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Title: Glomerular function of lead-exposed workers
Authors: Chia, K.S. 
Jeyaratnam, J. 
Tan, C.
Ong, H.Y.
Ong, C.N. 
Lee, E.
Keywords: Creatinine clearance
Serial blood lead
Serum α1-microglobulin
Serum β2-microglobulin
Issue Date: 1995
Citation: Chia, K.S., Jeyaratnam, J., Tan, C., Ong, H.Y., Ong, C.N., Lee, E. (1995). Glomerular function of lead-exposed workers. Toxicology Letters 77 (1-3) : 319-328. ScholarBank@NUS Repository.
Abstract: Among lead-exposed workers, there is evidence of increased mortality from chronic renal diseases (nephritis and nephrosis). Epidemiological studies using early markers of nephropathy among lead-exposed workers failed to demonstrate early renal changes. This study is aimed at assessing the glomerular function of 137 lead-exposed subjects and at evaluating whether changes in markers of glomerular function are related to exposure indices derived from longitudinal blood lead data. A control group of 153 postal workers was also investigated. Several exposure indices were derived for the exposed workers, including a time-integrated index Pb in blood (PbB)(int) and the number of times the PbB was above critical values (PbB400, Pb500, PbB600). Through multiple linear regression analysis, PbB(int) was the best predictor of variation in serum β2-microglobulin (Sβ2m) and α1- microglobulin (Sα1m) and urinary albumin (UAlb). A small but statistically significant difference in the mean β2m was found. Sβ2m was also the only marker showing a significantly higher prevalence rate ratio (PRR) of abnormalities among lead-exposed workers. Though there was no clear dose- response relationship with PbB(int) as the index of dose, all the 15 subjects with abnormal Sβ2m in the older age group were found in the highest PbB(int) group. Furthermore, of the 8 subjects with low 4-h creatinine clearance (CrCl(4h)), 6 had abnormal levels of β2m. Two subjects with CrCl(4h) of less than 75 ml/min/1.74 m2 had high PbB(int) values, thus suggesting that high blood lead levels over a prolonged time may be associated with decreased CrCl(4h). Though the long-term significance of elevated Sβ2m and UAlb is unclear, their association with high PbB(int) and decreasing CrCl(4h) indicate a potentially adverse effect. Their relationship with PbB400 and PbB600 suggests that the threshold of 700 μg/l for PbB may not prevent the occurrence of lead nephropathy.
Source Title: Toxicology Letters
ISSN: 03784274
DOI: 10.1016/0378-4274(95)03313-0
Appears in Collections:Staff Publications

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