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

AX6-251
Table AX6-9.7. Effects of Lead on the Hepatic System in Children and Adults
Reference, Study
Location, and Period Study Description Pb Measurement Findings, Interpretation
Children
United States
Saenger et al. (1984)
New York
NR
Adults
Asia
Al-Neamy et al. (2001)
United Arab Emirates
1999
Design: clinical cases
Subjects: children (n = 26) ages 2–9 yr; agematched
reference group (n = NR)
Outcome measures: urinary cortisol and 6∃-
OH-cortisol (CYP3A metabolite of cortisol)
Analysis: comparison of outcome measure
between children who qualified for EDTA
treatment (EDTA provocation >500 µg/24
hr)
Design: cross-sectional cohort
Subjects: adult male (n = 100) workers (e.g.,
gas pump attendants, garage workers,
printing workers, construction workers),
mean age 34.6 yr (SD 8.0); reference group
(n = 100) matched with Pb workers for age,
sex, nationality.
Outcome measures: serum protein, albumin,
ALT, AP, AST, BUN, (GT, LDH
Analysis: comparison of outcome measures
between Pb workers and reference group
Blood Pb (µg/dL) mean
(SE, range):
Chelated: 46 (2, 33–60)
Not chelated:
42 (3, 32–60)
Urinary Pb (µg/24 hr) mean
(SE, range), EDTAprovocation:
Chelated: 991 (132, 602–
2247)
Not chelated: 298 (32,
169–476)
Blood Pb (µg/dL) mean
(SD): Pb: 77.5 (42.8)
Reference: 19.8 (12.3)
Significantly lower (~45% lower) urinary excretion of 6∃-OHcortisol
(p = 0.001) and urinary 6∃-OH-cortisol: cortisol ratio
(p < 0.001) in children who qualified for chelation than in children
who did not qualify and significantly lower than age-matched
reference group. Urinary 6∃-OH-cortisol: cortisol ratio was
significantly correlated with blood Pb (r = −0.514, p < 0.001),
urinary Pb, and EDTA provocation urinary Pb (r = −0.593,
p < 0.001).
Significantly higher serum AP (p = 0.012) and LDH (p = 0.029) in
Pb workers compared to reference group (values within normal
range).