Research Unit Environment and Health, KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium.
Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Hypertens Res. 2023 Feb;46(2):395-407. doi: 10.1038/s41440-022-01069-x. Epub 2022 Oct 18.
Lead is an environmental hazard that should be addressed worldwide. Over time, human lead exposure in the western world has decreased drastically to levels comparable to those among humans living in the preindustrial era, who were mainly exposed to natural sources of lead. To re-evaluate the potential health risks associated with present-day lead exposure, a two-pronged approach was applied. First, recently published population metrics describing the adverse health effects associated with lead exposure at the population level were critically assessed. Next, the key results of the Study for Promotion of Health in Recycling Lead (SPHERL; NCT02243904) were summarized and put in perspective with those of the published population metrics. To our knowledge, SPHERL is the first prospective study that accounted for interindividual variability between people with respect to their vulnerability to the toxic effects of lead exposure by assessing the participants' health status before and after occupational lead exposure. The overall conclusion of this comprehensive review is that mainstream ideas about the public and occupational health risks related to lead exposure urgently need to be updated because a large portion of the available literature became obsolete given the sharp decrease in exposure levels over the past 40 years.
铅是一种应在全球范围内解决的环境危害物。随着时间的推移,西方世界的人类铅暴露已大幅减少,达到与生活在工业化前时代的人类相当的水平,后者主要受到天然铅源的暴露。为了重新评估当前铅暴露相关的潜在健康风险,采用了双管齐下的方法。首先,批判性地评估了最近发表的描述人群水平铅暴露相关不良健康影响的人口学指标。其次,总结了促进回收铅健康研究(SPHERL;NCT02243904)的主要结果,并将其与已发表的人口学指标进行了比较。据我们所知,SPHERL 是第一个前瞻性研究,通过在职业性铅暴露前后评估参与者的健康状况,考虑到个体对铅暴露毒性影响的易感性的个体间变异性,从而解释了人与人之间的差异。这项全面审查的总体结论是,由于过去 40 年来暴露水平急剧下降,大量现有文献已经过时,因此迫切需要更新有关公众和职业健康风险的主流观念。