engleski

Lead effect on blood pressure in moderately lead-exposed male workers

Aim. As lead (Pb) effect on human blood pressure (BP) is still controversial, the study considers possible interaction of relevant toxic and/or essential metals and a role of potential confounders in increasing BP in men. Method. In 151 healthy male industrial workers, aged 20-43 years, comprising 100 subjects with slight to moderate occupational Pb-exposure and 51 reference subjects, the following variables were measured: blood Pb (B-Pb), activity of delta-aminolevulinic acid dehydratase (ALAD), erythrocyte protoporphyrin (EP), blood cadmium (B-Cd), serum zinc (S-Zn), serum copper (S-Cu), body mass index (BMI), hematocrit (Hct), and systolic and diastolic BP (SBP, DBP). The interrelationship of any of the biomarkers of Pb (B-Pb, ALAD, EP) and possible confounding variables (B-Cd, S-Zn, S-Cu, BMI, Hct, smoking, alcohol, age) to SBP and DBP was evaluated by multiple regression analysis. Results. Median and range B-Pb values were 367 (99-659) ľg/L in Pb-workers and 103 (67-208) ľg/L in reference subjects (P<0.0001). The Pb-workers had been occupationally exposed to Pb for 5 (2-21) years. A significantly higher EP and lower ALAD was found in Pb-workers compared to reference subjects (P<0.0001), while there was no significant difference in the other measured variables. The multiple regression analyses showed that BMI was a significant predictor of increased SBP in Pb-workers (P<0.01) and all subjects (P<0.005), and of increased DBP in Pb-workers (P<0.005) and all subjects (P<0.0005). In addition, EP was a significant predictor of increased SBP in Pb-workers (P<0.01) and all subjects (P<0.05), and of increased DBP in all subjects (P=0.05) while this was marginally significant in Pb-workers (P<0.10). A decrease in ALAD was a significant predictor of increased DBP in all subjects (P<0.05), and a marginally significant predictor of increased SBP in Pb-workers (P<0.10). No significant association between B-Pb (either original, log-transformed, or corrected for Hct) and SBP and DBP was found. This may partly be ascribed to a fluctuating Pb-exposure in Pb-workers. Conclusion. Even moderate exposure to Pb can significantly contribute to an increase in BP in men. As EP and ALAD are known to better reflect long-term cumulative Pb-exposure, while B-Pb mainly reflects current or recent exposure level of an individual, cumulative Pb exposure appears to be relevant in increasing BP in humans.

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