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 United States 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 past 2 decades and summarized here has demonstrated that the brain is a critical target organ for detrimental Pb²⁺ effects, especially causing fronto-executive dysfunctions. This review summarizes the evidence supporting this last statement and, based on this evidence, argues that Pb²⁺ poisoning should be considered part of the neurodevelopmental disorder classifications within the fifth edition of 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.