• Nutrition Research and Practice
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• v.5 no.1
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• pp.40-45
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• 2011

Hemoglobin and zinc protoporphyrin (ZPP) tests are commonly used to screen for iron deficiency, but little research has been done to systematically evaluate the sensitivity and specificity of these two tests. The goal of this study was to evaluate the effectiveness of zinc protoporphyrin/heme (ZPP/H) ratio as a point-of-service screening test for iron deficiency among preschool-aged children by comparing the sensitivity and specificity of hemoglobin, ZPP/H ratio, and serum ferritin (SF). Also completed were assessments for the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) with indicators of ferritin models. This study was carried out with 95 children ages 3 to 6 y. Anthropometric measurements were assessed and blood samples were analyzed for hemoglobin, SF, transferrin saturation (TS), and ZPP. Anemia was common and the prevalences of anemia, ID, and IDA were 14.7%, 12.6%, and 5.2%, respectively. The ZPP/H ratio was strongly and significantly correlated with hemoglobin. And ZPP/H ratio was a more sensitive test for ID than hemoglobin or SF measurement, correctly identifying more than twice as many iron-deficient children (sensitivity of 91.7%, compared to 41.7% for hemoglobin and SF). However, ZPP/H ratio had lower specificity (60.2%, compared to 89.1% for hemoglobin or 96.4% for SF) and resulted in the false identification of more subjects who actually were not iron deficient than did hemoglobin or SF. Low hemoglobin concentration is a late-stage indicator of ID, but ZPP/H ratio can detect ID at early stages and can be performed easily at a relatively low cost. Therefore, ZPP/H ratio can serve as a potential screening test for pre-anemic iron deficiency in community pediatric practices.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.6 no.1
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• pp.77-87
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• 1996

In order to compare the difference of the measurement of delta aminolevulinic acid(${\delta}$-ALA) in urine between HPLC method(HALA) and colorimetric method(CALA), and also to provide useful information for the new diagnostic criteria of ${\delta}$-ALA in urine in lead poisoning, if at all possible in the future, authors studied 234 male lead workers who were selected from 7 storage battery factories, 3 secondary smelting industries, and 2 litharge making industries. Study subjects were selected on the basis of blood Zinc protoporphyrin(ZPP) level from low to high concentration to cover wide range of lead exposure. Study variables for this study were ${\delta}$-ALA measured by two different methods, blood lead(PbB), and blood ZPP. The results were as follows: 1. There was very high correlation between ${\delta}$-ALA measured by two method(r = 0.989 : HALA = -0.8194 + 0.8110 ${\times}$ CALA), but the value of CALA was measured about 2mg/L greater than HALA. 2. While the correlations of ${\delta}$-ALA by two method with blood lead and blood ZPP were 0.46 and 0.37 respectively, they were increased to 0.63 and 0.57 if ${\delta}$-ALA values were log-transformed. 3. Simple linear regression of ${\delta}$-ALA measured by two method on ZPP were as follows: CALA = 2.0421 + 0.0341 ${\times}$ ZPP ($R^2=0.1385$ p = 0.0001) HALA = 0.8006 + 0.0280 ${\times}$ ZPP ($R^2=0.1389$ p = 0.0001) 4. Simple linear regression of ${\delta}$-ALA measured by two method on PbB were as follows: CALA = - 0.4134 + 0.1545 ${\times}$ PbB ($R^2=0.2085$ p = 0.0001) HALA = -1.2893 + 0.1287 PbB ($R^2=0.2154$ p = 0.0001), 5. Simple linear regression of log-transformed ${\delta}$-ALA by two method on ZPP and PbB were as follows: logHALA = 0.3078 + 0.0060 ZPP ($R^2=0.3329$ p = 0.0001) logCALA = 1.0189 + 0.0044 ZPP ($R^2=0.3290$ p = 0.0001) logHALA = -0.0221 + 0.0246 PbB ($R^2=0.4046$ p = 0.0001) logCALA = 0.7662 + 0.0184 PbB ($R^2=0.4108$ p = 0.0001) 6. The cumulative percent of colorimetric method to detect lead workers whose value of PbS and ZPP were over screening level such as $40{\mu}/dl$ and $100{\mu}/dl$ respectively was higher than HPLC method if cut-off level of ${\delta}$-ALA for screening of lead poisoning was 5 mg/L. But if cut-off level of ${\delta}$-ALA measured by HPLC was reduced to 3 mg/L which is compatible to 5 mg/L of ${\delta}$-ALA measured by colorimetric method, there were good agreement between two methods and showed dose-response relationship with other lead exposure indices such as PbB and ZPP.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.23 no.2
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• pp.65-74
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• 2013

Objectives: This study attempted to develop a method to measure ultra-trace lead concentrations in plasma using Inductively Coupled Plasma Mass Spectrometry(ICP-MS) and to test whether plasma lead can be used as a biomarker for the biological monitoring of exposure to lead. Methods: Lead concentrations in 160 plasma samples of field workers and 42 plasma samples from the control group were measured by ICP-MS. Blood zinc protophorphyrin(ZPP) concentrations and urinary ${\delta}$-aminolevulinic acid${\delta}-ALA$) were measured for correlation analysis with plasma lead. Results: The mean lead level in the plasma of the workers exposed to lead at work were 786.1 ng/L. Plasma lead levels were not correlated with blood ZPP or urinary ${\delta}-ALA$ concentrations. Otherwise, plasma lead levels showed a good correlation coefficient of 0.400 with blood lead levels, and their correlation coefficient had a better value of 0.552 for the non-smoking and drinking group. In the general population group which was not exposed to lead in the workplace and was considered the control group, the mean concentration of plasma lead was 123.1 ng/L. The plasma lead levels for the general population group showed a good correlation coefficient of 0.520 with blood ZPP and urinary ${\delta}-ALA$ concentrations.

• Korean Journal of Community Nutrition
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• v.11 no.6
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• pp.771-778
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• 2006

Previous studies have suggested that delta-aminolevulinic acid dehydratase (ALAD) phenotype differently affect mineral metabolism. The objective of this study was to determine the effectiveness of 6-month iron supplementation as syrup of NaFeEDTA in improvement of iron status according to ALAD genotype. One hundred thirty adult women living in rural areas of Asan were provided NaFeEDTA syrup once a week for 6 months at the dose of 64mg Fe/week. Three hundred control subjects were observed during the study period. Fasting blood was obtained for analyzing hemoglobin (Hb) and zinc protophorphyrin (ZPP) and serum was analyzed for ferritin, iron and total iron capacity (TIBC) levels before and after iron supplementation. Ninety percent of ALAD 1-1 (ALAD1) and 10% of ALAD 1-2 (ALAD2) genotype were observed in the control group. However in the intervention group, 98% showed ALAD1 while only 2% was ALAD2, which is significantly lower proportions of ALAD2 compared to the control group (p<0.01). The iron status of Intervention group significantly improved except for ferritin and TIBC regardless or ALAD genotype, while the control group did not show any changes in iron status except for ZPP. ZPP concentration of the control group significantly increased in both ALAD1 and 2 while the intervention group showed significantly decreased ZPP after supplementation in ALAD1. Iron supplementation in the form of NaFeEDTA seems to be effective in reduction of ZPP levels although ALAD2 did not show significant changes due to the small number. However, it is difficult to make a conclusion from these results, and more specified further investigation is needed with more participants.

• Journal of the Ergonomics Society of Korea
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• v.32 no.3
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• pp.259-266
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• 2013

Objective: This study aims to evaluate the workloads of industrial and automobile storage battery industries and their association to biological exposure indices. Background: Occupational lead exposure at battery manufacturing workplace is the most serious problem in safety and health management. Method: We surveyed 145 workers in 3 storage battery industries. Environmental factors(lead in air, temperature, humidity and vibration)), biological exposure indices(lead in blood and zinc protoporphyrin in blood) and individual workload factors(process type, work time, task type, weight handling and restrictive clothing) were measured in each unit workplace. Results/Conclusion: Air lead concentration is statistically significant in associations with workload factors(process type, work time, task type, and restrictive clothing) and environmental factors (humidity and vibration), whereas zinc protoporphyrin in blood are significantly associated with work time and weight handling. And lead in blood is significantly associated with work time, weight handling and temperature. Application: The results of this study are expected to be a fundamental data to job design.

• Journal of Preventive Medicine and Public Health
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• v.26 no.1 s.41
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• pp.65-73
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• 1993

This study was carried out to evaluate the relationship between the biological lead exposure indices and air lead concentrations measured by personal air samplers. The 72 occupationally lead exposed workers were observed and the bioiogical lead Exposure indices chosen for this study were blood lead(PbB), urine lead(PbU), zinc protoporphyrin in whole blood(ZPP), $\delta$-aminolevulinic acid in urine(ALAU), $\delta$-aminolevulinic acid dehydratase activity (ALAD), coproporphyrin in urine(CPU) and hemoglobin(Hb). The workers were divided into four groups by air lead concentrations: Group I; under $0.05mg/m^3$, Group II; $0.05-0.10mg/m^3$, Group III; $0.10-0.15mg/m^3$ and Group IV; and over $0.15mg/m^3$. For evaluation the relationship between the biological lead exposure indices and air lead concentrations was used as correlation coefficients. The results obtained were as follows: 1. In Group I, II, III and IV, the mean value of PbB were $25.45{\pm}1.84{\mu}g/dl,\;27.87{\pm}3.53{\mu}g/dl,\;31.21{\pm}1.76{\mu}g/dl\;and\;47.02{\pm}13.96{\mu}g/dl$. Between Group IV and other groups showed statistically significant difference(p<0.05). 2. There was an increasing tendency of PbB, PbU, ALAU and ZPP according to the increase the mean air lead concentration, while ALAD has decreasing tendency. CPU and Hb did not show any constant tendency. 3. Correlation coefficients between PbB, PbU, ZPP, ALAU, ALAD, CPU, Hb and air lead concentration were 0.95, 0.83, 0.89, 0.72, -0.83, 0.51 and -0.45 respectively, and regression coefficient between PbB(Y) and PbA(X) was Y=126.8746X+16.9996(p<0.01).

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.18 no.3
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• pp.248-251
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• 2008

During survey of blood lead concentration of workers who worked in lead refining industry, we found that some foreign workers showed increased blood lead level compared with that of domestic workers. The mean concentration of lead in blood for foreign workers (15%, 13 workers, mean age: 29) was 55.8 ug/dL which was over biological exposure index, while that of Korean workers (85%, 76 workers, mean age: 42) was 28.9 ug/dL. Some other biological markers of lead exposure such as ZPP and ${\delta}-ALA$ also showed elevated levels. Most of foreign workers stayed in dormitories near or in the factories that may cause to let them under the condition of 24 hours exposure of lead. The lack of safety manual on proper prevention of lead exposure in their own language for effective communication may be one of reasons of elevated blood lead concentration of foreign workers.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.547-556
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• 1994

In order to identify the necessary information of biochemical Indices for renal effect of lead for the early detection in medical surveillance of lead worker, the reference values of urinary N-acetyl-$\beta$-D-glucosaminidase (NAG) activities were studied with 205 office workers in one industrial complex area who were not exposed to lead occupationally. While study variables selected for lead exposure were blood lead (PbB), blood zinc protoporphyrin(ZPP) and $\delta$-aminolevulinic acid (DALA) in urine, those for renal effect were urinary N-acetyl-$\beta$-D-glucosaminidase (NAG), blood urea nitrogen (BUN), serum creatinine(Cr), serum uric acid (Ua), and urinary total protein(U-TP). The results obtained were as follows: 1. The mean values of blood lead, ZPP and DALA in all subjects were $14.39{\pm}4.02{\mu}g/dl,\;21.61{\pm}8.00{\mu}g/dl,\;and\;2.73{\pm}0.90mg/l$ respectively. 2. The mean value of urinary NAG activities in all subjects was $3.51{\pm}2.01U/l$. The mean value of urinary NAG activities, which calculated from NAG activities divided by urinary creatinine concentration (CNAG), was $5.42{\pm}5.53U/g$ creatinine and log-arithmic normal distributed. 3. The reference value of urinary NAG activity was 12.06 U/g creatinine(95% CU=10.57-14.76 U/g creatinine). 4. Logarithmic CNAG(r=0.781 p<0.0l), U-TP(r=0.670 p<0.01) and ZPP(r=0.172 p<0.05) showed statistically significant correlation with CNAG.

• Journal of Veterinary Clinics
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• v.10 no.1
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• pp.111-130
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• 1993

Lead toxicity was evaluated in forty-five cats on a balanced diet, Treated with 0(control), 10, 100(low), 1, 000, 2, 000, and 4, 000(high) ppm of lead acetate orally on a body weight basis. The objectives were to establish toxic dosage level of leaf in cats, to characterize changes in behavior and clinical pathology, and to demonstrate what blood lead concentrations correlate with the known dosages of lead. Some high dose cats showed projectile vomiting, hyperactivity, and seizures. The growth rates did not appear to be altered in any of the dosed groups. Normal blood lead concentration in cats were lower than that of humans, dogs, and cattle. Blood lead concentrations of 3 to 20$\mu\textrm{g}$/100$m\ell$ could be termed a 'subclinical' range in the cat. Clinical lead toxicity in cats may have blood lead concentrations ranging 20 to 120$\mu\textrm{g}$/100$m\ell$. Zinc protoporphyrin concentrations were proportional to lead dosages and a significant ZPP elevation, greater than 50$\mu\textrm{g}$/100$m\ell$, may be indicative of clinical lead toxicity. The enzyme aminolevulinic acid dehydratase showed an inverss dose response relationship for all lead dosages and a significant ZPP elevation, greater than 50$\mu\textrm{g}$/100$m\ell$, may be indicative of clinical lead toxicity. The enzyme aminolevulinic acid dehydratase showed an inverse dose response relationship for all lead dosages and appears to be a good indicator of lead exposure in cats. Urinary aminolevuliruc acid concentrations generally increased with lead dosage, but individual values varied. Hair lead concentrations rose proportionately to lead dosages. Lead at least in high doses appears to inhibit chemotactic activity of polymorphonuclear cells and monocytes. No consistent dose response relationships were observed in hemoglobin, RBC, WBC, neutrophil, lymphocyte, monocyte, and eosinophil counts. There were no consistent dose related changes in total protein, plasma protein, BUN, and ALT values. Reticulocyte counts did not increase significantly in most lead dosage levels, and are probably of little value in diagnosing lead toxicity in cats. The fact that no significant changes were found in nerve conduction velocities may support that there was no segmental demyelination resulting from lead ingestion. The lethal dose in cats appear to range from 60 to 150mg/kg body weight. A reliable diagnosis of lead poisoning can be made utilizing blood lead, ZPP, and ALAD, and hair lead.

• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.43-50
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• 1996

We experienced a case of nephropathy in chronic lead poisoning. The patient was 43-year-old male who has been working in secondary lead smelting plant for 14 years. On admission, blood pressure was 160/90 mmHg and the others were non-specific. In past history, he received chelating agent administration for lead poisoning irregularly and medicated for gout, and the blood lead concentration was $180.0{\mu}g/dl$ on 2 months before admission. Smoking habit has been 1 pack per day for 15 years and drinking habit has been 1 bottle of Soju per day but less flow. In liver function test, AST/ALT were 27/28 IU/l and $\gamma-GT$ was 456 IU/l. In blood test, Hb : 11.5 g/dl, Hct : 34.0% and basophilic stipplings were found in peripheral blood smear. Chest PA was normal and abdominal ultrasonographic finding was non-specific except fatty liver. In the test of lead exposure indices, $PbB:83.0{\mu}g/dl,\;PbU:28.3{\mu}g/l$, and blood ZPP was $300.0{\mu}g/dl$. And in renal function test, BUN : 31.4 mg/dl, blood creatinine : 2.7mg/dl, blood uric acid. 9.1 mg/dl, urinary albumin : 100.0 mg/g creatinine, urinary $\alpha_1-microglobulin$ : 120.5 mg/g creatinine, urinary $\beta_2-microglobulin$ : $183.8{\mu}g/g$ creatinine, and 24 hours urinary creatinine clearance was 31.9 ml/min. The ultrasonoguided renal biopsy showed the global sclerosis of glomerulus, moderate atrophy and loss of tubule, and interstitial fibrosis in light microscopy. There were diffuse losses of brush border of proximal tubule in electronmicroscopy.