The Effect of Chelation Therapy with Succimer on Neuropsychological Development in Children Exposed to Lead

Background Thousands of children, especially poor children living in deteriorated urban housing, are exposed to enough lead to produce cognitive impairment. It is not known whether treatment to reduce blood lead levels prevents or reduces such impairment. Methods We enrolled 780 children with blood lead levels of 20 to 44 μg per deciliter (1.0 to 2.1 μmol per liter) in a randomized, placebo-controlled, double-blind trial of up to three 26-day courses of treatment with succimer, a lead chelator that is administered orally. The children lived in deteriorating inner-city housing and were 12 to 33 months of age at enrollment; 77 percent were black, and 5 percent were Hispanic. Follow-up included tests of cognitive, motor, behavioral, and neuropsychological function over a period of 36 months. Results During the first six months of the trial, the mean blood lead level in the children given succimer was 4.5 μg per deciliter (0.2 μmol per liter) lower than the mean level in the children given placebo (95 percent...