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Farmer JG, Specht A, Punshon T, Jackson BP, Bidlack FB, Bakalar CA, Mukherjee R, Davis M, Steadman DW, Weisskopf MG. Lead exposure across the life course and age at death. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 927:171975. [PMID: 38547974 PMCID: PMC11069331 DOI: 10.1016/j.scitotenv.2024.171975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Lead (Pb) exposure has been associated with an increased risk of all-cause mortality, even at low levels. Little is known about how the timing of Pb exposure throughout life may influence these relationships. Quantifying the amount of Pb present in various tissues of the body provides measurements of exposure from different periods of life. These include bone, tooth enamel, which is the hard outer layer of the crown, and tooth cementum, which is the calcified connective tissue covering the tooth root. The purpose of the study was to examine Pb exposure at multiple periods throughout life, including childhood (enamel), adulthood (cementum), and later life (bone), and to estimate their associations with age at death. METHODS 208 skeleton donors (born 1910-1960) from an ongoing case-control study were included in this study. Pb was measured in tibia (shin), bone using X-Ray Florescence and in teeth using Laser-Ablation Inductively Coupled Plasma Mass Spectroscopy. After excluding unusually high measurements (>2sd), this resulted in a final sample of 111 with all exposure measures. Correlations across measures were determined using partial Spearman correlations. Associations between Pb exposure and age at death were estimated using Multivariable Linear Regression. RESULTS Pb measures across exposure periods were all significantly correlated, with the highest correlation between cementum and tibia measures (r = 0.61). Donors were largely female (63.0 %), White (97.3 %), and attended some college (49.5 %). Single exposure models found that higher tooth cementum Pb (-1.27; 95 % CI: -2.48, -0.06) and tibia bone Pb (-0.91; 95 % CI: -1.67, -0.15) were significantly associated with an earlier age at death. When considered simultaneously, only cementum Pb remained significant (-1.51; 95 % CI: -2.92, -0.11). Secondary analyses suggest that the outer cementum Pb may be especially associated with an earlier age at death. CONCLUSION Results suggest that higher Pb exposure is associated with an earlier age at death, with adulthood as the life period of most relevance. Additional studies using Pb exposure measures from different life stages should be conducted.
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Affiliation(s)
- Justin G Farmer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States.
| | - Aaron Specht
- School of Health Sciences, Purdue University, 550 W Stadium Ave, West Lafayette, IN, United States
| | - Tracy Punshon
- Department of Biological Sciences, Dartmouth College, Hanover, NH, United States
| | - Brian P Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, United States
| | | | - Charlotte A Bakalar
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States
| | - Rajarshi Mukherjee
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States
| | - Mary Davis
- Department of Anthropology, University of Tennessee Knoxville, 1621 Cumberland Avenue, Knoxville, TN, United States
| | - Dawnie W Steadman
- Department of Anthropology, University of Tennessee Knoxville, 1621 Cumberland Avenue, Knoxville, TN, United States
| | - Marc G Weisskopf
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA, United States
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Cassidy-Bushrow AE, Wu KHH, Sitarik AR, Park SK, Bielak LF, Austin C, Gennings C, Curtin P, Johnson CC, Arora M. In utero metal exposures measured in deciduous teeth and birth outcomes in a racially-diverse urban cohort. ENVIRONMENTAL RESEARCH 2019; 171:444-451. [PMID: 30735952 PMCID: PMC6402585 DOI: 10.1016/j.envres.2019.01.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 05/20/2023]
Abstract
A growing number of studies have examined associations of metal exposures with birth outcomes, however, results from these studies have been inconsistent, and hampered by methodological limitations. We measured direct fetal exposure to three metals (lead, manganese and zinc) during the second and third trimester and examined its association with birth weight and gestational age at delivery. Participants in the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS), a population-based birth cohort established between September 2003 and December 2007, were invited to donate teeth to the study. Lead, manganese and zinc during the second and third trimesters were measured via high-resolution microspatial mapping of dentin growth rings, a validated biomarker for prenatal metal exposure. Gestational age at delivery and infant birth weight were obtained from the delivery medical record. A total of 145 children had tooth metal measurements and birth outcome data. Mean birth weight was 3431 ± 472 g and mean gestational age at delivery was 39.0 ± 1.3 weeks. Overall, there was a positive association between second (β = 0.21, 95% CI: 0.05, 0.37, P = 0.01) and third trimester (β = 0.21, 95% CI: 0.05, 0.37, P = 0.01) tooth manganese and birth weight Z-score; this remained statistically significant after covariate adjustment. There was also a negative association between second trimester tooth lead level and birth weight Z-score (β = -0.20, 95% CI: -0.38, -0.02, P = 0.02), however, this was attenuated after adjusting for covariates. Mixture analysis revealed similar findings. There was evidence for a sex-specific effect of manganese with birth weight Z-score, with the association stronger in female compared to male infants. Overall, we found evidence suggesting that higher in utero manganese is associated with larger birth weight Z-scores and that these associations may vary by infant sex.
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Affiliation(s)
- Andrea E Cassidy-Bushrow
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA; Center for Urban Responses to Environmental Stressors (CURES), Wayne State University, Detroit, MI, USA.
| | - Kuan-Han Hank Wu
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA
| | - Alexandra R Sitarik
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA
| | - Sung Kyun Park
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA; Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Lawrence F Bielak
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Christine Austin
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Division of Environmental Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Chris Gennings
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Division of Environmental Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Paul Curtin
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Division of Environmental Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Christine Cole Johnson
- Department of Public Health Sciences, Henry Ford Hospital, One Ford Place, Detroit, MI, USA; Center for Urban Responses to Environmental Stressors (CURES), Wayne State University, Detroit, MI, USA
| | - Manish Arora
- Senator Frank R Lautenberg Environmental Health Sciences Laboratory, Department of Environmental Medicine and Public Health, Division of Environmental Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
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de Oliveira VLF, Gerlach RF, Martins LC, de Souza Guerra C, Frazão P, Braga ALF, Pereira LAA. Dental enamel as biomarker for environmental contaminants in relevant industrialized estuary areas in São Paulo, Brazil. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:14080-14090. [PMID: 28411314 DOI: 10.1007/s11356-017-8878-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 03/20/2017] [Indexed: 06/07/2023]
Abstract
Heavy metal contamination is a long-standing and very well-known public health problem, and its exposure can cause damage to several organs of human body, especially on the central nervous system of young children and teenagers. The aim of this article is to evaluate lead, cadmium, and manganese contamination in 125 children from 6 to 13 years old living in contaminated areas during the period from 2006 to 2009 (São Vicente, Cubatão Downtown, Bertioga and Cubatão Pilões/Água Fria). This estuary area is the most important example of environmental degradation by chemicals from industrial sources. This is a cross-sectional study through clinical examinations and dental enamel tests. All mothers from these children lived in the area since before the pregnancy. Lead, cadmium, and manganese levels (μg/g) were measured on dental enamel samples through graphite furnace atomic absorption spectrometry, searching for the occurrence of heavy metals. The mean lead concentrations were 139.48 μg/g in Cubatão Pilões/Água Fria, 170.45 μg/g in Cubatão Downtown, 213.52 μg/g in São Vicente, and 151.89 μg/g in Bertioga. The mean cadmium concentrations were 10.83 μg/g in Cubatão Pilões/Água Fria, 12.58 μg/g in Cubatão Downtown, 10.92 μg/g in São Vicente, and 14.57 μg/g in Bertioga. The mean manganese concentrations were 23.49 μg/g in Cubatão Pilões/Água Fria, 30.90 μg/g in Cubatão Downtown, 41.46 μg/g in São Vicente, and 42.00 μg/g in Bertioga. Dental surface enamel may be used as an efficient biomarker of past environmental exposure to lead, manganese, and cadmium which are associated to well-known sources of heavy metal contamination. The results suggest that the evaluated children were exposed to sources of lead, cadmium, and manganese since before their conceptions. Although Bertioga initially was chosen as a control area of this study, it was also was verified to have heavy metal contamination on examined children.
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Affiliation(s)
- Vera Lucia Ferreira de Oliveira
- Unisanta (University Santa Cecília-Santos-SP-Brazil), São Paulo, Brazil.
- Department of Pathology of the Science Medical Faculty of São Paulo-Brazil, Washington Luiz 552 #501, São Paulo, Gonzaga Santos, 11055-000, Brazil.
| | | | - Lourdes Conceição Martins
- University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Unisantos (Catholic University of Santos-SP-Brazil), São Paulo, Brazil
| | - Carolina de Souza Guerra
- University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Unisantos (Catholic University of Santos-SP-Brazil), São Paulo, Brazil
| | - Paulo Frazão
- University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alfésio Luis Ferreira Braga
- University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Unisantos (Catholic University of Santos-SP-Brazil), São Paulo, Brazil
| | - Luiz Alberto Amador Pereira
- University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Unisantos (Catholic University of Santos-SP-Brazil), São Paulo, Brazil
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Lim S, Ha M, Hwang SS, Son M, Kwon HJ. Disparities in Children's Blood Lead and Mercury Levels According to Community and Individual Socioeconomic Positions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:6232-48. [PMID: 26035667 PMCID: PMC4483698 DOI: 10.3390/ijerph120606232] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/07/2015] [Accepted: 05/25/2015] [Indexed: 11/16/2022]
Abstract
We aimed to examine the associations between blood lead and mercury levels and individual and community level socioeconomic positions (SEPs) in school-aged children. A longitudinal cohort study was performed in 33 elementary schools in 10 cities in Korea. Among a total of 6094 children included at baseline, the final study population, 2281 children followed-up biennially, were analyzed. The geometric mean (GM) levels of blood lead were 1.73 μg/dL (range 0.02–9.26) and 1.56 μg/dL (range 0.02–6.83) for male and female children, respectively. The blood lead levels were significantly higher in males, children living in rural areas, and those with lower individual SEP. The GM levels of blood mercury were 2.07 μg/L (range 0.09–12.67) and 2.06 μg/L (range 0.03–11.74) for males and females, respectively. Increased blood mercury levels were significantly associated with urban areas, higher individual SEP, and more deprived communities. The risk of high blood lead level was significantly higher for the lower individual SEP (odds ratio (OR) 2.18, 95% confidence interval (CI) 1.36–3.50 in the lowest educational attainment of the father), with a significant dose-response relationship observed after adjusting for the community SEP. The association between high blood lead levels and lower individual SEP was much stronger in the more deprived communities (OR 2.88, 95% CI 1.27–6.53) than in the less deprived communities (OR 1.40, 95% CI 0.76–2.59), and showed a significant decreasing trend during the follow-up only in the less deprived communities. The risk of high blood mercury levels was higher in higher individual SEP (OR 0.64, 95% CI 0.40–1.03 in the lowest educational attainment of the father), with a significant dose-response relationship noted. Significant decreasing trends were observed during the follow-up both in the less and more deprived communities. From a public health point-of-view, community level intervention with different approaches for different metals is warranted to protect children from environmental exposure.
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Affiliation(s)
- Sinye Lim
- Department of Occupational and Environmental Medicine, Kyung Hee University Hospital, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul 130-872, Korea.
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-Ro, Dongnam-Gu, Cheonan, Chungnam 330-714, Korea.
| | - Seung-Sik Hwang
- Department of Social Medicine, Inha University School of Medicine, 366 Seohae-Daero, Jung-Gu, Incheon 400-712, Korea.
| | - Mia Son
- Department of Preventive Medicine, Kangwon National University School of Medicine, 1, Gangwondaehak-Gil, Chuncheon, Gangwon 200-701, Korea.
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-Ro, Dongnam-Gu, Cheonan, Chungnam 330-714, Korea.
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Abstract
PURPOSE OF REVIEW Accurate prenatal exposure assessment is one of the major challenges in environmental epidemiologic studies. Variations in placental transport make maternal biospecimens unreliable for many chemicals and fetal specimens collected at birth do not provide information on exposure timing over the prenatal period. RECENT FINDINGS The skeletal compartment is an important chemical repository, making calcified tissues important for measuring exposure. For decades teeth have been used to estimate long-term cumulative exposure to metals and some organic chemicals. Recently developed methodologies that combine sophisticated histological and chemical analysis to precisely sample tooth layers that correspond to specific life stages have the potential to reconstruct exposure in the second and third trimesters of prenatal development and during early childhood. SUMMARY Such a retrospective biomarker that precisely measures exposure intensity and timing during prenatal development would substantially aid epidemiologic investigations, particularly case-control studies of rare health outcomes.
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Abstract
Chronic kidney disease may be stimulated by many different etiologies, but its progression involves a common, yet complex, series of events that lead to the replacement of normal tissue with scar. These events include altered physiology within the kidney leading to abnormal hemodynamics, chronic hypoxia, inflammation, cellular dysfunction, and activation of fibrogenic biochemical pathways. The end result is the replacement of normal structures with extracellular matrix. Treatments presently are focused on delaying or preventing such progression, and are largely nonspecific. In pediatrics, such therapy is complicated further by pathophysiological issues that render children a unique population.
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Stupar J, Dolinsek F, Erzen I. Hair-Pb longitudinal profiles and blood-Pb in the population of young Slovenian males. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2007; 68:134-43. [PMID: 16757026 DOI: 10.1016/j.ecoenv.2006.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2005] [Revised: 03/20/2006] [Accepted: 03/27/2006] [Indexed: 05/10/2023]
Abstract
Hair-Pb longitudinal profiles of 25 mm hair length were measured in a population of Slovenian men (aged 18-25 years) using "tape sandwich" solid sampling electrothermal atomic absorption spectrometry (SS-ETAAS). From these data two parameters related to Pb exposure were deduced. Hair-Pb proximal (H-Pbprox.) denotes the Pb content of the proximal 3mm hair segment, while Hair-Pb average (H-Pbaver.) denotes the average Pb content of a 25 mm hair length. The former were found to be on average at least a factor of 2 lower than the H-Pbaver. values that are normally reported in the literature for hairs of 20-50 mm length. Hair-Pb gradient (H-Pbgrad.) defined as the difference in Pb content between the distal (25 mm) and the proximal (3 mm) hair segments divided by the hair length was found to be highly correlated to the level of air Pb pollution (R=0.9931; P<0.001; n=5), while association between H-Pbprox. and air-Pb was not significant (R=0.5765; P>0.05; n=5). Simultaneously, lead in whole blood (B-Pb) was determined by ETAAS as another parameter of Pb exposure. The frequency distribution of log B-Pb values followed a symmetrical Gaussian shape with a median value of 35 microg Pb/L. Log H-Pbprox. frequency distribution, on the contrary, showed a Poissonian shape. Transformation of the data revealed the existence of four homogeneous groups of males with different median H-Pbprox. values (40, 86, 326 and 2500 ng/g). The major proportion of the Slovenian male population ( approximately 70%) has H-Pbprox. contents between 60 and 600 ng/g. A weak but statistically significant association was found between logs H-Pbprox. and B-Pb (R=0.3957; P<0.05; n=247) but when only those subjects were retained whose both parameters were determined with reasonable accuracy and were either above or below the predetermined value (B-Pb=50 microg/L; H-Pbprox.=450 ng/g), substantial improvement in the strength of correlation was observed (R=0.7049; P<0.01; n=84). The poor strength of association between these parameters was attributed to the large variation in Pb intake and different kinetics of Pb appearance in hair and blood. This statement is consistent with reports dealing with the relationship between H-Pb and B-Pb found in the literature.
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Affiliation(s)
- Janez Stupar
- School of Environmental Sciences, Polytechnic, Nova Gorica, Vipavska 13, 5001 Nova Gorica, Pavsiceva 37, 1000 Ljubljana, Slovenia.
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Arora M, Kennedy BJ, Elhlou S, Pearson NJ, Walker DM, Bayl P, Chan SWY. Spatial distribution of lead in human primary teeth as a biomarker of pre- and neonatal lead exposure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2006; 371:55-62. [PMID: 16950500 DOI: 10.1016/j.scitotenv.2006.07.035] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2006] [Revised: 07/19/2006] [Accepted: 07/20/2006] [Indexed: 05/11/2023]
Abstract
Lead remains one of the most hazardous toxins in our environment. Because the toxic effects of lead are most prominent during early development, it is important to develop a suitable biomarker for lead exposure during the pre- and neonatal periods. In the present study, the spatial distribution of lead was measured in the enamel and dentine of ten human primary teeth using laser ablation-inductively coupled plasma-mass spectrometry. The neonatal line, visualized using confocal laser scanning microscopy, was used to demarcate the pre- and postnatal regions of the sample teeth. Lead levels in pre- and postnatally formed enamel and dentine were compared to blood-lead levels measured at birth and one year of age for four of these participants. Mean dentine-lead levels ranged from 0.17+/-0.02 to 5.60+/-1.79 microg/g, and mean enamel-lead levels ranged from 0.04+/-0.01 to 1.47+/-0.20 microg/g. The results of this preliminary study showed that the spatial distribution of lead in dentine reflected the blood-lead levels. The present study demonstrates a methodology where the spatial distribution of lead in the dentine of human primary teeth may be used to obtain temporal information of environmental lead exposure during the pre- and neonatal periods.
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Affiliation(s)
- Manish Arora
- Cellular and Molecular Pathology Research Unit, Department of Oral Pathology, University of Sydney, Westmead Centre for Oral Health, Westmead Hospital, Westmead, NSW 2145, Australia.
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Moreira FR, Moreira JC. A cinética do chumbo no organismo humano e sua importância para a saúde. CIENCIA & SAUDE COLETIVA 2004. [DOI: 10.1590/s1413-81232004000100017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
O chumbo é um dos contaminantes ambientais mais comuns, tóxico para os homens e animais, e sem nenhuma função fisiológica conhecida no organismo. Seus efeitos nocivos podem afetar praticamente todos os órgãos e sistemas do organismo humano. O chumbo entra no corpo principalmente por inalação ou ingestão, sendo diretamente absorvido, distribuído e excretado. Os tratos gastrointestinal e respiratório são os principais sítios de absorção do chumbo que, uma vez absorvido, é encontrado no sangue, tecidos moles e mineralizados. Cerca de 90% do chumbo corpóreo se armazena nos ossos, principal depósito do metal no corpo. Aproximadamente 5% da concentração do chumbo no sangue se situa no plasma, representando a fração lábil e biologicamente ativa do chumbo, capaz de cruzar as membranas celulares e causar seus efeitos tóxicos. O chumbo absorvido é excretado principalmente pela urina e fezes. Assim, o conhecimento da cinética do chumbo é importante para maior compreensão da toxicidade deste metal, uma vez que os riscos de efeitos adversos à saúde estão relacionados com o conteúdo corpóreo total do chumbo.
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Muntner P, He J, Vupputuri S, Coresh J, Batuman V. Blood lead and chronic kidney disease in the general United States population: results from NHANES III. Kidney Int 2003; 63:1044-50. [PMID: 12631086 DOI: 10.1046/j.1523-1755.2003.00812.x] [Citation(s) in RCA: 166] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND High lead exposure is associated with hypertension and renal dysfunction but the effect of low-level environmental exposure is not as well studied. METHODS We examined the association between blood lead and renal function among a representative sample of the civilian noninstitutionalized United States population with and without hypertension, age 20 years old or older, participating in the Third National Health and Nutrition Examination Survey (NHANES III) (N=15211). Elevated serum creatinine was defined as >or=99th percentile of each race-sex specific distribution for healthy young adults and chronic kidney disease (CKD) as a glomerular filtration rate (GFR) <60 mL/min estimated using the Modification of Diet in Renal Disease (MDRD) formula. RESULTS Among persons with and without hypertension, mean blood lead was 4.21 and 3.30 ug/dL, respectively, the prevalence of elevated serum creatinine was 11.5% and 1.8%, respectively, and CKD was 10.0% and 1.1%, respectively. Among persons with hypertension, a graded association was present between higher quartile of blood lead and a higher odds ratio of both an elevated serum creatinine and CKD. Comparing the highest to lowest quartile of blood lead, the multivariate adjusted odds ratio (95% CI) of an elevated serum creatinine and CKD were 2.41 (1.46, 3.97) and 2.60 (1.52, 4.45), respectively. The analogous adjusted odds ratios (95% CI) among normotensives were 1.09 (0.53, 2.22) and 1.09 (0.41, 2.89), respectively. Associations were consistent when modeling lead as a continuous variable and in all subgroups except smokers. CONCLUSION In the United States population with hypertension, exposure to lead, even at low levels, is associated with CKD. Reduction of lead exposure may reduce the burden of CKD in the community.
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Affiliation(s)
- Paul Muntner
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA.
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Rosen JF, Pounds JG. "Severe chronic lead insult that maintains body burdens of lead related to those in the skeleton": observations by Dr. Clair Patterson conclusively demonstrated. ENVIRONMENTAL RESEARCH 1998; 78:140-151. [PMID: 9719618 DOI: 10.1006/enrs.1997.3830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- J F Rosen
- Department of Pediatrics, Albert Einstein College of Medicine, Montefoire Medical Center, New York, New York, USA
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Stokes L, Letz R, Gerr F, Kolczak M, McNeill FE, Chettle DR, Kaye WE. Neurotoxicity in young adults 20 years after childhood exposure to lead: the Bunker Hill experience. Occup Environ Med 1998; 55:507-16. [PMID: 9849536 PMCID: PMC1757620 DOI: 10.1136/oem.55.8.507] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES An epidemiological study of young adults was conducted to determine whether environmental exposure to lead during childhood was associated with current adverse neurobehavioural effects. METHODS The exposed group consisted of 281 young adults who had been exposed environmentally to lead as children and the unexposed referent group consisted of 287 age and sex frequency matched subjects. Information on demographics, past and current health, and past exposures to neurotoxicants, and responses to the Swedish Q16 questionnaire were collected by interview. Standard neurobehavioural and neurophysiological tests were administered by computer or trained technicians. K x ray fluorescence was used to estimate tibial bone lead concentrations among the exposed and unexposed groups. Associations were examined between the exposed group and referents and tibial bone lead concentration and the neurobehavioural and neurophysiological outcomes of interest. RESULTS Among the measures of peripheral nerve function, after controlling for confounders, sural sensory nerve evoked response amplitude, peroneal motor nerve compound motor action potential amplitude, vibrotactile thresholds of fingers and toes, and standing steadiness were significantly associated with exposure group. Among the neurobehavioural tests, hand-eye coordination, simple reaction time latency, trails B latency, symbol digit latency, serial digit, and learning error score were also significantly associated with exposure group after controlling for confounders. Exposed subjects had significantly more neuropsychiatric symptoms than the referents. Associations between tibial bone lead concentration and scores for vocabulary, vibrotactile thresholds of the fingers, and vibrotactile thresholds of the toes approached significance. CONCLUSIONS Significant adverse central and peripheral neurological effects were found in a group of young adults 20 years after childhood environmental exposure to lead when compared with non-exposed controls. The absence of a significant association between neurological outcomes and tibial bone lead concentration, and the presence of significant associations between neurological outcomes and exposure group may be due to either the magnitude of measurement uncertainty in K x ray films relative to the actual tibial bone lead concentration in these young non-occupationally exposed subjects, or uncontrolled confounding of the exposure group.
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Affiliation(s)
- L Stokes
- Epidemiology and Surveillance Branch, Centers For Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia 30333, USA
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