilibrium quantification in children with chronic lead exposure" Neurotoxicology 9(3):327 340, 1988. PMID: 3200502.

Bhattacharya, A., Shukla, R., Bornschein, R., Dietrich, K., Keith, R. "Lead effects on postural balance of children" Environmental Health Perspectives 89:35 42, 1990. PMID: 2088753

Bhattacharya, A., Shukla, R., Dietrich, K.N., Miller, J., Bagchee, A., Bornschein, R.L., Cox, C., Mitchell, T. "Functional implications of postural disequilibrium due to lead exposure" Neurotoxicology, 14(2-3): 179-190, 1993. PMID: 8247392.

Bhattacharya, A., Shukla, R., Dietrich, K., Bornschein, R., "Effect of early childhood lead exposure on six year old children's postural balance" Developmental Medicine and Child Neurology 37: 861-878, 1995. PMID: 7493720

Bhattacharya, A., Shukla, R., Dietrich, K., Bornschein, R., “Effect of early lead exposure on the maturation of children's postural balance: a longitudinal study” Neurotoxicology and Teratology 28: 376-385, 2006. PMID: 16624520.

Conference Presentations: Bagchee, A, Succop, P and Bhattacharya, A, "Spectral analysis of postural sway in children with chronic lead exposure" Presented at the American Industrial Hygiene Association Conference, Washington D.C., May 18-24, 1996.

Prevention of Neuromotor Deficits with Chelation Therapy (1998-2002)

(NIEHS R01 ES008659)
PI: A. Bhattacharya

Purpose: This study investigated the influence of succimer chelation therapy in eliminating and/or minimizing lead-associated impairments of motor functions such as postural balance and locomotion or gait activities. In this study, postural balance and functional locomotion or gait were quantitated in 161 children in Cincinnati enrolled in a randomized, placebo-controlled, double blind clinical trial. 

Schematic of test conditions and nomenclature of gait forces and torques. (A) Normal walk test; (B) line walk test; (C) obstacle test; (D) bending test eyes open (BO) and eyes closed (BC) for postural balance evaluation. Nomenclature for gait variables are shown in (A) where the subject is stepping on the force plate during the single stance phase. +FY = propulsive force; -FY = braking force; ±FX = medio-lateral (M-L) forces; ±MZ: vertical torques around the Z-axis, this torque is applied about the point of contact of the heel strike foot on the force plate. An increased ±MZ is representative of higher effort by the body to bring the body’s center of gravity to the middle of their base of support thereby maintaining adequate upright balance during single stance phase of walking.

Publications: Bhattacharya, A, Smelser, D. T, Berger, O., Shukla R and Medvedovic, M, "Effect of succimer therapy on postural balance of a nine year old child: A case study" Neurotoxicology 19(1):57-64, 1998. PMID: 9498221

Bhattacharya, A, Shukla, R, Auyang, E, Dietrich, KN and Bornschein, RL “Effect Of Succimer Chelation Therapy On Postural Balance and Gait Outcomes in Children With Early Exposure To Environmental Lead”. NeuroToxicology 28: 686–695, 2007. PMID: 17499360

Early Detection of Degenerative Disorders & Innovative Solutions  (EDDI) Laboratory researchers were invited by the National Institute of Environmental Health Sciences (NIEHS) to present a hands-on demonstration of postural balance testing technology  for early detection of neurotoxicity at National Medical Research Day at the U.S. House of Representatives 1990  (Washington DC) & Earth-Tech '90 Show (at the Mall Washington, D.C.).

Earth-Tech '90 Show (at the Mall Washington, D.C.)
Dr. Louis Wade Sullivan, the Secretary of the U.S. Department of Health and Human Services (during President George H. W. Bush's Administration) receiving a “Hands-On” demonstration by evaluating his postural stability using  our Lab’s new technology "Quantitative Posturagraphy". The "Quantitative Posturagraphy" technology/custom software was developed by University of Cincinnati’s (COM) EDDI Lab for early detection of neurotoxicity associated with  environmental Pb exposure in children  (sponsored by NIEHS during late 1980’s).

Selected publication:
Bhattacharya, A., Shukla, R., Dietrich, K., and Bornschein, “Effect of early lead exposure on the maturation of children's postural balance: a longitudinal study” Neurotoxicology and Teratology 28: 376-385, 2006. PMID: 16624520

See more EDDI Lab publications

Earth‑Tech '90 Show (at the Mall Washington, D.C.)
Dr. Bhattacharya  describing the “Quantitative Posturagraphy” technology to Dr. Louis Wade Sullivan, the Secretary of the U.S. Department of Health and Human Services.

Daniel J. Travanti, Golden Globe Winner for Best Performance in a Television Series - Drama: "Hill Street Blues" receiving a "Hands-On" demonstration by evaluating his postural stability using our Lab’s new technology "Quantitative Posturagraphy" at the National Medical Research Day. Mr. Travanti was one of the celebrities invited by organizing committee of National Medical Research Day

National Medical Research Day at the U.S. House of Representatives 1990  (Washington DC)
Poster presentation of the “Quantitative Posturagraphy” technology and Demo for quantifying postural stability of visitors and politicians/staff at the U.S. House of Representatives.