Sokas R K, Weller S C, Stolley P D
Div. of Occupational/Environmental Medicine, George Washington University, Washington, DC 20037, USA.
J Environ Pathol Toxicol Oncol. 1995;14(1):53-9.
Thirty-two male veterans participated in a study to determine cumulative lead exposure in an urban population. Subjects were chosen on the basis of blood pressure status in order to attempt to compare lead exposure between patients with and without hypertension. Patients currently enrolled in hypertension clinic and on treatment were recruited and matched with controls for age, race, and socioeconomic status. Each subject underwent provocative chelation via slow intravenous infusion of CaNa2 EDTA and 6-h urinary lead measurement and completed an interviewer-administered questionnaire. Twenty blacks and 12 whites participated, with a median age of 52 years (range: 27 to 72). Urinary lead excretion ranged from below detection limits to frankly toxic levels in an individual with heavy moonshine ingestion. Lead levels were higher than reported in other non-workplace populations. The distribution of lead values was skewed, as expected, with a median excretion of 75 mcg lead/6 h (corresponding to a median 24 degrees post-chelation urinary lead excretion of 286 mcg) and modal values between 50 and 75 micrograms lead. Levels of 95 mcg lead/6 h (corresponding to 24 degrees levels of 333 mcg lead) and above were considered "high" (N = 11) and the remainder were "low" (N = 21). Among those able to recall various characteristics of their first childhood dwellings, the presence of flaking paint in a multiple family dwelling was strongly associated with "high" lead excretion (X2 = 9.32, p = 0.009). Hypertensives excreted slightly more lead than nonhypertensives, although the difference was not statistically significant in this small sample. Lead excretion was not associated with current (treated) blood pressure determinations among hypertensives. However, lead excretion was associated with systolic pressure as recorded on entry to the hypertension clinic (N = 21, R2 = 0.24, p = 0.03).
32名男性退伍军人参与了一项旨在确定城市人口中铅累积暴露情况的研究。根据血压状况选择研究对象,以尝试比较高血压患者和非高血压患者之间的铅暴露情况。招募了目前在高血压诊所就诊并正在接受治疗的患者,并将其与年龄、种族和社会经济地位相匹配的对照组进行对比。每位受试者通过缓慢静脉输注CaNa2 EDTA进行激发螯合,并测量6小时尿铅水平,同时完成一份由访谈员填写的问卷。参与研究的有20名黑人及12名白人,年龄中位数为52岁(范围:27至72岁)。尿铅排泄量从低于检测限到一名大量饮用自酿酒的个体中达到明显中毒水平不等。铅水平高于其他非工作场所人群的报告值。正如预期的那样,铅值分布呈偏态,排泄量中位数为75微克铅/6小时(相当于螯合后24小时尿铅排泄量中位数为286微克),众数在50至75微克铅之间。95微克铅/6小时(相当于24小时水平为333微克铅)及以上的水平被视为“高”水平(N = 11),其余为“低”水平(N = 21)。在那些能够回忆起其童年首个住所各种特征的人中,多家庭住宅中存在剥落油漆与“高”铅排泄量密切相关(X2 = 9.32,p = 0.009)。高血压患者排泄的铅略多于非高血压患者,尽管在这个小样本中差异无统计学意义。在高血压患者中,铅排泄量与当前(治疗后)血压测定值无关。然而,铅排泄量与进入高血压诊所时记录的收缩压相关(N = 21,R2 = 0.24,p = 0.03)。