Low-level Lead Exposure Impairs Fronto-executive Functions: A Call to Update the DSM-5 with Lead Poisoning as a Neurodevelopmental Disorder

Lead (Pb²⁺) exposure continues to occur despite efforts to reduce its environmental sources, and affects millions of children in the US alone. Finding Pb²⁺ in blood samples indicates that exposure has resulted in absorption with the potential for distribution to all cells in the body. Research conducted during the last two decades and summarized here has demonstrated that the brain is a critical target organ for detrimental Pb effects, especially causing fronto-executive dysfunctions (FED). This review summarizes the evidence supporting this last statement and based on this evidence argues that Pb²⁺-poisoning should be considered as part of the neurodevelopmental disorder classifications within the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) developed by the American Psychiatric Association. Inclusion in the DSM-5 or future revisions would have impact for diagnosis acceptance and subsequent availability of resources for interventions and research.