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

AX6-124
Table AX6-4.5 (cont’d). Renal Effects of Lead in Children
Reference, Study
Location, and Period Study Description Pb Measurement Findings, Interpretation
Europe (cont’d)
De Burbure et al.
(2006)
France, the Czech
Republic, and Poland
Study date not
provided
Factor-Litvak et al.
(1999)
Kosovo, Yugoslavia
1985-1993
804 exposed and control children.
Exposed children recruited from residents near historical
nonferrous smelters, must have lived ∃8 yrs near
smelters.
Mean age = 10 yrs; range = 8.5-12.3 yrs.
Renal outcome measures included serum creatinine,
cystatin C and ß 2-microglobulin as well as urinary RBP,
NAG, Clara cell protein.
577 children followed at 6 mo intervals through 7.5 yrs
of age.
Divided into a high exposure and a low exposure group,
based on residence in Kosovska Mitrovica with a Pb
smelter, refinery, and battery plant or in Pristina, 25 miles
away.
Renal outcome = Proteinuria assessed with a dipstick.
Multiple logistic regression modeling of proteinuria
dichotomized as either any or none, adjusting for
socioeconomic status, maternal education/ intelligence,
and quality of childrearing environment.
Mean blood Pb
Ranged from 2.8 to 4.2 mg/dL
in various control and exposed
groups.
Urinary cadmium, arsenic and
mercury as well as blood
cadmium also assessed.
Mead blood Pb from graph
peaked at ~38 µg/dL between
ages 3-5 in Kosovska
Mitrovica and at ~10 µg/dL in
controls.
Blood Pb level ranged from
1 to 70 µg/dL.
Serum concentrations of creatinine, cystatin C, and
ß 2-microglobulin negatively correlated with blood Pb
levels.
Authors state suggestive of an early renal
hyperfiltration that avgd 7% in the upper quartile of
PbB levels (>5.5 µg/dL; mean 7.84 µg/dL).
In higher exposed group, adjusted OR for proteinuria
was 3.5 (95% CI: 1.7, 7.2); adjusted odds of
proteinuria increased by 1.15 (95% CI: 1.1, 1.2) per
unit increase in blood Pb in the higher exposed group.
Proteinuria unrelated to blood Pb in lower exposed
control group.
Limitations = limited renal outcomes assessed, high
dropout rate in the study.