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

AX6-88
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)
Verschoor et al.
(1987)
Study location and
date not provided;
authors from The
Netherlands
Latin and South America
Cardozo dos Santos
et al. (1994)
Study location and
date not provided;
authors from Brazil
155 Pb workers (Pb battery and plastic stabilizer).
126 control industrial workers.
Workers with renal disease, HTN, prescription
medications excluded.
Renal outcomes = BUN, serum creatinine, uric acid,
∃2-microglobulin, and RBP, and urinary RBP, NAG,
albumin, uric acid, ∃2-microglobulin, IgG, and total
protein. Urine protein electrophoresis performed on subset
(n = 25).
Cadmium in blood and, in a subset of exposed workers, in
urine was also assessed due to this exposure in one plant
each from which Pb exposed and control workers were
drawn.
166 Pb battery workers.
60 control workers.
Renal outcomes = serum creatinine, NAG, urine albumin,
and total urinary protein, γ-glutamyl-transpeptidase,
alanine-aminopeptidase.
Mean blood Pb
47.5 µg/dL (workers)
8.3 µg/dL (controls)
Zinc protoporphyrin
also used as Pb dose measure.
Median blood Pb
36.8 µg/dL (workers)
11.6 µg/dL (controls)
Mean renal outcomes in all participants shown by
categorical Pb levels. NAG and RBP higher at blood
Pb levels >21 µg/dL compared to those below this
level (statistical significance not reported). Serum ∃2microglobulin
and urinary total protein lower at blood
Pb levels >21 µg/dL compared to those below this
level (again, statistical significance not reported).
In simple linear regression models of log transformed
urinary total protein, urinary RBP, NAG and serum ∃2microglobulin,
higher log transformed blood Pb was
significantly associated with lower serum ∃2microglobulin
and higher RBP and NAG.
A matched pair analysis of 55 pairs matched for age
within 5 yrs, smoking, socioeconomic status, and
duration of employment found no differences in renal
outcomes between exposed and controls.
Limitations = lack of adjustment, potential for healthy
worker bias, occupational cadmium exposure
(including in controls) not adequately adjusted.
Significant results.
Median NAG higher in exposed group (p < 0.001).
Blood Pb level and duration of exposure correlated
with NAG in combined group (Spearman’s correlation
coefficients = 0.32 and 0.22, respectively, p < 0.001 for
both).
No results mentioned for serum creatinine.
Limitations = statistical analysis (no regression for
renal outcomes).