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Lead intoxication is a classical environmental hazard that can cause encephalopathy. During recent years several studies have suggested poor performances in psychological tests and increased numbers of subjective symptoms among workers with comparatively low blood lead concentrations. Forty-nine long-term lead-exposed male workers with time-weighted average blood lead concentrations between 1*3 and 3-3 umoUl calculated from at least seven years' results have been compared with a referent group of 27 male industrial workers with normal blood lead concentrations and comparable intellectual backgrounds. Several indices of exposure were used. Both groups were examined with neuropsychological tests and a questionnaire covering neuropsychiatric symptoms. The exposed group performed less well in 11 of 14 non-verbal tests, and there were significant differences in tests of memory and reaction time. A non-linear doseeffect trend was indicated. The results are in accordance with those found in similar studies, and it is concluded that the blood lead concentration should be below 2-5 ,umol/l to avoid the effects shown in this study.Lead intoxication is a classic environmental and occupational hazard that in high doses causes encephalopathy with symptoms such as irritability, depressiveness, and concentration and memory disturbances. During recent years, several studies have suggested poor performance in psychological tests of intellectual functions'`7 and an increased number of subjective symptoms89 among workers with comparatively low blood lead concentrations. The exposure, however, has been either short or not registered regularly. Therefore, it seemed important to study workers exposed for many years with blood lead analyses performed regularly during the time of their exposure. Methods and material LEAD EXPOSUREThe register of workers who had had their blood lead concentrations analysed at the laboratory of the department of occupational medicine in Orebro during 1967-79 was chosen as the source of subjects. The register contained information about the date At the time of the present investigation haemoglobin concentration, the present state of blood lead (B-Pb), and zinc protoporphyrin (B-ZPP) were examined. All blood lead measurements were conducted by the same laboratory during the whole period of measurements and by the same atomic absorption spectrophotometer (Perkin Elmer 403). Blood lead concentration has been recorded two to four times a year in the exposed group. The laboratory had participated regularly in interlaboratory comparisons with approved results. B-ZPP was measured from duplicate samples by the laboratory at the department of occupational medicine in Lund. 10

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A sample of 368 car owners answered a mailed questionnaire constructed on the basis of a model of attitudes toward seat belt use. A factor analysis yielded a belief pattern interpreted in terms of five factors, labeled "discomfort," "worry," "risk," "effect," and "inconvenience." The model appeared useful since an independent measure of attitude to seat belt use (A 0 ) could be predicted (r = .84) from a linear combination of these factor scores. The correlation between the attitude measure and reported use of seat belts was .56, or about the same as that between the belief factor combination and reported use. The combination of the "discomfort" and "effect" factors gave near optimal predictions (r=.S2), The results were replicated on a new sample. A model of seat belt use was suggested in which conceptions about discomfort of belt usage and effects of belts in an accident were regarded as determinants of usage.1 This study is part of a research project concerning factors influencing the use of seat belts in private automobiles. The project was carried out by the authors under the Swedish Road Safety Office Contract Inf. 32, and it was supported by a grant from the Swedish Renault, Inc.