• Journal of Preventive Medicine and Public Health
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• 제30권4호
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• pp.741-751
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• 1997

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.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1996년도 제48차 추계 학술대회 연제집
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• pp.271-272
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• 1996

• 한국산업보건학회지
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• 제11권2호
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• pp.111-117
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• 2001

A cross-sectional study was performed to evaluate associations between lead biomarkers, lead-related symptoms, and ${\delta}$-aminolevulinic acid dehydratase (ALAD) genotype among 598 lead workers and 144 control office workers in storage battery industries, secondary smelting and litharge making industries. Lead inhibits the second enzymes, ALAD, in the heme synthesis pathway. ALAD gene, which codes for one of three isozymic proteins (termed ALAD1-1, ALAD1-2, and ALAD2-2), seems to modify the toxicokinetics of lead. The result as follows; The percents of total workers whose genotype of ALAD1-1 and ALAD1-2 were 88.4% and 11.6%, respectively. The zinc protoporphyrin in blood (ZPP) and ${\delta}$-aminolevulinic acid in urine (ALAU) of lead workers with ALAD1-2 were significantly lower than those of lead workers with ALAD1-1, but there were no significant difference between two genotype for blood lead, age, and work duration. The proportion of ALAD1-2 genotype in control office workers was 13.2%. The proportions of ALAD1-2 genotype of lead workers were 14.0%(their mean air lead level below $0.024mg/m^3$), 10.4%($0.025-0.049mg/m^3$), 11.8%($0.050-0.099mg/m^3$), and 9.4%(above $0.100mg/m^3$), respectively. In the logistic analysis of 15 lead related symptoms, 'arthralgia'(S7) symptom of ALAD1-2 was significantly lower (OR=0.481; 95% CI=0.248-0.932) than that of ALAD1-1, but 'feeling of irritation'(S11) of ALAD1-2 was significantly higher(OR=1.636; 95% CI=1.035-2.586) than that of ALAD1-1 after controlling possible confounder (blood lead, work duration, smoking and drinking habit).

• Journal of Preventive Medicine and Public Health
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• 제19권2호
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• pp.167-176
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• 1986

For the purpose of determinating the normal values of some parameters relevant to lead exposure, a study was carried out from April 1 to June 30, 1986 on 258 healthy Korean adults who have had no apparant lead exposure. The lead indices subjected to this study were as follows; blood lead (PbB), hemoglobin (Hb), zinc protoporphyrin in blood (ZPP), delta-aminolevulinic acid dehydratase (ALAD) activity in blood, coproporphyrin in urine (CPU), delta-aminolevulinic acid in urine (ALAU). 1) The mean value of PbB was $17.17{\pm}7.87{\mu}g/100ml$, and there was no statistically significant difference by age & sex. The distribution of PbB fitted to the log-normal distribution ($x^2=7.38$, p>0.1). 2) The mean value of Hb in male ($15.17{\pm}1.56g/100ml$) was higher than in female ($13.22{\pm}1.51g/100ml$)(p<0.01). The distribution of Hb fitted to the normal distribution ($x^2=9.40$, p>0.1). 3) The mean value of ZPP was $32.61{\pm}8.78{\mu}g/100ml$, and there was no statistically significant difference by age & sex. The distribution of ZPP fitted to the normal distribution ($x^2=13.93$, p>0.05). The correlation of ZPP & ALAD (r=-0.229), CPU (r=0.183) was statistically significant respectively. 4) The mean value of ALAD was $30.20{\pm}10.96{\mu}mol$ ALA/min/L of R.B.C., and there was no statistically significant difference by age & sex. The distribution of ALAD activity did not fit to the normal distribution. The correlation between ALAD & PbB (r=-0.219) was statistically significant 5) The mean value of CPU was $36.10{\pm}24.54{\mu}g/L$, and there was no statistically significant difference by age & sex. The distribution of CPU did not fit to the normal distribution. The correlation between CPU & PbB (r=0.185), ZPP (r=0.183) was statistically signinificant respectively. 6) The mean value of ALAU was $1.94{\pm}0.96mg/L$, and there was no statistically significant difference by age & sex. The distribution of ALAU fitted to the normal distribution ($x^2=9.76$, p>0.1).

• 한국환경보건학회지
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• 제42권3호
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• pp.205-212
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• 2016

Objectives: The objective of this study was to evaluate the distribution of blood lead concentrations of residents in the areas surrounding an industrial complex. Methods: During the three-month period from August to October 2012, informed consent was obtained from a total of 417 residents in Gwangyang and Yeosu. We collected blood samples from all subjects, and their demographic characteristics were acquired using a questionnaire. The blood samples were analyzed using an atomic absorption spectrometer and data analysis was conducted using IBM SPSS version 21.0. Results: The geometric mean concentration of blood lead in all subjects was $1.85{\mu}g/dL$. The highest (p<0.01) blood lead concentrations were in the current drinking group ($2.24{\mu}g/dL$). Blood lead concentrations in the smoking group ($0.59{\mu}g/dL$) were significantly (p<0.05) higher than those in the non-smoking group ($0.24{\mu}g/dL$). Risk assessment was performe using the Korean National Environmental Health Survey (KNEHS) as a reference. The hazard indices of blood lead in males and females were 0.65 and 0.52, respectively Conclusion: We provided baseline data for reference values of toxicity and heavy lead concentrations. Our results might be useful for further evaluation of risks due to exposure to heavy metals via oral, air, and percutaneous routes.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.747-764
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• 1996

This study intended to obtain an useful information for health management of lead exposed workers and determine biological monitoring interval in early period of exposure by measuring the lead exposure indices and work duration in all male workers (n=433 persons) exposed less than 1 year in 6 storage battery industries and in 49 males who are not exposed to lead as control. The examined variables were blood lead concentration (PBB), Zinc-protoporphyrin concentration (ZPP), Hemoglobin (HB) and personal history; also measured lead concentration in air (PBA) in the workplace. According to the geometric mean of lead concentration in the air, the factories were grouped into three categories: A; When it is below $0.05mg/m^3$, B; When it is between 0.05 and $0.10mg/m^3$, and C; When it is above $0.10mg/m^3$. The results obtained were as follows: 1. The means of blood lead concentration (PBB), ZPP concentration and hemoglobin(HB) in all male workers exposed to lead less than 1 year in storage battery industries were $29.5{\pm}12.4{\mu}g/100ml,\;52.9{\pm}30.0{\mu}g/100ml\;and\;15.2{\pm}1.1\;gm/100ml$. 2. The means of blood lead concentration (PBB), ZPP concentration and hemoglobin(HB) in control group were $5.8{\pm}1.6{\mu}g/100ml,\;30.8{\pm}12.7{\mu}g/100ml\;and\;15.7{\pm}1.6{\mu}g/100ml$, being much lower than that of study group exposed to lead. 3. The means of blood lead concentration and ZPP concentration among group A were $21.9{\pm}7.6{\mu}g/100,\;41.4{\pm}12.6{\mu}g/100ml$ ; those of group B were $29.8{\pm}11.6{\mu}g/100,\;52.6{\pm}27.9{\mu}g/100ml$ ; those of group C were $37.2{\pm}13.5{\mu}g/100,\;66.3{\pm}40.7{\mu}g/100ml$. Significant differences were found among three factory group(P<0.01) that was classified by the geometric mean of lead concentration in the air, group A being the lowest. 4. The mean of blood lead concentration of workers who have different work duration (month) was as follows ; When the work duration was $1\sim2$ month, it was $24.1{\pm}12.4{\mu}g/100ml$, ; When the work duration was $3\sim4$ month, it was $29.2{\pm}13.4{\mu}g/100ml$ ; and it was $28.9\sim34.5{\mu}g/100ml$ for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 5. The mean of ZPP concentration of workers who have different work duration (month) was as follows ; When the work duration was $1\sim2$ month, it was $40.6{\pm}18.0{\mu}g/100ml$, ; When the work duration was $3\sim4$ month, it was $53.4{\pm}38.4{\mu}g/100ml$ ; and it was $51.5\sim60.4{\mu}g/100ml$ for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 6. Among total workers(433 person), 18.2% had PBB concentration higher than $40{\mu}g/100ml$ and 7.1% had ZPP concentration higher than $100{\mu}g/100ml$ ; In workers of factory group A, those were 0.9% and 0.0% ; In workers of factory group B, those were 17.1% and 6.9% ; In workers of factory group C, those were 39.4% and 15.4%. 7. The proportions of total workers(433 person) with blood lead concentration lower than $25{\mu}g/100ml$ and ZPP concentration lower than $50{\mu}g/100ml$ were 39.7% and 61.9%, respectively ; In workers of factory group A, those were 65.5% and 82.3% : In workers of factory group B, those were 36.1% and 60.2% ; In workers of factory group C, those were 19.2% and 43.3%. 8. Blood lead concentration (r=0.177, P<0.01), ZPP concentration (r=0.135, P<0.01), log ZPP (r=0.170, P<0.01) and hemoglobin (r=0.096, P<0.05) showed statistically significant correlation with work duration (month). ZPP concentration (r=0.612, P<0.01) and log ZPP (r=0.614, P<0.01) showed statistically significant correlation with blood lead concentration 9. The slopes of simple linear regression between work duration(month, independent variable) and blood lead concentration (dependent variable) in workplace with low air concentration of lead was less steeper than that of poor working condition with high geometric mean air concentration of lead. The study result indicates that new employees should be provided with biological monitoring including blood lead concentration test and education about personal hygiene and work place management within $3\sim4$ month.

• Journal of Preventive Medicine and Public Health
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• 제26권2호
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• pp.251-267
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• 1993

연폭로의 정도와 자각증상과의 관계를 알아보기 위하여 435명의 연폭로 남자 근로자와 212명의 일반 사무직 남자 근로자를 대상으로 연폭로 지표가 되는 혈중 연, 혈중 Zinc Protoporphyrin(ZPP), 요중 Delta-aminolevulinic acid(DALA), 혈색소, 혈구 용적 측정을 위한 혈액 시료 및 소변 시료를 채취하여 분석하였고, 연관련 자각증상 조사는 14개의 증상 조사 항목을(표 3 및 별첨 1) 피검자가 응답 하도록하여 상담 의사의 면접을 통한 확인을 거쳐 수집 하였다. 수집된 각 항목은 인체 조직계 증상군별로 1) 위장관계 증상 2) 신경과 근육 및 관절계 증상 3) 일반 체질적 증상 4) 정신과적 증상으로 구분하여 연폭로 지표 수준과 연폭로 작업 여부에 따른 자각증상 호소율을 비교 조사하여 얻은 결론은 다음과 같다. 1. 연폭로군에서 대조군보다 유의하게 높은 자각증상 호소율을 보인 증상군은 신경과 근육 및 관절계 증상으로 "손이나 발이 저리거나 쥐가 잘난다", "관절이 아프거나 쑤신다", "손가락, 손, 발 등에 힘이 없다", "근육통을 느낀다" 순 이었다. 2. 연폭로군과 대조군의 자각증상 호소율에 가장 큰 차이를 보인 증상 항목은 "손이나 발이 저리거나 쥐가 잘 난다"였으며, 전체 조사 대상에서 가장 높은 증상 호소율을 보인 증상 항목은 일반 체질적 자각 증상군의 "전보다 피곤감을 느낀다"였다. 3. 전체 조사 대상의 혈중 연과 혈중 ZPP 수준에 따른 연폭로량의 증가와 자각증상 호소율의 증가를 보인 증상 항목은 신경과 근육 및 관절계 증상군의 "손이나 발이 저리거나 쥐가 잘난다", "관절이 아프거나 쑤신다", "손가락. 손 발 등에 힘이 없다", "근육통을 느낀다"와 위장관계 증상군의 "아랫배가 아파서 고생한 적이 있다"였다. 4 연폭로군에서 혈중 연과 혈중 ZPP 수준에 따른 연폭로량의 증가와 자각증상 호소율의 증가를 보인 증상 항목은 신경과 근육 및 관절계 증상으로 혈중 연의 증가에 따라 증상 호소율이 증가하였다. 5. 연폭로군에서 39세 이하 와 40세 이상 연령군으로 나누어 비교시 39세 이하 군의 증상 호소율이 40세 이상 군보다 높게 나왔으며. 신경과 근육 및 관절계 증상이 39세이하 군에서 혈중 연의 증가와 함께, 40세 이상 군에서 혈중 ZPP의 증가와 함께 자각증상 호소율의 증가를 나타냈다. 6. 연폭로 지표에 따른 폭로수준과 증상 호소율과의 관계를 알아보기 위하여 대조군에 대한 폭로군, 연폭로군의 저농도 폭로군에 대한 고농도 폭로군의 교차비를 산출한 결과 신경과 근육 및 관절계 증상군의 "손이나 발이 저리거나 쥐가 잘난다", "관절이 아프거나 쑤신다", "손가락, 손, 발 등에 힘이 없다", "근육통을 느낀다"와 위장관계 증상군의 "아랫배가 아파서 고생한 적이 있다"가 연폭로량의 증가에 따른 교차비의 증가를 보여 양-반응의 관계를 추정할 수 있었다.

• Journal of Preventive Medicine and Public Health
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• 제29권1호
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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.

• 한국산업보건학회지
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• 제4권1호
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• pp.17-24
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• 1994

연폭로자에 있어서 연에 의한 생물학적 영향을 평가하는데는 요중 ${\delta}$-ALA 배설량이 아주 좋은 지표로 이용된다. 현재 이것은 Ehrlich's reagent와 ALA-pyrrole의 증색반응으로 측정하는 비색법이 주로 사용된다. 그러나 이 방법은 aminoacetone 같은 ALA 유사물질에 의하여 요중 배설량이 과다하게 측정된다. 한편 최근 개발된 fluorometric HPLC에 의한 요중 ${\delta}$-ALA 배설량의 분석은 아주 예민하고도 특이적인 것으로 알려져 있다. 따라서 본 연구는 혈중연과 다른 연폭로 지표를 측정하여 연폭로 수준이 다른 117명의 피검자에서 비색법과 HPLC 법에 의한 ${\delta}$-ALA 배설량을 측정하여 두 방법 간의 관련성을 조사하기 위하여 시도하였으며 결과는 다음과 같다. 1. 비색법에 의한 요중의 ${\delta}$-ALA 배설량은 HPLC 법에 비하여 전체적으로 2.15배, 혈중연 $20{\mu}g/dl$ 이하에서 2.47배, $21-40{\mu}g/dl$에서 2.53배, $41{\mu}g/dl$ 이상에서는 1.86배 높은 것으로 측정되었다. 2. 비색법에 의한 요중 ${\delta}$-ALA 배설량과 혈중연 및 혈중 ZPP 농도와의 상관은 0.571, 0.629였으며, HPLC 법은 0.610, 0.637로 통계적 유의성이 있었다(p<0.01). 3. 비색법과 HPLC 법에 의한 요중 ${\delta}$-ALA 배설량 간의 상관은 0.848 이었으며, 요비중으로 보정하였을 때는 0.852였으며 통계적으로 유의하였다(p<0.01). 4. HPLC 법에 의한 요중 ${\delta}$-ALA 배설량을 종속변수로 하고 비색버버을 독립변수로 하였을 때 희기방정식은 (ALA-UHP)=-0.245+0.536 (ALA-UCO)(p<0.0001)였으며, 요비중 1.024로 보정하였을 때의 희기방정식은 (SP ALA-UHP)=-0.525+0.599 (SP ALA-UCO)(p<0.0001)였다. 상기와 같은 결과에서 현행 산업안전보건법 시행규칙에서 연중독 진단을 행하는 경우 HPLC로 요중 ${\delta}$-ALA 배설량을 측정한다면 연중독 진단 기준의 개정이 필요할 것으로 생각된다.

• 한국산업보건학회지
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• 제6권1호
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• pp.77-87
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• 1996

다량의 연을 사용하는 제조업 중에서 7개의 축전지 제조업, 3개의 폐전지 제련공장, 그리고 2개의 연분 및 광명단을 제조 또는 사용하는 사업장 총 11개 대상 사업장에서 정기 보건관리시 혈중 Zinc Protoporphyrin 농도를 고려하여 생산직 남자 근로자 234명을 선정, 혈액에서 혈중연, 혈중 ZPP, 혈색소 등을 측정하고 소변에서 ${\delta}$-ALA 배설량을 비색법과 HPLC법으로 분석하여 그 차이점을 확인하고 연노출 지표들과의 관련성을 조사하여 연중독 판정기준의 새로운 기준을 마련하기 위하여 본 연구를 시도한 바 결과는 다음과 같다. 1. 비색법과 HPLC법에 의한 요중 ${\delta}$-ALA 배설량은 높은 상관성이 있으나 비색법이 HPLC법 보다 2 mg/L 정도 높게 측정되었다(r = 0.989, 회귀식 ; HALA = - 0.8194 + 0.8110 ${\times}$ CALA) 2. 요중 ${\delta}$-ALA 배설량은 두 방법 모두 혈중연 및 혈중 ZPP 농도와의 상관계수가 각각 0.46, 0.37 이상이었으며, ${\delta}$-ALA 배설량을 대수변환하였을 때는 상관계수가 0.63, 0.57로 높아졌으며 통계적으로도 유의하였다. 3. 혈중 ZPP를 독립변수로, 비색법과 HPLC법에 의한 요중 ${\delta}$-ALA 배설량을 종속변수로 한 단순회귀방정식은 다음과 같다. CALA = 2.0421 + 0.0341 ${\times}$ ZPP $R^2=0.1385$ p = 0.0001 HALA = 0.8006 + 0.0280 ZPP $R^2=0.1389$ p = 0.001 4. 혈중연을 독립변수로, 비색법과 HPLC법에 의한 요중 ${\delta}$-ALA 배설량을 종속변수로 한 단순 회귀 방정식은 다음과 같다. CALA = - 0.4134 + 0.1545 ${\times}$ PbB $R^2=0.2085$ p = 0.0001 HALA = - 1.2893 + 0.1287 ${\times}$ PbB $R^2=0.2154$ p = 0.0001 5. 비색법과 HPLC법에 의한 요중 ${\delta}$-ALA 배설량을 대수변환하였을 때 혈중연 및 혈중 ZPP를 독립변수로 하는 회귀식은 다음과 같다. logHALA = 0.3078 + 0.0060 ${\times}$ ZPP $R^2=0.3329$ p = 0.0001 logCALA = 1.0189 + 0.0044 ${\times}$ ZPP $R^2=0.3290$ p = 0.0001 logHALA = - 0.0221 + 0.0246 ${\times}$ PbB $R^2=0.4046$ p = 0.0001 logCALA = 0.7662 + 0.0184 ${\times}$ PbB $R^2=0.4108$ p = 0.0001 6. 요중 ${\delta}$-ALA 배설량에 대한 연중독 주의한계의 cut-off point를 5 mg/L로 하였을 경우 혈중연과 혈중 ZPP의 주의한계에 대한 비색법의 누적 빈도가 HPLC법 보다 높았으며, 따라서 HPLC법의 cut-off point를 3 mg/L로 하였을 때 비색법과 좋은 일치도를 보였고 연노출지표들과 량-반응 관계를 나타내었다. 이상의 결과로 연중독 판정기준의 주의한계와 선별한계의 개정이 필요하나 남자 근로자들만의 연구이므로 여자 근로자에 관한 연구가 추가로 필요하다고 생각된다.