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Blood lead levels in children and pregnant women living near a lead-reclamation plant.

OBJECTIVE: To determine the effect of lead contamination around a lead-reclamation plant on the blood lead levels of children and pregnant women living in the area. DESIGN: Prevalence study. SETTING: Residents living 150 m or less (high-exposure area), 151 to 400 m (intermediate-exposure area) or 401 to 800 m (low-exposure area) southeast from the plant. PARTICIPANTS: All children aged 10 years or less and all pregnant women living in the designated area. OUTCOME MEASURES: Correlation of venous blood lead levels with soil lead concentrations in the areas in which the subjects lived and with sociodemographic and behavioural factors. MAIN RESULTS: Of the estimated 57 pregnant women 38 (67%) participated: 20 were in the high-exposure area and 18 in the other two areas; their geometric mean blood lead levels were low (0.15 and 0.13 mumol/L respectively). Of the 625 eligible children 510 (82%) participated: 169 were in the high-exposure area, 179 in the intermediate-exposure area and 162 in the low-exposure area; their geometric mean lead levels were 0.43, 0.30 and 0.26 mumol/L respectively. Within each age group children in the high-exposure area had the highest levels. The mean levels for children aged 6 months to 5 years were 0.49, 0.35 and 0.28 mumol/L in the three areas respectively. Within each exposure group children aged 1 to 2 years had the highest levels. No potential confounding variables could explain the relation between blood lead level and soil lead concentration. CONCLUSIONS: The pregnant women's blood lead levels did not seem to be affected by exposure level, but the children's levels were primarily related to the soil lead concentration.

Adolescent↗

In vivo bone lead measurements: a rapid monitoring method for cumulative lead exposure.

Lead concentrations (microgram/g wet weight) in human bone (tibia) were measured noninvasively in vivo employing an X-ray fluorescence technique. Forty-five workers who had been subjected to chronic industrial exposure were found to have a mean bone lead content of 52.9 micrograms/g wet weight (0 to 198 micrograms/g). In addition to bone lead content, blood lead, body burden of lead as assessed by urinary lead excretion after EDTA chelation, zinc protoporphyrin, and unstimulated urinary lead excretion were evaluated. The results suggest that the in vivo measurement of tibia lead content may serve as an acceptable indicator of body lead burden and provide a practical technique for lead screening purposes. The correlation coefficient between X-ray fluorescence findings and lead excretion following Ca-EDTA administration is 0.69; p less than 0.001.

Bone and Bones↗

Lead in cerebrospinal fluid and its relationship to plasma lead in humans.

Lead levels in whole blood, plasma and cerebrospinal fluid (CSF) were determined in 18 patients suffering from Amyotrophic Lateral Sclerosis (ALS) and in 21 subjects hospitalized for neurological investigations. No significant differences were found for blood, plasma and CSF lead concentration between the ALS group and the other patient group. The plasma lead-CSF lead mean ratio was greater than 1 in both groups, while in subjects with a slight degree of blood-CSF barrier impairment a significant decrease of the ratio was demonstrated. A significant relationship between plasma lead and CSF lead levels (r = 0.405; p less than 0.01), but not between whole blood lead and CSF lead levels, was established. Lead levels in CSF were also age-related (r = 0.485; p less than 0.05) in the group of patients not suffering from ALS. In subjects with normal blood-brain barrier permeability, lead in plasma is a good indicator of CSF lead concentration.

Adult↗

Blood lead-urine lead relationships in adults and children.

To determine the potential for using instead of blood as an indicator of lead exposure, especially in infants, lead concentrations and high-precision lead isotopic measurements have been compared in venous blood and "spot" urine (n > 260 from 182 different subjects) collected within the same 24-h period. Physiological conditions for the children and most of the adults were considered to be in a steady-state between body stores and lead in the environment. In the case of some adults, conditions were initially not steady-state because exposure conditions changed (for example, subjects moved to a country with lead of different isotopic composition.) There was a high correlation (r2 = ) between the blood and urine measurements of the isotope ratios but about 10% of measurements were outliers--the blood and urine measurements were further apart than was consistent with the measurement error that was generally obtained. The discrepancy was usually found to be associated with the urine measurement and was attributed to contamination during sampling. Weekly urine and monthly blood monitoring of an adult male over a 24-month period showed and excellent correlations, although the standard deviations were about an order of magnitude higher than the precision measured for replicate analyses of a single blood or urine sample. "Spot" urine analyses for two male subjects gave excellent agreement with 24-h urine samples. Standard deviations of the spot analyses were of similar order to those in the 24-month monitored subject. In cases where female adults from Eastern Europe migrated to Australia, there was generally a more rapid exchange of skeletal lead with Australian environmental lead in urine compared with blood. These data do not support a differential partitioning of endogenous lead into the plasma. At this stage, isotopic measurements of urine can be used as a proxy for isotopic measurements in blood. However, lead concentrations in blood and in urine are only weakly related. Concentrations of lead in urine cannot serve to predict concentrations of lead in blood, particularly at the lower range of exposures, for example, at blood concentrations less than 10 microgram/d1.

Adult↗

Lead isotopes in the western North Atlantic: transient tracers of pollutant lead inputs.

In the early 1980s, Patterson and colleagues demonstrated that most lead in oceanic surface waters had an anthropogenic origin. Their discovery occurred during the phasing out of leaded gasoline in North America initiated in the previous decade. The corresponding decrease in the anthropogenic lead emissions, verified by Pb/210Pb ratios, accounted for the systematic decline in lead concentrations in surface waters of the western Sargasso Sea. Subsequent changes in anthropogenic lead inputs to the western Sargasso Sea surface waters have been documented by measurements of lead concentrations, isotopic compositions (206Pb/207Pb, 208Pb/206Pb), and Pb/210Pb ratios in precipitation and seawater for the period of 1981 to 1994. These data indicate the easterly trade winds are now the primary source of atmospheric lead in Bermuda, and they confirm that the decline of lead concentrations in the North Atlantic is associated with the phasing out of leaded gasoline in North America and western Europe over the past decade. Moreover, temporal variations in the relative contribution of industrial lead inputs from the two sides of the North Atlantic over that period can be quantified based on differences in their isotopic composition. The transient character of those isotopic signatures also allows calculations of pollutant lead penetration rates into the mixed layer and upper thermocline of the western Sargasso Sea.

Air Pollutants↗

Impact of reduction of lead in gasoline on the blood and hair lead levels in the population of Tarragona Province, Spain, 1990-1995.

The limitation in the use of lead in Spanish gasoline has induced a resulting decrease in atmospheric lead concentrations, a remarkable reduction in the lead levels of edible vegetables, as well as a marked decrease in the dietary lead intake of the population of Tarragona Province (Catalonia, N.E. Spain). The present study evaluates the impact of such decreases on blood lead values and hair lead concentrations in an adult and children population of that region. A total of 250 adult participants between 16-65 years of age and 252 children were included in the study. Blood and hair samples were subjected to lead analyses by graphite furnace atomic absorption spectrophotometry and inductively coupled plasma spectrometry, respectively. A substantial decline in both, blood lead levels in adults (47.5%) and lead concentrations in children's hair (53%) was observed. During the period 1990-1995, blood levels were reduced from 12.0 micrograms dl-1 to 6.3 micrograms dl-1, while the hair lead concentrations decreased from 8.8 micrograms g-1 to 4.1 micrograms g-1. These decreases were noted for all the subgroups (sex, age and place of residence) examined, and were mainly attributable to the reduced leaded gasoline consumption.

Adolescent↗

Formation of leadhillite and calcium lead silicate hydrate (C-Pb-S-H) in the solidification/stabilization of lead contaminants.

In this study, we have investigated the structure of Pb-doped solidified waste forms (SWF) for assessment of lead fixation. A large quantity of lead precipitates produced during the S/S, based upon the results of cement-water solution analysis, X-ray diffraction and electron probe microanalysis/electron dispersive spectroscopy investigations, have been shown to be principally leadhillite (lead carbonate sulfate hydroxide, Pb(4)SO(4)(CO(3))(2)(OH)(2)), lead carbonate hydroxide hydrate (3PbCO(3).2Pb(OH)(2).H(2)O) and two other unidentified lead salts. In the long curing, the lead species dissolved from the lead precipitates are fixed into the cement matrix, forming a gelling calcium lead silicate hydrate during cement-based solidification. On leaching the lead precipitates such as leadhillite were markedly dissolved/released and some dissolved lead species were adsorbed to silicate-rich surface of leached SWF with the subsequent formation of mainly amorphous gel of calcium lead silicate hydrate.

Calcium↗

Comparison of the rates of exchange of lead in the blood of newly born infants and their mothers with lead from their current environment.

Newly born infants (n = 15) were monitored for 6 months after birth or for longer periods to evaluate the changes in isotopic composition and lead concentration in infants as compared with that in women from the same population groups and to determine the clearance rates of lead from blood in the infants. These data represent the first published results for serial blood sampling in a relatively large cohort of newly born infants. Blood lead concentrations decrease from the cord to samples taken at 60 to 90 days and then increase by amounts varying from negligible to 166%. In spite of concern about individual susceptibility to lead pharmacokinetics, changes in isotopic ratio followed a smooth decrease over time for 9 of the 11 infants born to migrant parents, and the patterns of variation were quite reproducible. Data for 2 of 4 infants born to multigenerational Australian parents exhibited little change in isotopic ratio over time, and in the other two cases, the changes were attributed to diet. The rate of exchange (t1/2) for the migrant infants of lead in blood derived from the mother during pregnancy and the lead from the current environment was calculated by using a linear function and ranged from 65 to 131 (91+/-19, mean+/-SD) days. The half-lives for the exchange of skeletal and environmental lead for 7 of the 8 women before significant mobilization of lead from the maternal skeleton ranged from 50 to 66 (59+/-6) days. One explanation for the longer half-lives for infants as compared with the mothers may be the proportionally higher contribution of current environmental (Australian) lead in the infants at parturition. Exchanges of lead in infants are more complex than for the adults, reflecting inputs from sources such as maternal skeletal lead during breast feeding.

Adolescent↗

Living in a sea of lead--changes in blood- and hand-lead of infants living near a smelter.

Thirteen infants born into the lead contaminated environment of Port Pirie, South Australia, were followed approximately monthly from birth until they were about 36 months. Blood-lead levels of infants at birth were similar to their mothers but fell rapidly during the first 35 days of life. Thereafter, infants born with blood-lead levels at about 2-4 microg/dl began a slow linear increase until 14-18 months where a plateau occurred of 10.8-17.2 microg/dl. The blood-lead levels were well correlated with hand-lead loadings of infant (r(2)=0.72, P<0.01, log transformed data) and mother (r(2)=0.62, P<0.01, log transformed data) unless the birth lead level was exceptionally high. The principle factor determining exposure was the impact of smelter emissions on the house. Blood-lead increase was caused by the relatively more rapid increase in dose of lead compared with the increasing body mass, which was related directly to the maturation of motor development. Hand-lead of mothers were closely related to both infants' blood- and hand-lead levels until the point of blood-lead plateau then substantially fell as infants began to walk unaided. The estimated slope factor using the ICRP model was 0.75-0.94 microg/dl per microg/day with a maximum daily dose of 3-5 microg/kg/day, assuming 45% absorption. Ingestion appears to be the most likely route for at least 95% of the dose.

Environmental Monitoring↗

Impact of soil and dust lead on children's blood lead in contaminated areas of Sweden.

The impact of lead in soil and dust on blood lead concentrations in young children (i.e., 1-5 y of age, N = 202) and the risk of health effects were investigated in an urban and a mining area of Sweden. Blood, soil, and indoor dust, as well as information on lead-exposure factors, were collected. The blood lead concentrations (total range = 9-77 microg/l) the authors measured indicated a low risk for lead-induced health effects. Lead in soil (i.e., < 10-5,000 microg/g) and in dust (i.e., < 1-316 microg/g) had little effect on blood lead concentrations, given the present conditions and present concentration range--especially in the mining area. Urban children had significantly higher blood lead concentrations than children in the mining area, despite higher concentrations of lead in soil in the mining area. In the urban children, blood lead concentrations were influenced by parental smoking and lead in dust at day-care centers.

Air Pollutants↗

Dental lead, blood lead, and pica in urban children.

Lead storage in teeth was evaluated by examining the lead concentration in deciduous teeth of 32 children whose habits of pica and state of lead exposure had been studied when they were between 1 and 3 years of age. Concentratios of lead in their teeth depended on the reported amount of paint or plaster intake and the duration of exposure. The mean dental concentration of lead in exposed children was significantly higher than the mean value in 36 controls, who presumably did not have undue exposure to lead. A difference in dental lead concentration related to living area was noted. The significant difference in lead content of teeth between the two groups, even though the concentrations of lead in blood at 8 years of age were similar, emphasizes the importance of dental lead measurments for retrospective studies of lead exposure.

Calcium Sulfate↗

X-ray fluorescence measurements of lead burden in subjects with low-level community lead exposure.

A k-x-ray fluorescence (K-XRF) instrument that can measure in vivo bone lead at low levels was used on a population of 34 adults with no known history of excessive lead exposure. A questionnaire that gathered information relevant to occupational and environmental lead exposure was administered prior to the measurement. A 30-min measurement that produced an average estimated uncertainty of 6 mcg lead/g bone mineral was taken at the mid-tibial diaphysis for each subject. Eighteen subjects had bone lead levels below the measurement uncertainty. The remainder had bone lead levels ranging up to 21 mcg lead/g bone mineral. Bone lead levels were greater among older subjects. Among young adult subjects, bone lead levels greater than the measurement uncertainty were confined entirely to subjects who had grown up in housing that was estimated to have been build prior to 1955. Such a childhood environment is at high risk of fostering exposure to biologically absorbable lead through ingestion of lead paint-contaminated dust and lead pipe-contaminated water. We conclude that the K-XRF technique has the potential to distinguish between low levels of lead burden in epidemiologic studies.

Adult↗

Weight loss alters organ concentrations and contents of lead and some essential divalent metals in rats previously exposed to lead.

The loss of adipose tissue during energy restriction may be accompanied by a loss of lean body mass, including bone mass. Because most of the body lead burden is in the skeleton, we studied the effects of weight loss on the concentrations of lead in bone, blood and several organs in rats with prior but not current lead exposure. Concentrations of the essential divalent metals calcium, copper, iron, magnesium and zinc were also determined for comparison with lead. Lead-exposed rats (n = 25) were randomly assigned to one of three treatment groups: weight maintenance (WM), moderate weight loss (MWL) or substantial weight loss (SWL). For the two last-named groups, food intake was restricted for 4 wk to 70 and 40% of that of the WM group. Lead concentrations did not differ significantly (ANOVA, P > 0.05) among the three groups for blood, brain and bone. Significantly higher liver lead concentrations were observed in the SWL rats than in the WM and MWL groups. In general, organ concentrations of calcium, copper, magnesium and zinc were either lower or did not differ in the groups losing weight compared with the WM group. In contrast, organ Iron concentrations of the SWL group were higher than those of the other groups except in brain where there were no significant differences. The total liver content of lead was highest in the SWL group, but the lead content of other organs did not differ among the treatment groups. The contents of calcium, copper, magnesium and zinc generally were lower in the MWL and SWL groups than in the WM group in the liver and some of the other organs. The results demonstrate that weight loss can increase the quantity and concentration of lead in the liver, even in the absence of continued lead exposure. The data also demonstrate considerable differences among organ divalent metals in response to weight loss.

Analysis of Variance↗

Associations of lead exposure and dose measures with erythrocyte protein kinase C activity in 212 current Korean lead workers.

Lead can replace calcium in enzyme assays that measure protein kinase C activity and lead activates protein kinase C in human erythrocytes after exposure to lead in vitro. To examine the relevance of these observations to lead exposure in humans, we studied the associations of lead found in blood or tibia with activation of protein kinase C in erythrocytes isolated from workers in the lead industry. We examined erythrocytes among 212 lead workers, with a mean (+/-SD) age of 39.1 (10.0) years and exposure duration of 8.1 (6.5) years and measured protein kinase C activation by an in vitro back-phosphorylation assay. After adjustment for potential confounding factors (age and sex), tibia lead and exposure duration were significantly associated with erythrocyte protein kinase C activation (both p values < 0.05). No associations were observed between protein kinase C activation and blood-lead or zinc-protoporphyrin levels. These findings suggest that human exposure to lead results in activation of erythrocyte protein kinase C, which may be directly relevant to the neurotoxicity of lead.

Adult↗

Effects of tap water lead, water hardness, alcohol, and cigarettes on blood lead concentrations.

A survey of middle-aged men in 24 British towns has found pronounced geographical variation in blood lead concentrations. Towns with the highest mean blood lead concentrations have soft water supplies and have the highest water lead concentrations. Individual blood lead can be considerably increased by raised household tap water lead concentrations. Mean blood lead is estimated to be 43% higher for men when the concentration of lead in first-draw domestic tap water is 100 micrograms/l compared with a zero concentration. Individual blood lead is also affected by alcohol consumption and cigarette smoking, such that on average these two life-style habits together contribute an estimated 17% to the blood concentration of lead in middle-aged men. Lead in water should be given greater priority in any national campaign to reduce lead exposure.

Adult↗

Reduction in exposure to lead from drinking water and its effect on blood lead concentrations.

The water supply in Ayr (Scotland, UK) was plumbosolvent and many dwellings in Ayr contained lead pipes. In 1981 treatment of the water supply to reduce its plumbosolvency was initiated. Measurements of water and blood lead concentrations were made before and subsequent to the treatment. Most of the measurements made before and after water treatment began were made on water samples from the same dwellings and blood samples from the same women. Water treatment produced a sharp fall in water lead concentrations and a decrease in the median blood lead concentration from 21 to 13 micrograms/100 ml. Two women had higher than expected blood lead concentrations, both these women had been removing old paint. Women who had lead pipes removed from their dwellings all showed substantial decreases in their blood lead concentrations. The curvilinearity of the relation between blood lead and water lead concentrations is confirmed. Even relatively low (less than 40 micrograms/l) water lead concentrations may make a substantial contribution to blood lead concentrations.

Adult↗

Protein kinase C activity and the relations between blood lead and neurobehavioral function in lead workers.

At picomolar concentrations, lead activates protein kinase C (PKC). This activation has been implicated in the neurotoxicity of lead. No prior study has evaluated the association of PKC activity with neurobehavioral function in humans. The purpose of this study was to determine whether PKC activity is associated with neurobehavioral function or modifies the relationship between blood lead levels and neurobehavioral test scores. In this cross-sectional study of 212 current lead workers in the Republic of Korea, we assessed blood lead levels, neurobehavioral test scores, and PKC activity. PKC activity was determined by measuring the levels of phosphorylation of three erythrocyte membrane proteins (spectrin and the 52-kDa and 48-kDa subunits of band 4.9), using an in vitro back-phosphorylation assay. When linear regression was used to control for confounding variables, blood lead was a significant predictor of decrements in performance on tests of psychomotor function, manual dexterity, and executive ability. In linear regression models, back-phosphorylation levels were not associated with neurobehavioral test scores, but when dichotomized at the median, back-phosphorylation levels modified the relationship between blood lead and test scores. For spectrin and the 52-kDa and 48-kDa subunits of band 4.9, 5, 2, and 5 of 14 interaction terms, respectively, had associated p-values less than 0.10, all with positive signs, indicating that blood lead was associated with worse test scores only in subjects with lower back-phosphorylation levels. These data indicate that blood lead levels are associated with decrements in neurobehavioral test scores, mainly in the domains of manual dexterity and psychomotor function, but only in subjects with lower in vitro back-phosphorylation levels, which is equivalent to higher in vivo PKC activity. We hypothesize that subjects with higher PKC activity in the presence of lead may be more susceptible to the health effects of lead.

Adult↗

Chemical speciation of lead dust associated with primary lead smelting.

The research presented in this article assessed geochemical factors relating to dust produced during primary lead smelting. Bulk dust samples and size-selective airborne dust samples were collected from four areas of a primary lead smelter and analyzed by X-ray diffraction and sequential chemical extraction. X-ray diffraction showed that the smelter dusts were composed primarily of sulfides, oxides, sulfates, and silicates of metal ores, with galena being the primary dust component. Sequential extraction revealed the solubility of lead compounds at less than 7% in the exchangeable and mildly acidic steps for the bulk dusts collected from four smelter areas. The later steps of the extraction procedure were more effective in dissolving the lead compounds associated with the bulk dust samples, with 43%, 26%, and 8% of the total lead, in the ore storage, sinter, and blast/dross smelter areas, respectively, being extracted in the residual step. Sequential extraction of coarse airborne dust samples from the ore storage and sinter plant showed that 1.2% and 4.1% of the total lead, respectively, was exchangeable. The finer particle size fractions from these areas of the smelter showed higher percentages of exchangeable lead. Of the course airborne dust from the blast/dross furnace processes, 65% of the total lead was exchangeable. However, the largest percentage of lead from these areas was associated with the finer particle-size fractions. If lead bioavailability is related to its solubility as determined through sequential extraction, the health hazards associated with lead exposure may be appreciably enhanced in the blast and dross furnace processes.

Air Pollutants, Occupational↗