Many studies have been performed that conclude the ADHD and other adolescent behavioral issues are causally related to the ingestion of lead paint and lead dust.

The National Toxicology Program, U.S. Dept of Health and Human Resources, has created a comprehensive report entitled Monograph on Health Effects of Low-Lead, 10/14/2011, peer reviewed November 17-18, 2011. Specifically, this literature makes conclusions on the effects of blood lead levels with a focus on BPb levels less than 10ug/dL.  As described in Section 1.2.2, the NTP’s conclusions were derived by evaluating data from epidemiological studies with a focus on blood Pb levels <10µg/dL.  The evidence is discussed for specific health outcomes within each chapter, and varies by the study design and type of analysis used to examine the relationship of the health outcome with blood Pb across the hundreds of studies evaluated. In some cases, authors restricted the analysis to the population with blood Pb levels <10µg/dL, <5µg/dL, or even lower and the association of the health effect with the blood Pb level is clear.  For example, Lanphear et al. (2000) reported an inverse relationship between blood Pb and academic performance in a cross-sectional study of 4853 children ages 6-16 from the NHANES-III dataset; the association with blood Pb remained significant in further analyses restricted to 4681 children with blood Pb <10µg/dL (p<0.001), and 4043 children with blood Pb <5µg/dL.  In other cases, the authors reported a significant association between blood Pb and an effect in a population with a mean blood Pb level <10µg/dL.   These analyses support an effect of a blood Pb level <10µg/dL, but they do not exclude the possibility that individuals significantly above or below the mean blood Pb level are driving the effect.

As described above, the NTP’s conclusions were derived by evaluating data from epidemiological studies with a focus on blood Pb levels <10µg/dL. The evidence is discussed for specific health outcomes within each chapter, and varies by the study design and type of analysis used to examine the relationship of the health outcome with blood Pb across the hundreds of studies evaluated.  In some cases, authors restricted the analysis to the population with blood Pb levels <10µg/dL, <5µg/dL, or even lower and the association of the health effect with the blood Pb level is clear.  For example, Lanphear et al. (2000) reported an inverse relationship between blood Pb and academic performance in a cross-sectional study of 4853 children ages 6-16 from the NHANES-III dataset; the association with blood Pb remained significant in further analyses restricted to 4681 children with blood Pb <10µg/dL (p<0.001), and 4043 children with blood Pb <5µg/dL.  In other cases, the authors reported a significant association between blood Pb and an effect in a population with a mean blood Pb level <10µg/dL.

Several population based and epidemiologically based peer-reviewed studies and a Federal Report, collectively reach consistent and convergent disease-related outcomes, such studies are then translated into standards of pediatric and medical management of individual children (and adults). Thus, based upon this convergence and consistency in population studies, recently recognized outcomes of childhood lead poisoning have been established. The link between ADHD and lead has been established.