Does background postnatal methyl mercury exposure in toddlers affect cognition and behavior?

Abstract

Because the toxicological effects of mercury (Hg) are more serious in the developing central nervous system of children than adults, there are growing concerns about prenatal and early childhood Hg exposure. This study examined postnatal methylmercury (MeHg) exposure and cognition and behavior in 780 children enrolled in the Treatment of Lead (Pb)-exposed Children clinical trial (TLC) with 396 children allocated to the succimer and 384 to the placebo groups. Mercury exposure was determined from analyses of blood drawn 1 week before randomization and 1 week after treatment began when succimer had its maximal effect on blood Pb (PbB). The baseline MeHg concentrations were 0.54 microg/L and 0.52 microg/L and post-treatment concentrations were 0.51 microg/L and 0.48 microg/L for placebo and succimer groups, respectively. Because the baseline characteristics in the two groups were balanced and because succimer had little effect on MeHg concentration and no effect on the cognitive or behavioral test scores, the groups were combined in the analysis of MeHg and neurodevelopment. The children's IQ and neurobehavioral performance were tested at age 2, 5 and 7 years. We saw weak, non-significant but consistently positive associations between blood MeHg and IQ test scores in stratified, spline regression and generalized linear model data analyses. The behavioral problem scores were constant or decreased slightly with increasing MeHg concentration. Additional adjustment for PbB levels in multivariable models did not alter the conclusion for MeHg and IQ scores, but did confirm that concurrent PbB was strongly associated with IQ and behavior in TLC children. The effects of MeHg on neurodevelopmental indices did not substantially differ by PbB strata. We conclude that at the present background postnatal MeHg exposure levels of US children, adverse effects on children's IQ and behavior are not detectable.

Figure 1. Flow of patients through the TLC clinical trial

* Children who discontinued treatment and participated in the study through 7 years were included in the intent-to-treat analysis

Figure 2

IQ test scores by baseline blood MeHg level. Each data point shows the mean IQ test scores (adjusted for treatment group, exact age at IQ measurement, caregivers' IQ, clinical center, single parent, language, race, gender, parents' occupation, education and concurrent PbB) of children assessed at age 2, 5 and 7 years, grouped by quartiles of baseline blood MeHg concentration. The abscissa of each point is the median of each blood MeHg concentration category.

Figure 3. Comparison of blood total Hg concentration between NHANES and TLC data