Abstract
Objective
To investigate blood lead concentrations (BLCs) in children presenting with autistic spectrum disorder (ASD) and associations with clinical presentation (pica, motor delay, language delay and anaemia), age and social deprivation.
Setting
Community-based autism assessment clinics, north Bristol, UK (single-centre, retrospective cross-sectional study).
Patients
Children with autism who had BLC measured as part of an autism assessment during a 4-year period from November 2019 to November 2023.
Main outcome measures
Data were collected from electronic case notes for children who underwent an assessment for ASD during this period, including diagnoses and investigations.
Results
13/102 (13%) children with a diagnosis of autism had BLC ≥0.24 µmol/L, which is above the UK Health Security Agency threshold to trigger further investigation and identification of sources of exposure. Elevated BLC was not associated with the presence of pica or other clinical features including developmental delay.
Conclusion
Pica and developmental delay were not useful indicators of children with elevated BLC. Their absence could lead to cases of elevated BLC being missed in children with autism. This lends weight to an argument that lead should be screened for routinely in the preschool autism population alongside other common causes of behavioural difficulties and developmental delay such as anaemia.
To investigate blood lead concentrations (BLCs) in children presenting with autistic spectrum disorder (ASD) and associations with clinical presentation (pica, motor delay, language delay and anaemia), age and social deprivation.
Setting
Community-based autism assessment clinics, north Bristol, UK (single-centre, retrospective cross-sectional study).
Patients
Children with autism who had BLC measured as part of an autism assessment during a 4-year period from November 2019 to November 2023.
Main outcome measures
Data were collected from electronic case notes for children who underwent an assessment for ASD during this period, including diagnoses and investigations.
Results
13/102 (13%) children with a diagnosis of autism had BLC ≥0.24 µmol/L, which is above the UK Health Security Agency threshold to trigger further investigation and identification of sources of exposure. Elevated BLC was not associated with the presence of pica or other clinical features including developmental delay.
Conclusion
Pica and developmental delay were not useful indicators of children with elevated BLC. Their absence could lead to cases of elevated BLC being missed in children with autism. This lends weight to an argument that lead should be screened for routinely in the preschool autism population alongside other common causes of behavioural difficulties and developmental delay such as anaemia.
| Original language | English |
|---|---|
| Article number | e003268 |
| Number of pages | 6 |
| Journal | BMJ Paediatrics Open |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 7 Jul 2025 |