Désiré Rondia

Impairment of Renal Function with Increasing Blood Lead Concentrations in the General Population

BACKGROUND Nephropathy is known to occur in persons with heavy exposure to lead. Whether exposure to lead in the general population leads to impaired renal function is not known. METHODS We studied renal function and indexes of lead exposure in a random population sample of 965 men and 1016 women (age range, 20 to 88 years). In all the subjects we measured creatinine clearance and blood concentrations of lead and zinc protoporphyrin (an indirect measure of blood lead level). RESULTS The mean (+/- SD) creatinine clearance rate was 99 +/- 30 ml per minute in the men and 80 +/- 25 ml per minute in the women. In the men the geometric mean blood lead concentration was 114 micrograms per liter (0.55 mumol per liter) (range, 23 to 725 micrograms per liter [0.11 to 3.5 mumol per liter]), and in the women 75 micrograms per liter (0.36 mumol per liter) (range, 17 to 603 micrograms per liter [0.08 to 2.9 mumol per liter]); the zinc protoporphyrin values in blood averaged 1.0 and 1.1 micrograms per gram of hemoglobin, respectively. The creatinine clearance rate was inversely correlated with blood lead and zinc protoporphyrin values in the men and the women both before and after adjustments for age, bodymass index, and diuretic treatment. A 10-fold increase in blood lead concentration was associated with a reduction of 10 to 13 ml per minute in creatinine clearance. We also found a positive correlation between serum beta 2-microglobulin (which is inversely related to the glomerular filtration rate) and blood lead in men, between serum beta 2-microglobulin and zinc protoporphyrin in both sexes, and between serum creatinine and zinc protoporphyrin in men. CONCLUSIONS Exposure to lead may impair renal function in the general population. The alternative hypothesis that renal impairment may lead to an increase in the blood lead concentration cannot be excluded, however.

Impact of Environmental Cadmium Pollution on Cadmium Exposure and Body Burden

The body burden of cadmium, as estimated from 24-h urine cadmium levels, was determined in 1,523 subjects who were not occupationally exposed and who lived in five areas of Belgium. Urinary cadmium levels differed significantly with place of residence. These differences persisted after standardization for the other significant determinants (i.e., age, body mass index, smoking habits, social class, alcohol consumption, and menopause). The highest 24-h urine cadmium levels were found in subjects who lived in areas that contained cadmium-polluted soils. The body burden overload has been attributed mainly to the consumption of locally grown vegetables and the use of contaminated well water for cooking and drinking. Blood cadmium levels were also dependent on place of residence. However, the geographical differences in blood cadmium did not parallel those of urine cadmium. Blood cadmium is more influenced by recent exposure; therefore, this latter observation might reflect the recent implementation of preventive measures in some areas.

Environmental pollution by cadmium and cadmium body burden: an autopsy study.

The industrial area of Liège in Belgium is polluted by cadmium mainly because of past emission from non-ferrous metal industries. Persons who have lived in that area have accumulated significantly more cadmium in the renal cortex and in the liver than those who have resided in other regions of the country.

Determinants of serum zinc in a random population sample of four Belgian towns with different degrees of environmental exposure to cadmium

This report investigated the distribution of serum zinc and the factors determining serum zinc concentration in a large random population sample. The 1977 participants (959 men and 1018 women), 20–80 years old, constituted a stratified random sample of the population of four Belgian districts, representing two areas with low and two with high environmental exposure to cadmium. For each exposure level, a rural and an urban area were selected. The serum concentration of zinc, frequently used as an index for zinc status in human subjects, was higher in men (13.1 μmole/L, range 6.5–23.0 μmole/L) than in women (12.6 μmole/L, range 6.3–23.2 μmole/L). In men, 20% of the variance of serum zinc was explained by age (linear and squared term, R = 0.29), diurnal variation (r = 0.29), and total cholesterol (r = 0.16). After adjustment for these covariates, a negative relationship was observed between serum zinc and both blood (r = −0.10) and urinary cadmium (r = −0.14). In women, 11% of the variance could be explained by age (linear and squared term, R = 0.15), diurnal variation in serum zinc (r = 0.27), creatinine clearance (r = −0.11), log γ-glutamyltranspeptidase (r = 0.08), cholesterol (r = 0.07), contraceptive pill intake (r = −0.07), and log serum ferritin (r = 0.06). Before and after adjustment for significant covariates, serum zinc was, on average, lowest in the two districts where the body burden of cadmium, as assessed by urinary cadmium excretion, was highest. These results were not altered when subjects exposed to heavy metals at work were excluded from analysis.

Transfer of cadmium from a sandy acidic soil to man : a population study

This population study included 230 subjects (age range 20-83 years) who consumed vegetables grown in kitchen gardens on a sandy acidic soil (mean pH approximately 6.3). The study investigated the association between the Cd (cadmium) levels in blood and urine and the Cd concentration in the soil (range 0.2-44 ppm). Seventy-six subjects were current smokers and 122 participants lived in a district with known Cd pollution. Urinary Cd in the 230 subjects averaged 8.7 nmole/24 hr, (range 1.3 to 47 nmole/24 hr) after age adjustment positively correlated with the Cd level in the soil; a twofold increase of the Cd concentration in the soil was accompanied by a 7% rise in urinary Cd in men (R2 = 0.05; P = 0.04) and by a 4% rise in women (R2 = 0.02; P = 0.05). Blood Cd averaged 11.5 nmole/liter (range 1.8-41 nmole/liter) and was negatively associated with the Cd level in the soil. After adjustment for significant covariates (smoking and serum gamma-glutamyl transpeptidase in both sexes, and age and serum ferritin in women), a twofold increase in the Cd concentration in the soil was accompanied by a 6% decrease in blood Cd in men (R2 = 0.03; P = 0.09) and by a 10% decrease in women (R2 = 0.06; P less than 0.01). In conclusion, in a rural population, consuming vegetables grown on a sandy acidic soil, 2 to 4% of the variance of urinary Cd was directly related to the Cd level in the soil. The negative correlation with blood Cd, a measure of more recent exposure, was biased by the implementation of preventive measures in the polluted district.

Blood lead levels and age: a study in two male urban populations not occupationally exposed.

Blood lead was measured in two adult male populations who were submitted to different environmental lead exposures. Their differential variations in mean blood lead vs. age result from the difference between the external lead concentrations. It is inferred that a homeostasis phenomena plays a significant role and that the blood compartment is unable to adapt to some extent to a high environmental lead exposure.

Aminolevulinate dehydratase and blood lead levels in urban male adults

SummaryThe existence of an association between aminolevulinic acid dehydratase activity in erythrocytes (ALA-d) and blood lead level (Pb-B) has been investigated in a male urban population not occupationally exposed to lead. The data show a decrease of the mean ALA-d activity when Pb-B rises but the association is not statistically ascertained in every case when the data are examined by two different procedures.It appears first that the statistical significance depends on an adequate choice of the distribution function of the ALA-d. Secondly, factors such as interindividual variability of this biological index, lack of precision in the analytical measurements of the Pb-B and the range of the environmental exposure under observation may influence the statistical significance and induce misleading statements. The data aggregation allows the avoidance of some inconsistencies.Furthermore, the estimation of mean ALA-d for the different Pb-B may also be biased by confounding risk factors (such as smoking habits). As such factors are not presently taken into consideration in public health surveys, the no-threshold Pb-B hypothesis, suggested by the observed dose-effect relationship, cannot be strongly supported.