Maheswaran R, Gill J S, Beevers D G
University Department of Medicine, Dudley Road Hospital, Birmingham, United Kingdom.
Am J Epidemiol. 1993 Mar 15;137(6):645-53. doi: 10.1093/oxfordjournals.aje.a116722.
The association between environmental lead exposure and raised blood pressure remains controversial. This association was examined in a cross-sectional study in 1981 on 809 male workers who were occupationally exposed to lead in a factory manufacturing car lead accumulator batteries in Birmingham, United Kingdom. Lead exposure was assessed by blood lead levels, blood zinc protoporphyrin levels, and years of industrial exposure to lead. The geometric mean blood lead level was 31.6 micrograms/dl with minimum and maximum values of 0 microgram/dl and 98 micrograms/dl, respectively. Unadjusted systolic blood pressure rose with increasing blood lead levels (analysis of variance, F = 3.3, p < 0.05) from 127 mmHg (95% confidence interval (CI) 123.5-130.5) in men with blood lead levels less than 21 micrograms/dl to 133 mmHg (95% CI 128.7-137.3) in men with levels exceeding 50 micrograms/dl. Following adjustment for the confounding effects of age, body mass index, and alcohol consumption, however, the effect of blood lead on systolic pressure was diminished (analysis of variance, F = 1.3, not significant) to 129 mmHg and 132 mmHg in the respective categories. There was no association between diastolic blood pressure and blood lead. Zinc protoporphyrin levels and years of industrial lead exposure did not raise adjusted systolic or diastolic pressure. In conclusion, subject to the limitations inherent in a cross-sectional survey, the findings are consistent with a weak effect of industrial lead exposure on systolic blood pressure, within the range of exposures observed in this study.
环境铅暴露与血压升高之间的关联仍存在争议。1981年,在英国伯明翰一家生产汽车铅酸蓄电池的工厂中,对809名职业性接触铅的男性工人进行了一项横断面研究,以检验这种关联。通过血铅水平、血锌原卟啉水平和工业铅暴露年限来评估铅暴露情况。血铅水平的几何平均值为31.6微克/分升,最小值和最大值分别为0微克/分升和98微克/分升。未调整的收缩压随着血铅水平的升高而升高(方差分析,F = 3.3,p < 0.05),血铅水平低于21微克/分升的男性收缩压为127 mmHg(95%置信区间[CI] 123.5 - 130.5),血铅水平超过50微克/分升的男性收缩压为133 mmHg(95%CI 128.7 - 137.3)。然而,在对年龄、体重指数和饮酒的混杂效应进行调整后,血铅对收缩压的影响减弱(方差分析,F = 1.3,无显著性),相应类别中的收缩压分别降至129 mmHg和132 mmHg。舒张压与血铅之间无关联。锌原卟啉水平和工业铅暴露年限并未升高调整后的收缩压或舒张压。总之,鉴于横断面调查固有的局限性,本研究结果表明,在本研究观察到的暴露范围内,工业铅暴露对收缩压的影响较弱。