Kim, Hee-Seon;Song, Ok-Young;Kim, Kyung-Min;Lee, Sung-Soo;Young Hwangbo;Ahn, Kyu-Dong;Lee, Byung-Kook
Journal of Community Nutrition
/
제3권2호
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pp.96-102
/
2001
A cross-sectional study was performed to estimate the nutritional status of Korean male lead workers and to assess the relationship between calcium nutritional status and blood lead levels. A flood consumption survey was conducted by the 24-hr recall method with 118 lead workers and 63 non-lead exposed controls. Blood lead levels were analyzed from whole blood and serum calcium concentrations were also assessed. Results of dietary analysis showed Korean lead workers consumed relatively sufficient nutrients (more than 75% of RDA) except, calcium. Mean dietary calcium intake of lead workers was 502.2mg(72% of RDA) while that of the non-lead workers was estimated as 600.8mg(86% of RDA). Intakes of protein, iron, niacin and vitamin C of lead workers were significantly lower than those of non-lead workers. There was a wide range of blood lead levels(5.5 to 73.5$\mu\textrm{g}$/㎗) observed while mean blood lead level of lead workers was 30.9$\mu\textrm{g}$/㎗. However, 98% of lead workers showed normal serum ca1cium concentrations (range ; 8.9 to 10.7mg/㎗, mean ; 9.77mg/㎗) while 66% of lead workers were estimated to intake a dietary calcium lower than 75% of RDA. Mean blood lead levels of non-1ead workers were significantly lower(mean ; 5.1$\mu\textrm{g}$/㎗, p < 0.001) and the serum calcium concentration was significantly higher(mean ; 10.20mg/㎗, p < 0.001) than lead workers. Results of unadjusted correlation showed that serum calcium level and dietary calcium intake were negatively correlated with blood lead concentration. In a multiple regression of blood lead levels with variables known as affecting blood lead 1eve1 such as age, body mass index and occupational lead exposure, serum calcium was insignificant while dietary calcium intake showed statistically significant(p < 0.05) relation. Since calcium is a very important nutrient to reduce hazardous effects of lead, it should be strongly recommended that lead workers need to increase dietary calcium intake.
This study was designed to investigate the difference of airborne lead concentration by type of lead industries and type of lead exposure and to evaluate their association with lead biomarkers of lead workers in 11 lead using industries. Total of 182 lead workers (male: 167, female: 15) from 11 lead industries were participated for this study from March, 2004 to August, 2005. Airborne lead concentration were measured by representative personal sampling of workers in each unit workplace and applied same concentration value to the workers in the same unit workplace who did not measure their airborne lead with personal air sampling. Tibia lead, blood lead, zinc protoporphyrin in whole blood, ${\delta}$-aminolevulinic acid in urine, hemoglobin and hematocrit were selected as study variables of indices of lead exposure. Information about type of lead exposure (fume or non-fume other), age, work duration, smoking & drinking habit were also collected. Significant differences were seen in the means of zinc protoporphyrin, blood lead and tibia lead in lead workers by different airborne lead concentration in workplace. While blood lead and tibia lead in lead workers were significantly higher in secondary smelting than other types of lead industries, zinc protoporphyrin, ${\delta}$-aminolevulinic acid in urine and airborne lead concentration were significantly higher in litharge manufacturing. While the mean blood lead was significantly higher in the lead workers working in fume type unit workplace than those of non-fume lead workers, the mean airborne lead concentration of fume workers was significantly lower than non-fume lead workers. In the multiple regression analysis of airborne lead concentration and the type of lead exposure on tibia lead and lead exposure indices after adjustment of related covariates, airborne lead concentration was statistically significantly associated with blood lead and tibia lead, but the type of lead exposure was only associated with blood lead. To verify the causal association of airborne lead concentration on blood lead and tibia lead, further studies are needed.
Kim, Hee-Seon;Song, Ok-Young;Lee, Sung-Soo;Young Hwangbo;Ahn, Kyu-Dong;Lee, Byung-Kook
Nutritional Sciences
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제4권2호
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pp.91-97
/
2001
The purpose of this study was to assess the nutritional status of Korean workers with occupational exposure to lead by estimating nutrients and flood intakes so that we can eventually establish the dietary guidelines to be recommended for the lead workers. Food consumption survey was conducted by a 24-hr recall method with 135 lead workers and 50 non-exposed controls. Food intake data were convened into nutrients intake using computer aided nutritional analysis program. Mean daily energy intake and percentage of recommended daily allowance (RDA) of male lead workers were 2138 local and 87% of RDA while those of control were estimated as 2234 kcal and 91% of RDA. Mean daily intakes of nutrients of male lead workers were 78 g (111% RDA) for protein 502 mg (71% RDA) for calcium, 11.7 mg (97% RDA) for iron, 665 $\mu$g R.E (95% RDA) for vitamin A, 1.39 mg (108% RDA) for thiamin, 1.14 mg (77% RDA) for riboflavin, 15 mg N.E (92% RDA) for niacin and 66 mg (94% RDA) for vitamin C. On average, male lead workers showed significantly lower protein, calcium, iron, sodium, potassium, niacin and vitamin C intakes than control group while cholesterol intake of the male lead workers was significantly higher than that of control group. Intakes of calcium of male lead workers were Less than 75% RDA meaning that nutritional intake of calcium of male lead workers was insufficient and could possibly result in nutritional deficient. Some food groups such as milk, meat and fish must be strongly suggested to improve nutritional status of lead workers. Continuing nutrition monitoring and appropriate nutrition intervention for lead workers most be conducted further.
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.
In 1967, the problem of occupational lead exposure came to public attention in Korea. Since then, regular progress has been made in lowering workplace lead exposures, instituting new workplace controls, and implementing health examinations of exposed workers. Past serious lead poisoning episodes made it possible to introduce biological monitoring programs on a voluntary basis in high-lead-exposure facilities in Korea. Industry-specific occupational health services for lead workers in Korea during the last 22 years can be categorized into three phases. During the first phase (1988-1993), efforts were directed at increasing awareness among workers about the hazards of lead exposure, biological monitoring of blood zinc protoporphyrin began, and a respiratory protection program was introduced. During the second phase (1994-1997), a computerized health management system for lead workers was developed, blood-lead measurement was added to biologic monitoring, and engineering controls were introduced in the workplace to lower air-lead levels to comply with air-lead regulations. Finally, during the third phase (1998-present), a new biomarker, bone-lead measurement by X-ray fluorescence, was introduced. Bone-lead measurement proved to be useful for assessing body burden and to demonstrate past lead exposure in retired workers. Occupational health service practice for lead workers, including the industry-specific group occupational health system, has brought considerable success in the prevention of lead poisoning and in reducing the lead burden in Korean lead workers during the last several decades. The successful achievement of prevention of lead poisoning in Korea was a result of the combined efforts of lead workers, employers, relevant government agencies, and academic institutes.
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.
Genotype of ALAD and VDR yields two alleles, respectively and it has been implicated in susceptibility to lead toxicity. Also genotype known to variety by race. To evaluate the genetic susceptibility of ALAD and VDR gene on health effect of lead exposure, this study was done with new workers who entered lead industries from 1992 to 2001. Among database of lead industries of Soonchunhyang University Institute of Industrial Medicine, only new workers were selected for this study. The total of eligible workers for this category was 3,540 workers including non lead exposed workers of same lead industries. Genotype of ALAD and VDR were measured from stored blood in specimen bank of Soonchunhyang University, blood lead and other relevant information were obtained from database of each workers which were gathered at their first year of employment. Among 3,540 new employed study subjects during period of 1992-2001, 3204 workers(90.5%) had ALAD genotype 1-1; whereas 336 workers(9.5%) had variant type of ALAD (1-2 or 2-2). Lead exposed workers, 9.8%(n=243) male and 8.1%(n=16) female were heterozygous for the ALAD allele. Also non lead exposed workers, 8.9%(n=67) male and 9.3%(n=10) female were heterozygous for the ALAD allele. For VDR genotype, 2,903 workers(89.7%) out of total tested 3,238 workers were belonged to type bb and 335 workers(10.3%) were type bB or BB. Lead exposed workers, 10.4%(n=235) male and 12.2%(n=24) female were heterozygous for the VDR allele. Also non lead exposed workers, 9.2%(n=64) male and 12.5%(n=12) female were heterozygous for the VDR allele. No significant differences were seen in mean blood lead levels by ALAD and VDR genotype, nor was significantly associated with blood lead except age in multiple regression analysis.
연 폭로에 의한 조혈기능의 장해정도를 파악하고 연중독 환자를 조기에 발견하기 위하여 1985년 8월부터 1년간 경상북도 구미공단내 5개 산업장의 연취급 여성근로자 284명과 대조군 123명을 대상으로 혈중 연량콰 혈색소량을 측정하여 얻은 성적을 분석한 결과 다음과 같다. 연 취급 근로자의 평균연령은 $20.3{\pm}2.9$세이었고 대조군의 평균연령은 $21.1{\pm}3.5$세이었으며, 연작업자의 평균 근속기간은 $26.46{\pm}19.26$개월이었다. 연 취급 근로자의 평한 혈중연량은 $30.11{\pm}6.61{\mu}g/100ml$이었고 대조군의 경우 $21.86{\pm}3.75{\mu}g/100ml$로 두군 모두 정상범외내였으나, 폭로군이 대조군에 비해 유의하게 (P<0.01) 높았다. 연 취급 근로자의 평균 혈색소량은 $14.00{\pm}0.57g/100ml$이었고 대조군의 경우 $14.03{\pm}0.64g/100ml$로 정상치를 나타내었다. 혈색소치 12g/100ml이하는 한사람도 없었으며, 12.0~13.0g/100ml경우는 연 취급근로자에서 4.5%로 나타났다. 혈중 연량과 빈혈과의 용량-반응관계, 연령 및 근속기간과 혈중연량 및 혈색소치와의 사이에 유의한 상관관계를 관찰할 수 없었다. 이상의 성적으로 보아 작업장의 연 허용기준치를 넘지 않으면 장기간 근무하여도 연 중독의 피해가 없는 것으로 판단되기 때문에 작업장의 위생공학적인 환경관리가 무엇보다도 중요하다고 본다.
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.
Objectives: Blood lead and hyperhomocysteinemia have been found to be associated with cardiovascular disease. The objective of the present study was to assess the relationship of lead biomarkers on plasma homocysteine and blood pressure. Methods: To evaluate the effect of lead biomarkers including blood lead on plasma homocysteine and blood pressure in retired lead workers, 66 retired lead workers without any occupational exposure to organic solvent, mercury and arsenic were agreed to participate this study. For the control subjects 42 controls were recruited from same area of retired lead workers with consideration of demographic characteristics. Results: The mean levels of blood lead and ZPP of retired lead workers were significantly higher than control group. There were positive significant correlations between blood lead and plasma homocysteine, also systolic and diastolic blood pressure. The multiple linear regression analysis also reveled that plasma homocysteine was significantly associated with blood lead after adjusting for age, gender, body mass index, lead exposure, smoking and drinking. Diastolic blood pressure was significantly associated with blood lead, plasma homocysteine, and total cholesterol; whereas, systolic blood pressure was significantly associated with plasma homocysteine only. Conclusions: Blood lead showed significant association with plasma homocysteine and blood pressure even after more than mean 10 years from their retirements.
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