An analysis of reported symptoms and their relationship with indicators of lead absorption--blood lead (Pb-B) and zinc protoporphyrin (ZPP)--and of arsenic absorption--urinary arsenic (As-U)--was undertaken among 680 active copper smelter workers. Lead and arsenic absorption in the copper smelter employees were characterized by the median values of 30.4 micrograms/dl for Pb-B, 41.5 micrograms/dl for ZPP, and 26 micrograms/L for As-U. Blood lead was 40 micrograms/dl or higher in 16.7% of cases, ZPP was 50 micrograms/dl or higher in 31.2%, and urinary arsenic was 50 micrograms/L or higher in 16.4% of currently active copper smelter workers. The number of reported symptoms (from a total of 14 symptoms) increased with ZPP levels; the relationship with Pb-B was less marked. Arsenic contributed relatively little. Mean Pb-B, ZPP, and As-U levels for subjects reporting each of the 14 symptoms were compared with those of subjects who did not report the symptoms. Mean Pb-B was found to differ significantly for one symptom, fatigue. Significant differences in mean ZPP levels were found for fatigue, sleep disturbances, weakness, paresthesia, and joint pain. Prevalence rates for these symptoms rose more markedly with increasing ZPP than with Pb-B levels. The results indicate a relationship between certain CNS and musculo-skeletal symptoms and increased lead absorption in this population. Adherence to exposure standards that preclude undue lead absorption and appropriate biological monitoring including ZPP levels, are necessary to prevent adverse, especially long-term, health effects.
A medical cross-sectional examnation of a copper smelter work force was undertaken after environmental contmination with lead, cadmium and arsenic had been documented. A total of 920 subjects was examined, including active smelter employees, retired workers and copper mine employees who had never worked in the smelter.Slight to moderate absorption of lead and cadmium was definitely present in the active copper smelter employees, who had significantly higher levels of Pb-B, ZPP and Cd-B than retired employees and miners. Cd-U levels were higher in retired workers, who were also older and had, as a group, longer duration of exposure in the smelter. Cd-U did not exceed 10 pg/g creatinine, the level considered critical for nephrotoxicity, in any of the subjects. Median Cd-B level for active workers was 2.75 1tg/L. Lead absorption was characterized by a relatively small proportion (16.7%) of active employees with Pb-B levels 40 pg/dL or higher.We were particularly interested in exploring the possibility that simultaneous exposure to lead and cadmium, although at levels not associated with nephrotoxicity for each metal separately, could result in renal function impairment. Distribution patterns of BUN and serum creatinine levels were unremarkable. Urinary I,microglobulin levels were less than 200 ptgg creatinine in 95% of copper smelter employees. There were no significant correlations between urinary N-microglobulin levels and Cd-U, Cd-B, Pb-B and ZPP or between urinary 02-microglobulin excretion and serum creatinine or BUN levels. Urinary O-microglobulin levels were significantly correlated with age in the copper smelter workers, but not in the miners. Nevertheless, in the absence of any significant correlations between urinaryimicroglobuUn and Cd-U, Cd-B, a causal relationship with cadmium absorption cannot be affirmed.That kidney function could be impaired by long-term exposure in the smelter was only indiretly suggested. Effects on renal function at the low levels of cadmium and lead absorption that were observed in this smelter population are minil.
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