BackgroundLead exposure has been associated with higher blood pressure, hypertension, electrocardiogram abnormalities, and increased mortality from circulatory causes.ObjectiveWe assessed the association between bone lead—a more accurate biomarker of chronic lead exposure than blood lead—and risk for future ischemic heart disease (IHD).MethodsIn a prospective cohort study (VA Normative Aging Study), 837 men who underwent blood or bone lead measurements at baseline were followed-up for an ischemic heart disease event between 1 September 1991 and 31 December 2001. IHD was defined as either a diagnosis of myocardial infarction or angina pectoris that was confirmed by a cardiologist. Events of fatal myocardial infarction were assessed from death certificates.ResultsAn IHD event occurred in 83 cases (70 nonfatal and 13 fatal). The mean blood, tibia, and patella lead levels were higher in IHD cases than in noncases. In multivariate Cox-proportional hazards models, one standard deviation increase in blood lead level was associated with a 1.27 (95% confidence interval, 1.01–1.59) fold greater risk for ischemic heart disease. Similarly, a one standard deviation increase in patella and tibia lead levels was associated with greater risk for IHD (hazard ratio for patella lead = 1.29; 95% confidence interval, 1.02–1.62).ConclusionsMen with increased blood and bone lead levels were at increased risk for future IHD. Although the pathogenesis of IHD is multifactorial, lead exposure may be one of the risk factors.

Blood lead may adversely affect bone mineral density.

To study the association between levels of lead in blood and bone among female former smelter workers in Bunker Hill, Idaho, the authors performed a longitudinal study using homeostatic regulators of calcium and biomarkers of bone turnover. The authors measured participants' blood lead levels (by means of a graphite furnace atomic absorption spectrophotometer) and tibia-bone lead levels (by means of the 109Cd K x-ray fluorescence system) in 1994 and again in 2000; serum ionized calcium, parathyroid hormone, osteocalcin, urinary deoxypyridinoline, pyridinoline, and 1, 25-dihydroxyvitamin D were measured. After controlling for weight and age, significant predictors of changes in blood lead levels from 1994 to 2000 in postmenopausal women were duration of employment, higher ionized calcium levels, alcohol consumption, and higher parathyroid hormone levels. Predictors of change in tibia-bone lead levels in the same group of women were employment in a technical job such as mining and higher urinary pyridinoline levels (p < .05). Changes in blood and bone lead levels over time were associated with increased bone resorption, especially among postmenopausal women.