American Journal of Epidemiology Vol. 153, No. 5 : 453-464
Copyright © 2001 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Associations of Blood Lead, Dimercaptosuccinic Acid-chelatable Lead, and Tibia Lead with Neurobehavioral Test Scores in South Korean Lead Workers
1 Division of Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD.
2 Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
3 Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD.
4 Institute of Industrial Medicine, Soonchunhyang University, Chonan, South Korea.
5 Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.
6 Lead Poisoning/Trace Elements Laboratory, Wadsworth Center, New York State Department of Health, Albany, NY.
7 Department of Community and Preventive Medicine, Mount Sinai Medical Center, New York, NY.
The authors performed a cross-sectional study to evaluate associations between blood lead, tibia lead, and dimercaptosuccinic acid (DMSA)-chelatable lead and measures of neurobehavioral and peripheral nervous system function among 803 lead-exposed workers and 135 unexposed controls in South Korea. The workers and controls were enrolled in the study between October 1997 and August 1999. Central nervous system function was assessed with a modified version of the World Health Organization Neurobehavioral Core Test Battery. Peripheral nervous system function was assessed by measuring pinch and grip strength and peripheral vibration thresholds. After adjustment for covariates, the signs of the ß coefficients for blood lead were negative for 16 of the 19 tests and blood lead was a significant predictor of worse performance on eight tests. On average, for the eight tests that were significantly associated with blood lead levels, an increase in blood lead of 5 µg/dl was equivalent to an increase of 1.05 years in age. In contrast, after adjustment for covariates, tibia lead level was not associated with neurobehavioral test scores. Associations with DMSA-chelatable lead were similar to those for blood lead. In these currently exposed workers, blood lead was a better predictor of neurobehavioral performance than was tibia or DMSA-chelatable lead, mainly in the domains of executive abilities, manual dexterity, and peripheral motor strength.
cross-sectional studies; lead; lead poisoning; nervous system; adult; nervous system; neurobehavioral manifestations; neurologic manifestations; occupational exposure; spectrometry; x-ray emission
Abbreviations: CES-D, Center for Epidemiologic Studies Depression Scale; DMSA, dimercaptosuccinic acid
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