Lead exposure levels and duration of exposure absence predict neurobehavioral performance

Winker, Robert; Ponocny‐Seliger, Elisabeth; Rüdiger, H. W.; Barth, Alfred

doi:10.1007/s00420-005-0031-1

Cited by 12 publications

(8 citation statements)

References 12 publications

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“…This clinical observation on improvement in overt symptoms finds some support from the relatively limited number of studies that have examined the impact of naturally declining blood lead concentrations on cognitive function in occupationally exposed subjects (Chuang et al 2005; Lindgren et al 2003; Winker et al 2006). Improvement or resolution of neurocognitive or neurobehavioral symptoms may sometimes lag the decline in blood lead concentration, possibly because of the relatively slower removal of lead from the central nervous system (Cremin et al 1999; Goldstein et al 1974).…”

Section: Medical Treatment Of Elevated Blood Lead Concentration and Omentioning

confidence: 83%

Recommendations for Medical Management of Adult Lead Exposure

Kosnett

Wedeen

Rothenberg

et al. 2007

Environ Health Perspect

323

253

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Research conducted in recent years has increased public health concern about the toxicity of lead at low dose and has supported a reappraisal of the levels of lead exposure that may be safely tolerated in the workplace. In this article, which appears as part of a mini-monograph on adult lead exposure, we summarize a body of published literature that establishes the potential for hypertension, effects on renal function, cognitive dysfunction, and adverse female reproductive outcome in adults with whole-blood lead concentrations < 40 μg/dL. Based on this literature, and our collective experience in evaluating lead-exposed adults, we recommend that individuals be removed from occupational lead exposure if a single blood lead concentration exceeds 30 μg/dL or if two successive blood lead concentrations measured over a 4-week interval are ≥ 20 μg/dL. Removal of individuals from lead exposure should be considered to avoid long-term risk to health if exposure control measures over an extended period do not decrease blood lead concentrations to < 10 μg/dL or if selected medical conditions exist that would increase the risk of continued exposure. Recommended medical surveillance for all lead-exposed workers should include quarterly blood lead measurements for individuals with blood lead concentrations between 10 and 19 μg/dL, and semiannual blood lead measurements when sustained blood lead concentrations are < 10 μg/dL. It is advisable for pregnant women to avoid occupational or avocational lead exposure that would result in blood lead concentrations > 5 μg/dL. Chelation may have an adjunctive role in the medical management of highly exposed adults with symptomatic lead intoxication but is not recommended for asymptomatic individuals with low blood lead concentrations.

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Section: Medical Treatment Of Elevated Blood Lead Concentration and Omentioning

confidence: 83%

Recommendations for Medical Management of Adult Lead Exposure

Kosnett

Wedeen

Rothenberg

et al. 2007

Environ Health Perspect

323

253

View full text Add to dashboard Cite

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“…It also is relevant in the context of low socioeconomic populations where the prevalence of these disorders is high and stress and lead tend to co-occur. Thus, the public health implications may be significant, given the possibility of improved neurobehavioral performance after reducing blood lead, which has been shown in serveral studies (Chuang et al 2005; Schwartz et al 2001; Winker et al 2006), and stress (Bremner et al 2008). …”

Section: Discussionmentioning

confidence: 99%

“…The relationship between lead and cognitive impairment has been documented extensively in children and in occupationally exposed populations (e.g., Fiedler et al 2003; Schwartz et al 2001, 2005; Stewart et al 1999; Winker et al 2006). Previous studies by our group and others have also shown an inverse association in bone lead levels as well as blood lead levels with cognition and changes in cognition over time among nonoccupationally exposed older men and older women (Balbus-Kornfeld et al 1995; Muldoon et al 1996; Shih et al 2007; Weuve et al 2009).…”

mentioning

confidence: 99%

Interaction of Stress, Lead Burden, and Age on Cognition in Older Men: The VA Normative Aging Study

Peters¹,

Weisskopf²,

Spiro

et al. 2010

Environ Health Perspect

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BackgroundLow-level exposure to lead and to chronic stress may independently influence cognition. However, the modifying potential of psychosocial stress on the neurotoxicity of lead and their combined relationship to aging-associated decline have not been fully examined.ObjectivesWe examined the cross-sectional interaction between stress and lead exposure on Mini-Mental State Examination (MMSE) scores among 811 participants in the Normative Aging Study, a cohort of older U.S. men.MethodsWe used two self-reported measures of stress appraisal—a self-report of stress related to their most severe problem and the Perceived Stress Scale (PSS). Indices of lead exposure were blood lead and bone (tibia and patella) lead.ResultsParticipants with higher self-reported stress had lower MMSE scores, which were adjusted for age, education, computer experience, English as a first language, smoking, and alcohol intake. In multivariable-adjusted tests for interaction, those with higher PSS scores had a 0.57-point lower (95% confidence interval, −0.90 to 0.24) MMSE score for a 2-fold increase in blood lead than did those with lower PSS scores. In addition, the combination of high PSS scores and high blood lead categories on one or both was associated with a 0.05–0.08 reduction on the MMSE for each year of age compared with those with low PSS score and blood lead level (p < 0.05).ConclusionsPsychological stress had an independent inverse association with cognition and also modified the relationship between lead exposure and cognitive performance among older men. Furthermore, high stress and lead together modified the association between age and cognition.

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“…Even when significant associations between lead exposure and cognitive measures were observed, studies failed to separate the acute or transient effects of recent lead exposure from the chronic effects of cumulative exposure. More recent evidence [Stewart et al, 1999;Schwartz et al, 2000Schwartz et al, , 2001Schwartz et al, , 2005Wright et al, 2003;Weisskopf et al, 2004;Bleecker et al, 2005;Winker et al, 2005Winker et al, , 2006Shih et al, 2006] from larger comprehensive studies reveals a consistent concern about the chronic effects of cumulative lead exposure on the adult brain.…”

Section: Introductionmentioning

confidence: 99%