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

AX6-120
Table AX6-4.4. Renal Effects of Lead on Mortality
Reference, Study
Location, and Period Study Description Pb Measurement Findings, Interpretation
United States
Cooper (1988);
Cooper et al. (1985)
16 U.S. plants
Employment between
1946 and 1970;
mortality from 1947
to 1980
Steenland et al. (1992)
Idaho
Employed between
1940 and 1965;
mortality up to 1988
4519 male battery plant workers.
2300 male Pb production workers.
Employed for at least one yr between 1946 and 1970.
Cause of death per death certificate (extrapolated when
missing).
Standardized mortality ratios (SMRs) compared with
national age-specific rates. PMR also assessed.
Analyzed separately by battery and Pb production, by hire
date before and after 1/1/1946, and by cumulative yrs of
employment (1-9, 10-19, 20+).
1990 male Pb smelter workers.
Employed in a Pb-exposed department for at least one yr
between 1940 and 1965.
Vital status was determined using records from the Social
Security Administration and the National Death Index.
Mean blood Pb
63 µg/dL in n = 1326 battery
workers
80 µg/dL in n = 537
production workers
Past Pb exposures poorly
documented prior to 1960
Mean blood Pb
56.3 µg/dL (n = 173, measured
in 1976)
High Pb exposure defined as
workers from departments
with an avg >0.2 mg/m 3
airborne Pb or ∃50% of jobs
had avg levels more than twice
that level (1975 survey). In
this category, n = 1,436.
Follow-up >90% in both groups; 2339 deaths
observed.
“Chronic or unspecified nephritis” SMR:
222 (95% CI: 135, 343) in battery workers
265 (95% CI: 114, 522) in Pb production workers
“Other hypertensive disease” SMR (“includes HTN
and related renal disease without mention of heart
disease)”:
320 (95% CI: 197, 489) in battery workers
475 (95% CI: 218, 902) in Pb production workers
Race adjusted proportionate mortality ratios analyses
similar.
Nephritis deaths observed primarily in workers hired
before 1946.
Limitations = due to mortality analysis (inaccuracies
of death certificates, exposure assessment generally
limited).
Compared to the U.S. white male population, the
standardized mortality ratio (SMR) for chronic kidney
disease, based on only 8 deaths, was 1.26 (95%
CI = 0.54, 2.49). SMR = 1.55 in high Pb exposure
group, also not significant. The SMR for chronic
kidney disease increased with duration of exposure
from 0.79 in workers exposed 1-5 yrs to 2.79 in
workers exposed >20 yrs; however SMR was not
significant.