• lead
• neurobehavioural testing

The article of Dr Goodman and coworkers on “Neurobehavioural testing in workers occupationally exposed to lead”¹ covers an interesting approach with a surprising main message: “None of the individual studies is conclusive or adequate in providing information on the subclinical neurobehavioural effects ...”. Such a sentence astonishes a reader since the studies used were selected from established journals.

A long section of the discussion deals with an article of Meyer-Baron and Seeber,² the beforehand published meta-analysis on the topic. We agree that prospective studies are the best basis to receive a stable knowledge about exposure effects, also in neurobehavioural studies. However, the repeated information on cross sectional studies should also be accepted as source for conclusions on (neurobehavioural) effects due to exposures. Meta-analyses are one approach to search such summarising information.

Taking into account that the extended study selection in the article of Goodman et al may lead to different results we do not agree with several arguments. For example, they refer to the bias problem, the exposure range, the interpretation in terms of age related changes, and the results for the digit symbol test. On these problems an exchange of opinions has been published in Archives of Toxicology.^3,4 Without making reference to this discussion, several arguments and conclusions were presented again. They are identical with the main conclusions in an anonymous “expert opinion” for the German Battery Association.⁵

From our point of view …