Prospective associations between childhood low-level lead exposure and adult mental health problems: The Port Pirie cohort study

• We examine blood lead levels in early childhood and adult mental health problems.
• Childhood lead showed small bivariate links with some adult mental health problems.
• These lead–mental health problems associations were only apparent for females.
• All associations became non-significant after covariate adjustment.
• Other early childhood factors may better predict adult mental health problems.

Low-level environmental lead exposure during childhood is associated with poorer emotional/behavioural functioning in later childhood and adolescence. Scarce research has examined whether these apparent effects persist into adulthood. This study is the first to examine prospective associations between lead exposure across early childhood and several common adult mental health problems.Childhood data (including blood lead concentrations) and adult data (from mental health questionnaires and psychiatric interviews) were available for 210 participants (44% males, mean age = 26.3 years) from the Port Pirie cohort study (1979–1982 birth cohort).Participants had a mean childhood (to 7 years) average blood lead concentration of 17.2 μg/dL. Among females, childhood blood lead showed small significant positive associations with lifetime diagnoses of drug and alcohol abuse and social phobia, and with anxiety, somatic and antisocial personality problems. For example: for a 10 μg/dL blood lead increase, females were 2.84 times (95% CI 1.10, 7.30) more likely to have an alcohol abuse diagnosis. However, adjustment for childhood covariates – particularly stimulation within the home environment – rendered these associations non-significant. No significant or sizeable unadjusted or adjusted associations were seen for males.The associations between early lead exposure and emotional/behavioural functioning in children might persist into adulthood, at least for females. However, it is unclear whether such results arise from residual confounding, or other mechanisms. Interventions that focus on improving the childhood home environment may have a long-term positive impact on adult mental health outcomes. However, more prospective research using large and representative samples is needed to substantiate these results.