Annals of Occupational and Environmental Medicine

  • Volume 34
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  • Pages.34.1-34.13
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  • 2022
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  • 1225-3618(pISSN)
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  • 2052-4374(eISSN)
The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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The health effects of low blood lead level in oxidative stress as a marker, serum gamma-glutamyl transpeptidase level, in male steelworkers

  • Su-Yeon Lee (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Yong-Jin Lee (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Young-Sun Min (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Eun-Chul Jang (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Soon-Chan Kwon (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Inho Lee (Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital)
  • Received : 2022.05.30
  • Accepted : 2022.10.26
  • Published : 2022.12.31
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Abstract

Background: This study aimed to investigate the association between lead exposure and serum gamma-glutamyl transpeptidase (γGT) levels as an oxidative stress marker in male steelworkers. Methods: Data were collected during the annual health examination of workers in 2020. A total of 1,654 steelworkers were selected, and the variables for adjustment included the workers' general characteristics, lifestyle, and occupational characteristics. The association between the blood lead level (BLL) and serum γGT level was investigated by multiple linear and logistic regression analyses. The BLL and serum γGT values that were transformed into natural logarithms were used in multiple linear regression analysis, and the tertile of BLL was used in logistic regression analysis. Results: The geometric mean of the participants' BLLs and serum γGT level was 1.36 ㎍/dL and 27.72 IU/L, respectively. Their BLLs differed depending on age, body mass index (BMI), smoking status, drinking status, shift work, and working period, while their serum γGT levels differed depending on age, BMI, smoking status, drinking status, physical activity, and working period. In multiple linear regression analysis, the difference in models 1, 2, and 3 was significant, obtaining 0.326, 0.176, and 0.172 (all: p < 0.001), respectively. In the multiple linear regression analysis stratified according to drinking status, BMI, and age, BLLs were positively associated with serum γGT levels. Regarding the logistic regression analysis, the odds ratio of the third BLL tertile in models 1, 2, and 3 (for having an elevated serum γGT level within the first tertile reference) was 2.74, 1.83, and 1.81, respectively. Conclusions: BLL was positively associated with serum γGT levels in male steelworkers even at low lead concentrations (< 5 ㎍/dL).

Keywords

Acknowledgement

The authors thank Mr. Nam Hun Heo, Department of Clinical trial center, Soonchunhyang University Hospital, Choenan, Korea for his statistical assistance and Enago (www.enago.co.kr) for the English language review.

References

  1. Sohn HS. Current status of lead smelting and recycling. Resources Recycling 2019;28(4):3-14.
  2. Dobrakowski M, Pawlas N, Kasperczyk A, Kozlowska A, Olewinska E, Machon-Grecka A, et al. Oxidative DNA damage and oxidative stress in lead-exposed workers. Hum Exp Toxicol 2017;36(7):744-54.
  3. Korea Occupational Safety & Healthy Agency. Workers' health checkup practice guidelines. https://www.kosha.or.kr/kosha/data/mediaBankMain.do. Updated 2022. Accessed March 10, 2022.
  4. Agency for Toxic Substances and Disease Registry. Lead toxicity. https://www.atsdr.cdc.gov/csem/leadtoxicity/safety_standards.html. Updated 2019. Accessed March 10, 2022.
  5. Centers for Disease Control (CDC). Prevention. Adult blood lead epidemiology and surveillance (ABLES). https://www.cdc.gov/niosh/topics/ables/ReferenceBloodLevelsforAdults.html. Updated 2021. Accessed on March 11, 2022.
  6. Kim DW, Ock J, Moon KW, Park CH. Association between Pb, Cd, and Hg exposure and liver injury among Korean adults. Int J Environ Res Public Health 2021;18(13):6783.
  7. Tsoi MF, Cheung CL, Cheung TT, Cheung BM. Continual decrease in blood lead level in Americans: United States National Health Nutrition and Examination Survey 1999-2014. Am J Med 2016;129(11):1213-8.
  8. Lee JW, Choi H, Hwang UK, Kang JC, Kang YJ, Kim KI, et al. Toxic effects of lead exposure on bioaccumulation, oxidative stress, neurotoxicity, and immune responses in fish: a review. Environ Toxicol Pharmacol 2019;68:101-8.
  9. Teschke R, Brand A, Strohmeyer G. Induction of hepatic microsomal gamma-glutamyltransferase activity following chronic alcohol consumption. Biochem Biophys Res Commun 1977;75(3):718-24.
  10. Sheehan M, Haythorn P. Predictive values of various liver function tests with respect to the diagnosis of liver disease. Clin Biochem 1979;12(6):262-3.
  11. Dalton TP, Chen Y, Schneider SN, Nebert DW, Shertzer HG. Genetically altered mice to evaluate glutathione homeostasis in health and disease. Free Radic Biol Med 2004;37(10):1511-26.
  12. Pompella A, Visvikis A, Paolicchi A, De Tata V, Casini AF. The changing faces of glutathione, a cellular protagonist. Biochem Pharmacol 2003;66(8):1499-503.
  13. Lee DH, Blomhoff R, Jacobs DR Jr. Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res 2004;38(6):535-9.
  14. Lim JS, Yang JH, Chun BY, Kam S, Jacobs DR Jr, Lee DH. Is serum gamma-glutamyltransferase inversely associated with serum antioxidants as a marker of oxidative stress? Free Radic Biol Med 2004;37(7):1018-23.
  15. Centers for Disease Control (CDC) and Prevention. CDC updates blood lead reference value to 3.5 ㎍/dL. https://www.cdc.gov/nceh/lead/news/cdc-updates-blood-lead-reference-value.html. Updated 2022. Accessed on March 5, 2022.
  16. Kunutsor SK, Abbasi A, Adler AI. Gamma-glutamyl transferase and risk of type II diabetes: an updated systematic review and dose-response meta-analysis. Ann Epidemiol 2014;24(11):809-16.
  17. Mistry D, Stockley RA. Gamma-glutamyl transferase: the silent partner? COPD 2010;7(4):285-90.
  18. National Institute on Alcohol Abuse and Alcoholism. Helping patients who drink too much: a clinician's GUIDE. https://pubs.niaaa.nih.gov/publications/practitioner/cliniciansguide2005/guide.pdf. Updated 2016. Accessed January 12, 2022.
  19. Jung JG, Kim JS, Yoon SJ, Lee S, Ahn SK. Korean alcohol guidelines for primary care Physician. Korean J Fam Pract 2021;11(1):14-21.
  20. Ministry of Health and Welfare. The physical activity guide for Korean. http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=337139. Updated 2013. Accessed March 10, 2022.
  21. Ministry of Health and Welfare. Notice. The criteria for health checkup of Korean. Partial revision. http://www.law.go.kr. Accessed March 10, 2022.
  22. Puukka K, Hietala J, Koivisto H, Anttila P, Bloigu R, Niemela O. Age-related changes on serum GGT activity and the assessment of ethanol intake. Alcohol Alcohol 2006;41(5):522-7.
  23. Agarwal S, Fulgoni VL 3rd, Lieberman HR. Assessing alcohol intake & its dose-dependent effects on liver enzymes by 24-h recall and questionnaire using NHANES 2001-2010 data. Nutr J 2016;15(1):62.
  24. Breitling LP, Raum E, Muller H, Rothenbacher D, Brenner H. Synergism between smoking and alcohol consumption with respect to serum gamma-glutamyltransferase. Hepatology 2009;49(3):802-8.
  25. Park EY, Lim MK, Oh JK, Cho H, Bae MJ, Yun EH, et al. Independent and supra-additive effects of alcohol consumption, cigarette smoking, and metabolic syndrome on the elevation of serum liver enzyme levels. PLoS One 2013;8(5):e63439.
  26. Lee DH, Lim JS, Song K, Boo Y, Jacobs DR Jr. Graded associations of blood lead and urinary cadmium concentrations with oxidative-stress-related markers in the U.S. population: results from the third National Health and Nutrition Examination Survey. Environ Health Perspect 2006;114(3):350-4.
  27. Obeng-Gyasi E. Lead exposure and oxidative stress-a life course approach in U.S. adults. Toxics 2018;6(3):E42.
  28. Xu Z, Zheng Z, Gao X. Operation optimization of the steel manufacturing process: a brief review. Int J Miner Metall Mater 2021;28(8):1274-87.
  29. Mousavian NA, Mansouri N, Nezhadkurki F. Estimation of heavy metal exposure in workplace and health risk exposure assessment in steel industries in Iran. Measurement 2017;102:286-90.
  30. Korean Statistical Information Service. Blood lead levels. https://kosis.kr/statHtml/statHtml.do?orgId=106&tblId=DT_106N_99_1100052&vw_cd=MT_OTITLE&list_id=106_002_002&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=MT_OTITLE&path=%252FstatisticsList%252FstatisticsListIndex.do. Updated 2022. Accessed September 15, 2022.
  31. Muntner P, Menke A, DeSalvo KB, Rabito FA, Batuman V. Continued decline in blood lead levels among adults in the United States: the National Health and Nutrition Examination Surveys. Arch Intern Med 2005;165(18):2155-61.
  32. Ruiz-Hernandez A, Navas-Acien A, Pastor-Barriuso R, Crainiceanu CM, Redon J, Guallar E, et al. Declining exposures to lead and cadmium contribute to explaining the reduction of cardiovascular mortality in the US population, 1988-2004. Int J Epidemiol 2017;46(6):1903-12.
  33. Afridi HI, Kazi TG, Jamali MK, Kazi GH, Arain MB, Jalbani N, et al. Evaluation of toxic metals in biological samples (scalp hair, blood and urine) of steel mill workers by electrothermal atomic absorption spectrometry. Toxicol Ind Health 2006;22(9):381-93.
  34. Choi JW, Kim NS, Cho KS, Ham JO, Lee BK. The change of air lead concentrations in litharge making and smelting industries. J Korean Soc Occup Environ Hyg 2010;20(1):10-8.
  35. Obeng-Gyasi E. Cholesterol and oxidative stress in U.S. pregnant women exposed to lead. Med Sci (Basel) 2019;7(3):E42.
  36. Ajeel MA, Ajeel AA, Nejres AM, Salih RA. Assessment of heavy metals and related impacts on antioxidants and physiological parameters in oil refinery workers in Iraq. J Health Pollut 2021;11(31):210907.
  37. Mazumdar I, Goswami K. Chronic exposure to lead: a cause of oxidative stress and altered liver function in plastic industry workers in Kolkata, India. Indian J Clin Biochem 2014;29(1):89-92.
  38. Khan DA, Qayyum S, Saleem S, Khan FA. Lead-induced oxidative stress adversely affects health of the occupational workers. Toxicol Ind Health 2008;24(9):611-8.
  39. Al-Neamy FR, Almehdi AM, Alwash R, Pasha MA, Ibrahim A, Bener A. Occupational lead exposure and amino acid profiles and liver function tests in industrial workers. Int J Environ Health Res 2001;11(2):181-8.
  40. Joo Y, Kwon YM, Kim SY, Choi K, Lee C, Yu SD, et al. A study on heavy metals exposure and major sociodemographic influence factors among Korean Adults - Korean National Environmental Health Survey (2009-2017). J Environ Health Sci 2019;45(5):541-55.
  41. Choi W, Kim S, Baek YW, Choi K, Lee K, Kim S, et al. Exposure to environmental chemicals among Korean adults-updates from the second Korean National Environmental Health Survey (2012-2014). Int J Hyg Environ Health 2017;220(2 Pt A):29-35.
  42. Jung SK, Choi W, Kim SY, Hong S, Jeon HL, Joo Y, et al. Profile of environmental chemicals in the Korean population-results of the Korean National Environmental Health Survey (KoNEHS) cycle 3, 2015-2017. Int J Environ Res Public Health 2022;19(2):626.
  43. Lanphear BP, Rauch S, Auinger P, Allen RW, Hornung RW. Low-level lead exposure and mortality in US adults: a population-based cohort study. Lancet Public Health 2018;3(4):e177-84.
  44. Menke A, Muntner P, Batuman V, Silbergeld EK, Guallar E. Blood lead below 0.48 micromol/L (10 microg/dL) and mortality among US adults. Circulation 2006;114(13):1388-94.
  45. Tsoi MF, Lo CW, Cheung TT, Cheung BM. Blood lead level and risk of hypertension in the United States National Health and Nutrition Examination Survey 1999-2016. Sci Rep 2021;11(1):3010.
  46. Kim Y, Lee BK. Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data. Environ Res 2012;118:124-9.
  47. Harari F, Sallsten G, Christensson A, Petkovic M, Hedblad B, Forsgard N, et al. Blood lead levels and decreased kidney function in a population-based cohort. Am J Kidney Dis 2018;72(3):381-9.
  48. Alarcon WA; State Adult Blood Lead Epidemiology and Surveillance (ABLES) Program Investigators. Elevated blood lead levels among employed adults-United States, 1994-2013. MMWR Morb Mortal Wkly Rep 2016;63(55):59-65.
  49. Northcote J, Livingston M. Accuracy of self-reported drinking: observational verification of 'last occasion' drink estimates of young adults. Alcohol Alcohol 2011;46(6):709-13.