Khan Dilshad Ahmed, Qayyum Shazia, Saleem Shahid, Khan Farooq Ahmad
Department of Pathology, AM College NUST, Rawalpindi.
J Pak Med Assoc. 2009 Jun;59(6):350-4.
To determine total lead body burden by the Lead mobilization test (LMT) by measuring 4 hours urinary lead excretion in the lead exposed as compared to unexposed industrial workers after administration of 10 mg/Kg of dimercaptosuccinic acid and correlate it with blood lead levels, at Wah district Rawalpindi.
Total 149 males consisting of 87 lead exposed workers and 62 controls were included. Dimercaptosuccinic acid (DMSA), 10mg/kg body weight, was administered orally. Four hours urine specimens before and after DMSA administration were collected. Blood lead levels (BLL) were determined on 3010B ESA lead analyzer and urinary lead was measured on atomic absorption analyst 800 (Perkin Elmer).
The lead exposed workers had high BLL median (range) 291 (90-611) ug/L as compared to controls 108 (10-310) ug/L (p=0.01). The occupational workers also revealed high DMSA-chelated urinary lead excretion (DMSA Pb-U) median (range) 28 (1.7-268) ug/4h as compared to controls 6 (1-27) ug/4h (p<0.01). Four hours DMSA Pb-U was significantly correlated with BLL (r=0.67), baseline Pb-U (r=0.54) and DMSA Pb-U/creatinine ratio (r=.81) in the lead exposed group (p<0.001). Increased lead exposure was detected in 43% of the subjects by using the WHO criteria for BLL while 54% were identified with LMT. Thirteen (15%) lead exposed workers had BLL more than OSHA permissible limits.
Lead mobilization test is a more reliable diagnostic test than BLL for assessment of toxicologically active fraction of total lead body burden and imminent health risks in occupational workers.
通过对拉瓦尔品第瓦赫地区接触铅和未接触铅的产业工人给予10mg/Kg二巯基丁二酸后测量4小时尿铅排泄量，利用铅动员试验（LMT）确定体内铅的总负荷，并将其与血铅水平相关联。
共纳入149名男性，其中87名接触铅的工人和62名对照。口服给予体重10mg/kg的二巯基丁二酸（DMSA）。收集DMSA给药前后的4小时尿液标本。使用3010B ESA铅分析仪测定血铅水平（BLL），并使用原子吸收分析仪800（珀金埃尔默）测量尿铅。
接触铅的工人BLL中位数（范围）为291（90 - 611）μg/L，高于对照组的108（10 - 310）μg/L（p = 0.01）。职业工人DMSA螯合尿铅排泄量（DMSA Pb-U）中位数（范围）为28（1.7 - 268）μg/4h，也高于对照组的6（1 - 27）μg/4h（p < 0.01）。在接触铅组中，4小时DMSA Pb-U与BLL（r = 0.67）、基线Pb-U（r = 0.54）和DMSA Pb-U/肌酐比值（r = 0.81）显著相关（p < 0.001）。根据世界卫生组织BLL标准，43%的受试者检测到铅暴露增加，而LMT识别出54%的受试者。13名（15%）接触铅的工人BLL超过职业安全与健康管理局的允许限值。
对于评估职业工人体内总铅负荷的毒理学活性部分和即将面临的健康风险，铅动员试验是比BLL更可靠的诊断测试。
