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119 Renal effects induced by occupational co-exposure to cadmium and lead in metallurgy workers
  1. R H Hambach1,
  2. D Lison2,
  3. P C D’Haese3,
  4. J Weyler4,
  5. E De Graef5,
  6. A De Schryver4,
  7. L V Lamberts3,
  8. M van Sprundel4
  1. 1University of Antwerp/Occupational Health Service Mensura, Wilrijk, Belgium
  2. 2Louvain Centre of Toxicology and Applied Pharmacology, UCL, Brussels, Belgium
  3. 3Laboratory of Pathophysiology, University of Antwerp, Antwerp, Belgium
  4. 4Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium
  5. 5Umicore PMR, Department of Health & Safety, Hoboken, Belgium


Objectives Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on early renal biomarkers.

Methods Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers i.e., microalbumin (µ-Alb), beta-2-microglobulin (β2-MG), retinol binding protein (RBP), N-acetyl-β-D-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey. In order to explore the effect of Pb on the association between Cd and renal biomarkers (i.e., effect modification or interaction), we performed a multiple linear regression analysis (adjusting for age and pack-years of smoking) including an interaction term Pb x Cd.

Results The median Cd-B, Cd-U, Pb-B were: 0.8 µg/l (IQR = 0.5, 1.2), 0.5 µg/g creatinine (IQR = 0.3, 0.8) and 158.5 µg/l (IQR = 111.0, 219.3), respectively. The statistically significant interaction term Pb-B x Cd-B indicates that the impact of Cd-B on the enzymes NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75th percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75th percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., µ-Alb and β2-MG).

Conclusions Our findings indicate that Pb modifies (increases) the strength of the association between Cd and early renal biomarkers.

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