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At least 217 records · Page 12Linked to original sources
PubMed2003

Assessing remedial effectiveness through the blood lead:soil/dust lead relationship at the Bunker Hill Superfund Site in the Silver Valley of Idaho.

The 21 square mile Bunker Hill Superfund Site in northern Idaho includes several thousand acres of contaminated hillsides and floodplain, a 365-acre abandoned lead/zinc smelter and is home to more than 7000 people in 5 residential communities. Childhood lead poisoning was epidemic in the 1970s with >75% of children exceeding 40 microg/dl blood lead. Health response activities have been ongoing for three decades. In 1991, a blood lead goal of 95% of children with levels less than 10 microg/dl was adopted. The cleanup strategy, based on biokinetic pathways models, was to reduce house dust lead exposure through elimination of soil-borne sources. An interim health intervention program, that included monitoring blood lead and exposures levels, was instituted to reduce exposures through parental education during the cleanup. In 1989 and 2001, 56% and 3% of children, respectively, exceeded the blood lead criteria. More than 4000 paired blood lead/environmental exposure observations were collected during this period. Several analyses of these data were accomplished. Slope factors derived for the relationship between blood lead, soil and dust concentrations are age-dependent and similar to literature reported values. Repeat measures analysis assessing year to year changes found that the remediation effort (without intervention) had approximately a 7.5 microg/dl effect in reducing a 2-year-old child's mean blood lead level over the course of the last ten years. Those receiving intervention had an additional 2-15 microg/dl decrease. Structural equations models indicate that from 40 to 50% of the blood lead absorbed from soils and dusts is through house dust with approximately 30% directly from community-wide soils and 30% from the home yard and immediate neighborhood. Both mean blood lead levels and percent of children to exceed 10 microg/dl have paralleled soil/dust lead intake rates estimated from the pathways model. Application of the IEUBK model for lead indicates that recommended USEPA default parameters overestimate mean blood lead levels, although the magnitude of over-prediction is diminished in recent years. Application of the site-specific model, using the soil and dust partitions suggested in the pathways model and an effective bioavailability of 18%, accurately predicts mean blood lead levels and percent of children to exceed 10 microg/dl throughout the 11-year cleanup period. This reduced response rate application of the IEUBK is consistent with the analysis used to originally develop the cleanup criteria and indicates the blood lead goal will be achieved.

Absorption↗
PubMed2000

Elevated blood lead levels and blood lead screening among US children aged one to five years: 1988-1994.

OBJECTIVES: To estimate the proportion of children 1 to 5 years of age who received blood lead testing during 1988-1994 and to assess whether predictors of testing coincided with predictors of elevated blood lead levels. DESIGN: Cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey. Participants. US children 1 to 5 years of age. Outcome Measures. Prevalence of blood lead testing and elevated blood lead levels among children 1 to 5 years of age and odds ratios for factors predicting blood lead testing and elevated blood lead levels. RESULTS: Overall, 6.3% had elevated blood lead levels and 10.2% had undergone previous blood lead tests. Being of minority race/ethnicity, living in an older home, residing in the Northeast or Midwest regions of the United States, being on Medicaid, having a head of household with <12 years of education, and having a history of anemia were significant factors in both models. Additional independent risk factors for an elevated blood lead level included being sampled in phase 1 of the survey, being 1 to 2 years of age, not having a regular doctor, and being sampled during the summer months. Additional independent correlates of a previous blood lead test included having moved less than twice in one's lifetime, having a female head of household, and having parents whose home language was English. Of an estimated 564 000 children 1 to 5 years of age who had elevated blood lead levels and no previous screening test in 1993, 62% were receiving Medicaid, 40% lived in homes built before 1946, and 34% were black, non-Hispanic. CONCLUSIONS: Lead screening was more frequent among children with risk factors for lead exposure. However, among children with elevated blood lead levels, only one third had been tested previously. In 1993 an estimated 564 000 children 1 to 5 years of age had elevated blood lead levels but were never screened. Physicians should screen Medicaid-eligible children and should follow state or local health department recommendations about identifying and screening other at-risk children. In areas where no health department guidelines exist, physicians should screen all children or screen based on known risk factors.

Black or African American↗
PubMed2004

Lead in topsoil, hay, silage and blood of cows from farms near a former lead mine and current smelting plant before and after installation of filters.

This study covers 1975 to 2003 with measurements of lead in soil (n = 24), hay (n = 259), silage (n = 35) and blood of cows (n = 1279) from farms (n = 1 to 14) situated 1 to 10 km around a lead smelter. Until 1978, when protective filters were installed in the plant chimneys, the farms had been exposed to heavy industrial-metallurgic effluent. Early measurments (1968 to 1975) high lead (> 600.0 mg lead/kg) in the topsoil, and continuing measurements (1981 to 2003) showed no significantly decreased lead after the installation of filters; however, mean lead in hay samples gradually decreased. In 1975 lead concentrations in 4 samples of hay were 227.0 to 953.0 mg/kg DM. In 2002 (n = 12) mean lead concentrations were about 100-fold lower (5.6 +/- 3.3 mg lead/kg DM). A similar trend of decreasing lead concentrations occurred also in the blood of cows. In 1975 (n = 9) average lead concentration was 1.2 +/- 0.6 mg/kg whole blood, while in 2002 (n = 58) it was about 20-times lower (0.07 +/- 0.005 mg/kg). This significant decrease in lead concentration may be attributed to sanitation of the major source of industrial emission of lead gasses and dust by installation of bag filters to the plant chimneys in 1978. After 1982 mean cow lead blood concentrations were within normal reference values (< 0.250 mg of lead/kg). However, during the last 10y mean lead concentrations have still been 1- to 2-fold above the values measured in blood (n = 32) from 3 control areas in Slovenia. Cattle blood levels proved a good bioindicator of environmental contamination. Monitoring lead in the blood of animals on farms near the smelter should continue because the persistence of lead in topsoil is the main problem in this area.

Agriculture↗
PubMed1995

Leaded eye cosmetics: a cultural cause of elevated lead levels in children.

BACKGROUND: Preventing lead exposure is of paramount importance because lead is significantly toxic at subclinical levels, and treating patients with elevated blood lead levels is difficult. Children were evaluated for lead exposure in California through a state-mandated lead screening program that was begun in November 1991. Imported eye cosmetics were identified as a suspected source of lead exposure for Pakistani and Indian children who used these products. METHODS: A retrospective chart review of children at a county hospital clinic was undertaken for the period beginning October 1991 and ending February 1994. Lead exposure questionnaires were filled out at clinic visits, and telephone interviews were conducted with parents or guardians of children from ethnic groups who use eye cosmetics. RESULTS: Lead level results were available for 175 children. The average lead level was 4.3 micrograms/dL (0.21 mumol/L) for Pakistani/Indian children not using eye cosmetics and 12.9 micrograms/dL (0.62 mumol/L) (P = .03) for those using the products. Chemical evaluation of some of the eye cosmetics used by these children revealed high lead content. CONCLUSIONS: Use of eye cosmetics imported from Pakistan was found to be strongly correlated with elevated blood lead levels. Although importation of leaded eye cosmetics is prohibited by law, legislation has not been effective in protecting children from this source of lead exposure. Education regarding low-level lead toxicity and avoidance of substances containing lead is needed, particularly for targeted subpopulations.

Child, Preschool↗
PubMed1998

The effect of lead in tap water on blood lead in children in a smelter town.

Hettstedt, a city in eastern Germany with a long history of mining and smelting of non-ferrous ores, has multiple lead waste deposits and the remains of a former lead smelter and a copper-silver smelter. As part of a cross-sectional study, an analysis of lead concentrations in drinking water and in blood was undertaken to determine the impact of lead in drinking water on the internal burden of lead in children. The geometric mean of blood lead levels among children 5-14 years old was 35.0 micrograms/l with a 95% confidence interval (C.I.) of 33.4-36.7. The geometric mean of lead in the random tap water samples was 0.5 microgram/l (95% C.I., 0.5-0.6) and 0.7 microgram/l (95% C.I., 0.6-0.8) in the stagnant tap water samples. Blood lead levels were somewhat correlated with the random water measures but not the stagnant water measures (random sample: r = 0.12, P = 0.012; stagnant sample: r = 0.04, P = 0.396). After adjustment for relevant confounders, lead in drinking water (random sample) was not significantly associated with blood lead levels. Factors that were significantly associated with blood lead included gender, the city area of residence, lead in house dust, regular contact with dogs and dirtiness of the child after playing outdoors. Based on this study, lead in domestic tap water contributed little to the lead exposure of children in the lead contaminated region of Hettstedt.

Adolescent↗
PubMed2006

Prediction of left main coronary artery obstruction by 12-lead electrocardiography: ST segment deviation in lead V6 greater than or equal to ST segment deviation in lead V1.

BACKGROUND: Acute coronary syndrome (ACS) resulting from culprit lesion in left main coronary artery (LMCA) can cause rapid hemodynamic deterioration. It is important to identify these patients early to facilitate timely revascularization. ST segment elevation in aVR greater than or equal to V(1) (aVR-V(1)>or= 0) has been suggested as a sensitive predictor of LMCA disease. As a result of balanced forces, we hypothesized that ST deviation in V(6) greater than or equal to ST deviation in V(1) (V(6)-V(1)>or= 0) might be a good determinant of LMCA disease. METHODS: We compared admission 12-lead ECGs of ACS resulting from culprit LMCA lesion (n = 75, group I) with ACS resulting from culprit left anterior descending lesion (n = 81, group II). Group I was selected over a period of 10 years. We compared V(6)-V(1)>or= 0 to aVR-V(1)>or= 0 in both groups. We also looked at ratios of ST deviations in V(6),V(1) (V(6)/V(1)>or= 1) and aVR,V(1) (aVR/V(1)>or= 1) in patients where ST segment in V(1) was not isoelectric (group I = 54 and group II = 55). RESULTS: ST deviation in V(6) was significantly greater in group I as compared to group II (P < 0.001). The reliabilities of V(6)-V(1)>or= 0, V(6)/V(1)>or= 1, aVR-V(1)>or= 0, and aVR/V(1)>or= 1 in predicting LMCA disease were determined. CONCLUSION: This is the largest series of ECG analysis on ACS resulting from culprit LMCA lesion. V(6)-V(1)>or= 0 and V(6)/V(1)>or= 1 were more sensitive in predicting LMCA as culprit vessel in comparison to previously reported greater ST segment elevation in aVR than V(1).

Aged↗
PubMed1996

Partition of circulating lead between serum and red cells is different for internal and external sources of lead.

Serum lead, whole blood lead, and lead in both tibia and calcaneus were measured in each of 49 active lead workers. Serum lead correlated more strongly with both in vivo bone lead measurements than did whole blood lead. The ratio of serum lead to whole blood lead varied from 0.8% to 2.5% and showed a positive correlation with tibia, and an even stronger correlation with calcaneus lead. This implies that lead released from bone (endogenous exposure) results in a higher proportion of whole blood lead being in serum than is the case for exogenous exposure. This observation needs to be confirmed, and the relationships amongst the parameters must be studied further, particularly in former or retired lead workers. If confirmed, since at least a portion of lead in serum is readily diffusible and thus toxicologically more immediately significant than lead bound to red cells, the health implications of endogenous exposure may have to be reassessed.

Adult↗
PubMed1999

Blood lead levels among children of lead-exposed workers: A meta-analysis.

BACKGROUND: To further assess the utility of targeted blood lead screening for children from households with members having occupational lead exposures, we conducted a meta-analysis of all available reports of take-home lead exposures. Our objective was to estimate the blood lead levels among U.S. children (ages 1-5) from households with lead-exposed workers. METHODS: Reports considered for inclusion were cited in Medline, Toxline, Excerpta Medica, and Bio-Med plus all unpublished reports available at the National Institute for Occupational Safety and Health through 1994. The a priori criteria for inclusion of U.S. reports required their having data on: (1) venous blood lead levels for children, (2) children's ages, (3) data for at least five children, (4) workers' occupations, (5) workers' blood lead levels, and (6) data collection methods. RESULTS: Based on a meta-analysis of 10 reports from 1987 through 1994, the children (n=139) of lead-exposed workers (n=222) had a geometric mean blood lead level of 9.3 microg/dL compared to a U.S. population geometric mean of 3.6 microg/dL (P=0.0006). Also in this group, 52% of the children had blood lead levels (BLLs) >/= 10 microg/dL compared to 8.9% in the U.S. (P=.0010), and 21% of the children had BLLs >/= 20 microg/dL compared to 1.1% in the U.S. (P=. 0258). CONCLUSIONS: We estimate, based on 1981-83 survey data, that there are about 48,000 families with children under six living with household members occupationally exposed to lead. If the findings from this meta-analysis (admittedly limited by small numbers) are generalizable, about half of the young children in these families may have BLLs >/= 10 microg/dL. Data were too sparse to determine if children of workers with elevated blood leads were at greater risk than children whose parents were only known to be lead exposed. Our findings support the position that children of lead-exposed workers should be targeted for blood lead screening. Am. J. Ind. Med. 36:475-481, 1999. Published 1999 Wiley-Liss, Inc.

Child, Preschool↗
PubMed1982

Relationship of air lead and blood lead for workers at an automobile battery factory.

Air lead and blood lead data, recorded over a period of 3 years for 972 employees at an automobile battery factory as part of a lead control program, were summarized and statistically analyzed. The air lead values were measured by mobile area samplers for approximately 2 years and then by personal samplers for approximately 1 year. Blood lead analyses were usually performed once a month for most of the workers. The trend in air lead levels was significantly upward in the 1st year and significantly downward in the 2nd year while the trend in blood lead levels was significantly downward in the 1st year and in the 3rd year. There were no other significant trends. To assess the relationship between air lead and blood lead, data were used whenever an air lead obtained by personal sampler was followed within 1 month by a blood lead on the same worker. The variables age, job tenure, and department identity were included in an analysis of covariance. Only air lead and departments were significant, accounting for 9% and 13% of the variance in blood lead, respectively. From these data 95% confidence limits were calculated for predicting blood leads from given air leads for an individual worker. These were 30-68 micrograms/100 ml at 200 micrograms/m3, 25-62 micrograms/100 ml at 100 micrograms/m3, and 22-60 micrograms/100 ml at 50 micrograms/m3.

Adult↗
PubMed2006

Lead concentrations and isotope ratios in street dust in major cities in Greece in relation to the use of lead in petrol.

Until recently, the most important source of environmental lead pollution in cities was thought to come from the combustion of leaded petrol. A simple way to monitor the extent of this phenomenon, used in a number of studies in the past, has been to measure lead levels in street dust. Nowadays, it would be expected that lead concentrations in urban dust would have decreased from earlier values, following the progressive reduction of lead in petrol over the past few years, and this hypothesis has recently been confirmed in Manchester, UK. The object of the present work is to determine levels of lead pollution in cities in Greece on 1997 and, if possible, to discover whether similar reductions in lead concentrations have occurred there also. Surveys have been conducted in Thessaloniki, Athens and Piraeus. Samples of roadside dust were collected from streets (categorised by traffic density), national gardens and school playgrounds, and lead was extracted by digestion with concentrated nitric acid. Lead concentrations were determined by graphite furnace atomic absorption spectrometry and lead isotope ratios measured by inductively coupled plasma mass spectrometry. Results for Thessaloniki showed that mean lead concentrations in all categories of location are similar to present levels in Manchester. Further, lead concentrations in dust in the busiest streets in Thessaloniki have fallen by about 55% since a previous study 17 years ago. In Athens and Piraeus, the lead levels in street dust are much higher and significant differences were observed between the various types of street. In particular, it was observed that lead levels in school playgrounds in these two cities were much higher than in similar locations in Thessaloniki and Manchester, with a possible hazard to children. Isotope ratio measurements showed that Thessaloniki's lead is isotopically distinct from that found in Athens and Piraeus, which presumably reflects differences in sources of supply.

Cities↗
PubMed2002

Effect on blood lead of airborne lead particles characterized by size.

Worker exposure to airborne lead particles was evaluated for a total of 117 workers in 12 work-places of four different industrial types in Korea. The particle sizes were measured using 8-stage cascade impactors worn by the workers. Mass median aerodynamic diameters (MMAD) were determined by type of industry and percentage of lead particles as a fraction of airborne lead (PbA) concentration was determined by particle size. Blood lead (PbB) levels of workers who matched airborne lead samples were also examined. A Scheffé's pairwise comparison test showed that MMAD and the fractions of each of respirable particles and lead particles < or =1 microm relative to PbA varied greatly by the type of industry. The concentrations of lead particles < or =1 microm, which the Center for Policy Alternatives model assumes is relatively constant at 12.5 microg/m3, increased with increasing PbA concentration. In addition, a better correlation was detected between concentrations of particles < or =1 microm and concentrations of respirable lead particles (r = 0.82) than that between concentrations of small particles and PbA (r = 0.61). A simple linear regression indicated that PbB correlated better with respirable lead concentration (r2 = 0.35, P = 0.0001) than with PbA concentration and had a higher slope coefficient. Controlling for respirable lead concentration reduced the partial correlation coefficient between PbA concentration and PbB level from 0.56 to 0.20 (P = 0.053). The results indicate that the contribution of respirable lead particles to lead absorption would be greater than that of PbA. This study concludes that the measurement of PbA only may not properly reflect a worker's exposure to lead particles with diverse characteristics. For the evaluation of a worker's exposure to various types of lead particles, it is recommended that respirable lead particles as well as PbA be measured.

Aerosols↗
PubMed2006

Marginal zinc deficiency exacerbates bone lead accumulation and high dietary zinc attenuates lead accumulation at the expense of bone density in growing rats.

Environmental lead exposure is associated with reduced bone growth and quality, which may predispose to osteoporosis. Zinc supplementation may reduce lead accumulation; however, effects on bone development have not been addressed. Our objective was to investigate the effects of marginal zinc (MZ) and supplemental zinc (SZ) intakes on bone lead deposition and skeletal development in lead-exposed rats. In a factorial design, weanling Sprague-Dawley rats were assigned to MZ (8 mg/kg diet); zinc-adequate control (CT; 30 mg/kg); zinc-adequate, diet-restricted (DR; 30 mg/kg); or SZ (300 mg/kg) groups, with and without lead acetate-containing drinking water (200 mg Pb/l) for 3 weeks. Excised femurs were analyzed for bone mineral density (BMD) by dual-energy x-ray absorptiometry, morphometry, and mineral content. MZ had higher femur lead and lower femur zinc concentrations and impaired skeletal growth and mineralization than CT. DR inhibited growth but did not result in higher femur lead concentrations than CT. SZ had higher femur zinc and lower femur lead concentrations than the other treatments. DR and SZ had impaired BMD versus CT and MZ. Lead also retarded skeletal growth and impaired BMD, but an interaction between lead and MZ was only found for femoral knee width, which was lower in MZ exposed to lead. In summary, while MZ deficiency exacerbated bone lead concentration, it generally did not intensify lead toxicity. SZ was protective against bone lead but was detrimental to BMD, suggesting that the optimal level of SZ to reduce lead absorption, while supporting growth and bone development, requires further investigation.

Animals↗
PubMed2004

Identification of sources of lead in children in a primary zinc-lead smelter environment.

We compared high-precision lead isotopic ratios in deciduous teeth and environmental samples to evaluate sources of lead in 10 children from six houses in a primary zinc-lead smelter community at North Lake Macquarie, New South Wales, Australia. Teeth were sectioned to allow identification of lead exposure in utero and in early childhood. Blood lead levels in the children ranged from 10 to 42 micro g/dL and remained elevated for a number of years. For most children, only a small contribution to tooth lead can be attributed to gasoline and paint sources. In one child with a blood lead concentration of 19.7 microg/dL, paint could account for about 45% of lead in her blood. Comparison of isotopic ratios of tooth lead levels with those from vacuum cleaner dust, dust-fall accumulation, surface wipes, ceiling (attic) dust, and an estimation of the smelter emissions indicates that from approximately 55 to 100% of lead could be derived from the smelter. For a blood sample from another child, > 90% of lead could be derived from the smelter. We found varying amounts of in utero-derived lead in the teeth. Despite the contaminated environment and high blood lead concentrations in the children, the levels of lead in the teeth are surprisingly low compared with those measured in children from other lead mining and smelting communities.

Adolescent↗
PubMed1997

Accumulated body burden and endogenous release of lead in employees of a lead smelter.

Bone lead levels for 367 active and 14 retired lead smelter workers were measured in vivo by X-ray fluorescence in May-June 1994. The bone sites of study were the tibia and calcaneus; magnitudes of concentration were used to gauge lead body burden. Whole blood lead readings from the workers generated a cumulative blood lead index (CBLI) that approximated the level of lead exposure over time. Blood lead values for 204 of the 381 workers were gathered from workers returning from a 10-month work interruption that ended in 1991; their blood level values were compared to their tibia and calcaneus lead levels. The resulting relations allowed constraints to be placed on the endogenous release of lead from bone in smelter works. Calcaneus lead levels were found to correlate strongly with those for tibia lead, and in a manner consistent with observations from other lead industry workers. Relations between bone lead concentration and CBLI demonstrated a distinctly nonlinear appearance. When the active population was divided by date of hire, a significant difference in the bone lead-CBLI slope emerged. After a correction to include the component of CBLI existing before the workers' employment at the smelter was made, this difference persisted. This implies that the transfer of lead from blood to bone in the workers has changed over time, possibly as a consequence of varying exposure conditions.

Adult↗
PubMed1997

Lead exchange in teeth and bone--a pilot study using stable lead isotopes.

Stable lead isotopes and lead concentrations were measured in the enamel and dentine of permanent (n = 37) and deciduous teeth (n = 14) from 47 European immigrants to Australia to determine whether lead exchange occurs in teeth and how it relates to lead exchange in bone. Enamel exhibits no exchange of its European-origin lead with lead from the Australian environment. In contrast, dentine lead exchanges with Australian lead to the extent of approximately 1% per year. In one subject, trabecular bone from the tooth socket exchanged almost all its European lead with Australian lead over a a 15-year period (turnover of approximately 6% per year), similar to the approximately 8% per year proposed for lead turnover in trabecular bone. The repository characteristics of intact circumpulpal dentine were investigated by analyses of four sets of contiguous slices from six teeth: 1) a set consisting of slices with intact circumpulpal dentine and cementum; 2) a set in which these areas were removed; 3) another set consisting of slices with intact circumpulpal dentine and cementum; and 4) a set without cementum. These analyses show relatively small differences in isotopic composition between contiguous slices except that circumpulpal dentine appears to be the dominant control on lead concentration. There is a significant correlation (R2 = 0.19, p = 0.01, n = 34) of dentine lead concentration and rate of exchange with residence time from the country of origin and Australian lead, but there is no such correlation with enamel lead concentration. Analyses of permanent and deciduous teeth of subjects from other countries who have resided in Australia for varying lengths of time should resolve some of the questions arising from this pilot study.

Adult↗
PubMed1995

Survey of lead exposure around a closed lead smelter.

OBJECTIVE: To test the hypothesis that elevated lead in soil is positively correlated with blood lead (BPb) levels in children in an urban population surrounding a closed lead smelter, a US Environmental Protection Agency Superfund clean-up site was surveyed. METHOD: A total of 827 volunteers including 490 children under 6 years of age participated. A questionnaire was administered. Blood lead was determined as was lead content of samples of house dust, soil, paint, and water of the participants' homes. RESULTS: The arithmetic mean venous BPb in 490 children between 6 and 72 months of age was 6.9 micrograms/dL (0.33 mumol/L) range 0.7 to 40.2 micrograms/dL (0.03 to 1.94 mumol/L). The BPb of 78 (16%) children in this group was > or = 10 micrograms/dL (0.48 mumol/L). Based on multiple regression modeling, lead in house dust accounted for 18% of the variance in BPb. Lead in paint together with the condition of the house were the main contributors to the dust lead variance (26%) with soil lead accounting for an additional 6%. Lead in paint alone accounted for 3% of the BPb variance. Lead in paint together with the condition of the house accounted for 12% of BPb variance, and lead in soil accounted for an additional 3%. Factors other than environmental lead such as education of parents, household income, and behavior were associated with BPb levels. CONCLUSIONS: The mean BPb in children was below the present level of concern of the Centers for Disease Control and Prevention. Children with BPb of > or = 10 micrograms/L (0.48 mumol/L) tended to live in poorly maintained older houses. Based on these findings lead in soil and paint in well-maintained homes contributed little to the lead exposure of children.

Child, Preschool↗
PubMed1996

Lead levels and related biochemical findings occurring in Ghanaian subjects occupationally exposed to lead.

Blood and urine lead levels in relation to blood delta-aminolevulinic acid dehydratase (ALAD) activity and also blood and renal status were evaluated in lead smelters, automobile mechanics and gasoline retailers in the city of Accra, Ghana. Relationship between high blood lead levels (mean: 108 ug/dl) and low ALAD activity (mean: 74.3 units) indicating lead over exposure was found in the lead smelters. Non-toxic lead exposure was, however, noted in the automobile mechanics and the gasoline retailers. Their respective mean blood lead levels were 27.8 ug/dl (mean blood ALAD activity 212.5 units) and 8.6 ug/dl (ALAD: 239.9 units). Personal habits at the work place appear to play a major role in facilitating exposure to lead among all the three groups of workers in addition to lack of control measures at the work place of the lead smelters to protect them against lead exposure. Anaemia was found in 48% of the lead smelters, 12.5% of the gasoline retailers but in none of the automobile mechanics. When compared with lead free subjects (mean blood ALAD activity: 270.9 units), urine microalbumin was significantly (p < 0.01) raised in all the lead smelters suggesting that they may be prone to renal glomerular damage. Plasma creatinine, BUN and uric acid were raised in only one of the lead smelters. The data supports the establishment of blood ALAD activity level at 100 units or less as indication of excessive body lead.

Adolescent↗
PubMed2006

Detection of acute ischemia from the EASI-derived 12-lead electrocardiogram and from the 12-lead electrocardiogram acquired in clinical practice.

ST-segment measurements in the standard 12-lead electrocardiogram (ECG) of patients with acute coronary syndromes are crucial for these patients' management. Our objective was to determine whether the 12-lead ECG derived from the 3-lead EASI system can attain a level of diagnostic performance similar to that of the Mason-Likar (ML) 12-lead ECG acquired in clinical practice (CP) by paramedics and emergency department technicians. Using 120-lead body surface potential maps recorded before and during balloon inflation angioplasty from 88 patients (divided into "responders" and "nonresponders"), and electrode placement data from 60 applications of precordial leads in CP, we generated for the "nonischemic" and "ischemic" states of each patient the following lead sets: the ML 12-lead ECG, the EASI-derived 12-lead ECG, and 60 sets of 12-lead CP ECGs. We extracted ST deviations at J + 60 milliseconds, summed them for all 12 leads of each lead set to obtain SigmaST, and, by using the bootstrap method, determined the mean sensitivity and specificity for recognizing the "ischemic" state at various thresholds of SigmaST. Results were displayed as receiver operating characteristics, and the area under these curves (AUC) +/- SE was used as the measure of diagnostic performance. AUC +/- SE for all patients were ML ECG, 0.66 +/- 0.03; EASI ECG, 0.64 +/- 0.03; and CP ECG, 0.67 +/- 0.03. Corresponding results for responders only were 0.81 +/- 0.04 for ML ECG, 0.78 +/- 0.04 for EASI ECG, and 0.81 +/- 0.04 for CP ECG. The differences between the AUCs for the different lead sets were not significant (P > .05). Thus, the EASI-derived 12-lead ECG is as good for detecting acute ischemia as is the 12-lead ECG acquired in CP.

Electrocardiography↗