A study of the relationship between ambient lead and blood lead among lead battery workers

The Relationships Between Blood Pb Levels and Blood Pressure Among Lead-Exposed Workers in China: A Repeated-Measure Study

OBJECTIVES

To explore the differences in the increase of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in 3 consecutive years among lead (Pb) workers.

METHODS

Four hundred forty-eight Pb workers were enrolled in this repeated-measure study. Blood Pb, SBP, and DBP were measured in 2015 to 2017. Repeated measure of analysis of variance was used to compare the differences in the increase of SBP and DBP.

RESULTS

The mean SBP values were 124.0/125.5/126.9 mm Hg, and the mean DBP values were 75.4/77.4/77.8 mm Hg from 2015 to 2017. The differences in the increase of SBP and DBP were 2.94/2.42 mm Hg during the 3-year period. The average annual increase of SBP or DBP showed an upward trend in different Pb dose groups ( F = 4.904, P = 0.002; F = 3.612, P = 0.013).

CONCLUSIONS

Lead exposure caused average annual increases in SBP and DBP with 0.98 and 0.81 mm Hg, which provided basic data for health surveillance.

Reducing occupational lead exposures: Strengthened standards for a healthy workforce

Outdated federal and state occupational lead standards leave workers and their families vulnerable to the adverse effects of lead. Standards should be updated to reflect the best available scientific and medical evidence, which documents harm to multiple organ systems even at low levels of exposure. This commentary will review the inadequacies of existing policies, highlight susceptible populations, and briefly summarize state revision efforts to date. Federal policies must be strengthened to protect all workers and their families from this well-documented hazard.

Blood pressure and occupational exposure to noise and lead (Pb): A cross-sectional study

Several studies have explored the hypothesis that low blood lead (PbB) and high noise levels may be associated with an increased risk of hypertension. To assess the possible relationship between occupational exposure to lead (Pb) and noise and elevated blood pressure, we studied 105 workers (age: 41.27 ± 6.25 years and length of employment: 4.12 ± 5.33 years) employed in a Pb battery recycling plant by measuring A-weighted equivalent sound level, PbB, δ-aminolevulinic acid dehydratase (ALAD) activity and zinc protoporphyrin (ZPP) levels and systolic and diastolic blood pressure (SBP and DBP). Results showed that occupational exposure to higher ambient Pb and noise levels was related to slightly increased SBP and DBP. PbB values correlated significantly with SBP and DBP, whereas noise levels correlated neither with SBP nor with DBP. Furthermore, workers exposed to higher ambient Pb had higher PbB and ZPP and showed more decreased ALAD activity. Blood pressure does not correlate with noise exposure but only with PbB concentration.

An examination of blood lead levels in thai nielloware workers

Objectives

The objectives of this study were to determine the lead levels in blood samples from nielloware workers, to determine airborne lead levels, to describe the workers' hygiene behaviors, and to ascertain and describe any correlations between lead levels in blood samples and lead levels in airborne samples.

Methods

Blood samples and airborne samples from 45 nielloware workers were collected from nielloware workplaces in Nakhon Sri Thammarat Province, Thailand. Lead levels were determined by flame atomic absorption spectrometry (FAAS), at a wavelength of 283.3 nm. FAAS was used especially adequate for metals at relatively high concentration levels.

Results

The geometric mean of the 45 airborne lead levels was 81.14 µg/m³ (range 9.0-677.2 µg/m³). The geometric mean blood lead level of the 45 workers was 16.25 µg/dL (range 4.59-39.33 µg/dL). No worker had a blood lead level > 60 µg/dL. A statistically significantly positive correlation was found between airborne lead level and blood lead levels (r = 0.747, p < 0.01). It was observed that personal hygiene was poor; workers smoked and did not wash their hands before drinking or eating. It was concluded that these behaviors had a significant correlation with blood lead levels (p < 0.001).

Conclusion

Improvements in working conditions and occupational health education are required due to the correlation found between blood leads and airborne lead levels.

Review: Lead exposure in battery manufacturing and recycling in developing countries and among children in nearby communities

The battery industry is the largest consumer of lead, using an estimated 80% of the global lead production. The industry is also rapidly expanding in emerging market countries. A review of published literature on exposures from lead-acid battery manufacturing and recycling plants in developing countries was conducted. The review included studies from 37 countries published from 1993 to 2010 and excluded facilities in developed countries, such as the United States and those in Western Europe, except for providing comparisons to reported findings. The average worker blood lead level (BLL) in developing countries was 47 μg/dL in battery manufacturing plants and 64 μg/dL in recycling facilities. Airborne lead concentrations reported in battery plants in developing countries averaged 367 μg/m3, which is 7-fold greater than the U.S. Occupational Safety and Health Administration's 50 μg/m3 permissible exposure limit. The geometric mean BLL of children residing near battery plants in developing countries was 19 μg/dL, which is about 13-fold greater than the levels observed among children in the United States. The blood lead and airborne lead exposure concentrations for battery workers were substantially higher in developing countries than in the United States. This disparity may worsen due to rapid growth in lead-acid battery manufacturing and recycling operations worldwide. Given the lack of regulatory and enforcement capacity in most developing countries, third-party certification programs may be the only viable option to improve conditions.

Personal exposure, behavior, and work site conditions as determinants of blood lead among bridge painters

Bridge painters are exposed to lead during several job tasks performed during the workday, such as sanding, scraping, and blasting. After the Occupational Safety and Health Administration standard was passed in 1993 to control lead exposures among construction workers including bridge painters, this study was conducted among 84 bridge painters in the New England area to determine the significant predictors of blood lead levels. Lead was measured in personal air and hand wipe samples that were collected during the 2-week study period and in blood samples that were collected at the beginning and at the end of the study period. The personal air and hand wipe data as well as personal behaviors (i.e., smoking, washing, wearing a respirator) and work site conditions were analyzed as potential determinants of blood lead levels using linear mixed effects models. Our results show that the mean air lead levels over the 2-week period were the most predictive exposure measure of blood lead levels. Other individual-level significant predictors of blood lead levels included months worked on bridge painting crews, education, and personal hygiene index. Of the site-level variables investigated, having a containment facility on site was a significant predictor of blood lead levels. Our results also indicate that hand wipe lead levels were significantly associated with higher blood lead levels at the end of the study period compared with the beginning of the study period. Similarly, smoking on site and respirator fit testing were significantly associated with higher blood lead levels at the end of the study period. This study shows that several individual-level and site-level factors are associated with blood lead levels among bridge painters, including lead exposure through inhalation and possible hand-to-mouth contact, personal behaviors such as smoking on site, respirator fit testing, and work site conditions such as the use of better containment facilities. Accordingly, reduction in blood lead levels among bridge painters can be achieved by improving these workplace practices.

Lead exposure study among workers in lead acid battery repair units of transport service enterprises, Addis Ababa, Ethiopia: a cross-sectional study

BACKGROUND

Lead exposure is common in automobile battery manufacture and repair, radiator repair, secondary smelters and welding units. Urinary Aminolevulinic acid has validity as a surrogate measure of blood lead level among workers occupationally exposed to lead. This study had therefore assessed the magnitude of lead exposure in battery repair workers of three transport service enterprises.

METHODS

To this effect, a cross-sectional study was carried out on lead exposure among storage battery repair workers between November 2004 and May 2005 from Anbasa, Comet and Walia transport service enterprises, Addis Ababa, Ethiopia. Subjective information from the workers was obtained by making use of structured questionnaire. Other information was obtained from walkthrough evaluation of the repair units. Aminolevulinic acid levels in urine were used as an index of the exposure. This was coupled to measurements of other relevant parameters in blood and urine collected from adult subjects working in the repair units as well as age matched control subjects that were not occupationally exposed to lead. Aminolevulinic acid was determined by spectrophotometry, while creatinine clearance, serum creatinine, urea and uric acid levels were determined using AMS Autolab analyzer.

RESULTS

Urinary aminolevulinic acid levels were found to be significantly higher in exposed group (16 mug/ml +/- 2.0) compared to the non-exposed ones (7 mug/ml +/- 1.0) (p < 0.001). Alcohol taking exposed subjects exhibited a significant increase in urinary aminolevulinic acid levels than non-alcohol taking ones (p < 0.05). Moreover, urinary aminolevulinic acid levels of exposed subjects increased with age (p < 0.001) as well as duration of employment (p < 0.001). Whereas serum uric acid levels of exposed subjects was significantly higher than non-exposed ones (p < 0.05), no statistically significant difference had been found in renal indices and other measured parameters between exposed and non-exposed subjects. From the questionnaire responses and walkthrough observations, it was also known that all the repair units did not implement effective preventive and control measures for workplace lead exposure.

CONCLUSION

Taken together, these findings indicated that workers in lead acid battery repair units of the transport service enterprises are not protected from possibly high lead exposure. Thus, strict enforcement of appropriate and cost effective preventive and control measures is required by all the enterprises.

Relationship of blood lead levels to blood pressure in exhaust battery storage workers

Several researches has focused the hypothesis that low blood lead levels could be associated with an increased risk of hypertension. To assess the relation between occupational lead exposure and elevated blood pressure a group of 27 workers, age range from 27 to 62 years, mean (SD) 36.52 (+/- 8.16) yr; length of employment mean (DS) 2.97 (+/- 1.67) yr, were recruited as study subjects. The following variables were measured: blood lead concentration (BPb), delta-Aminolevulinic Acid Dehydratase (ALAD) activity, Zinc Protoporphirin (ZPP), creatinine, hematocrit, Body Mass Index (BMI) and Systolic Blood Pressure (SBP) and Diastolic Blood (DBP) Pressure. The results showed that long term occupational exposure was related to a slight increase of systolic and diastolic blood pressure among workers who had been exposed to higher level of lead with respect to workers exposed to lower level of lead. Furthermore, blood lead concentration (BPb) and ZPP resulted higher among workers exposed to higher level of ambient lead, while in the same group of workers ALAD activity resulted more inhibited. The authors concluded long term cumulative lead exposure can significantly increase blood pressure in low level Pb exposed workers.

Neurobehavioral changes in Taiwanese lead-exposed workers

OBJECTIVE

The dysfunction of the central nervous system (CNS) caused by lead exposure was evaluated.

METHODS

Workers who have been exposed to lead for at least 3 years and have been informed of having elevated blood lead levels (BLLs) were recruited. According to their current BLLs, 33 and 28 males were assigned to the medium (40-80 microg/dL) and low (<40 microg/dL) BLLs groups, respectively. Sixty-two nonexposed healthy men served as the control group. Their neurobehaviors were examined by a computerized evaluation system.

RESULTS

Significantly impaired neurobehavioral functions were shown in the medium BLLs group, which included slow performance of psychomotor tasks, impaired processing of visual-spatial information, reduced memory and learning functions, low performance accuracy, slow execution of responses, and poor attentional control.

CONCLUSIONS

Subtle CNS dysfunction could be detected from lead-exposed workers who have no obvious neurologic and cognitive deficits.

Lead exposure in Mexican radiator repair workers

BACKGROUND

Lead exposure was investigated among 73 Mexican radiator repair workers (RRWs), 12 members of their family (4 children and 8 wives), and 36 working controls. RRWs were employed at 4 radiator repair shops in Mexico City and 27 shops in Cuernavaca and surrounding areas.

METHODS

Exposure was assessed directly through the use of personal air sampling and hand wipe samples. In addition, industrial hygiene inspections were performed and detailed questionnaires were administered. Blood lead levels were measured by graphite furnace atomic absorption spectroscopy (AAS).

RESULTS

The mean (SD) values for blood lead of the RRWs, 35.5 (13.5) microg/dl, was significantly greater than the same values for the working controls, 13.6 (8.7) microg/dl; P < 001. After excluding a single outlier (247 microg/m(3)), air lead levels ranged from 0 to 99 microg/m(3) with a mean (SD) value of 19 (23) microg/m(3) (median = 7.9 microg/m(3)). In a final multivariate regression model of elevated blood lead levels, the strongest predictors were smoking (vs. non-smoking), the number of radiators repaired per day on average, and the use (vs. non-use) of a uniform while at work, which were associated with blood lead elevations of 11.4 microg/dl, 1.95 microg/dl/radiator/day, and 16.4 microg/dl, respectively (all P <.05). Uniform use was probably a risk factor because they were not laundered regularly and consequently served as reservoir of contamination on which RRWs frequently wiped their hands.

CONCLUSIONS

Lead exposure is a significant problem of radiator repair work, a small industry that is abundant in Mexico and other developing countries.

Using structural equation model to explore occupational lead exposure pathways

The aim of the present study was to demonstrate the use of a structural equation model to explore the complicated lead exposure pathways in a lead battery plant. A total of 96 out of 113 assembly workers were recruited in this study. Lead measurements included blood lead, respirable airborne lead, and body surface lead loadings. Latent variables of inadvertent contact of lead on fingers and ingested lead had indirect and direct effects on the blood lead levels, respectively, and so did the variables of respirable airborne lead, smoking, and the working-place clothes being washed. A model chi(22)2 value of 31.1 (P=0.094) for a goodness of fit test indicates that the derived structural equation model appropriately accounted for the variation of blood lead levels. It is concluded that lead loadings on fingers and lips had significant effects on occupational lead uptake, and, after-work hours and break times at work were the critical time periods for inadvertent lead exposure.