Air Quality Criteria for Lead Volume II of II - (NEPIS)(EPA) - US ...

AX6-83
Table AX6-4.2 (cont’d). Renal Effects of Lead in the Occupational Population
Reference, Study
Location, and
Period Study Description Pb Measurement Findings, Interpretation
Europe (cont’d)
Coratelli et al. (1988)
Study location and
date not provided;
authors from Italy
Fels et al. (1994)
Study location and
date not provided
Garçon et al. (2004)
France
Study date not
provided
20 Pb battery factory workers.
20 controls.
12 mo longitudinal study.
Renal outcomes = urinary alanine aminopeptidase, NAG
and lysozyme.
81 male Pb workers; 45 age matched controls.
Extensive exclusionary criteria.
Renal outcomes
Serum creatinine
Glomerular markers = 6-keto-prostaglandin F 1 alpha,
thromboxane B 2, and fibronectin.
Proximal tubular markers = brush border antigens (BBA,
BB50, HF5) and intestinal alkaline phosphatase.
Distal nephron markers = prostaglandin E2, prostaglandin
F 2 alpha.
35 male nonferrous metal smelter workers.
Renal outcomes = α1-microprotein, ∃ 2-microglobulin,
retinol binding protein, α and π glutathione S transferases
(GST).
Oxidative stress markers also measured.
All variables log transformed.
Initial mean blood Pb
47.9 µg/dL (workers)
23.6 µg/dL (controls)
Median blood Pb
42.1 µg/dL (workers)
7.0 µg/dL (controls)
Mean blood Pb
39.6 µg/dL
Mean blood cadmium
5.8 µg/L
Mean urine cadmium
4.7 µg/g creatinine
NAG and lysozyme higher in exposed compared to
controls throughout study. A statistically significant
decline in urinary NAG was noted in association with a
one mo period of decreased occupational exposure in the
Pb workers. NAG correlated with time of exposure
(nonlinear) but not blood Pb. Clinical renal function
measures were not studied.
Serum creatinine similar in exposed compared to controls.
Medians of several markers statistically greater in workers
compared to controls. After adjustment for age and
erythrocyte protoporphyrin, several renal marker outcomes
showed “some relation” to blood Pb. The table of these
data shows r and r 2 but not beta coefficients making the
actual statistical method used unclear.
Study limitations include lack of adjustment in statistical
analysis, potential for healthy worker bias.
Correlations between urine Pb and cadmium and the renal
outcomes assessed (not blood Pb or cadmium).
Significant positive correlations included:
urine Pb and α GST (p < 0.01)
urine cadmium and RBP (p < 0.05)
Also, urine cadmium and 8-OHdG negatively correlated.
Limitations = use of urine Pb, lack of adjustment for other
covariates, sample size.
Significant correlations between blood Pb and two
markers of oxidative stress were observed along with a
correlation between blood cadmium and one marker of
oxidative stress.