Objectives To determine whether adult lead exposure is associated with incidence of end-stage renal disease (ESRD) in a cohort with measured blood leads.
Method We studied 58 000 US male adults from 11 states with blood lead levels measured between 1980–2005. Most were exposed occupationally. One-third had a single blood lead test; the remainder had a median of three. Subjects were divided into five groups by highest blood lead (0–5, 6–24, 25–39, 40–51 ug/dl; 16%, 33%, 34%, and 17% respectively.
Results Median follow-up was 12 years; there were 302 ESRD cases. Among those with race information (31%), the ESRD standardised incidence ratio (SIR) (US referent) was 1.08 (0.89–1.31) overall. The SIR in the highest BL category was 1.47 (0.98–2.11), increasing to 1.56 (1.02–2.29) for those followed 5+ years. For the entire cohort (race imputed), the overall SIR was 0.92 (0.82–1.03), increasing to 1.36 (0.99–1.73) in the highest BL category (1.43 (1.01- 1.85) with 5+ years follow-up). RRs in internal analyses via Cox regression (entire cohort, 5+ years follow-up) across BL categories were 1.0 (categories 1 and 2 combined), 0.92, 1.08, and 1.96 (test for trend p = 0.003). The effect of lead was strongest in non-whites.
Conclusions Data were limited by lack of detailed work history and reliance on a few blood lead tests per person to estimate exposure. Data suggest current US occupational limits on blood lead levels may need to be strengthened to avoid renal disease.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.