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Serial chromosome and biochemical studies were carried out in 11 subjects before and during initial occupational exposure to moderate quantities of lead fumes in a storage battery plant. The rate of abnormal metaphases, mostly with chromatid and one-break chromosome aberrations, was approximately doubled after one month of work; it further increased after two months of work; remained in this range up to seven months of exposure; and then tended to decrease somewhat. Blood lead levels increased progressively in the first few months, then reached a steady state. Urinary lead and coproporphyrin levels increased sharply after one month of work, while urinary delta-aminolevulinic acid (ALA) levels increased moderately. The ALA dehydratase (ALAD) activity of red blood cells (RBCs) was reduced to almost 50% of the initial values after one month, decreased further in subsequent months, and remained decreased through the remainder of the study.

In patients with cirrhosis, the etiocholanolone test showed a decrease in the bone marrow granulocyte reserve; in all the cases studied, the baseline counts of peripheral granulocytes were normal. The mechanisms leading to such a defect are explained.