ABSTRACT Eighty-one percent of all hourly paid men who had been employed for more than six months in a factory making lead acid batteries and plastics completed a modified Cornell medical index health questionnaire. Blood lead and erythrocyte protoporphyrin (EPP) were also measured. The questions were grouped into symptom categories as follows: all physical, all psychological, “potentially lead induced,” pulmonary, cardiovascular, gastrointestinal, skin, nervous system, genitourinary, and fatigue. For each symptom category the pooled percentages of men whose symptom scores were above the common median of the three blood lead groups 10-, 40-, and 60 and over μg/100 ml (0·48-, 1·93-, and 2·90 and over μmol/l) within age/smoking subgroups were calculated. In every symptom category the percentages in the two lower blood lead groups differed little, but the percentages were consistently higher in men with blood concentration of 60 μg/100 ml (2·90 μmol/l) and over. Differences between a combined 10-59 μg/100 ml (0·48-2·85 μmol/l) blood lead group and the 60 and over μg/100 ml (≥2·90 μmol/l) group were statistically significant at the 0·01 level for “potentially lead induced” symptoms and at the 0·05 level for skin and psychological symptoms. Broadly similar results were obtained with four log10 EPP groups 0·6-, 1·5-, 1·7-, and ≥2·0, but differences did not reach statistical significance. There was no obvious explanation as to why symptoms that are not found in classic lead poisoning should be increased almost as much as those that are. It was thought that these results could be biased due to the men's knowledge of the symptoms associated with lead exposure, but the possibility that they may be partly due to lead absorption cannot be excluded.
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