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Bone lead associations with blood lead, kidney function and blood pressure among US, lead-exposed workers in a surveillance programme
  1. Vaughn Barry1,
  2. Andrew C Todd2,
  3. Kyle Steenland1
  1. 1 Department of Environmental Health, Rollins School of Public Health at Emory University, Atlanta, Georgia, USA
  2. 2 Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  1. Correspondence to Dr Vaughn Barry, Department of Environmental Health, Rollins School of Public Health at Emory University, Atlanta, GA 30322, USA; vbarry{at}


Objectives Bone lead and past blood lead levels may be more strongly associated with current health effects than current blood lead, representing recent exposure. We examined whether current bone lead was correlated with maximum past blood lead and compared how three lead measures predicted current blood pressure (BP) and kidney function among workers with past occupational lead exposure.

Methods Adult men in a lead surveillance programme residing near New York City were enrolled. Current bone and blood lead, BP and estimated glomerular filtration rate (eGFR) were measured. Maximum past blood lead was obtained from surveillance data. Regression models were used to determine associations of health with different lead measures.

Results Among 211 participants, median (IQR) bone, maximum past blood and current blood leads were 13.8 (9.4–19.5) µg lead per bone mineral gram, 29.0 (14.0–38.0) µg/dL and 2.5 (1.5–4.4) µg/dL, respectively. Maximum past and current blood lead were significantly associated with current bone lead in adjusted analyses (both p<0.0001), with associations driven by high blood lead. Bone lead was associated with increased continuous systolic BP (coefficient=0.36; 95% CI 0.05 to 0.67; p=0.02); categorical analyses indicated this was driven by the top two bone lead quartiles. Bone lead was non-significantly associated with decreased (worse) eGFR (coefficient=−0.15; 95% CI −0.36 to 0.07; p=0.18).

Conclusions Bone lead was significantly associated with past maximum and current blood lead. The association between bone and current blood lead was possibly driven by bone lead resorption into blood. Bone lead, but not past or current blood lead, was associated with elevated systolic BP.

  • lead
  • blood lead
  • bone lead
  • blood pressure
  • renal

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  • Contributors KS designed the study. ACT measured bone lead among the study participants. VB analysed the data. All authors contributed to the analysis and interpretation of data. VB and KS drafted the first version of the manuscript. All authors critically revised the manuscript and approved the final text.

  • Funding This study was funded by a grant from the National Institute for Occupational Safety and Health (NIOSH), US Department of Health and Human Services (#5R01OH010745).

  • Competing interests None declared.

  • Ethics approval This study was approved by the Emory University and Mount Sinai Institutional Review Boards.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at Preliminary results were presented as an accepted abstract at the International Society for Environmental Epidemiology meeting held in Ottawa during 26–30 August 2018.

  • Patient consent for publication Obtained.