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The relationship between bone lead and hemoglobin.

Abstract

OBJECTIVE

To determine whether the concentration of lead in bone constitutes a biological marker that is more sensitive for chronic toxicity than blood lead levels.

DESIGN

Survey.

SETTING

A construction trade union with members who engage in carpentry, demolition, and other construction activities.

PARTICIPANTS

Members of the construction trade union.

MAIN OUTCOME MEASURES

We measured blood pressure, serum creatinine, hematocrit, and hemoglobin. We measured blood lead by anodic stripping voltametry and used a cadmium 109 K x-ray fluorescence instrument to make in vivo measurements of lead in the tibia (a heavily cortical bone) and the patella (a heavily trabecular bone). Information was also collected on medical history, smoking, and alcohol ingestion.

RESULTS

Bone lead levels in the patella were found to be significantly correlated with a decrease in hemoglobin and hematocrit, even after adjusting for age, blood lead, body mass index, cigarette smoking, and alcohol ingestion and removing outliers. Blood lead levels were low (mean = 0.40 mumol/L [8.3 micrograms/dL]) and were not correlated with either hemoglobin or hematocrit. In the final multivariate regression model that corrected for measurement error, an increase in patella bone lead level from the lowest to highest quintile in this study population (37 micrograms/g) was associated with a decrease in hemoglobin and hematocrit of 11 g/L (95% confidence interval [CI], 2.7 to 19.3 g/L) and 0.03 (95% CI, 0.01 to 0.05), respectively.

CONCLUSION

We conclude that patella bone lead levels are associated with decreased hematocrit and hemoglobin levels despite the presence of low blood lead levels. This conclusion may reflect a subclinical effect of bone lead stores on hematopoiesis and is the first epidemiological evidence that bone lead may be an important biological marker of ongoing chronic toxicity.

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  • Authors+Show Affiliations

    ,

    Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.

    , , ,

    Source

    JAMA 272:19 1994 Nov 16 pg 1512-7

    MeSH

    Adult
    Biomarkers
    Blood Chemical Analysis
    Blood Pressure
    Bone and Bones
    Cross-Sectional Studies
    Female
    Hematocrit
    Hemoglobins
    Humans
    Lead
    Lead Poisoning
    Linear Models
    Logistic Models
    Male
    Middle Aged
    Multivariate Analysis
    Occupational Exposure
    Patella
    Spectrometry, X-Ray Emission
    Tibia

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    7966843

    Citation

    Hu, H, et al. "The Relationship Between Bone Lead and Hemoglobin." JAMA, vol. 272, no. 19, 1994, pp. 1512-7.
    Hu H, Watanabe H, Payton M, et al. The relationship between bone lead and hemoglobin. JAMA. 1994;272(19):1512-7.
    Hu, H., Watanabe, H., Payton, M., Korrick, S., & Rotnitzky, A. (1994). The relationship between bone lead and hemoglobin. JAMA, 272(19), pp. 1512-7.
    Hu H, et al. The Relationship Between Bone Lead and Hemoglobin. JAMA. 1994 Nov 16;272(19):1512-7. PubMed PMID: 7966843.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The relationship between bone lead and hemoglobin. AU - Hu,H, AU - Watanabe,H, AU - Payton,M, AU - Korrick,S, AU - Rotnitzky,A, PY - 1994/11/16/pubmed PY - 1994/11/16/medline PY - 1994/11/16/entrez SP - 1512 EP - 7 JF - JAMA JO - JAMA VL - 272 IS - 19 N2 - OBJECTIVE: To determine whether the concentration of lead in bone constitutes a biological marker that is more sensitive for chronic toxicity than blood lead levels. DESIGN: Survey. SETTING: A construction trade union with members who engage in carpentry, demolition, and other construction activities. PARTICIPANTS: Members of the construction trade union. MAIN OUTCOME MEASURES: We measured blood pressure, serum creatinine, hematocrit, and hemoglobin. We measured blood lead by anodic stripping voltametry and used a cadmium 109 K x-ray fluorescence instrument to make in vivo measurements of lead in the tibia (a heavily cortical bone) and the patella (a heavily trabecular bone). Information was also collected on medical history, smoking, and alcohol ingestion. RESULTS: Bone lead levels in the patella were found to be significantly correlated with a decrease in hemoglobin and hematocrit, even after adjusting for age, blood lead, body mass index, cigarette smoking, and alcohol ingestion and removing outliers. Blood lead levels were low (mean = 0.40 mumol/L [8.3 micrograms/dL]) and were not correlated with either hemoglobin or hematocrit. In the final multivariate regression model that corrected for measurement error, an increase in patella bone lead level from the lowest to highest quintile in this study population (37 micrograms/g) was associated with a decrease in hemoglobin and hematocrit of 11 g/L (95% confidence interval [CI], 2.7 to 19.3 g/L) and 0.03 (95% CI, 0.01 to 0.05), respectively. CONCLUSION: We conclude that patella bone lead levels are associated with decreased hematocrit and hemoglobin levels despite the presence of low blood lead levels. This conclusion may reflect a subclinical effect of bone lead stores on hematopoiesis and is the first epidemiological evidence that bone lead may be an important biological marker of ongoing chronic toxicity. SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/7966843/The_relationship_between_bone_lead_and_hemoglobin_ L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/272/pg/1512 DB - PRIME DP - Unbound Medicine ER -