Department of Environmental Health, Emory University, Atlanta, Georgia, USA
Department of Environmental Health, Emory University, Atlanta, Georgia, USA.
Occup Environ Med. 2020 Jun;77(6):415-417. doi: 10.1136/oemed-2019-106363. Epub 2020 Mar 22.
Very high exposure to inorganic lead causes serious kidney damage. We have studied workers with occupational exposure and data on blood lead.
We extended follow-up for 7 more years, for a previously studied cohort of 58 307 male workers who were part of a surveillance programme in 11 different states. Mortality was assessed using the National Death Index, and end-stage renal disease (ESRD) incidence was assessed using the US Renal Data System. We conducted internal analyses via Cox regression adjusting for age, calendar time and race.
The cohort was followed for a median of 18 years and had 524 cases of ESRD and 6527 deaths. Average maximum blood lead was 26 µg/dL; the mean year of first blood lead test was 1997. No trends by lead level were seen overall or when restricting to those with 15+ years follow-up. Among non-Caucasians with >15 years of follow-up, there was a positive but inconsistent trend (Rate ratios (RRs) 1.00, 2.10, 1.33, 2.20 and 2.76 for maximum blood lead categories of <20 µg/dL, 20-29 µg/dL, 30 to <40 µg/dL, 40 to ≤50 µg/dL and >50 µg/dL, respectively (p for linear trend 0.26). Those with >15 years of follow-up and birth year <1941 showed a positive trend with increased blood lead (RRs 1.00, 1.14, 1.18, 1.46, 1.66, p trend=0.26).
We found no association between higher lead exposure and ESRD. There were positive but not statistically significant trends of increased risk for non-Caucasians with >15 years of follow-up and for older men with >15 years of follow-up.
极高的无机铅暴露会导致严重的肾脏损害。我们研究了职业暴露的工人和血液铅数据。
我们将之前研究的队列中的 58307 名男性工人的随访时间延长了 7 年，这些工人是 11 个不同州的监测计划的一部分。使用国家死亡指数评估死亡率，使用美国肾脏数据系统评估终末期肾病（ESRD）的发病率。我们通过 Cox 回归进行内部分析，调整年龄、日历时间和种族。
该队列的中位随访时间为 18 年，有 524 例 ESRD 病例和 6527 例死亡。平均最大血铅为 26μg/dL；首次血铅检测的平均年份为 1997 年。总体上或当限制在随访时间超过 15 年的人群中时，未观察到铅水平的趋势。在随访时间超过 15 年的非白种人中，存在正但不一致的趋势（最大血铅水平<20μg/dL、20-29μg/dL、30-<40μg/dL、40-≤50μg/dL 和>50μg/dL 的类别中，比值比（RR）分别为 1.00、2.10、1.33、2.20 和 2.76（p 趋势=0.26）。随访时间超过 15 年且出生年份<1941 年的人，随着血铅的增加，呈现出正趋势（RR 分别为 1.00、1.14、1.18、1.46、1.66，p 趋势=0.26）。
我们没有发现更高的铅暴露与 ESRD 之间存在关联。在随访时间超过 15 年的非白种人和随访时间超过 15 年的老年男性中，存在阳性但无统计学意义的风险增加趋势。
