Graziano J H
Division of Environmental Sciences, Columbia University, College of Physicians & Surgeons, New York, NY 10032.
Clin Chem. 1994 Jul;40(7 Pt 2):1387-90.
Extensive research has been devoted to the development of biomarkers of environmental and occupational exposure to lead (Pb). This body of work can serve as a paradigm for biomarker development for other chemical exposures. Early efforts focused on indirect measurements of exposure by analyzing precursors and enzymes of a biosynthetic pathway (heme) in blood and urine. However, the direct measurement of Pb in blood has become increasingly simple and reliable and is now widely accepted for pediatric surveillance programs, in part because of known associations of Pb with adverse health outcomes. Other markers of exposure include measurements of Pb in important compartments: bone Pb, tooth Pb, and chelatable Pb. In addition, the technique of stable isotope dilution is available, since Pb exists in numerous nonradioactive isotopic forms. The strengths and weaknesses of all Pb biomarkers for confirming a diagnosis or for epidemiologic research vary widely depending upon the hypothesis under investigation.
大量研究致力于开发环境和职业铅（Pb）暴露的生物标志物。这项工作可以作为其他化学物质暴露生物标志物开发的范例。早期的努力集中在通过分析血液和尿液中生物合成途径（血红素）的前体和酶来间接测量暴露。然而，血液中铅的直接测量变得越来越简单可靠，现在已被儿科监测项目广泛接受，部分原因是已知铅与不良健康结局之间的关联。其他暴露标志物包括测量重要部位的铅：骨铅、牙铅和可螯合铅。此外，由于铅以多种非放射性同位素形式存在，稳定同位素稀释技术也可用。所有铅生物标志物在确诊或流行病学研究中的优缺点因所研究的假设而异。
