13.02.2013 Views

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

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

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

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

AX6-144<br />

Table AX6-5.1 (cont’d). Effects <strong>of</strong> <strong>Lead</strong> on Blood Pressure and Hypertension<br />

Reference, Study<br />

Location, and<br />

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

United States (cont’d)<br />

Tepper et al.<br />

(2001)<br />

U.S.-Cincinnati,<br />

OH<br />

After 1991 to<br />

be<strong>for</strong>e 2001<br />

43 females and 57 males, current or<br />

<strong>for</strong>mer workers at a Pb-acid battery<br />

factory, between 36 and 73 yrs <strong>of</strong> age,<br />

with at least 10 yrs working in battery<br />

production, participated. Multivariate<br />

regression models and logistic<br />

regression models were constructed to<br />

assess Pb exposure effect on outcome<br />

(hypertension: >140/90 mm Hg and<br />

>160/95 mm Hg or taking<br />

antihypertensive meds; diastolic and<br />

systolic blood pressure, and left<br />

ventricular mass/body surface area<br />

(g/m 2 ). Echocardiograms were used to<br />

determine left ventricular mass.<br />

Variables used to adjust all models<br />

were age, BMI, sex, and family history<br />

<strong>of</strong> hypertension.<br />

Plant blood Pb records were<br />

used to calculate cumulative<br />

blood Pb index (CBLI) used as<br />

a tertile measure, a linear<br />

continuous measure, and a log<br />

trans<strong>for</strong>med measure.<br />

CBLI µg/dL-yr<br />

1st tertile: 138-504<br />

2nd tertile: 505-746<br />

3rd tertile: 747-1447<br />

Time-avgd blood Pb TABL)<br />

was treated the same way:<br />

TABL µg/dL<br />

1st tertile: 12-25<br />

2nd tertile: 26-33<br />

3rd tertile: 34-50<br />

No odds ratios were given <strong>for</strong> hypertension and any Pb variable <strong>for</strong> hypertension<br />

defined as >140/90 mm Hg but ORs were claimed not significant. Odds ratios were<br />

2.71 and 1.44 <strong>for</strong> the 3rd tertile CBLI and TABL Pb measures compared to 1st tertile,<br />

apparently significant, but no probabilities, SEs or CIs given.<br />

With the 81 subjects not taking anti-hypertensive meds, neither CBLI tertile nor<br />

TABL tertile were significantly associated with either diastolic or systolic blood<br />

pressure (coefficients, SEs or 95% CIs not given). Using log trans<strong>for</strong>med CBLI<br />

probability <strong>of</strong> a positive association with diastolic blood pressure was 0.06. Using log<br />

trans<strong>for</strong>med TABL, probability <strong>of</strong> a positive association with diastolic blood pressure<br />

was 0.10. No coefficients, SEs, or CIs given.<br />

Left ventricular mass adjusted <strong>for</strong> body surface area was not significantly related to<br />

any Pb measure. No coefficients, SEs or CIs given.<br />

Despite the certainty <strong>of</strong> the authors that “we found no convincing evidence <strong>of</strong> an<br />

association…”, the very low power <strong>of</strong> this study gives certainty to none <strong>of</strong> the<br />

findings. Very poor reporting <strong>of</strong> results further reduces the possibility <strong>of</strong> evaluation.<br />

No model diagnostic testing was reported.

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!