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Introduction: The aim of the study was to assess the effect of lead concentration and shift work on the occurrence of insomnia in the employees of the Zinc Steelworks in Miasteczko Śląskie in Poland. Materials and Methods : The study group consisted of 240 employees of the zinc smelter, reporting periodic and control examinations to the Occupational Medicine Clinic. Respondents were asked to complete a questionnaire consisting of the Athens Insomnia Scale and questions about the place and nature of work. Results: Analyzing the results of lead and zinc proporphiryn( ZPP) levels in the shift and non-shift subgroups of the study group, a slightly higher mean level of lead and ZPP was found in the shift subgroup. Using logistic regression, the probability of insomnia was determined depending on the concentration of lead and ZPP in the organism. As the level of lead and ZPP increases in the study group, the probability of insomnia increases. It is the largest among the examined group working in shifts. Conclusions: As the blood lead level increases, the likelihood of insomnia in steel plant workers increases.

Introduction: Lead is naturally available toxic heavy metal which is one of the main causes of environmental pollution and produces detrimental effects on health, particularly young children. Lead toxicity has become an emerging global burden of disease varying with the age, socio-economic status, occupation, industrialization, social customs and behaviours. The objective of this study was to find out the baseline blood lead level among children between 8-18 years. Methods: A descriptive study was conducted in Gokarneshwor Municipality, Kathmandu with a total of 160 children between 8-18 years of age from 2018 to 2019 after taking ethical approval from Research and Institutional Review Committee (Reference number: 17-074/075). Informed written consent was taken from the principal along with their respective parents and semi structured questionnaires were asked to students. Sample size was calculated and simple random sampling was done. The data was analyzed using Statistical Package for Social Science version 16. Point estimate at 95% Confidence Interval was calculated along with frequency and descriptive statistics. Results: The mean blood lead level of the children was 4.39±7.35 µg/dl. Mean hemoglobin being 12.63g/dl; out of 160 children 30 (18.75%) children had blood lead levels. Children with elevated blood lead level had mean haemoglobin level within normal range (13.05gm/dl), however out of 30 children, 8 (27%) had haemoglobin level below normal. Conclusions: Lead exposure in the children of urban area of Nepal is considerably high as compared to similar studies coducted in similar settings.

Lead is an occupational toxicant and a recognised health threat particularly in developing countries. Hence, this study explored the interaction of blood lead level (BLL), a conventional marker of lead exposure, with indices of calcium metabolism and biomarkers of bone-turnover in 120 adult male automobile technicians (AT) with ≥ 1 year duration in professional practice. The AT as well as the control group, which comprised 120 age, body-size and socio-economically matched male administrative workers, were recruited from Sagamu, South West Nigeria. Levels of blood lead, serum indices of calcium metabolism [total calcium (tCa), ionised calcium (iCa), phosphate, albumin, magnesium (Mg) and 25-Hydroxycholecalceferol (25-OHCC)], biomarkers of bone formation [bone alkaline phosphatase (BALP) and osteocalcin (OC)] and biomarkers of bone resorption [tartarate-resistant acid phosphatase-5b (TACRP-5b) and urinary hydroxyproline (UHYP)] were determined in all participants. The BLL, 25-OHCC, TRACP-5b and UHYP significantly increased while tCa and iCa significantly reduced in AT compared to control. However, no significant difference was observed in phosphate, albumin, Mg, BALP and OC in AT compared to control. Interestingly, BLL demonstrated a significant negative association with tCa and iCa but a significant positive association with 25-OHCC, TRACP-5b and UHYP. However, BLL did not show significant association with phosphate, albumin, Mg, BALP and OC. Increased lead exposure as well as altered calcium metabolism and bone-turnover demonstrated by the automobile technicians may be suggestive of lead-induced accelerated bone demineralisation. These workers may be predisposed to high risk of increased susceptibility to bone diseases if this sub-clinical picture is sustained.

The negative impact of lead exposure on young children and those who become pregnant is well documented but is not well known by those at highest risk from this hazard. Scientific evidence suggests that there is no known safe blood lead level (BLL), because even small amounts of lead can be harmful to a child's developing brain (1). In 2012, CDC introduced the population-based blood lead reference value (BLRV) to identify children exposed to more lead than most other children in the United States. The BLRV should be used as a guide to 1) help determine whether medical or environmental follow-up actions should be initiated for an individual child and 2) prioritize communities with the most need for primary prevention of exposure and evaluate the effectiveness of prevention efforts. The BLRV is based on the 97.5th percentile of the blood lead distribution in U.S. children aged 1-5 years from National Health and Nutrition Examination Survey (NHANES) data. NHANES is a complex, multistage survey designed to provide a nationally representative assessment of health and nutritional status of the noninstitutionalized civilian adult and child populations in the United States (2). The initial BLRV of 5 μg/dL, established in 2012, was based on data from the 2007-2008 and 2009-2010 NHANES cycles. Consistent with recommendations from a former advisory committee, this report updates CDC's BLRV in children to 3.5 μg/dL using NHANES data derived from the 2015-2016 and 2017-2018 cycles and provides helpful information to support adoption by state and local health departments, health care providers (HCPs), clinical laboratories, and others and serves as an opportunity to advance health equity and environmental justice related to preventable lead exposure. CDC recommends that public health and clinical professionals focus screening efforts on populations at high risk based on age of housing and sociodemographic risk factors. Public health and clinical professionals should collaborate to develop screening plans responsive to local conditions using local data. In the absence of such plans, universal BLL testing is recommended. In addition, jurisdictions should follow the Centers for Medicare & Medicaid Services requirement that all Medicaid-enrolled children be tested at ages 12 and 24 months or at age 24-72 months if they have not previously been screened (3).

Could trace elements in hairdressing cosmetics prove carcinogenic to hairdressers, who use them regularly as raw materials in hairdressing business? The toxic effects of selected trace elements contained in hairdressing cosmetics on hairdressers were investigated by regressing the quality of life values for hairdressers with their blood/urine levels of the toxic metals A hundred subjects were randomly drawn from a cluster of hairdressers. Blood lead level, 17.47 ± 4.59 µg/dL, confirmed that the hairdressers were regularly exposed to lead. Mean blood mercury level, 25.06 ± 4.11 ng/dL, was above the normal blood mercury concentration of less than 10–20 ng/mL. Mean blood cadmium level, 3.64 ± 1.87 µg/dL, was within the normal range, 50 to p value) for nickel was significant at 10%. P value as insignificant at 1%, 5% and 10% for lead (0.868), mercury (0.940), cadmium (0.224) and arsenic (0.475). Therefore, Ni contained in hairdressing cosmetics might have carcinogenic effects that affected the quality of life of hairdressers, unlike other trace elements tested, namely, lead, mercury, cadmium and arsenic. Further research with the tumor markers assessment is recommended to confirm the carcinogenic effect of Ni.

PURPOSE: Lead Poisoning is a major health problem in Iran. We aimed to compare efficacy of a standard regimen (Succimer) with that of a low-priced combination of D-penicillamine and Garlic in outpatients with lead poisoning. METHODS: In this retrospective cross-sectional study, year-long clinical files of outpatients with lead poisoning in two referral toxicology clinics in Mashhad, Iran were reviewed. A total of 79 patients (all men), received either Succimer or a combination of D-penicillamen plus garlic (DPN + Gar), for 19 and 30 days, respectively. Clinical and laboratory data, including blood lead level (BLL), were analyzed and treatment expanses were compared between the two regimens. RESULTS: Of 79 male patients, 42 were treated by DPN + Gar and 37 received Succimer. Mean BLL of DPN + Gar group before treatment (965.73 ± 62.54 µg/L) was higher than that of the Succimer group (827.59 ± 24.41) (p

Introduction: Lead is a heavy metal with vast usage in the industry. Lead toxicity affects any organ in the body. It causes various clinical presentations, which leads to diagnostic complexity. Regarding recent increased observation of cases with lead toxicity in our center, we aimed to evaluate the frequencies of lead toxicity in patients referred to Imam-Reza Hospital’s laboratory and find a possible relationship between the blood lead level (BLL) and hematological and biochemical tests. Methods: From 2016 to 2017, the patients referred to Imam-Reza hospital’s laboratory to detect BLL enrolled in the study. Among them, 254 adult cases with BLLs≥10 μg/dl were selected. Complete blood counts and peripheral blood smear were done. Other lab data were extracted from hospital files. Results: The mean BLL of 1649 participants was 59.11±116.25 μg/dl, ranging from 0 to 1580. Sixty nine percent of them had lead toxicity. Eighty-one percent (n=1341) of patients were males and 18.7% (n=308) were females. In 254 selected cases, the mean BLL was 138.17±189.98 μg/dl. There were significant inverse correlations between BLL and red blood cell counts, hemoglobin, mean cell hemoglobin, total iron-binding capacity, target shape and basophilic stippling, as well as positive correlations between BLL and white blood cell counts, red cell distribution width, neutrophil counts and iron. Conclusion: Lead toxicity seems to be more frequent than it is expected. Patients with unexplained anemia with increased iron and decreased total iron-binding capacity are better to be evaluated for BLL.

The detrimental impact of the heavy metal lead (Pb) on human health has been studied for years. The fact that Pb impairs human body has been established from countless painful and sad historical events. Nowadays, World Health Organization and many developmental countries have established regulations concerning the use of Pb. Measuring the blood lead level (BLL) is so far the only way to officially evaluate the degree of Pb exposure, but the so-called safety value (10 μg/dL in adults and 5 μg/dL in children) seems unreliable to represent the security checkpoint for children through daily intake of drinking water or physical contact with a lower contaminated level of Pb contents. In general, unsolved mysteries about the Pb toxicological mechanisms still remain. In this review article, we report on the methods to prevent Pb poison for further Pb toxicological research. We establish high-sensitivity Pb monitoring, and also report on the use of fluorescent biosensors such as genetically-encoded fluorescence resonance energy transfer-based biosensors built for various large demands such as the detection of severe acute respiratory syndrome coronavirus 2. We also contribute to the development and optimization of the FRET-based Pb biosensors. Our well-performed version of Met-lead 1.44 M1 has achieved a limit of detection of 10 nM (2 ppb; 0.2 μg/dL) and almost 5-fold in dynamic range (DR) supported for the real practical applications-that is, the in-cell Pb sensing device for blood and blood-related samples, and the Pb environmental detections in vitro. The perspective of our powerful Pb biosensor incorporated with a highly sensitive bio-chip of the portable device for quick Pb measurements will be addressed for further manipulation.

Lead is a persistent and common environmental contaminant that can be found in food and water. It is well-known that lead acetate causes hyperten-sion, disturbance of lipid metabolism in humans and animals. Nowadays, the phytotherapy remains a very interesting field to recovery of deleterious effect of heavy metals. The aim of this study was to evaluate the effects of aqueous extract of Artemisia absinthium to modulating the effect of lead acetate induced changes in systolic and diastolic blood pressure levels, lipid profiles in serum, heart, aorta and liver tissues and determination of lead burden in blood, when added to intoxicated animal. Male rats (80-120) g were divided into four groups of six animals each. Intoxicated animals re-ceived intraperitoneally (i.p) injections of lead acetate (20 mg/kg/body weight) solution for 4 weeks every two days. Rats treated with plant receive orally the extract of A.absinthium (5%) for 4 weeks. Orally administration of the wormwood extract in rats intoxicated with lead acetate decreased sig-nificantly the systolic (SBP), diastolic blood pressure (DBP) and blood lead level. Levels of total lipids, TC and TG were decreased significantly in group (Pb+PL) compared to control, especially in heart and liver tissues. In serum, a significant elevation of TC and TG was noted in intoxicated rats compared to control. The cardiac damage induced by Pb was evidenced by an increase in the levels of LDH and AST. In conclusion, the data indicate that the worm-wood extract has a significant ability to reduce hypertension, blood lead lev-el, equilibrate lipid metabolism and cardiac enzymes level.

Kadar timbal darah menggambarkan kadar timbal dalam tubuh. Absorbsi timbal darah yang meningkat menyebabkan peningkatan jumlah retikulosit. Hematoksik dapat digunakan untuk meningkatkan kewaspadaan terhadap efek timbal darah pada masyarakat seperti pekerja cat oplosan. Tujuan penelitian untuk mengetahui hubungan dan keeratan hubungan kadar timbal darah dengan hasil hitung retikulosit pekerja cat oplosan di wilayah Jakarta Timur. Metode Penelitian analitik observasional pendekatan desain cross sectional, secara non probabilityconsecutive sampling. Hasil penelitian, pada Pekerja Cat Oplosan di wilayah Jakarta Timur diperoleh kadar timbal darah tertinggi 0,45 mg/L, dengan persentase retikulosit tertinggi 1,62 %. Terdapat Pekerja Cat Oplosan dengan kadar timbal melebihi batas rujukan (>0,40 mg/L) dengan persentase retikulosit diatas normal (>1,5 %) sebanyak 10 %. Pekerja Cat Oplosan dengan kadar timbal dalam batas rujukan dengan persentase retikulosit normal masih besar yaitu 80 %. Kesimpulan, terdapat hubungan yang signifikan antara kadar timbal darah dengan persentase retikulosit pada pekerja cat oplosan di wilayah Jakarta Timur (p-value = 0,000) dan menunjukkan hubungan yang kuat dengan arah hubungan positif nilai r = 0,663. Keeratan hubungan dengan arah positip berarti semakin tinggi kadar timbal darah dapat memperpendek umur dan pematangan eritrocit ditandai peningkatan jumlah retikulosit.

Background Bone is thought to be the reservoir of the human lead burden, and vitamin D is associated with bone turnover. We aimed to explore whether exposure to lower 25-hydroxy vitamin D (25(OH)D) levels was associated with higher blood lead levels (BLLs) by increasing the bone turnover rate in individuals with type 2 diabetes. Methods A total of 4103 type 2 diabetic men and postmenopausal women in Shanghai, China, were enrolled in 2018. Their 25(OH)D, β-C-terminal telopeptide (β-CTX), N-MID osteocalcin and procollagen type 1 N-peptide (P1NP) levels were detected. Their BLLs were determined by atomic absorption spectrometry. Mediation analyses were performed to identify the possible role that bone turnover played in the underlying mechanisms. Results In both the men and postmenopausal women, all three bone turnover markers were inversely associated with 25(OH)D and positively associated with the BLL (all P < 0.01) after adjusting for age, current smoking habits, metabolic parameters, duration of diabetes, vitamin D intake, and use of anti-osteoporosis medication. In the mediation analyses, none of the direct associations between 25(OH)D and BLL was significant for the three bone turnover markers, but all three bone turnover markers were found to be significant mediators of the indirect associations between 25(OH)D and BLL. Conclusion The association between vitamin D and BLL was fully mediated by bone turnover markers in type 2 diabetic patients (mediation effect). This finding suggested that vitamin D may protect against blood lead exposure from the bone reservoir by decreasing bone turnover in individuals with type 2 diabetes.

Delta-aminolevulinic acid dehydratase (ALAD) enzyme catalyzes the second phase of the heme biosynthesis and is involved in lead toxicokinetics. This research aimed to evaluate its influence on the relationship between blood lead (PbB) levels and intellectual performance in Afro-Brazilian children. PbB, hemoglobin concentration, ALAD activity, and polymorphism were determined in whole blood. Anthropometric, socioeconomic, and family environment stimuli data were collected with appropriate instruments. The non-verbal intelligence of children and their mothers or guardians was assessed using the correspondent Raven’s Progressive Matrix versions. The medians (range) of PbB levels and ALAD activity were 1.0 μg/dL (0.1–21.3) and, 71 U/L (31–113), respectively. ALAD G177C was distributed as follows: 97.9% for ALAD1/1 and 2.1% for ALAD1/2 genotypes. The mean of Raven raw score was 19.3 (± 5.6) points and there were no differences according to sex or environmental Pb exposure. No statistically significant association was observed between PbB level and children’s IQ. However, ALAD activity presented an inverse significant association with PbB levels, children’s percentile IQ, and children’s IQ/Age ratio, suggesting a neuroprotective role of ALAD1 genotype in those with low PbB level.

Objectives Lead exposure in children contributes to 600,000 new cases of intellectual disabilities every year with maximum occurrence in developing countries. Currently limited information is available on the blood lead level (BLL) in children of India. The aim was to estimate BLL in the school going children of local population of Jodhpur. Methods Four hundred twenty-six primary school children of government and private schools participated in this cross sectional study. Information regarding possible lead exposure was collected. BLL was estimated on Lead Care II analyser (Magellan Diagnostics, USA). Results The mean and median BLL were 4.25 ± 1.75 μg/dL ( Conclusions BLL in children residing in Jodhpur is much higher in comparison to western counterparts. Screening and awareness programs regarding potential sources of lead exposure can help in improving BLL.

Lead is a heavy metal without a biological role. High level of lead exposure is known to be associated with hypertension, but the risk at low levels of exposure is uncertain. In this study, data from US NHANES 1999–2016 were analyzed. Adults with blood lead and blood pressure measurements, or self-reported hypertension diagnosis, were included. If not already diagnosed, hypertension was defined according to the AHA/ACC 2017 hypertension guideline. Results were analyzed using R statistics version 3.5.1 with sample weight adjustment. Logistic regression was used to study the association between blood lead level and hypertension. Odds ratio (OR) and 95% confidence interval (95% CI) were estimated. Altogether, 39,477 participants were included. Every doubling in blood lead level was associated with hypertension (OR [95%CI] 1.45 [1.40–1.50]), which remained significant after adjusting for demographics. Using quartile 1 as reference, higher blood lead levels were associated with increased adjusted odds of hypertension (Quartile 4 vs. Quartile 1: 1.22 [1.09–1.36]; Quartile 3 vs. Quartile 1: 1.15 [1.04–1.28]; Quartile 2 vs. Quartile 1: 1.14 [1.05–1.25]). In conclusion, blood lead level is associated with hypertension in the general population with blood lead levels below 5 µg/dL. Our findings suggest that reducing present levels of environmental lead exposure may bring cardiovascular benefits by reducing blood pressure.

Exposure to lead, a toxic metal, can result in severe effects in children, including decreased ability to learn, permanent neurologic damage, organ failure, and death. CDC and other health care organizations recommend routine blood lead level (BLL) testing among children as part of well-child examinations to facilitate prompt identification of elevated BLL, eliminate source exposure, and provide medical and other services (1). To describe BLL testing trends among young children during the coronavirus disease 2019 (COVID-19) pandemic, CDC analyzed data reported from 34 state and local health departments about BLL testing among children aged

To see the present scenario of blood lead (BPb) levels of Silver Jewellery Workers (SJW) and its effects on haematological and heme biosynthesis parameters. Forty-two SJW of having an age range of 20-45 years were included for this study and compared with 50 healthy male subjects of the same age. Blood lead, RBC δ- aminolevulinic acid dehydratase (δ-ALDH), urinary δ- aminolevulinic acid (U- δ-ALA), urinary porphobilinogen (U-PBG) and haematological parameters were measured. Blood lead level of silver jewellery workers was significantly elevated (p

Graphical abstract, Highlights • BLL had a significant direct correlation with abnormal neurobehavior. • Serum serotonin levels were significantly lower in children with high blood lead levels (BLL). • Serum serotonin and dopamine receptor expression were upregulated in children with high BLL. • Serum serotonin levels had significant negative association with adverse neurobehavior. • Dopamine receptor expression had significant positive association with adverse neurobehavior., Present study aimed to assess the alterations in neurotransmitter expression and its association with Blood Lead Level (BLL) and neurobehavioral pattern in children. 72 school going children were recruited. Blood lead levels were determined by Atomic Absorption Spectrophotometer. Neurobehavioral state was assessed by means of population specific scale i.e. CPMS (Childhood Psychopathological measurement Schedule). Serum serotonin and dopamine were estimated by ELISA, receptor and transporter gene expressions were assessed by quantitative real time PCR. Significant positive correlation was observed between Total CPMS score (i.e. adverse neurobehaviour) and BLL. Further, serum serotonin levels and dopamine receptor expression showed a negative and positive association with BLL, respectively. In similarity, serum serotonin levels showed a negative correlation and dopamine receptor expression had a significant positive correlation with total CPMS score. Environmental exposure to Lead (Pb) may result in significant alterations in the neurotransmitter levels which may be associated with neurobehavioral changes in the children exposed to Pb.

Lead exposure is one of the most concerning public health problems worldwide, particularly among children. Yet the impact of chronic lead exposure on the thyroid status and related intelligence quotient performance among school-age children remained elusive.The aim of this study was to evaluate the influence of lead exposure on the thyroid hormones, amino acid neurotransmitters balances, and intelligence quotient (IQ) among school-age children living nearby a lead-zinc mining site. Other factors such as rice lead levels, mothers' smoking behavior, and diet intake were also investigated.A total of 255 children aged 7-12 years old were recruited in this study. Blood lead level (BLL), thyroid hormones including free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH), and amino acid neurotransmitters such as glutamate (Glu), glutamine (Gln), and γ-aminobutyric acid (GABA) were measured using graphite furnace atomic absorption spectroscopy (GFAAS), chemiluminescence immunoassay, high performance liquid chromatography (HPLC). Raven's standard progressive matrices (SPM) and the questionnaire were used to determine IQ and collect related influence factors.The average BLL of children was 84.8 μg/L. The occurrence of lead intoxication (defined as the BLL ≥ 100 μg/L) was 31.8%. Serum TSH levels and IQ of lead-intoxicated children were significantly lower than those without lead toxicity. The GABA level of girls with the lead intoxication was higher than those with no lead-exposed group. Correlation analyses revealed that BLL were inversely associated with the serum TSH levels (R= -0.186, p0.05), but positively related with IQ grades (R = 0.147, p0.05). Moreover, BLL and Glu were inversely correlated with IQ. In addition, this study revealed four factors that may contribute to the incidence of lead intoxication among children, including the frequency of mother smoking (OR = 3.587, p0.05) and drinking un-boiled stagnant tap water (OR = 3.716, p0.05); eating fresh fruits and vegetables (OR = 0.323, p0.05) and soy products regularly (OR = 0.181, p0.05) may protect against lead intoxication.Lead exposure affects the serum TSH, GABA levels and IQ of school-aged children. Developing good living habits, improving environment, increasing the intake of high-quality protein and fresh vegetable and fruit may improve the condition of lead intoxication.

Emisi kendaraan bermotor mengandung logam berat salah satunya adalah timbal (Pb). Pedagang kaki lima termasuk ke dalam kelompok masyarakat berisiko tinggi terhadap paparan emisi kendaraan bermotor. Penelitian ini bertujuan untuk menganalisis dan mengkaji kadar timbal dalam darah pedagang kaki lima. Rancangan penelitian yang digunakan adalah cross sectional dengan metode pengumpulan data melalui observasi, wawancara dan kuesioner. Pengukuran timbal menggunakan metode Spektrofotometer Serapan Atom (SSA). Sampel ditentukan dengan metode purposive sampling sebanyak 30 pedagang kaki lima. Hasil penelitian menunjukkan bahwa 18 responden (60%) memiliki kadar timbal dalam darah melebihi kadar normal yaitu

The risk of hearing loss from exposure to ototoxic chemicals is not reflected in occupational exposure limits and most jurisdictions. The aims of this research were to investigate dose-response relationships between exposure to lead, mercury, toluene, and styrene and hearing impairment based on current epidemiological evidence, conduct cross-jurisdictional comparisons, and investigate control measures for exposure to ototoxic chemicals. Ovid Medline and Ovid Embase databases were used to find relevant publications. A total of 86 epidemiological studies met the eligibility criteria for final evaluation. When significant associations between exposure and outcome were identified, exposure levels were evaluated to determine whether No Observed Adverse Effect Level (NOAEL) and Lowest Observed Adverse Effect Level (LOAEL) could be identified. Cross-jurisdictional comparisons included the U.K., U.S., Canada, and Australia occupational health and safety legislations. The majority of lead (75%), styrene (74%), and toluene (77%) studies showed significantly increased risks of hearing loss from exposure to these substances, although numerous studies on toluene (70%) and styrene (16%) compared auditory function between "solvent mixture" or "noise and solvent mixture" exposed groups and controls and not necessarily on groups exposed to a single agent. Based on five studies, blood lead ranges of 1-1.99 μg/dL to 2.148-2.822 μg/dL were identified as NOAELs while blood lead levels of 2 μg/dL up to 2.823-26.507 μg/dL were identified as LOAELs for hearing loss. Except for general duty clauses, the U.S., Canadian, and Australian jurisdictions have set no enforceable regulations specific to ototoxic chemical exposures. A biological exposure index of 2 μg/dL is recommended for prevention of hearing impairment from lead exposure. Based on Safe Work Australia, noise exposure limits may be reduced to 80 dB(A) for 8 hr. Other recommendations include performing audiometric testing and controlling exposure through all routes of entry.

Opium sale is prohibited in Iran, and sellers mix it with lead to increase the weight. Herein, we describe neuromuscular findings in nine patients who developed lead poisoning due to opium/drug consumption. The mean age of patients was 53 ± 3.5 years and their mean blood lead level was 122.6 ± 20.8 μg/dL. Most of the patients had an acute/subacute course presenting as axonal or demyelinating sensorimotor polyneuropathy, motor neuron disease, and multiple mononeuropathies with favorable response to the chelation therapy. Lead poisoning should be considered in patients with a history of opium use and neuromuscular symptoms.

Background Lead is a hazardous heavy metal, which causes many problems in the human body. Unfortunately, recent reports showed that smugglers and opium sellers add lead to drugs during the production procedure in order to increase its weight and cost. Purpose The aim of this study was development of a rapid and accurate method for measurement of blood lead levels (BLL) in the oral and inhaled opiate abuser people. Methods BLL in samples obtained from the oral and inhaled opium addicted patients referring to Sina Hospital in Tabriz, Iran, during 2017 was compared with healthy control group (N=15). The wet digestion method was used to prepare whole blood and Mercury Droplet Electrode Polarography (MDEP) method was utilized for measurement of the lead content of digested samples. Results Results showed that there were significant differences between the BLL of samples obtained from oral (17.12±74.61 μg/dL, p Conclusion Based on the results of this study it was observed that BLL in opium addicted people needs to be measured as soon as possible. Furthermore, screening of blood lead concentrations in opium-addicted people with a rapid and accurate MDEP method is very necessary and important.

Background: Uremic pruritus (UP) is commonly described as a daily or near-daily occurrence of itch that spans large bilaterally symmetrical surface areas. Blood lead level (BLL) has been noted to be associated with inflammation and nutritional status in long-term HD patients. Objective: To evaluate the possible relationship between BLL and UP in chronic HD patients. Patients and Methods: This Cross-Sectional Study was carried out in the Hemodialysis Unit in EL Agouza Hospital from November 2018 to the end of April 2019 and included 100 randomly selected patients with end- stage who received hemodialysis sessions thrice weekly, four hours /session, for more than 6 months. Dialysate with standard ionic composition and a bicarbonate-based buffer is used for all patients. Results: The mean age of the chosen patients were ±SD 48.6 ± 7.1 years and the difference among the groups was non-significant (p-value 0.116). The study included 42 females (42%) and 58 males (58%). There was no significant difference among the studied groups (p=0.292) regarding sex. According to Pruritus Onset in our study, there was a non-statistically significant difference among the studied groups. In our study, there was a statistically highly significant difference among different groups regarding Serum Lead (μg/dL) (p-value

Background We aimed to provide a quantitative summary of evidence for a relationship between prenatal lead (Pb) exposure and birth weight. Methods PubMed and Web of Science databases were searched for eligible epidemiological studies. We transformed findings in eligible studies with different effect-size metrics to standardized regression coefficients, and used fixed-effects or random-effects models to assess the pooled effects of prenatal Pb exposure on birth weight. Results There was a significant negative association between prenatal Pb exposure and birth weight. Birth weight reduction was associated with elevated lead levels in maternal blood (β = -0.094; 95% confidence interval [CI]: -0.157 to -0.030) and cord blood (β = -0.120; 95% CI: -0.239 to -0.001). Conclusions This meta-analysis is the first to provide a quantitative assessment of Pb exposure during pregnancy and an increased risk of lower birth weight.

Objective: Due to the rapid pace of industrialization and the high prevalence of addiction, toxicity caused by heavy metals, especially lead, has become one of the major health problems associated with high morbidity and mortality. Therefore, reliable information is critical to manage this condition. Methods: This descriptive cross-sectional study was performed on 30 cadavers, suspected of lead poisoning. The hospital records and the results of anatomical investigations were studied. Data were collected in a researcher-made questionnaire and analyzed in SPSS Version 22. Results: The results showed a significant correlation between the pathological results of pulmonary autopsy and the duration of drug use (P= 0.01). Also, the pathological results of cardiac autopsy had significant correlations with age (P= 0.006) and blood lead level (P= 0.03). Moreover, significant correlations were found between the pathological results of liver autopsy and age (P=0.00), between the pathological results of brain autopsy and the route of drug administration (P=0.01), and between the pathological results of kidney autopsy and age (P=0.00). Most pathological changes were observed in the brain and kidney tissues. Conclusion: Lead poisoning does not cause any specific pathological changes in the liver, heart, brain, lung, or kidney tissues; however, these non-specific changes, alone or together, can lead to death

The current study was aimed to ascertain the effect of blood lead level on brain tissues in patients with type 2 diabetes. A total of 300 human participants ages 27 to 60 years with type 2 diabetes (n = 150) and healthy individuals (n = 150) were included in this study. The serum samples were used for measuring HbA1c and fasting blood glucose. Blood lead level was measured using flame atomic absorption spectrophotometer. Magnetic resonance imaging sub-analysis was used to assess the brain hyperintensities. Brain hyperintensities were found in 55% of patients with diabetes and 6% of non-diabetic control group subjects. The deep white matter hyperintensities were observed in 45% of diabetic patients, while the subcortical hyperintensities were noted in 10% of cases. Entorhinal cortex changes (31%) and hippocampus changes (42%) were noted in diabetic patients with brain hyperintensities. Diabetic patients with brain hyperintensities showed higher blood lead levels, HbA1c, and fasting blood sugar (p

The aim of this study was to investigate the association between blood lead level (BLL) and hypertension in adults when lead exposure for the general population is low. The study used data from the US National Health and Nutrition Examination Survey (NHANES) 1999–2016. Participants aged 20 to 79 years were included in our study. Weighted multiple linear regression and logistic regression were conducted to test the association between BLL and systolic/diastolic blood pressure and hypertension status, respectively, while controlling for age, gender, race/ethnicity, body mass index, income level, and education. A total of 30,467 participants were included in this study. There was no association between BLL and hypertension status for the overall sample. Among those who were not taking antihypertensive medication, after adjusting for covariates, systolic blood pressure was positively correlated with BLL in non-Hispanic Whites (P = 0.004) and non-Hispanic Blacks (P = 0.0005), but not Hispanics (P = 0.07) nor Others (P = 0.37). The relationship between diastolic blood pressure and lead levels was also significant in non-Hispanic Whites and non-Hispanic Blacks. This study showed that higher BLL was associated with higher systolic and diastolic blood pressure in some population groups, but not associated with hypertension status.

The objective was to determine if refugee females of reproductive age (FRA) are at risk of having elevated blood lead levels (BLL). A retrospective quality improvement project conducted at a Denver community health center (9/2014–3/2019) evaluated BLLs from initial domestic medical examinations (DME) in 312 FRA refugees (13–45 years). Associations between elevated BLL and demographic factors were explored using multivariable regression analysis. Of 312 FRA refugees, BLLs ranged from

Limited epidemiologic studies questioned the association between pre- and postnatal lead exposure and the development of cerebral palsy (CP). Moreover, the genotypes of δ-aminolevulinic acid dehydratase (δ-ALAD) in CP patients and their mothers and their association to the blood lead levels (BLLs) were not previously studied. This study aimed to evaluate the association between δ-ALAD gene polymorphism and BLL in cases of CP and their mothers. A case control study was carried out on 23 CP cases and equal number of healthy matched controls. The mothers of the included children were asked to answer a questionnaire involving the baseline clinical and demographic characteristics. Also, questionnaires were done to detect the sources of environmental lead exposure and screen lead exposure during the pregnancy period. BLL, δ-ALAD enzyme activity, and genetic analysis for ALAD G177C were done for each child and his mother. There was significant (p0.001) elevation of BLL in CP cases and their mothers that was positively correlated (r = 0.436, p0.05). There were progressive decreases in δ-ALAD activity with increasing BLL in both children and mothers (p0.05). There were non-significant (p0.05) differences between CP and the control group regarding frequency of ALAD G177C genotypes, while there was a significant (p = 0.04) increase in the frequency of ALAD 1-2 (GC) genotype in the mothers of the CP group associated with high BLL and significant decrease in δ-ALAD activity (p0.001). The study can indicate the significance of δ-ALAD gene polymorphism in the prenatal exposure to lead and the affection of the developing brain, pointing to the importance of controlling lead in pregnant women especially those with ALAD 1-2 genotype.

There are limited data regarding low lead exposure and iron status in Chinese children. This study aimed to examine the association between low-level lead exposure and iron status in a large population of children aged 0–5 years. We reviewed the records of children aged 0–5 years who had blood lead, iron, ferritin, and hemoglobin measurements during 2014–2017 at the Guangdong Women and Children Hospital. We identified 17,486 children with a blood lead level

We herein report a 24-year-old male construction worker with occupational lead poisoning who presented with acute abdomen and normocytic anemia. The levels of urinary delta-aminolevulinic acid and free erythrocyte protoporphyrin were elevated without any increase in the level of urine porphobilinogen. Detection of an elevated blood lead level of 100 μg/dL confirmed a diagnosis of lead poisoning. Chelation therapy with calcium disodium ethylenediaminetetraacetate resulted in prompt improvement of the clinical symptoms and the blood lead level. Clinicians should be aware that lead poisoning caused by occupational exposure can still occur sporadically in construction workers in Japan.

Background Abdominal pain may be a presenting symptom of lead poisoning and is often difficult to diagnose. This study aimed to determine the prevalence of abdominal pain in patients seen in the Laghman Hakim Hospital ED and GI clinic who were lead-intoxicated, with or without opiate use disorder. Methods Between July 2017 and January 2018, patients seen in the ED and GI clinic of Loghman Hakim Hospital with unexplained abdominal pain or abdominal pain resistant to treatment were enrolled. Informed consent was obtained from potential enrollees. For standardization, a pre-designed data collection tool was developed for uniform data acquisition. Opiate use was determined historically. For this study, lead poisoning was defined as a blood lead level (BLL) greater than or equal to 30 μg/dL (1.45 μmol/L) with concomitant GI symptoms. Results Of 125 patients admitted, 28 (22.4%) had BLLs higher than 30 μg/dL. None of the patients had signs and symptoms of opioid withdrawal syndrome during evaluation. Elevated BLLs were significantly correlated with oral opium use/abuse, history of addiction for over the preceding 12 years. The daily opium use was more than 2.75 g. There was a statistical correlation between lead toxicity and abdominal pain consistency and intensity, constipation, and paresthesias. Anemia, leukocytosis, and abnormal liver enzyme tests were laboratory findings associated with lead toxicity. Four patients died, one of whom was diagnosed with lead toxicity. Conclusion Lead toxicity should be considered in the potential differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs or GI clinics if a positive history of opium abuse exists.

Background Encephalopathy is an uncommon but serious presentation of lead toxicity. Objective We aimed to determine and follow-up the brain magnetic resonance imaging (MRI) abnormalities in the patients with lead encephalopathy due to ingestion of lead contaminated opium. Methods In a cross-sectional study during lead-contaminated opium outbreak, all lead-poisoned patients with any signs/symptoms of encephalopathy were included. Results Of 19 patients with lead encephalopathy, five died early and other five could not be sent to MRI during their hospitalization period. Mean age was 51 ± 11 years and males were dominant (89%). Median [IQR] blood lead level (BLL) was 101 [81, 108] μg/dL (range; 50 to 200 μg/dL). There was no correlation between MRI findings and signs/symptoms. MRI was normal in six and abnormal in three. Bilateral symmetric involvement of parieto-occipital lobes was observed. Gray matter, gray-white matter junction, and subcortical white matter were also affected. Follow-up MRI was performed in two with abnormal MRI which showed complete and near complete resolution of the abnormalities after cessation of opium use and treatment. Conclusion: There was no correlation between MRI findings and BLL. Complete recovery of brain MRI lesions was detected after cessation of opium use.

The presented case demonstrates that acute lead poisoning may occur due to just short-term exposure to a mixture of lead-containing dust and ammunition. Such exposure may result in high blood lead levels persisting for years in the absence of any symptoms. A middle-aged male with a history of an approximately 7-day cleanup of an old recreational firing range with large ammunition and dust deposits presented to an emergency department with abdominal pain, dyspnea, fatigue and impaired cognitive function. Given his occupational history, specific tests were performed that showed high lead concentrations in both blood and urine. The patient was diagnosed with acute lead poisoning. He was started on chelation therapy that improved both clinical and laboratory parameters. Over a subsequent nearly 3-year follow-up, the patient's blood lead levels fluctuated and continued to be increased. Given the absence of other sources of lead exposure, these were likely due to the formation of bone deposits. Med Pr. 2020;71(3):375-9.

In spite of the established knowledge regarding their toxicities, occupational exposure to heavy metals like lead and cadmium still continues because of their wide distribution in environment. Due to lack of awareness, most of the workers usually eat, smoke, drink at their workplace which may aggravate the metal exposure. The present study was planned to assess the blood levels of lead and cadmium in occupationally exposed workers of Jodhpur (India). A total of 110 individuals working in different industrial set ups (furniture, metal handicraft, welders) of Jodhpur district (exposed group), aged between 20 and 60 years and 97 apparently healthy people (controls) with no history of occupational heavy metal exposure aged between 25 and 60 were recruited. Details of personal habits and demographics were recorded by means of self-developed questionnaire. 5 ml of whole blood was drawn from every individual. Metal levels were measured by graphite furnace atomic absorption spectrophotometer. Statistical analysis was done using GraphPad Prism Software. Results showed that Blood Lead Level and Blood Cadmium Level (CdB) were significantly higher in the exposed group as compared to the non-exposed group. Significant age and gender-based differences were found in terms of blood cadmium levels but no such difference was observed in case of blood lead. The study also revealed that higher blood levels of these metals in workers are influenced by their occupational practices, lack of protection against workplace environment pollutants, thus increasing their susceptibility to metal toxicity.

Lead is a widely used heavy metal, which is absorbed in humans by different routes. It causes wide varieties of health hazards including eye pathologies. Diabetic retinopathy (DR) is a common complication of diabetes mellitus. The current study was conducted to study blood lead level (BLL) as a risk factor for development of retinopathy among diabetics. Two hundred thirty-six diabetic patients, aged above 45 years, were examined for DR through dilated fundus examinations. Whole blood samples were collected for BLL assay by atomic absorption. Diabetic retinopathy was graded following the Scottish grading system. Diabetic retinopathy was observed in 75 (31.7%) cases. BLL was significantly higher (p = 0.0083) in DR cases [GM = 8.5 µg/dl (95% CI 8–9)] in comparison with the other diabetics without DR [GM = 10.25 µg/dl (95% CI 9.4–11). Also, BLL was significantly correlated with the grade of retinopathy (p value = 0.0023, r = 0.386). In addition, the data revealed that the effect of BLL in pathogenesis of DR was more significant among females and participants aged below 60 years. The current data suggested that high BLL can be considered as a contributing factor for development of DR among diabetics. Further larger and long-term studies are recommended for more robust data.

Background and Aims: The aim of this study is to determine the lead level in blood, workers expose to lead. Methods: 42 subjects blood was analyzes for Lead. 21,14,2,5 persons are from fuel station workers, idol painters, application of lead containing pigment to eyes and garage workers respectively. Studied from January 2012 to 2017. Analysis blood by method of inductivity coupled atomic emission spectroscopy. Results: 21 fuel outlet works 11 (45.83%) Lead levels in blood were from 35.4 to 190 (mean 72.77) mcg/dl, remaining 10 lead levels were < 10 mcg/dl. Out of 14 idol painters 9 (64.28%) persons blood Lead levels were 10.06 to 18.57 (12.57) mcg/dl, remaining 5 it was < 10 mcg/dl. 2 Surma application to eyes their Lead levels were 29.22 and 10.93 respectively. 5 garage workers Lead levels were 13.54 to 46.75 (mean23.52) mcg/dl. Conclusion: Occupation exposure to lead containing fuel, paints, surma and garage workers blood levels of lead is significant.

Improper treating, sorting, storing, transporting, or disposing of wastes poses a potential risk to the health of humans and the environment. The workers of waste management plants are at risk of exposure to heavy metals and their toxic and hazardous effects through respiratory or cutaneous routes. Accordingly, concentrations of two heavy metals in the biological samples of workers of a municipal waste management (MSW) plant in Iraqi Kurdistan were measured in 139 persons who worked for at least 6 months. Blood and plasma samples were collected to measure lead and zinc concentrations, respectively. Their working units, occupational history, smoking habits, and the distance living from the landfill site were recorded in a predesigned questionnaire. A blood lead level (BLL) of less than 40 μg/dL was considered a safe cutoff. The lower limit of normal fasting plasma zinc was set at 70-120 μg/dL. The study showed that the mean age of the workers was 33.43, ranging from 16 to 67 years old, and they worked for the last 4.93 years. Further, 22.3% of the staff had previous experience in a job with suspected exposure to heavy metals. The mean BLL concentrations and the plasma zinc level were 31 μg/dl and 5.77 μg/dl, respectively. The study did not find a substantial difference in lead and zinc among workers with different characteristics. We did not find any predictor for lead and zinc concentrations in our sample. The study showed that the mean levels of lead and zinc were lower than the permitted ranges.

Although considerable research has been conducted regarding airborne lead exposures during lead paint removal, little data has been collected measuring the lead concentration on workers’ hands in the construction industry. As a result, there are gaps in our understanding of the effectiveness of a standard work practice control (handwashing) in the prevention and control of elevated blood lead levels (BLLs) in the workplace. The primary objective of this study was to assess if a National Institute for Occupational Safety and Health (NIOSH) formulation intended to remove lead from skin (Hygenall© LeadoffTM Foaming Soap) is more effective than a commonly used soap in the industrial painting industry (Zep Cherry Bomb Soap) in reducing the concentration of lead on workers’ hands after exposure. A secondary aim was to assess if using LeadoffTM Foaming Soap during handwashing reduces worker uptake of lead on bridge painting projects. We evaluated hand wipe, air sample and blood lead level data collected by two industrial bridge painting contractors. Airborne exposures ranged from 350 μg/m3 to 19,700 μg/m3. The geometric mean lead concentration remaining on workers’ hands after using Zep Cherry Bomb Soap was 77 μg per hand wipe compared with 61 μg per hand wipe after use of LeadoffTM Foaming Soap for all work classifications. The geometric lead concentration on workers’ hands decreased by 16 μg/hand wipe for all work classifications combined after using LeadoffTM Foaming Soap—a decrease of 21%. The use of Hygenall LeadoffTM Foaming Soap reduced the maximum lead concentration on workers’ hands by 85%. The geometric mean BLL for all work classifications was 12.1 μg/dl before the use of LeadoffTM. After two months of airborne exposure and use of LeadoffTM Foaming Soap at breaks and at the end of the workday, the geometric mean BLL for all work classifications increased to 18.1 μg/dl. Worker BLLs increased despite the reduction in the concentration of lead measured on workers’ hands—most likely a result of ineffective inhalation exposure controls. We found that the LeadoffTM Foaming Soap was more effective in removing lead from workers’ hands than Zep Cherry Bomb.

OBJECTIVES Multiple case reports of lead toxicity related to retained bullet fragments in pediatric patients sustaining gunshot wound have been published. The purpose of the present study was to determine whether the demographic and clinical characteristics of gunshot wounds (GSWs) could be classified high/low risk and whether routine blood lead monitoring is necessary in these patients. METHODS A single-center prospective case series of pediatric GSW patients presenting to the emergency department (ED). The data points that were collected and analyzed included age, sex, race, wound location, disposition, and baseline and follow-up lead levels within 6 months post-injury. RESULTS Twenty patients were enrolled in the study and the median age was 7.5 years (interquartile range 5.25-10.75); 75% of the patients were African American. A total of 15 patients (75%) had injuries in either a lower or upper extremity, 9 of whom required admission. Almost all of the injuries involving the head, chest, or abdomen required admission. Of the patients, 65% were admitted and 35% were discharged. All of the patients had an initial blood lead level taken, and follow-up lead levels were determined at 6 months post-injury to be

Objective To summarize the evidence on the effectiveness of soil remediation to prevent or reduce lead exposure. Methods We systematically searched MEDLINE, the Agricultural & Environmental Science Database, Web of Science, and Scopus from 1980 to February 15, 2021. We also performed reference list checking, hand-searched websites, and contacted experts. Eligible studies evaluated the effect of soil remediation to prevent or reduce lead exposure in humans of any age. We screened all records dually; one investigator performed the data extraction; a second checked for completeness and accuracy. Two investigators independently rated the risk of bias of included studies and graded the certainty of evidence. We synthesized findings narratively. Results We identified 6614 potentially relevant publications, all focused on children, of which five studies (six records) fulfilled our prespecified inclusion criteria. The number of evaluated participants ranged from 31 to 1425, with follow-up periods of 11 months to one year. The primary soil remediation method was the replacement of the upper layer with clean soil. Outcomes were limited to blood lead levels (BLL), dust lead levels, and soil lead levels. The largest study, a controlled before– after study (n = 1425) reported favorable effects of soil remediation compared to no intervention. This finding was consistent with results from two cross-sectional studies and one uncontrolled before–after study. One year post-remediation, the mean reduction in BLL was 2.1 μg/dL (p, Graphical abstract Unlabelled Image, Highlights • Lead exposure from contaminated soil is an important public health issue, concerning both children and adults. • Soil remediation alone or in combination with other interventions appears to reduce the blood lead levels in children. • The effect of soil remediation on health outcomes, in high lead exposure areas or in low/middle-income countries is unclear.

Exposure to lead-based paints is a major threat to the health of painters. This study aimed to evaluate the blood concentration of lead (Pb) in painters of buildings and cars. The present study was a cross-sectional study in which a semi-structured questionnaire was used to collect the socio-demographic information. Lead concentration in blood samples was determined using the atomic absorption spectrometry method. A total of 32 male painters were selected based on inclusion criteria. The mean blood lead level (BLL) in the painters was 8.1 ± 4.93 μg/dL. Pb levels in car and building painters were 9.42 ± 5.5 μg/dL and 6.7 ± 1.85 μg/dL, respectively. Pb concentration in none of the blood samples was more than 30 μg/dL. The prevalence of BLL ≥ 5 μg/dL and BLL ≥ 10 μg/dL was 97% and 19%, respectively. According to the findings, the rate of BLL among car painters was higher than building painters. Considering the presence of Pb in all blood samples, it seems necessary to increase the awareness of painters about the adverse effects of lead exposure even in low concentrations. However, the sample size in this study was small and more investigations are required in this regard.

Lead (Pb) in lipstick products has become an increasing concern, which can cause safety problems to human body directly with diet. To investigate the Pb exposure and potential health risk level of typical popular lip cosmetics in Chinese e-commerce market, Python crawler was introduced to identify and select 34 typical popular lip cosmetics, including 12 lipsticks, 13 lip glosses, and 9 lip balms. And then this study used ICP-MS to determine the content of Pb. Furthermore, the ingestion health risk assessment method issued by United States Environmental Protection Agency (USEPA) and Monte Carlo simulation algorithm were applied to assess the probabilistic health risks of adults exposure. Finally, taking the possible exposure of children contacting with lip products, the health risk assessment of children blood Pb was carried out. The results showed that the concentration of Pb in lip products ranged from 0 to 0.5237 mg/kg, which was far lower than the limit set by various countries. The probabilistic non-carcinogenic risks and carcinogenic risks were 4.93 ×10−7~2.82 ×10−3 and 1.68 ×10−12~9.59 ×10−9, respectively, which were in an acceptable level. The results of blood Pb assessment suggested that the Pb content of lip cosmetics had no obvious influence on blood Pb concentration of children, and background Pb exposure is the main factor affecting children's blood Pb level (BLL). Overall, the samples of lip products are selected by Python crawler in this study, which are more objective and representative. This study focuses on deeper study of Pb, especially for the health risk assessment of blood Pb in children exposed to lip products. These results perhaps could provide useful information for the safety cosmetics usage for people in China and even the global world.

Introduction: Lead (Pb), on chronic exposure is associated with various systemic illness and some of its toxicity effects is posited to involve calcium metabolism and hypothesis pathways. Present study aims to comprehensively evaluate the association between chronic lead exposure and markers of calcium homeostasis markers by executing systematic review, to improve the current insights on Pb-Calcium metabolism interaction. Methods: Observational studies documenting the changes in calcium homeostasis markers (i.e. serum calcium, parathyroid hormone, vitamin D & calcitonin) among chronically (occupational) Pb exposed individuals as compared to control (individuals without obvious lead exposure) were systematically searched from Pubmed, Scopus and Embase digital databases since inception to September 24, 2020 (partly updated on March17, 2021). The systematic review adhered to PRISMA (Preferred Reporting Items of Systematic reviews and Meta-Analysis) guidelines during the execution. The mean differences of calcium homeostasis markers between Pb exposed and control groups were pooled using random-effects model. Heterogeneity was assessed by I2 statistic and Cochran-Q test. Risk of bias among the included studies was performed using Newcastle Ottawa Scale. Sub-group, sensitivity and meta-regression analyses were performed where data permitted. Results: The systematic search identified eleven studies, including 837 occupationally Pb exposed and 739 control participants. Chronically (i.e. Occupationally) Pb exposed individuals exhibited mean 36.13 (95% CI 25.88 to 46.38) µg/dl blood lead level (BLL) higher than controls. The Pb exposed group exhibited significantly lower serum calcium (-0.72 mg/dl, 95% CI -1.07 to -0.36), and trend of higher parathyroid levels (37.97 pg/ml, 95% CI -14.36 to 90.29) and lower vitamin D levels (-12.26 ng/ml, 95% CI -25.36 to 0.84) as compared to control group. The studies exhibited high levels of heterogeneity. Subgroup analysis exploring the influence of simultaneous exposure to other heavy metals did not alter the results. Conclusion: The pooled results show inverse relationship between chronic lead exposure and calcium homeostasis markers, particularly serum calcium. Present observations should caution the policymakers drafting regulations, to incorporate these (calcium homeostasis related parameters) investigations mandatory during the periodic examination (along with BLL) of individuals with chronic lead exposure (e.g. occupational lead exposure).

Aims: This study aimed to evaluate the association between blood lead level (BLL) and abdominal aortic calcification (AAC) in US adults aged ≥40 years.Methods: We obtained data from 2013 to 2014 National Health and Nutrition Examination Survey (NHANES). Participants missing the data of BLL and AAC scores were excluded. BLL was measured using inductively coupled plasma mass spectrometry directly. AAC scores were quantified by Kauppila score system, and severe AAC was defined as AAC score >6. Weighted multivariable regression analysis and subgroup analysis were conducted to explore the independent relationship between BLL with AAC score and severe AAC.Results: A total of 1,530 participants were included with the mean BLL of 1.45 ± 1.31 ng/dl and mean AAC score of 1.40 ± 3.13. The prevalence of severe AAC was 7.98% overall, and participants in higher BLL quartile showed higher prevalence of severe AAC (Quartile 1: 3.55%, Quartile 2: 7.28%, Quartile 3: 9.88%, Quartile 4: 12.58%, P < 0.0001). BLL was positively associated with higher AAC score (β = 0.15, 95% CI: 0.02, 0.27, P = 0.021) and increased risk of severe AAC (OR = 1.11; 95% CI: 1.00–1.22; P = 0.047). Subgroup analysis and interaction test indicated that the association between BLL and AAC was similar in different population settings.Conclusions: Higher BLL was associated with higher AAC score and increased risk of severe AAC. Lead burden should be considered for people with AAC in clinical settings.

The objective of this report is to update the previous one. A mother developed pre-eclampsia at term and delivered an infant with multiple congenital abnormalities which were likely related to the mother’s high blood lead level. This level was due to a bullet lodged in the fourth lumbar vertebra for the previous 15 years. It increased during the third trimester from 31 to 85 micrograms per deciliter. The infant’s cardio-vascular birth defects were surgically repaired and she underwent repeated chelation which reduced her blood lead level to undetectable. Her other birth defects resolved, she completed high school and is in excellent health.

IMPORTANCE: Childhood lead exposure has been linked to disrupted brain development, but long-term consequences for structural brain integrity are unknown. OBJECTIVE: To test the hypothesis that childhood lead exposure is associated with magnetic resonance imaging (MRI) measurements of lower structural integrity of the brain in midlife. DESIGN, SETTING, AND PARTICIPANTS: The Dunedin Study followed a population-representative 1972-1973 birth cohort in New Zealand (N = 564 analytic sample) to age 45 years (until April 2019). EXPOSURES: Childhood blood lead levels measured at age 11 years. MAIN OUTCOMES AND MEASURES: Structural brain integrity at age 45 years assessed via MRI (primary outcomes): gray matter (cortical thickness, surface area, hippocampal volume), white matter (white matter hyperintensities, fractional anisotropy [theoretical range, 0 {diffusion is perfectly isotropic} to 100 {diffusion is perfectly anisotropic}]), and the Brain Age Gap Estimation (BrainAGE), a composite index of the gap between chronological age and a machine learning algorithm–estimated brain age (0 indicates a brain age equivalent to chronological age; positive and negative values represent an older and younger brain age, respectively). Cognitive function at age 45 years was assessed objectively via the Wechsler Adult Intelligence Scale IV (IQ range, 40-160, standardized to a mean of 100 [SD, 15]) and subjectively via informant and self-reports (z-score units; scale mean, 0 [SD, 1]). RESULTS: Of 1037 original participants, 997 were alive at age 45 years, of whom 564 (57%) had received lead testing at age 11 years (302 [54%] male) (median follow-up, 34 [interquartile range, 33.7-34.7] years). Mean blood lead level at age 11 years was 10.99 (SD, 4.63) μg/dL. After adjusting for covariates, each 5-μg/dL higher childhood blood lead level was significantly associated with 1.19-cm(2) smaller cortical surface area (95% CI, −2.35 to −0.02 cm(2); P = .05), 0.10-cm(3) smaller hippocampal volume (95% CI, −0.17 to −0.03 cm(3); P = .006), lower global fractional anisotropy (b = −0.12; 95% CI, −0.24 to −0.01; P = .04), and a BrainAGE index 0.77 years older (95% CI, 0.02-1.51 years; P = .05) at age 45 years. There were no statistically significant associations between blood lead level and log-transformed white matter hyperintensity volume (b = 0.05 log mm(3); 95% CI, −0.02 to 0.13 log mm(3); P = .17) or mean cortical thickness (b = −0.004 mm; 95% CI, −0.012 to 0.004 mm; P = .39). Each 5-μg/dL higher childhood blood lead level was significantly associated with a 2.07-point lower IQ score at age 45 years (95% CI, −3.39 to −0.74; P = .002) and a 0.12-point higher score on informant-rated cognitive problems (95% CI, 0.01-0.23; P = .03). There was no statistically significant association between childhood blood lead levels and self-reported cognitive problems (b = −0.02 points; 95% CI, −0.10 to 0.07; P = .68). CONCLUSIONS AND RELEVANCE: In this longitudinal cohort study with a median 34-year follow-up, higher childhood blood lead level was associated with differences in some MRI measures of brain structure that suggested lower structural brain integrity in midlife. Because of the large number of statistical comparisons, some findings may represent type I error.

Automobile technicians in resource-poor settings often work in poor environments and are exposed to chemicals that put them at risk of ill health and disease. These chemical exposures could affect blood coagulation, leading to bleeding disorders or thrombosis. The present study is aimed at assessing prothrombin test (PT) and activated partial thromboplastin test (aPTT) values, serum zinc (Zn) and copper (Cu) concentrations, and blood lead level (BLL) among occupationally exposed automobile technicians compared to unexposed controls. A total of 140 consenting participants comprising 70 automobile technicians and 70 unexposed controls were recruited for this case–control study. A 6-mL blood sample was drawn from each participant for estimation of BLL, serum Zn and Cu concentrations, and PT and aPTT values. Blood lead level, and serum Zn and Cu concentrations were determined using atomic absorption spectrophotometry, while PT and aPTT values were determined using Innovin PT and Actin FS Activated PTT reagents on the Sysmex CA-101 coagulation analyser. Data were analysed using t-tests, chi-square tests, and logistic and multiple linear regression analyses with statistical significance set at p < 0.05. The mean BLL, serum Zn concentration, and PT and aPTT values were significantly higher in automobile technicians compared to controls. Binary logistic regression showed that automobile technicians had higher odds of elevated PT value (OR = 21.769; p = 0.000), aPTT value (OR = 1.348; p = 0.018), BLL (OR = 1.261; p = 0.000) and serum Zn concentration (OR = 1.063; p = 0.005) than unexposed controls. Linear regression showed significant positive association of PT value with BLL and with serum Zn concentration. Higher PT and aPTT values reflect prolonged blood coagulation time among automobile technicians, which indicates impairment of extrinsic and intrinsic coagulation pathways associated with work-related exposures.