Lead-induced anemia: dose-response relationships and evidence for a threshold.

Schwartz, Joel; Landrigan, Philip J.; Baker, Edward L.; Orenstein, Walter A.; Lindern, Ian H. von

doi:10.2105/ajph.80.2.165

Cited by 117 publications

(67 citation statements)

References 15 publications

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“…Moreover, the non-linear trend estimated in HCT is in agreement with the results of other studies. In particular, on the basis of their investigations, some Authors (Schwartz et al, 1990;Hense et al, 1992;Jacob et al, 2000) pointed out or hypothesised a parabolic doseresponse relationship similar to that found in this analysis.…”

Section: Haematocritsupporting

confidence: 74%

Adverse haematological outcome and environmental lead poisoning

Fontana¹,

Baldi

Franchini

et al. 2004

J Expo Sci Environ Epidemiol

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The South-eastern Area (SA) of the Municipality of La Spezia (Liguria Region, Italy) is characterised by a heavy environmental lead (Pb) contamination, chiefly due to the emissions of a Pb-processing plant in operation since 1930. In order to assess the risk of Pb poisoning of residents of SA, and to estimate the degree of association between the blood Pb level (BLL) and haematocrit % (HCT), intended as a biomarker of early haematological dysfunction, we reanalysed data of 785 individuals collected in 1992 as a part of a larger national biological monitoring project. Multiple normal regression modelling was applied to estimate the role of residence on log-transformed BLL, and Median Ratio (MR) was used as an index of effect. The same statistical modelling was also applied to reveal the relationship between HCT and BLL. Allowing for several confounders (including occupational exposure to Pb), residents of SA showed a 14% increase (MR ¼ 1.14, 95% IC ¼ 1.06-1.23%) in the median BLL value compared to people living outside SA. The excess reached 27% (MR ¼ 1.27, 95% IC ¼ 1.14-1.41%) after 30 years of residence. Parallel results were also obtained in a subgroup composed only of pupils (o18 years, non-smokers, non-drinkers). Finally, regression analysis highlighted a statistically significant parabolic trend in HCT in relation to BLL. The non-linear dose-response relationship, which attests to an adverse effect on the erythrocytic function of BLLs at least over 17.00 mg/dl, is in agreement with the findings of other authors and consistent with the results of an excess occurrence of self-reported anaemia obtained from a previous comparative survey carried out on the same population.

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Section: Haematocritsupporting

confidence: 74%

Adverse haematological outcome and environmental lead poisoning

Fontana¹,

Baldi

Franchini

et al. 2004

J Expo Sci Environ Epidemiol

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“…Still, such studies have rarely noted a threshold value of lead 48) . By applying logistic regression analyses to data of both BPb and Hct obtained from 579 children aged 1 to 5 yr, Schwartz et al reported that the probability of anemia (Hct <35%) in one-year-old children was 0% at BPb levels below 20 µg/dl, 2% at levels between 20 and 39 µg/dl, 18% at levels between 40 and 60 µg/dl, and 40% at BPb levels above 60 µg/dl 74) . The authors concluded that BPb levels close to the recommended limit value of 25 µg/dl were associated with dose-related depression of Hct in young children.…”

Section: Recent Perspective On Lead Toxicity In Childrenmentioning

confidence: 99%

Lead Toxicity: Does the Critical Level of Lead Resulting in Adverse Effects Differ between Adults and Children?

Murata

Iwata

Dakeishi

et al. 2009

Journal of Occupational Health

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µg/dl for industrial workers and 5 µg/dl for children. To examine whether the critical level of lead producing adverse effects truly differs between workers and children, we provided an overview of studies addressing the critical level of lead in workers, together with a perspective on lead toxicity in children. Data sources and extraction: In 25 reports published in English with keywords of "benchmark dose (BMD)," "lead" and "humans," only five studies proved to be relevant to lead toxicity. Four more studies with figures illustrating significant relationships between lead and neurotoxic outcomes were selected. Data synthesis: Based on data from previous reports using a BMD approach, the critical organ of lead in workers was thought to be the nervous system and the critical BPb level (numberweighted mean) was between 10.7 and 17.5 µg/dl. The neurotoxic effects of lead exposure at such levels seemed reversible. The BPb level at which leadassociated intellectual deficits occurred in children was as low as the critical level of BPb (below 5 µg/dl) for inhibited heme synthesis in workers. Conclusions: The neurotoxic effects of lead in workers appear to be initiated at BPb levels below 18 µg/dl, which are somewhat higher than the critical level of lead neurotoxicity in children. Each national institute for risk Review management should take evidence-based preventive action against subclinical lead poisoning in workers, as well as in children. (J Occup Health 2009; 51: 1-12)

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“…Prior studies have focused mainly on the associations between blood lead levels and hematopoietic outcomes (13)(14)(15)(16)(17)(18), and they have demonstrated significant interindividual variation. Fewer studies have utilized measures of chelatable lead, a measure of bioavailable lead burden, and tibia lead, a measure of cumulative lead dose (19,20).…”

mentioning

confidence: 99%

Associations of lead biomarkers and delta-aminolevulinic acid dehydratase and vitamin D receptor genotypes with hematopoietic outcomes in Korean lead workers

Lee

et al. 2001

Scand J Work Environ Health

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Lead-induced anemia: dose-response relationships and evidence for a threshold.

Cited by 117 publications

References 15 publications

Adverse haematological outcome and environmental lead poisoning

Adverse haematological outcome and environmental lead poisoning

Lead Toxicity: Does the Critical Level of Lead Resulting in Adverse Effects Differ between Adults and Children?

Associations of lead biomarkers and delta-aminolevulinic acid dehydratase and vitamin D receptor genotypes with hematopoietic outcomes in Korean lead workers

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