Blood lead concentration, renal function, and blood pressure in London civil servants.

Staessen, Jan A; Yeoman, W. B.; Fletcher, A; Markowe, Hugh L.J.; Marmot, Michael; Rose, Geoffrey; Semmence, A.; Shipley, MJ; Bulpitt, CJ

doi:10.1136/oem.47.7.442

Cited by 33 publications

(40 citation statements)

References 22 publications

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“…This concurs with the conclusion drawn in a recent comprehensive review. 5 This study is the first to use a nationally representative sample of the English population whereas previous studies in the UK have investigated age-sexrestricted 9,10 or occupational 11 subgroups of the population, and the results of these studies were inconsistent and conflicting.…”

Section: Discussionmentioning

confidence: 98%

Blood lead and blood pressure: evidence from the Health Survey for England 1995

et al. 1999

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Objectives: To examine the relationship between blood lead and blood pressure (BP) and to estimate the possible effects of a decrease in blood lead on BP. Methods: A 2-ml blood sample was collected from a sub-sample of those included in the Health Survey for England 1995, a cross-sectional survey of a nationally representative sample of the adult English population. Blood lead concentration was measured by atomic absorption spectrometry and three BP readings were taken under standardised conditions using the Dinamap 8100 monitor. Analyses were carried out using data on 2563 men and 2763 women aged 16 and over. Results: In stepwise multiple regression analyses adjusting for various confounders-age, body mass index, smoking status, social class, region of residence

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Section: Discussionmentioning

confidence: 98%

Blood lead and blood pressure: evidence from the Health Survey for England 1995

et al. 1999

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“…Among drinkers (n = 1068) the median ethanol intake was 18.4 g/day and more than 90% of total alcohol intake was due to wine. With regard to smoking habits, 72% of subjects were nonsmokers; among current smokers (369 subjects) the median consumption was of 15 cigarettes daily (25th-75th centiles: [8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Resultsmentioning

confidence: 99%

“…Grandjean et al (12) observed that the positive relationship between B-Pb and blood pressure was no longer significant when alcohol intake and hemoglobin were included in a multiple regression analysis. Staessen et al (13) reported that the addition of gender and age as covariates to models predicting blood pressure reduced the partial correlations of systolic and diastolic blood pressure with B-Pb to a nonsignificant level. Sharp et al (6) observed that a positive relationship between blood pressure and B-Pb was present in black males but not among nonblack males; the inclusion of alcohol use indicators in multiple regression models did not alter the relationship between blood pressure and B-Pb by more than 10%.…”

Section: Introductionmentioning

confidence: 99%

Association of blood lead to blood pressure in men aged 55 to 75 years: effect of selected social and biochemical confounders. NFR Study Group.

Menditto

Morisi

Spagnolo

et al. 1994

Environ Health Perspect

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The association of blood lead (B-Pb) concentration to blood pressure was investigated in men aged 55 to 75 years living in the Rome area, who had no history of exposure to lead in the workplace and who participated between 1989 and 1990 in an epidemiologic survey for coronary heart disease (New Risk Factor Project). Of the 1856 individuals eligible for the study, 59 were excluded from analyses because not all relevant data were available; and 478 were excluded because they were treated for hypertension. In the remaining subjects (n = 1319) the median B-Pb concentration was 113 pg/l (range: 40-442 pg/I). Systolic blood pressure (SBP) averaged 140 ± 18 (standard deviation) mm Hg (range 98-220) and diastolic blood pressure (DBP) 84 ± 9 mm Hg (range 56-118). Median B-Pb values increased significantly from 1 1 1 pg/l in subjects with normal blood pressure (n = 668) to 1 13.5 pg/l in subjects with borderline high blood pressure (n = 373) and to 120 pg/l in subjects with increased blood pressure (n = 278). After log-normal conversion of B-Pb, the linear correlation coefficient between ln[B-Pb(ug/l)] and both SBP and DBP was statistically significant (r = 0.1332, p <0.001 and r = 0.0737, p = 0.007, respectively). The linear regression coefficient was 6.8 mm Hg/ln(pg/l) for SBP and 1.8 mm Hg/ln(pg/l) for DBP. Multiple regression analyses revealed that, after correction for body mass index (BMI), age, heart rate, skinfold thickness, serum lipids, and glucose levels, blood lead was still a significant predictor of increased SBP and DBP. The adjusted regression coefficient was 5.6 mm HgAn(ug/l) for SBP and 1.7 mm Hg/ln(pg/l) for DBP. In further analyses subjects were divided, according to alcohol consumption, into drinkers (n = 1068) and nondrinkers (n = 251). Among nondrinkers the median B-Pb levels was 97 pg/l (2.5th and 97.5th centiles 55-181 pg/I) and SBP and DBP averaged 138 ± 17 and 84 ± 9 mm Hg, respectively. No significant relationship between In[B-Pb] and blood pressure was found. In drinkers the median B-Pb level was 1 17 pg/l (2.5th and 97.5th centiles: 63-252 pg/I) and SBP and DBP averaged 141 ± 18 and 84 ± 9 mm Hg, respectively. The linear regression coefficient was 7.5 mm Hg/ln(pg/l) for SBP and 2.6 mm Hg/ln(pg/l) for DBP. In multiple stepwise regressions including BMI, age, heart rate, smoking, skinfold thickness, serum lipids, and glucose levels as covariates-the partial correlation coefficient of systolic and diastolic blood pressure with In[B-Pb] remained statistically significant. The adjusted regression coefficients were 5.6 mm Hg/ln(pg/l) for SBP and 2.5 mm Hg/ln(pg/l) for DBP. These findings indicate that a slight to moderate positive relationship exists between blood pressure and blood lead concentrations in male drinkers aged 55 to 75 years. -Environ Health Perspect 102(Suppl 9): 107-111 (1994)

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“…Levels in men are usually somewhat higher than in women (10). B-Pb also norn~ally increases with age (1 1, 12).…”

Section: Samplingmentioning

confidence: 99%

Evaluation of selected publications on reference values for lead in blood

Gerhardsson

Kazantzis²,

Schütz³

1996

Scand J Work Environ Health

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. Evaluation of selected publications on reference values for lead in blood. 1996;22:325-31. Scand J Work Environ HealthAs a part of the global Tracy project, whose aim is to define metal concentrations in tissues and body fluids of reference populations, more than 1000 papers published from 1980 to 1994 were scrutinized that presented tentative reference values for lead in blood in occupationally unexposed adult populations. Ten studies exemplifying criteria for proper sampling, analysis and data treatment are presented and discussed. Levels of lead in blood are influenced by numerous factors. Accordingly, a wide variation in blood lead concentrations was observed. As an example, in a global study in 1983 of nonsmoking female schoolteachers, the geometric mean value for lead in blood varied from 52 yg . I-' in Tolcyo, Japan, up to 193 yg . I-' in Mexico City. The Tracy survey de~uonstrates the importance of factors such as age, gender, ethnicity, food, drinking and smoking habits, hobbies, season and year of sampling, residential area, and geographic location. Lead in blood was shown to be both time and area specific. Thus it was not possible to establish a general reference value for lead in blood.Key terms inorganic lead.Lead has many uses in society. World-wide emission of lead occurs through the use of leaded gasoline (1). Industrial emissions may also contribute, in some areas, to increased lead levels in air, food, and water. Lead has been a constituent in house paint in some countries (2). Furthermore, the use of lead pipes in fresh water systems and the use of lead-glazed household ceramics may substantially increase lead intake (3).The absorption of lead from the gastroi~ltestinal tract is about 10% in adults, but can be considerably higher in children (4). It increases when a person's diet is deficient in calcium and iron. In occupational settings, the main intake is through inhalation. Absorption through the respiratory tract is influenced by the size and solubility of the inhaled particles.After absorption into blood plasma, lead is quicltly taken up by the red blood cells, which contain about 99% of the lead in whole blood (5). Thus far, lead in whole blood (B-Pb) has been the main indicator medium used for the biological ~nonitoring of humans. As an indicator of exposure and of internal dose, B-Pb is a mandatory requirement for the biological monitoring of lead-exposed worl

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Blood lead concentration, renal function, and blood pressure in London civil servants.

Cited by 33 publications

References 22 publications

Blood lead and blood pressure: evidence from the Health Survey for England 1995

Blood lead and blood pressure: evidence from the Health Survey for England 1995

Association of blood lead to blood pressure in men aged 55 to 75 years: effect of selected social and biochemical confounders. NFR Study Group.

Evaluation of selected publications on reference values for lead in blood

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