Lead exposure in early childhood is an important cause of cognitive delay and behavior problems (1-6). In 1993, the National Institutes of Environmental Health Sciences with support from the NIH Office of Research on Minority Health initiated the Treatment of Lead-Exposed Children (TLC) Trial. That randomized, multi-center, placebo-controlled, double blind clinical trial was designed to assess the developmental benefits of oral chelation therapy, with a medication called succimer, for low-moderate levels of lead exposure before 33 months of age. CHOP has been one of four sites for enrollment and follow-up of children in the TLC Study (7-9). The primary outcome of interest is developmental status as measured by full scale deviation IQ score using the Wechsler Preschool and Primary Scales of Intelligence (revised) three years after randomization. Secondary objectives involve the evaluation of the effects of lead chelation on other measures of developmental status, particularly tests of neuro-psychological development (including attention and executive function); changes in height, weight and head circumference, and changes in systolic and diastolic blood pressure levels. In addition, the interactions between iron deficiency and low moderate level of lead poisoning are being explored.
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