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

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AX6-102<br />

Table AX6-4.2 (cont’d). Renal Effects <strong>of</strong> <strong>Lead</strong> in the Occupational Population<br />

Reference, Study<br />

Location, and<br />

Period Study Description Pb Measurement Findings, Interpretation<br />

Middle East<br />

Al-Neamy et al.<br />

(2001)<br />

United Arab Emirates<br />

Feb-June, 1999<br />

Ehrlich et al. (1998)<br />

South Africa<br />

Study date not<br />

provided<br />

100 “industrial” workers exposed in a range <strong>of</strong> industries<br />

100 working controls.<br />

Matched <strong>for</strong> age, sex, and nationality.<br />

Renal outcomes = BUN, serum creatinine.<br />

382 Pb battery factory workers.<br />

Mean age = 41.2 yrs.<br />

All males.<br />

Multiple linear regression adjusted <strong>for</strong> age, weight, and<br />

height (Covariates assessed <strong>for</strong> inclusion also included<br />

smoking, alcohol ingestion, and diabetes).<br />

Clinical renal outcomes included serum creatinine, uric<br />

acid, and BUN.<br />

Mean serum creatinine<br />

1.13 mg/dL<br />

Renal early biological effect markers (NAG, RBP,<br />

intestinal alkaline phosphatase, tissue nonspecific alkaline<br />

phosphatase, Tamm-Horsfall glycoprotein, epidermal<br />

growth factor, and microalbuminuria) were measured in<br />

199 participants randomly selected by tertiles <strong>of</strong> current<br />

blood Pb.<br />

Mean blood Pb<br />

77.5 µg/dL (workers)<br />

19.8 µg/dL (controls)<br />

Mean blood Pb<br />

53.5 µg/dL<br />

Mean exposure duration<br />

11.6 yrs<br />

Mean cumulative blood Pb<br />

(defined as sum <strong>of</strong> the avg<br />

blood Pb in each yr over all yrs<br />

<strong>of</strong> employment; done in subset<br />

<strong>of</strong> 246 with past blood Pb data)<br />

579.0 (µg Η yr)/dL<br />

Mean historical blood Pb<br />

(defined as cumulative blood<br />

Pb divided by yrs <strong>of</strong> exposure)<br />

57.3 µg/dL<br />

Mean tibia Pb<br />

69.7 μg/g bone mineral<br />

(measured 2 yrs after initial<br />

study on random sample <strong>of</strong> 40)<br />

Mean BUN and serum creatinine not statistically<br />

different between exposed workers and controls.<br />

Limitations = data analysis.<br />

After adjustment <strong>for</strong> age, weight, and height,<br />

categorical current and historical blood Pb and zinc<br />

protoporphyrin were associated with serum creatinine<br />

and uric acid, in separate models. Associations<br />

between cumulative blood Pb or exposure duration<br />

and the renal outcomes were not observed.<br />

Among the EBE markers, only current blood Pb was<br />

borderline associated with NAG (p = 0.09).<br />

Associations with renal dysfunction were observed at<br />

blood Pb levels

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