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

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AX6-126<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 />

Price et al. (1999)<br />

Belgium, Poland,<br />

Germany and Italy<br />

Study date not<br />

provided<br />

Sch≅rer et al. (1991)<br />

Germany<br />

1988-1989<br />

S⎯nmez et al. (2002)<br />

Turkey<br />

Study date not<br />

provided<br />

Urinary Pb measured in 481 European children (236<br />

controls, 245 exposed) aged 6 – 14 yrs.<br />

Several renal outcome measures assessed including<br />

urinary NAG and ∃ 2-microglobulin; values not reported.<br />

22 children, age 5-14 yrs, with CRI.<br />

20 siblings or neighbors as lower exposed group.<br />

16 control children without known Pb exposure.<br />

39 adolescent auto repair workers (mean age 16.2 yrs).<br />

13 adult battery workers as positive controls (mean age<br />

32 yrs).<br />

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

14.8 yrs).<br />

Serum creatinine<br />

0.99 mg/dL (exposed group)<br />

0.99 mg/dL (positive/ adult controls)<br />

0.89 mg/dL (negative/ adolescent controls)<br />

Urinary NAG<br />

4.7 IU/g creatinine (exposed group)<br />

7.4 IU/g creatinine (positive/ adult controls)<br />

3.1 IU/g creatinine (negative/ adolescent controls)<br />

Mean urinary Pb<br />

Range from 3.9 to 7.2 µg/g<br />

creatinine (controls)<br />

Range from 5.2 to 24.6 µg/g<br />

creatinine (exposed)<br />

Mean blood Pb<br />

2.9 µg/dL in children with<br />

CRI, not tested in other groups<br />

Mean dental Pb content<br />

2.8 µg/g in children with CRI<br />

1.7 µg/g in sibs/neighbors<br />

1.4 µg/g in controls<br />

Mean blood Pb<br />

8.13 µg/dL (exposed group)<br />

25.3 µg/dL<br />

(positive/adult controls)<br />

3.49 µg/dL<br />

(negative/ adolescent controls)<br />

Urinary Pb generally higher in exposed children as<br />

compared to controls. Authors unexpectedly found<br />

substantial differences in renal biomarkers by study<br />

site. Authors note several renal biomarkers differed<br />

between exposed and control groups. Also<br />

questioned the use <strong>of</strong> “control” groups in ubiquitous<br />

exposures.<br />

Pb levels in teeth significantly higher in both the<br />

patient and sibling/neighbor control groups compared<br />

to the unexposed control group.<br />

All participants had normal blood urea, creatinine,<br />

and uric acid levels as well as normal routine<br />

urinalysis.<br />

Blood Pb level and urinary NAG significantly higher<br />

in adolescent auto repair workers compared to the<br />

negative control group.<br />

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

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