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Huang YQ, He GD, Feng YQ. The association of lead exposure with blood pressure and hypertension: a mediation analyses of estimated glomerular filtration rate. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:59689-59700. [PMID: 37014600 DOI: 10.1007/s11356-023-26734-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 03/27/2023] [Indexed: 05/10/2023]
Abstract
The link between lead and blood pressure was debatable, and whether it was mediated by renal function was unknown. The purpose was to investigate the relationship between blood lead concentrations and blood pressure and hypertension, as well as the mediating role of estimated glomerular filtration rate (eGFR) in this relationship. Participants aged 18 were recruited from the National Health and Nutrition Examination Survey (1999-2014) and provided with lead and blood pressure data. Multivariate linear and logistic regression, stratification, interaction tests, and a restricted cubic spline curve were used to assess the association of blood lead with systolic/diastolic blood pressure (SBP/DBP) and hypertension, and mediation effect analysis was used to investigate the role of eGFR in this relationship. A total of 20,073 subjects were enrolled, and among them, 9837 (49.01%) were male and 7800 (38.86%) were hypertensive patients. Multivariate linear and logistic regression analysis showed that blood lead levels were significantly associated with SBP (β = 3.14, 95%CI: 2.03, 4.25; P < 0.001), DBP (β = 3.50, 95%CI: 2.69, 4.30; P < 0.001), and hypertension (OR = 1.29, 95%CI: 1.09, 1.52; P = 0.0026). In comparison to the lowest blood lead quartile, the highest lead group was significantly associated with SBP (= 2.55, 95%CI: 1.66, 3.44; P = 0.0001), DBP (= 2.60, 95%CI: 1.95, 3.24; P = 0.0001), and hypertension (OR = 1.26, 95%CI: 1.10, 1.45; P = 0.0007). Mediation analysis showed that the proportion of blood lead mediated for SBP, DBP, and hypertension was 3.56% (95%CI: 0.42%, 7.96%; P = 0.0320), 6.21% (95%CI: 4.02%, 9.32%; P < 0.0001), and 17.39% (95%CI: 9.34%, 42.71%; P < 0.0001), respectively. Adjusted restricted cubic spline curves presented a non-linear correlation of blood lead levels with DBP (P-non-linearity < 0.001), linear with SBP (P-non-linearity = 0.203), and hypertension (P-non-linearity = 0.763). Our findings demonstrated that blood lead levels were non-linear with DBP, but linear with SBP and hypertension, and this relationship was mediated by eGFR.
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Affiliation(s)
- Yu-Qing Huang
- Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Two Road, Yuexiu District, Guangzhou, 510080, China
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guo-Dong He
- Research Department of Medical Sciences, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying-Qing Feng
- Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, No. 106, Zhongshan Two Road, Yuexiu District, Guangzhou, 510080, China.
- Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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Lead Levels in Non-Occupationally Exposed Women with Preeclampsia. Molecules 2021; 26:molecules26103051. [PMID: 34065439 PMCID: PMC8160711 DOI: 10.3390/molecules26103051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/15/2021] [Accepted: 05/17/2021] [Indexed: 11/29/2022] Open
Abstract
There are many controversies regarding the relationship between lead exposure andcomplications in pregnancy. Preeclampsia (PE) is a maternal hypertensive disorder which is one of the main causes of maternal and foetal mortality. The aim of our study was to assess blood lead level (BLL) in Polish women with PE (PE group, n = 66) compared with healthy, non-pregnant women (CNP group, n = 40) and healthy pregnant women (CP group, n = 40). BLL was determined by inductively coupled plasma mass spectrometry (ICP-MS). The systolic blood pressure (SBP), diastolic blood pressure (DBP) and BLL in the CP group were significantly lower than in the PE group (p < 0.001). Logistic regression analyses of BLL showed a significant positive relationship with the presence of PE. Furthermore, both the SBP and DBP values were positively associated with BLL. This study indicates that preeclamptic women tend to present with significantly higher BLL compared to healthy pregnant women. There were no differences in the BLL between the CP and CNP groups.
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Rapisarda V, Ledda C, Ferrante M, Fiore M, Cocuzza S, Bracci M, Fenga C. Blood pressure and occupational exposure to noise and lead (Pb): A cross-sectional study. Toxicol Ind Health 2015; 32:1729-36. [PMID: 25883097 DOI: 10.1177/0748233715576616] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Several studies have explored the hypothesis that low blood lead (PbB) and high noise levels may be associated with an increased risk of hypertension. To assess the possible relationship between occupational exposure to lead (Pb) and noise and elevated blood pressure, we studied 105 workers (age: 41.27 ± 6.25 years and length of employment: 4.12 ± 5.33 years) employed in a Pb battery recycling plant by measuring A-weighted equivalent sound level, PbB, δ-aminolevulinic acid dehydratase (ALAD) activity and zinc protoporphyrin (ZPP) levels and systolic and diastolic blood pressure (SBP and DBP). Results showed that occupational exposure to higher ambient Pb and noise levels was related to slightly increased SBP and DBP. PbB values correlated significantly with SBP and DBP, whereas noise levels correlated neither with SBP nor with DBP. Furthermore, workers exposed to higher ambient Pb had higher PbB and ZPP and showed more decreased ALAD activity. Blood pressure does not correlate with noise exposure but only with PbB concentration.
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Affiliation(s)
- Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Caterina Ledda
- Hygiene and Public Health, Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - Margherita Ferrante
- Hygiene and Public Health, Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - Maria Fiore
- Hygiene and Public Health, Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - Salvatore Cocuzza
- Otorhinolaryngology, Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy
| | - Massimo Bracci
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Concettina Fenga
- Occupational Medicine, Department of the Environment, Security, Territory, Food and Health Sciences, University of Messina, Messina, Italy
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Abstract
Despite the recognition of lead nephropathy as a consequence of environmental and occupational lead exposure, lead nephropathy still appears to be underrecognized by physicians as a cause and promoter of chronic kidney disease (CKD), especially in people with more apparent causative factors such as diabetes and hypertension. This review focuses on the clinical, pathophysiological and epidemiological perspectives of lead nephropathy with the objective of promoting the awareness of this important but overlooked cause of CKD among physicians. Literature was reviewed using available medical journals and online literature search through Google, Pubmed, Medline, Medscape and HINARI databases. The key words employed were: Lead Nephropathy, Environmental and Occupational lead exposure and chronic kidney disease. Lead nephropathy which is a tubulointerstitial nephritis, may present acutely or chronically in association with hypertension. The clinical diagnosis of lead nephropathy is complex, because the symptoms are varied and non-specific especially with subclinical nephrotoxicity. The recognition of lead nephropathy can be enhanced if physicians have a high index of suspicion in the assessment of patients with renal disease. It is recommended that the evaluation of environmental and occupational nephrotoxins like lead be incorporated into programs for the prevention of CKD, especially in developing countries where lead exposure and toxicity still remain largely unchecked and the prevalence and burden of CKD is increasing.
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Affiliation(s)
- Datonye Dennis Alasia
- Nephrology Unit, Department of Internal Medicine, University of Port Harcourt, Port Harcourt, Nigeria
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The association of prolonged QT interval on electrocardiography and chronic lead exposure. J Occup Environ Med 2014; 55:614-9. [PMID: 23722940 DOI: 10.1097/jom.0b013e318291787a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to examine the association of lead exposure with cardiac conduction disturbance among lead-exposed and nonexposed workers in Taiwan. METHODS The participants comprised 312 lead workers and 329 referents who had no known occupational lead exposure. During their annual health examination, they were invited to take part in the survey. Standard resting 12-lead electrocardiograms were obtained and the electrocardiographic features studied were related to blood lead levels (BLLs). RESULTS The mean BLLs were 26.05 (SD = 13.98) and 2.62 (SD = 1.42) μg/dL in lead-exposed and reference groups, respectively. Compared with the referents, lead workers had significantly shorter PR interval and longer QTc interval. Especially, workers with BLL > 30 μg/dL had the highest risk after adjusting for age, sex, body mass index, and other potential confounders. CONCLUSION The data suggest that lead exposure is positively associated with prolonged QTc interval.
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Elevated risk of hypertension induced by arsenic exposure in Taiwanese rural residents: possible effects of manganese superoxide dismutase (MnSOD) and 8-oxoguanine DNA glycosylase (OGG1) genes. Arch Toxicol 2011; 86:869-78. [DOI: 10.1007/s00204-011-0797-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
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Alghasham AA, Meki ARM, Ismail HA. Association of Blood Lead level with Elevated Blood Pressure in Hypertensive Patients. Int J Health Sci (Qassim) 2011; 5:17-27. [PMID: 22489226 PMCID: PMC3312765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND Lead is a metal with many important industrial uses. The relationship between lead exposure and the rise of blood pressure has received a great deal of attention as it was implicated that the mortality from cardiovascular diseases might be reduced by lowering lead levels in the environment. OBJECTIVES The study was to investigate the correlation between the blood lead (B-Pb) levels and the values of blood pressure in hypertensive patients. Moreover, the plasma activities of angiotensin converting enzyme (ACE), plasma levels of nitric oxide (NO), total antioxidants (TAOX) and malondialdehyde (MDA) were estimated to investigate the correlations between the measured parameters and B-Pb levels in hypertensive patients. METHODS Fifty-five hypertensive patients were compared with fifty-three age and sex matched control group. The B-Pb levels were detected by flame atomic absorption spectrometry. The plasma levels of ACE activities, NO, TAOX and MDA were measured by colorimetric methods. RESULTS In the hypertensive patients, B-Pb levels were significantly higher than controls. Concomitantly, the plasma levels of ACE activities and MDA were significantly increased while the plasma levels of NO and TAOX were significantly reduced in the hypertensive patients in comparison with controls. There were significant positive correlations between B-Pb and each of MDA, and systolic as well as diastolic blood pressure. Conversely, a significant negative correlation was found between B-Pb and NO. CONCLUSIONS Our study indicated that a positive relationship exists between blood pressure and B-Pb levels. The increased B-Pb levels were associated with oxidative stress. Moreover, The B-Pb level was negatively correlated with NO and this may clarify the implication of Pb as leading risk factor for the cardiovascular diseases and hypertension. These findings provide support for continued efforts to reduce lead concentration in the population at Qassim region.
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Fontaine J, Dewailly É, Benedetti JL, Pereg D, Ayotte P, Déry S. Re-evaluation of blood mercury, lead and cadmium concentrations in the Inuit population of Nunavik (Québec): a cross-sectional study. Environ Health 2008; 7:25. [PMID: 18518986 PMCID: PMC2442064 DOI: 10.1186/1476-069x-7-25] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2007] [Accepted: 06/02/2008] [Indexed: 05/26/2023]
Abstract
BACKGROUND Arctic populations are exposed to mercury, lead and cadmium through their traditional diet. Studies have however shown that cadmium exposure is most often attributable to tobacco smoking. The aim of this study is to examine the trends in mercury, lead and cadmium exposure between 1992 and 2004 in the Inuit population of Nunavik (Northern Québec, Canada) using the data obtained from two broad scale health surveys, and to identify sources of exposure in 2004. METHODS In 2004, 917 adults aged between 18 and 74 were recruited in the 14 communities of Nunavik to participate to a broad scale health survey. Blood samples were collected and analysed for metals by inductively coupled plasma mass spectrometry, and dietary and life-style characteristics were documented by questionnaires. Results were compared with data obtained in 1992, where 492 people were recruited for a similar survey in the same population. RESULTS Mean blood concentration of mercury was 51.2 nmol/L, which represent a 32% decrease (p < 0.001) between 1992 and 2004. Mercury blood concentrations were mainly explained by age (partial r2 = 0.20; p < 0.0001), and the most important source of exposure to mercury was marine mammal meat consumption (partial r2 = 0.04; p < 0.0001). In 2004, mean blood concentration of lead was 0.19 mumol/L and showed a 55% decrease since 1992. No strong associations were observed with any dietary source, and lead concentrations were mainly explained by age (partial r2 = 0.20.; p < 0.001). Blood cadmium concentrations showed a 22% decrease (p < 0.001) between 1992 and 2004. Once stratified according to tobacco use, means varied between 5.3 nmol/L in never-smokers and 40.4 nmol/L in smokers. Blood cadmium concentrations were mainly associated with tobacco smoking (partial r2 = 0.56; p < 0.0001), while consumption of caribou liver and kidney remain a minor source of cadmium exposure among never-smokers. CONCLUSION Important decreases in mercury, lead and cadmium exposure were observed. Mercury decrease could be explained by dietary changes and the ban of lead cartridges use likely contributed to the decrease in lead exposure. Blood cadmium concentrations remain high and, underscoring the need for intensive tobacco smoking prevention campaigns in the Nunavik population.
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Affiliation(s)
- Julie Fontaine
- Unité de recherche en Santé publique, Centre de recherche du CHUL-CHUQ, 2875 boul. Laurier, Bureau 600, Québec (Québec), G1V 2M2, Canada
| | - Éric Dewailly
- Unité de recherche en Santé publique, Centre de recherche du CHUL-CHUQ, 2875 boul. Laurier, Bureau 600, Québec (Québec), G1V 2M2, Canada
| | - Jean-Louis Benedetti
- Institut national de santé publique du Québec, 945, avenue Wolfe, Québec (Québec), G1V 5B3, Canada
| | - Daria Pereg
- Unité de recherche en Santé publique, Centre de recherche du CHUL-CHUQ, 2875 boul. Laurier, Bureau 600, Québec (Québec), G1V 2M2, Canada
| | - Pierre Ayotte
- Unité de recherche en Santé publique, Centre de recherche du CHUL-CHUQ, 2875 boul. Laurier, Bureau 600, Québec (Québec), G1V 2M2, Canada
| | - Serge Déry
- Regional Board of Health and Social Services of Nunavik, C.P. 900, Kuujjuaq (Québec), J0M 1C0, Canada
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Kaewboonchoo O, Saleekul S, Powwattana A, Kawai T. Blood lead level and blood pressure of bus drivers in Bangkok, Thailand. INDUSTRIAL HEALTH 2007; 45:590-4. [PMID: 17878631 DOI: 10.2486/indhealth.45.590] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
This study aims to evaluate blood lead level (PbB) and blood pressure of bus drivers in Bangkok, Thailand, after the phasing out of lead in gasoline. The subjects comprised of 439 male bus drivers whose age ranged between 23 and 59 yr with the mean age of 42 +/- 8 yr. Average working experience was 10 +/- 7 yr. The mean of the systolic and diastolic blood pressure were 131 +/- 17 and 81 +/- 11 mmHg, respectively. PbB ranged from 2.5 to 16.2 microg/dl with the mean PbB of 6.3 microg/dl. Prevalence rate of systolic and diastolic hypertension among bus drivers were 23.0% and 18.2%, respectively. There were significant correlations between PbB and blood pressure both in systolic and diastolic blood pressure after controlling for age, BMI, alcohol consumption, smoking and physical exercise. However, the data on psycho-social factors which may affect on blood pressure of bus drivers were not available. Therefore, further study is needed to clarify the relationship between blood pressure and psycho-social stress among bus drivers in Bangkok. These findings suggested lead exposure at low PbB is related to increases in blood pressure.
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Bleecker ML, Ford DP, Vaughan CG, Walsh KS, Lindgren KN. The association of lead exposure and motor performance mediated by cerebral white matter change. Neurotoxicology 2006; 28:318-23. [PMID: 16781776 DOI: 10.1016/j.neuro.2006.04.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2005] [Revised: 04/27/2006] [Accepted: 04/29/2006] [Indexed: 10/24/2022]
Abstract
The goals were to determine if lead exposure is associated with cerebral white matter changes (WMC) and if so, does WMC mediate the relation between lead and psychomotor slowing as measured by Grooved Pegboard (GP). In the literature, age is the strongest predictor of WMC and therefore 61 lead smelter workers age 50 and under were included in the study population. Mean (range) age was 40 (23-50) years, years of education was 9 (0-13), duration of employment was 19 (1-26), current blood lead (PbB) was 29 (16-42) microg/dl, working lifetime weighted integrated blood lead (IBL) was 826 (65-1451) microg year/dl, working lifetime weighted average blood lead (TWA) was 42 (17-59) microg/dl, and bone lead (PbBn) was 39 (-12-90) microg Pb/g bone mineral. WMC, recorded as hyperintensities on T2-weighted MRI of the brain were graded. Lead variables were entered in a logistic regression attempting to differentiate normal versus abnormal MRI, after controlling for age and cerebrovascular risk factors. Direct effects of lead on GP and indirect effects of lead on GP through WMC was modeled using multiple linear regression analyses after controlling for the covariates. WMC were present in 23% of MRIs. Logistic regression of WMC on lead exposure metrics demonstrated significantly elevated odds ratios for IBL, TWA, and PbBn after the covariates. Of the lead exposure variables, IBL (beta=0.339, p<0.10) had a larger direct effect on GP after adjusting for the covariates than PbBn (beta=0.265, p<0.10). After adjusting for the lead term and covariates WMC accounted for an additional effect on GP performance after PbBn (beta=0.261, p<0.10) and after IBL (beta=0.278, p<0.05). Path analysis demonstrated that some of the relationship of both PbBn and IBL with GP is mediated by WMC.
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Affiliation(s)
- Margit L Bleecker
- Center for Occupational and Environmental Neurology, 2 Hamill Road, Suite 225, Baltimore, MD 21210, USA.
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Fenga C, Cacciola A, Martino LB, Calderaro SR, Di Nola C, Verzera A, Trimarchi G, Germanò D. Relationship of blood lead levels to blood pressure in exhaust battery storage workers. INDUSTRIAL HEALTH 2006; 44:304-9. [PMID: 16716009 DOI: 10.2486/indhealth.44.304] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Several researches has focused the hypothesis that low blood lead levels could be associated with an increased risk of hypertension. To assess the relation between occupational lead exposure and elevated blood pressure a group of 27 workers, age range from 27 to 62 years, mean (SD) 36.52 (+/- 8.16) yr; length of employment mean (DS) 2.97 (+/- 1.67) yr, were recruited as study subjects. The following variables were measured: blood lead concentration (BPb), delta-Aminolevulinic Acid Dehydratase (ALAD) activity, Zinc Protoporphirin (ZPP), creatinine, hematocrit, Body Mass Index (BMI) and Systolic Blood Pressure (SBP) and Diastolic Blood (DBP) Pressure. The results showed that long term occupational exposure was related to a slight increase of systolic and diastolic blood pressure among workers who had been exposed to higher level of lead with respect to workers exposed to lower level of lead. Furthermore, blood lead concentration (BPb) and ZPP resulted higher among workers exposed to higher level of ambient lead, while in the same group of workers ALAD activity resulted more inhibited. The authors concluded long term cumulative lead exposure can significantly increase blood pressure in low level Pb exposed workers.
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Affiliation(s)
- Concettina Fenga
- Social and Environmental Medicine Department, Section of Occupational Health University of Messina, Via Consolare Valeria, Gazzi 98124, Messina, Italy
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Vigeh M, Yokoyama K, Mazaheri M, Beheshti S, Ghazizadeh S, Sakai T, Morita Y, Kitamura F, Araki S. Relationship between increased blood lead and pregnancy hypertension in women without occupational lead exposure in Tehran, Iran. ACTA ACUST UNITED AC 2005; 59:70-5. [PMID: 16075900 DOI: 10.3200/aeoh.59.2.70-75] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study was conducted to assess the relationship between blood lead levels and pregnancy-induced hypertension. Participants were 110 pregnant women, of whom 55 were hypertensive, 27 +/- 5.6 yr of age (mean +/- standard deviation) (range = 17-40 yr); the other 55 women were age- and gravidity-matched normotensive controls. Participants were selected on the basis of their medical history and the results of a questionnaire-based interview. Subjects were at gestational ages 37 +/- 2.5 wk (range = 30-41 wk) and were not occupationally exposed to lead. Blood samples were collected within 24 hr after delivery, and blood lead levels were measured. For the hypertensive cases, blood lead levels were 5.7 +/- 2 microg/dl (range = 2.2-12.6 microg/dl [0.27 +/- 0.10 micromol/l; range = 0.11-0.60 micromol/l]), which were significantly higher than those of the control group (i.e., 4.8 +/- 1.9 microg/dl; range = 1.9-10.6 microg/dl [0.23 +/- 0.09 micromol/l; range = 0.09-0.51 micromol/l]). There were no significant differences in blood lead concentrations among hypertensive subjects with proteinuria (n = 30) and those without proteinuria (n = 25). Results of this study indicated that low-level lead exposure may be a risk factor for pregnancy hypertension.
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Affiliation(s)
- Mohsen Vigeh
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Vupputuri S, He J, Muntner P, Bazzano LA, Whelton PK, Batuman V. Blood lead level is associated with elevated blood pressure in blacks. Hypertension 2003; 41:463-8. [PMID: 12623944 DOI: 10.1161/01.hyp.0000055015.39788.29] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic lead exposure has been associated with elevated blood pressure in epidemiological studies. It is not known whether the previously observed relation between blood lead and hypertension persists after significant reductions have been made in environmental lead contamination. We examined the relation between blood lead levels and blood pressure in a representative sample of 14 952 whites and blacks aged 18 years or older who participated in the Third National Health and Nutrition Examination Survey. Blood lead was measured by atomic absorption spectrophotometry and blood pressure by standard sphygmomanometry. Mean blood lead levels were significantly higher for black men and women (5.4 and 3.4 microg/dL, respectively) compared with white men and women (4.4 and 3.0 microg/dL, respectively). After multivariate adjustment for important covariables, each standard deviation higher blood lead (3.3 microg/dL) was associated with a 0.82 (95% confidence interval [CI], 0.19 to 1.44) mm Hg and a 1.55 (95% CI, 0.47 to 2.64) mm Hg higher systolic blood pressure among black men and women, respectively. In contrast, blood lead level was not associated with blood pressure among white men or women. The multivariate-adjusted odds ratio (95% CI) of hypertension associated with a 1-SD higher level of blood lead was 1.08 (95% CI, 0.99 to 1.19) for black men and 1.39 (95% CI, 1.21 to 1.61) for black women. These findings suggest that increased levels of blood lead remain an important environmental risk factor for elevated blood pressure in blacks.
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Affiliation(s)
- Suma Vupputuri
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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14
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Nawrot TS, Thijs L, Den Hond EM, Roels HA, Staessen JA. An epidemiological re-appraisal of the association between blood pressure and blood lead: a meta-analysis. J Hum Hypertens 2002; 16:123-31. [PMID: 11850770 DOI: 10.1038/sj.jhh.1001300] [Citation(s) in RCA: 149] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2001] [Revised: 08/31/2001] [Accepted: 08/31/2001] [Indexed: 11/09/2022]
Abstract
Studies on the possible association between blood pressure and blood lead have reached divergent conclusions. In a previous meta-analysis, a doubling of the blood lead concentration was associated with a 1.0/0.6 mm Hg increase in systolic and diastolic blood pressure (BP). This meta-analysis updates the analysis originally performed in 1994. Articles on the association between BP and blood lead were identified from computer searches from January 1980 to February 2001 using the Medical Literature Analysis and Retrieval System. Of the studies reviewed, 31 provided sufficient details to be considered. The meta-analysis included 58518 subjects recruited from the general population in 19 surveys and from occupationally exposed groups in 12 studies. In all but four studies, the results were adjusted for age, and most studies took into account additional confounding factors such as body mass index and the use of alcohol and medication. Weighted joint P-values were calculated using Stouffer's procedure. The association between BP and blood lead was similar in both men and women. In the combined studies, a two-fold increase in blood lead concentration was associated with a 1.0 mm Hg rise in the systolic pressure (95% CI +0.5 to +1.4 mm Hg; P < 0.001) and with a 0.6 mm Hg increase in the diastolic pressure (95% CI +0.4 to +0.8 mm Hg; P < 0.001). On balance, this meta-analysis suggests that there can only be a weak association between BP and blood lead.
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Affiliation(s)
- T S Nawrot
- University of Leuven (K.U. Leuven), Studiecoördinatie Centrum, Department Moleculair en Cardiovasculair Onderzoek, Herestraat 49, B-3000 Leuven, Belgium.
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Todd AC, Ginde NR, Ho CK, Luo JC, Tolman J, Tsai JL, Wu TN, Liou SH. A pilot evaluation of tibia lead concentrations in Taiwan. Am J Ind Med 2001; 40:127-32. [PMID: 11494339 DOI: 10.1002/ajim.1079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aims of this study were to examine some of the factors that influence tibia lead concentrations, tibia lead x-ray fluorescence measurement uncertainty and blood lead concentrations, and to compare tibia lead concentrations in Taiwanese lead workers to those observed in lead workers from other countries. METHODS A pilot evaluation of 43 adult lead workers who underwent measurements of tibia lead and blood lead concentrations. RESULTS Mean and maximum tibia lead concentrations were 54 microg of Pb per g of bone mineral(microg/g) and 193 microg/g, respectively. Mean and maximum blood lead concentrations were 44 microg/dl and 92 microg/dl, respectively. CONCLUSION Past occupational control of lead exposure in Taiwan, ROC, did not prevent these workers from accumulating tibia lead concentrations greater than those in similar workers elsewhere in the world.
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Affiliation(s)
- A C Todd
- Department of Community and Preventive Medicine, The Mount Sinai School of Medicine, New York, NY 10029, USA.
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Dewailly E, Ayotte P, Bruneau S, Lebel G, Levallois P, Weber JP. Exposure of the Inuit population of Nunavik (Arctic Quebec) to lead and mercury. ARCHIVES OF ENVIRONMENTAL HEALTH 2001; 56:350-7. [PMID: 11572279 DOI: 10.1080/00039890109604467] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The authors conducted a survey during 1992 to evaluate blood levels of lead and mercury in Inuit adults of Nunavik (Arctic Quebec, Canada). Blood samples obtained from 492 participants (209 males and 283 females; mean age = 35 yr) were analyzed for lead and total mercury; mean (geometric) concentrations were 0.42 micromol/l (range = 0.04-2.28 micromol/l) and 79.6 nmol/l (range = 4-560 nmol/l), respectively. Concentrations of omega-3 fatty acid in plasma phospholipids--a biomarker of marine food consumption--were correlated with mercury (r = .56, p < .001) and, to a lesser extent, with blood lead levels (r = .31, p < .001). Analyses of variance further revealed that smoking, age, and consumption of waterfowl were associated with lead concentrations (r2 = .30, p < .001), whereas age and consumption of seal and beluga whale were related to total mercury levels (r2 = .30, p < .001). A significant proportion of reproductive-age women had lead and mercury concentrations that exceeded those that have been reportedly associated with subtle neurodevelopmental deficits in other populations.
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Affiliation(s)
- E Dewailly
- Unité de Recherche en Santé Publique, Centre Hospitalier Universitaire de Québec, Beauport, Canada
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