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Predictive value of determinations of zinc protoporphyrin for increased blood lead concentrations.
Clin Chem. 1998 Jun; 44(6 Pt 1):1283-8.CC

Abstract

Blood lead (PbB) and red cell zinc protoporphyrin (ZPP) concentrations are widely used biomarkers for lead toxicity. It is uncertain, however, whether either or both are needed for monitoring lead exposure and how discordant PbB and ZPP values should be interpreted. We reviewed the results of PbB and ZPP determinations in 94 workers in a lead-battery plant over a 13-year period and retrieved all 807 sets of tests in which both PbB and ZPP were available, with a follow-up PbB value 6 months later. PbB exceeded 1.93 micromol/L (40 microg/dL) in 414 (51%), and 2.90 micromol/L (60 microg/dL) in 105 (14%) of the blood samples. We derived the test properties of various ZPP concentrations for concurrent "toxic" PbB concentrations, defined as > or = 1.93 and 2.90 micromol/L (40 and 60 microg/dL). The results indicated that, given a population of lead-exposed workers with a 10% prevalence of PbB of > or = 2.90 micromol/L (60 microg/dL), a policy of testing PbB only in those with ZPP > 0.71 micromol/L (40 microg/dL) would obviate 42% of the PbB tests, but would miss about three cases with toxic PbB concentrations in every 200 workers at risk. A finding of increased ZPP concentrations with a concurrent "nontoxic" PbB was associated with an increased risk of a toxic PbB concentration 6 months later. We conclude that (a) screening by testing only ZPP does not safeguard exposed persons against lead toxicity, and (b) the frequency of PbB monitoring should be guided by estimates of the risk of future lead toxicity in individual workers.

Authors+Show Affiliations

Occupational Health and Rehabilitation Institute, Raanana, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

9625054

Citation

Froom, P, et al. "Predictive Value of Determinations of Zinc Protoporphyrin for Increased Blood Lead Concentrations." Clinical Chemistry, vol. 44, no. 6 Pt 1, 1998, pp. 1283-8.
Froom P, Kristal-Boneh E, Benbassat J, et al. Predictive value of determinations of zinc protoporphyrin for increased blood lead concentrations. Clin Chem. 1998;44(6 Pt 1):1283-8.
Froom, P., Kristal-Boneh, E., Benbassat, J., Ashkanazi, R., & Ribak, J. (1998). Predictive value of determinations of zinc protoporphyrin for increased blood lead concentrations. Clinical Chemistry, 44(6 Pt 1), 1283-8.
Froom P, et al. Predictive Value of Determinations of Zinc Protoporphyrin for Increased Blood Lead Concentrations. Clin Chem. 1998;44(6 Pt 1):1283-8. PubMed PMID: 9625054.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictive value of determinations of zinc protoporphyrin for increased blood lead concentrations. AU - Froom,P, AU - Kristal-Boneh,E, AU - Benbassat,J, AU - Ashkanazi,R, AU - Ribak,J, PY - 1998/6/13/pubmed PY - 1998/6/13/medline PY - 1998/6/13/entrez SP - 1283 EP - 8 JF - Clinical chemistry JO - Clin Chem VL - 44 IS - 6 Pt 1 N2 - Blood lead (PbB) and red cell zinc protoporphyrin (ZPP) concentrations are widely used biomarkers for lead toxicity. It is uncertain, however, whether either or both are needed for monitoring lead exposure and how discordant PbB and ZPP values should be interpreted. We reviewed the results of PbB and ZPP determinations in 94 workers in a lead-battery plant over a 13-year period and retrieved all 807 sets of tests in which both PbB and ZPP were available, with a follow-up PbB value 6 months later. PbB exceeded 1.93 micromol/L (40 microg/dL) in 414 (51%), and 2.90 micromol/L (60 microg/dL) in 105 (14%) of the blood samples. We derived the test properties of various ZPP concentrations for concurrent "toxic" PbB concentrations, defined as > or = 1.93 and 2.90 micromol/L (40 and 60 microg/dL). The results indicated that, given a population of lead-exposed workers with a 10% prevalence of PbB of > or = 2.90 micromol/L (60 microg/dL), a policy of testing PbB only in those with ZPP > 0.71 micromol/L (40 microg/dL) would obviate 42% of the PbB tests, but would miss about three cases with toxic PbB concentrations in every 200 workers at risk. A finding of increased ZPP concentrations with a concurrent "nontoxic" PbB was associated with an increased risk of a toxic PbB concentration 6 months later. We conclude that (a) screening by testing only ZPP does not safeguard exposed persons against lead toxicity, and (b) the frequency of PbB monitoring should be guided by estimates of the risk of future lead toxicity in individual workers. SN - 0009-9147 UR - https://www.unboundmedicine.com/medline/citation/9625054/Predictive_value_of_determinations_of_zinc_protoporphyrin_for_increased_blood_lead_concentrations_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=9625054.ui DB - PRIME DP - Unbound Medicine ER -