Visual contrast sensitivity (VCS) tests have been used successfully in medical diagnosis and subclinical neurotoxicity detection. This paper reports VCS measurements in three studies of children in the Czech Republic. Study 1 compared children in standard schools and schools for the learning disabled. Studies 2 and 3 compared children in Teplice, an area in which soft-brown coal combustion produced high levels of pollutants (e.g. Hg, As, SO2, NOx, and aromatic hydrocarbons), with children in areas of low air pollution, Znojmo and/or Prachatice. It was hypothesized that in utero exposure to the combustion products disrupted neurological development (Sram, 1991). The VCS test (Stereo Optical Co.) consisted of circular fields containing sinusoidal gratings at 5 spatial frequencies (1.5-18 cycles/degree) and various levels of contrast. Subjects indicated orientation of the gratings by pointing left, up, or right. Visual acuity and VCS were measured in each eye of 74 children in Study 1,327 second-grade children in Study 2, and 426 fourth-grade children in Study 3. Hair samples were collected in Studies 2 and 3 analyzed for Hg and As content. Children attending schools for the learning disabled scored significantly lower than controls on VCS, whereas visual acuity was normal. The deficit was greatest at mid- to high spatial frequency. In Study 2, significant VCS deficits were seen in exposed second-grade children at low to mid-spatial frequency, even though visual acuity was slightly above control level. Regression analyses showed that VCS had no relationship to As, but a significant negative correlation with hair Hg was observed in the exposed district. However, current Hg levels were higher in Prachatice. VCS deficits were not observed in the fourth-grade students of Teplice in Study 3. The results of Study 1 indicated that behavioral VCS testing in field studies is practical in young, non-English speaking children, and suggested that vision may be compromised in learning-disabled children. Studies 2 and 3 indicated that at these levels, current Hg body-burdens are poor predictors of VCS. If the VCS deficits seen in Study 2 were related to prenatal exposures, the results of Study 3 suggest that they represent a developmental delay. A longitudinal-study design is needed to address this issue.

National Health and Environmental Effects Research Laboratory U S EPA RTP NC 27711 USA