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

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AX6-237<br />

Table AX6-9.4 (cont’d). Effects <strong>of</strong> <strong>Lead</strong> on Hematopoietic System in Adults<br />

Reference, Study<br />

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

Europe (cont’d)<br />

Graziano et al. (1990)<br />

Yugoslavia<br />

1986<br />

Asia<br />

Hsiao et al. (2001)<br />

China<br />

1989–1999<br />

Hsieh et al. (2000)<br />

China<br />

NR<br />

Design: prospective<br />

Subjects: pregnant women (n = 48) from<br />

high-Pb (smelter/refinery) and low-Pb areas<br />

(6 highest and lowest mid-pregnancy blood<br />

Pb concentrations), within each <strong>of</strong> 4 Hgb<br />

strata (g/dL): 9.0–9.9, 10.0–10.9, 11.0–11.9,<br />

12.0–12.9<br />

Outcome measures: Hgb, EPO<br />

Analysis: ANOVA <strong>of</strong> outcome measures in<br />

subjects stratified by blood Pb and blood<br />

Hgb<br />

Design: longitudinal<br />

Subjects: adult battery manufacture workers<br />

(n = 30, 13 females), mean age 38.3 yr<br />

Outcome measures: blood Hgb, Hct,<br />

RBC count<br />

Analysis: GEE <strong>for</strong> repeated measures<br />

(models: linear correlation, threshold<br />

change, synchronous change, lag change);<br />

logistic regression<br />

Design: cross-sectional<br />

Subjects: Adults in general population<br />

(n = 630, 255 females)<br />

Outcome measures: blood Hgb, Hct, RBC<br />

count, ALAD genotype<br />

Analysis: comparison <strong>of</strong> outcome measures<br />

between ALAD genotype strata<br />

Blood Pb (µg/dL) mean<br />

range <strong>for</strong> Hgb strata<br />

High Pb: 16.9–38.6<br />

Low Pb: 2.4–3.6<br />

Blood Pb (µg/dL) mean:<br />

1989: 60<br />

1999: 30<br />

Blood Pb ( µg/dL) mean<br />

(SD):<br />

ALAD1,1 (n = 630):<br />

6.5 (5.0)<br />

ALAD1,1/2,2 (n = 30):<br />

7.8 (6.0)<br />

Significant effect <strong>of</strong> blood Pb (p = 0.049) and blood Hgb (p = 0.001)<br />

on mid-term and term serum EPO (blood Pb p = 0.055, Hgb<br />

p = 0.009), with significantly lower serum EPO associated with<br />

higher blood Pb.<br />

Significant association between increasing blood Pb and increasing<br />

RBC count and Hct:<br />

Odds ratios (95% CI):<br />

Synchronous change model:<br />

Blood Hgb: 0.95 (0.52, 1.78)<br />

RBC count: 3.33 (1.78, 6.19)<br />

Hct: 2.19 (1.31, 3.66)<br />

Lag change:<br />

Blood Hgb: 1.70 (0.99, 2.92)<br />

RBC count: 2.26 (1.16, 4.41)<br />

Hct: 2.08 (1.16, 4.41)<br />

Mean blood Pb not different between ALAD genotype strata<br />

(p = 0.17). RBC count, Hgb, Hct not different between ALAD<br />

genotype strata (p = 0.7).

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