Predictors of DMSA chelatable lead, tibial lead, and blood lead in 802 Korean lead workers
A C Todda, B-K Leeb, G-S Leeb, K-D Ahnb, E L Moshiera, B S Schwartzc d e
a Department of
Community and Preventive Medicine, Mount Sinai School of Medicine, Box
1057, 1 Gustave L Levy Place, New York, NY 10029, USA, b Institute of Industrial
Medicine, Soonchunhyang University, Chonan, Korea, c Division of
Occupational and Environmental Health, Department of Environmental
Health Sciences, Johns Hopkins School of Hygiene and Public Health,
Baltimore, MD, USA, d Department
of Epidemiology, e Department
of Medicine, Johns Hopkins School of Medicine
Correspondence to: Dr A C Todd andrew.todd{at}MSSM.EDU
Accepted 22 September 2000
OBJECTIVES
To examine
the interrelations among chelatable lead (by dimercaptosuccinic acid,
DMSA), tibial lead, and blood lead concentrations in 802 Korean workers
with occupational exposure to lead and 135 employed controls with only
environmental exposure to lead.
METHODSThis was a
cross sectional study wherein tibial lead, DMSA chelatable lead, and
blood lead were measured. Linear regression was used to identify
predictors of the three lead biomarkers, evaluating the influence of
age, job duration, sex, education level, alcohol and tobacco use,
creatinine clearance rate, and body mass index.
RESULTSDMSA
chelatable lead concentrations ranged from 4.8 to 2102.9 µg and were
positively associated with age, current smoking, and creatinine
clearance rate. On average, women had 64 µg less DMSA chelatable lead
than men. When blood lead and its square were added to a model with
age, sex, current smoking, body mass index, and creatinine clearance
rate, blood lead accounted for the largest proportion of the variance
and sex became of borderline significance. Tibial lead concentrations
ranged from 
7 to 338 µg/g bone mineral and were positively
associated with age, job duration, and body mass index. Women had, on
average, 9.7 µg/g less tibial lead than men. Blood lead
concentrations ranged from 4.3 to 85.7 µg/dl and were positively
associated with age and tibial lead, whereas current smokers had higher
blood lead concentrations and women had lower blood lead concentrations.
CONCLUSIONSThe data
suggest that age and sex are both predictors of DMSA chelatable lead,
blood lead, and tibial lead concentrations and that tibial lead stores
in older subjects are less bioavailable and may contribute less to
blood lead concentrations than tibial lead stores in younger subjects.
Although blood lead concentrations accounted for a large proportion of
the variance in DMSA chelatable lead concentrations, suggesting that
measurement of both in epidemiological studies may not be necessary,
the efficacy of each measure in predicting health outcomes in
epidemiological studies awaits further investigation.
Keywords: dimercaptosuccinic acid; bone lead; x ray fluorescence
© 2001 by Occupational and Environmental Medicine
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