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

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AX6-110<br />

Table AX6-4.3 (cont’d). Renal Effects <strong>of</strong> <strong>Lead</strong> in the Patient Population<br />

Reference, Study<br />

Location, and<br />

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

Australia<br />

Craswell et al. (1987)<br />

Germany and<br />

Australia<br />

Study date not<br />

provided<br />

German participants from industrialized area where<br />

chronic Pb nephropathy not previously observed.<br />

Gp 1 = 8 healthy controls (from hospital staff)<br />

Gp 2a = 12 CRI patients, no gout or Pb exposure<br />

Gp 2b = 7 CRI patients, no gout but + Pb exposure<br />

Gp 3a = 7 CRI patients with gout but no Pb exposure<br />

Gp 3b = 6 CRI patients with gout and Pb exposure<br />

Australian participants from Queensland site <strong>of</strong> known<br />

chronic Pb nephropathy.<br />

Gp 1 = 9 healthy controls (from hospital staff)<br />

Gp 2a = 14 CRI patients, no gout or Pb exposure<br />

Gp 2b = 11 CRI patients, no gout but + Pb exposure<br />

Gp 3a = 25 CRI patients with gout but no Pb exposure<br />

Gp 3b = 11 CRI patients with gout and Pb exposure<br />

CRI defined as serum creatinine ≥ 1.5 mg/dL<br />

“Excess” EDTA chelatable Pb defined as Pb excreted over<br />

4 days after EDTA minus twice baseline Pb excreted pre-<br />

EDTA.<br />

Median blood Pb (hemoglobin<br />

corrected)<br />

Gp 1<br />

German = 6.8 µg/dL<br />

Australian = 11.0 µg/dL<br />

Gp 2a<br />

German = 6.2 µg/dL<br />

Australian = 9.1 µg/dL<br />

Gp 2b<br />

German = 8.5 µg/dL<br />

Australian = 16.2 µg/dL<br />

Gp 3a<br />

German = 10.6 µg/dL<br />

Australian = 12.8 µg/dL<br />

Gp 3b<br />

German = 12.0 µg/dL<br />

Australian = 27.1 µg/dL<br />

Median “excess” EDTA<br />

chelatable Pb<br />

Gp 1<br />

German = 68.4 µg<br />

Australian =82.9 µg<br />

Gp 2a<br />

German = 126.4 µg<br />

Australian = 393.7 µg<br />

Gp 2b<br />

German = 489.0 µg<br />

Australian = 1181.1 µg<br />

Gp 3a<br />

German = 227.9 µg<br />

Australian = 808.1 µg<br />

Gp 3b<br />

German = 422.7 µg<br />

Australian = 1077.5 µg<br />

Using nonparametric statistical techniques due to<br />

skewed data, German participants excreted<br />

statistically less Pb than their Australian counterparts.<br />

Mean EDTA chelatable Pb levels were significantly<br />

higher in German patients with gout than in those<br />

without gout; the observed increase in the Australian<br />

patients was <strong>of</strong> borderline significance (p < 0.1).<br />

Limitations = small groups, limited data analysis.

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