A cross-sectional epidemiologic study was conducted to evaluate vitamin C nutritional status by assessing dietary intake and blood vitamin C level and to identify the relationships between dietary vitamin C intake, serum vitamin C level and blood lead level in Korean lead workers. The study population was 118 lead workers from two battery manufacturing factories and 63 non-lead-exposed controls. A food consumption survey was conducted by the 24-hr recall method to determine the dietary vitamin C intake level. The anthropometric measurements, blood collection, and survey were performed between September and November, 2000. Blood lead levels and serum vitamin C levels were measured using an atomic absorption spectrometer and high performance liquid chromatography, respectively. Vitamin C nutritional status of Korean lead workers was lower than that of the control group, in terms of both dietary intake and the biochemical index: the mean daily dietary intake level of vitamin C of lead workers was 65.9mg (94% RDA), while that of controls was 132.6mg(189% RDA) ; and the serum vitamin C status of lead workers (0.10mg/dl) was significantly lower than that of controls (1.08mg/dl ; p<0.001). Both dietary vitamin C intake and serum vitamin C levels showed a significant negative correlation with blood lead level (p<0.001), which indicates that strategies of dietary management to promote the health of Korean lead workers should focus on promoting the vitamin C intakes of individuals.
Objectives : To estimate the correlation of blood lead level of families and environmental factors and infer its influence on blood lead levels in the Korean urban area in Seoul Korea. Methods : The study subjects comprised 499 men and 489 women from 366 families and we analyzed the blood lead level using induced coupled plasma/mass spectroscopy and had interviews. Results : The mean blood lead level of men was 3.00 $\mu\textrm{g}$/dL. The stastical analysis of this study used the tool of frequency rate and t-test between blood lead levels of families and environmental factors. Especially father's smoking and dusty workplace environment showed significancy to blood lead levels. Conclusion : There was positive relationship of blood lead level to several environmental factors. These facts show outdoor environment is more influential than home environment.
In order to provide basic data for the prevention of adverse effects of lead on health, we examined lead levels in the blood of 30 handicapped workers employed in manufacturing electronic components in Seoul from 2002 to 2008. The average lead level in the blood of all the subjects was $4.79{\pm}4.32{\mu}g/dL$ in females, $2.64{\pm}2.31{\mu}g/dL$ in males, and $3.88{\pm}3.75{\mu}g/dL$ in total. Lead levels examined in this study were significantly lower than other investigators study have reported. The average lead level from personal exposure of the subjects was $1.44{\pm}0.91mg/m^3$ in the workplace. The relation between blood lead levels and personal exposure was a simple linear regression; it's equation was "Lead level in blood = 6.04 - 1.92 lead level by personal exposure".
The welders and car painters are frequently exposed to heavy metals such as lead, zinc, cadmium and chromium, and those are a major source of heavy metal poisoning. This study was carried out to investigate the relationship of the heavy metal level in blood by age, working duration, and smoking status among 105 industrial workers and 88 general people in Gyeongnam province from October 2003 to October 2004. The heavy metal level in blood was analyzed by atomic absorption spectrophotometer. Mean blood lead level in exposed group and control group was 8.40±4.67μl/dl, 1.82±1.35μl/dl, respectively. Mean blood zinc level in exposed group and control group was 9.43±5.38 ㎍/ml, 2.89±1.79㎍/ml, respectively. Mean blood cadmium level in Exposed group and control group was 1.53±1.05μl/dl, 0.60±0.49 μl/dl, respectively. Mean blood chromium level in exposed group and control group was 0.89±0.76μl/dl, 0.68±0.63μl/dl, respectively. Lead, zinc, cadmium and chromium level in blood of exposed group was significantly higher than that of control group. In the comparison of smoking status, lead, zinc and cadmium level of smoker's was significantly higher than that of non-smoker's. Comparison of heavy metal level by age, lead, zinc, cadmium level in 40's, 50's (exposed group) in blood significantly higher than that of 20's, 30's. In exposed group, working duration has no significant difference. In conclusion, smoking was the most hazardous factor to elevate in blood heavy metal levels.
The most critical health effect of lead exposure is the neurodevelopmental effect to children caused by the increased blood lead level. Therefore, the endpoint of the risk assessment for lead-contaminated sites should be set at the blood lead level of children. In foreign countries, the risk assessment for lead-contaminated sites is conducted by estimating the increased blood lead level of children via oral intake and/or inhalation (United States Environmental Protection Agency, USEPA), or by comparing the estimated oral dose to the threshold oral dose of lead, which is derived from the permissible blood lead level of children (Dutch National Institute for Public Health and the Environment, RIVM). For the risk assessment, USEPA employs Integrated-Exposure-Uptake-Biokinetic (IEUBK) Model to check whether the estimated portion of children whose blood lead level exceeds 10 µg/dL, threshold blood lead level determined by USEPA, is higher than 5%, while Dutch RIVM compares the estimated oral dose of lead to the threshold oral dose (2.8 µg/kg-day), which is derived from the permissible blood lead level of children. In Korea, like The Netherlands, risk assessment for lead-contaminated sites is conducted by comparing the estimated oral dose to the threshold oral dose; however, because the threshold oral dose listed in Korean risk assessment guidance is an unidentified value, it is recommended to revise the existing threshold oral dose described in Korean risk assessment guidance. And, if significant lead exposure via inhalation is suspected, it is useful to employ IEUBK Model to derive the risk posed via multimedia exposure (i.e., both oral ingestion and inhalation).
In order to provide a basic data for the prevention of the adverse effect of lead on health, We examined lead level in the blood and urine of 371 healthy men living in Choongchung-do from May to June, 1997. The results were as follows ; 1. Average lead level of all the subjects was $3.98{\pm}1.02{\mu}g/dl$ in blood, and $3.94{\pm}2.09{\mu}g/L$ in urine, respectively. Lead contents examined in this study were significantly lower than those of other investigators. 2. The lead levels of all the subjects in blood and urine had almost normal distribution. 3. Relation between lead content in blood and urine was a simple linear regression; its equation was "Lead level in blood=36.76+0.77 lead level in urine".
Measurement of blood lead (PbB) and blood zinc protoporphyrin (ZPP) are most common biological indices to identify the individual at risk for excess or the health sequences by lead exposure. Because PbB is known most important and reliable index of lead exposure, PbB is often regarded as a gold standard to detect lead exposure. But in Korea PbB is a secondary test item of detailed health check-up with positive finding of screening test in most occasion. Our lead standard requires all lead workers to take annual heath-check twice a year for investigation of their health effect due to lead exposure. Blood ZPP is one of most important index to detect high lead absorption in lead workers as a screening test. Measurement of blood ZPP is known ,well to correlate with PbB in steady state of exposure in most lead workers and is often used as a primary screening test to detect high lead absorption of lead workers with the advantage of simplicity, easiness, portability and low cost. The current cut-off criteria of blood ZPP for further detailed health check-up is $100{\mu}g/d\ell$ which is supposed to match the level of $40{\mu}g/d\ell$ of PbB according to our standard. Authors tried to investigate the validity of current criteria of cut-off level $(100{\mu}g/d\ell)$ of blood ZPP and possible another better cut-off level of it to detect the lead workers whose PbB level over $40{\mu}g/d\ell$. The subjects in our study were 212 male workers in three small scale storage battery industries. Blood ZPP, PbB and hemoglobin (Hb) were selected as the indices of lead exposure. The results were as follows. 1. The mean of blood ZPP, PbB and Hb in lead workers were $79.5{\pm}46.7{\mu}g/d\ell,\;38.7{\pm}15.1{\mu}g/d\ell,\;and\;14.8{\pm}1.2g/d\ell$, respectively. There were significant differences in blood ZPP, PbB and Hb by industry (P<0.01). 2. The percents of lead workers whose blood ZPP were above $100{\mu}g/d\ell$ in the group of work duration below 1, 1-4, 5-9 and above 10 years were 8.6%, 17.2%, 47.6%, and 50.0%, respectively. The percents of lead workers whose PbB were above $40{\mu}g/d\ell$ in those were 31.4%, 40.4%, 71.4%, and 86.4%, respectively. 3. The percents of lead workers whose PbB were below $40{\mu}g/d\ell$, $40-59{\mu}g/d\ell$ and above $60{\mu}g/d\ell$ were 54.7%, 34.9% and 10.4%, respectively. Those of lead workers whose blood ZPP were below $100{\mu}g/d\ell$, $100-149{\mu}g/d\ell$ and above $150{\mu}g/d\ell$ were 79.2%, 13.7% and 7.1%, respectively. 4. Simple linear regression of PbB on blood ZPP was statistically significant (P<0.01) and as PbB was $40{\mu}g/d\ell$, blood ZPP was $82.1{\mu}g/d\ell$. 5. While the highest sensitivity and specificity of blood ZPP test to detect lead workers with PbB eve. $40{\mu}g/d\ell$ were observed in the cut-off level of $50{\mu}g/d\ell$ and $100{\mu}g/d\ell$ of blood ZPP, respectively, the highest validity (sensitivity+specificity) of blood ZPP to detect lead workers with PbB over $40{\mu}g/d\ell$ was observed in the cut-off level of around $70{\mu}g/d\ell$ of blood ZPP. But even with optimal cut-off level of around $70{\mu}g/d\ell$ of blood ZPP, still 25.0% of false negative and 20.7% false positive lead workers were found. As the result of this study, it was suggested that reconsideration of current blood ZPP cut-off of our lead standard from $100{\mu}g/d\ell$ to somewhat lower level such as around $70{\mu}g/d\ell$ and the inclusion of PbB measurement as a primary screening test for lead workers was highly recommended for the effective prevention of lead workers.
In order to survery the risk of air-borne lead to human, the relation between air-borne lead level and blood lead level was examined by using of the kinetic model and statistical model. The results of this survey were as follows: 1. The pathways of lead intake were food and water, mainly. 2. Though blood lead level of Korean urbanire was higher than that of American or Japanese, it was not so severe as to influence human health. 3. The lead content in food and water was high, and so it is needed to confirm the cause of high content was whether second contamination by air pollution or not.
In order to study the change of laboratory parameters of lead poisoning, 8 persona who had not been treated previously for lead poisoning (Group 1 and 6 persons who had been inadequately treated for few months for chronic lead poisoning at local clinic (Group 2) were examined. They had occupational exposure to lead for 3 to 18 years (mean, 7.6). In group 1 blood lead, urine lead, urine coproporphyrin and ${\delta}$-aminolevulinic acid levels before our treatment exceeded the critical levels of lead poisoning. In group 2 urine lead level exceeded but blood lead, urine coproporphyrin and ${\delta}$-aminolevulinic acid levels were within normal limits. All of them were treated with D-penicillamine for 4 months as inpatients at Industrial Accident Hospital. The dose of D-penicillamine was the same in all patients; 600 mg per day p.o. and the chelating agent was administer every other week. For laboratory analysis, 24 hour urine and 10 gm of whole blood were collected every 1 month on last day of non-administration period. The results were as follows: 1. It was found that urine lead level was decreased below the cirtical level of lead poisoning after 4 month's treatment with D-penicillamine and blood lead level was decreased more progressively below the critical level after 1 month treatment. 2. Urine coproporphyrin and ${\delta}$-aminolevulinic acid levels were decreased progressively to normal range after 1 month treatment. 3. Two months after treatment, blood lead, urine lead, urine coproporphyrin and ${\delta}$-aminolevulinic acid levels showed some increasing trends. 4. Urine lead level should be checked in a person who had been inadequately treated with chelating agents because blood lead, coproporphyrin and ${\delta}$-aminolevulinic acid might be in normal range.
This study intended to obtain an useful information on the prevalence of subjective symptoms, and to clarify the interrelationships between blood lead and lead related symptoms in low level lead exposure. The 93 male workers exposed to lead and 56 male nonexposed workers were examined for their blood lead(PBB), Zinc-protoporphy(ZPP), hemoglobin(HB) and personnal history, and completed 15 questionnaires related to symptoms of lead absorption : also measured lead concentration in air (PBA) in the workplace. The results obtained were as follows ; 1. The means of blood lead (PBB), blood ZPP and hemoglobin (HB) among workers exposed to lead were $26.1{\pm}8.8{\mu}g/dl,\;28.3{\pm}26.0{\mu}g/dl$ and $16.2{\pm}1.2g/dl$ : whereas those of nonexposed workers were $18.7{\pm}5.1{\mu}g/dl,\;20.6{\pm}8.7{\mu}g/dl$ and $17.3{\pm}1.1g/dl$. The means of above three indicies between two groups showed significant difference statistically (p<0.05). 2. The means of blood lead (PBB), blood ZPP and hemoglobin of workers exposed .to different lead concentration in air were as follows : When it was below $25{\mu}g/m^3$, the indices were $24.7{\pm}79,\;26.1{\pm}26.8{\mu}g/dl\;and\;16.4{\pm}1.1g/dl$ respectively : These indices were $27.1{\pm}8.5,\;23.9{\pm}10.92{\mu}g/dl\;and\;16.2{\pm}1.3g/dl$ when the lead concentration in air was $25{\sim}50{\mu}g/m^3$ : and they were $3.4{\pm}9.3,\;42.3{\pm}31.3{\mu}g/dl\;and\;15.5{\pm}1.2g/dl$ when the concentration of lead was above $50{\mu}g/m^3$. Although there were statistical difference in blood lead and hemoglobin among three different lead concentration in air, there was no statistical difference of blood ZPP among the three groups with different exposure levels (p>0.05). 3. The most frequent by complained symptom was 'Generalized weakness and fatigue', and fewest symptom was 'Intermittent pains in abdomen' 4. Only two symptoms out of fifteen symptoms checked by themselves revealed significant difference between exposed and nonexposed groups. These were 'Intermittent pains of abdomen' and 'Joint pain or arthralgia' (p<0.05), No positive correlation was found between the levels of blood lead and symptom groups categorized as gastrointestinal, neuromuscular and constitutional symptoms, 5. Blood lead (r=0.3995) and ZPP (r=0.2837) showed statistically significant correlation with mean lead concentration in air, whereas correlations were not demonstrated between blood lead and lead related symptoms or blood ZPP and lead related symptoms. 6. Blood lead (PBB) and ZPP showed association (r=0.2466) and the equation PBB=23.75+0.0842 ZPP was derived. 7. On stepwise multiple regression, using blood lead level as a dependent variable and ZPP, hemoglobin (HB), age, work duration (WD) and symptom prevalence as a independent variables, only ZPP significantly contributed a lot to blood lead level. 8. While the ZPP measurement was found to be a good indicator in evaluating health effect of lead absorption in low level lead exposure, lead related symptoms were not sensitive enough to evaluate of lead absorption in low level exposure.
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