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

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AX6-125<br />

Table AX6-4.5 (cont’d). Renal Effects <strong>of</strong> <strong>Lead</strong> in Children<br />

Reference, Study<br />

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

Europe (cont’d)<br />

Fels et al. (1998)<br />

Poland<br />

1995<br />

_ktem et al. (2004)<br />

Turkey<br />

Study date not<br />

provided<br />

112 children (50 controls, 62 exposed).<br />

Mean age = 9.9 yrs and 10.6 yrs in controls and exposed<br />

group, respectively.<br />

Numerous (29) renal outcome measures were examined<br />

including serum creatinine and ∃ 2-microglobulin, and<br />

urinary NAG, RBP, Clara cell protein, ∃2-microglobulin,<br />

6-keto-prostaglandin F 1α (6-keto-PGF 1α), prostaglandin<br />

E2 (PGE 2) and thromboxane B 2 (TXB 2).<br />

Urinary RBP<br />

46 µg/g creatinine (exposed)<br />

42 µg/g creatinine (controls)<br />

Urinary ∃ 2-microglobulin<br />

89 µg/g creatinine (exposed)<br />

37 µg/g creatinine (controls)<br />

Serum creatinine<br />

0.63 mg/dL (exposed)<br />

0.63 mg/dL (controls)<br />

79 adolescent auto repair workers (mean age 17.3 yrs).<br />

71 rural adolescents as negative controls (mean age 17.0<br />

yrs).<br />

Renal outcomes = urinary NAG, ∃ 2-microglobulin, uric<br />

acid, and calcium; blood urea nitrogen (BUN), serum<br />

creatinine and uric acid.<br />

Mean blood Pb<br />

13.3 µg/dL (exposed)<br />

3.9 µg/dL (controls)<br />

Mean blood Pb<br />

7.79 µg/dL (exposed workers)<br />

1.6 µg/dL (controls)<br />

Significantly higher mean serum ∃ 2-microglobulin,<br />

and urinary transferrin, 6-keto-PGF1α, thromboxane<br />

B 2, epidermal growth factor, ∃ 2-microglobulin, PGE 2,<br />

and Clara cell protein in the exposed children. In<br />

contrast, NAG-B was lower in the exposed group.<br />

Categorical blood Pb associated with prevalence <strong>of</strong><br />

values above the upper reference limits <strong>for</strong> several<br />

biomarkers. Urinary 6-keto-PGF 1α, TXB 2, ∃ 2microglobulin,<br />

Clara cell protein, epidermal growth<br />

factor and PGE 2 positively correlated with blood Pb<br />

(r = 0.441, 0.225, 0.203, 0.261, 0.356, and 0.23,<br />

respectively; all with significant p-values).<br />

Limitations = data analysis, limited adjustment.<br />

No difference in mean BUN, serum creatinine, uric<br />

acid, or GFR (apparently estimated) between workers<br />

and controls.<br />

Urinary NAG and calcium significantly higher in<br />

workers compared to controls. Urinary NAG<br />

positively correlated blood Pb (r = 0.427).<br />

Limitations = data analysis, lack <strong>of</strong> adjustment.

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