The relationship between blood pressure and environmental exposure to lead and cadmium in Belgium.

The question whether in the general population environmental exposure to lead and cadmium influences blood pressure after controlling for confounding factors remains debated. The environmental exposure of the Belgian population to both lead and cadmium is high as compared with other countries. The Cadmibel Cooperative Study was therefore designed to elucidate whether environmental exposure to lead and cadmium has any effect on blood pressure and renal function in the population at large. Before embarking on the large Cadmibel project, a small study was conducted. Blood pressure and the 24-hr urinary excretion of cadmium (CdU) and lead (PbU) were determined in a random 4% sample of the population of a small Belgian town. CdU averaged 0.27 micrograms/24 hr in 46 youths (mean age 14 +/- 3 years, +/- SD), increased with age, and was higher in 57 adult men (age 41 +/- 14 years), as compared with 59 adult women (age 39 +/- 14 years) (1.05 vs. 0.81 micrograms/24 hr; p less than 0.01). PbU averaged 5.8 micrograms/24 hr in youths and similarly increased with age; adult men excreted more lead than women (13.3 vs. 8.3 micrograms/24 hr; p less than 0.001). Among men, manual workers excreted more cadmium (1.4 vs. 0.8 micrograms/24 hr; p less than 0.05) but a similar amount of lead (7.0 vs. 6.9 micrograms/24 hr) as compared with office workers. In simple regression analysis, CdU was positively correlated with both systolic (r = 0.30; p less than 0.05) and diastolic (r = 0.38; p less than 0.01) blood pressure in women.(ABSTRACT TRUNCATED AT 250 WORDS)

Impact of air pollution by lead on the heme biosynthetic pathway in school-age children.

Blood-lead level (Pb-B), erythrocyte delta-aminolevulinic acid dehydratase (ALAD) activity, free erythrocyte porphyrin (FEP) concentration, delta-aminolevulinic acid concentration in urine (ALAU), hematocrit value, and hemoglobin concentration were compared for groups of children 10-13 years old from areas differently polluted by lead (rural area and lead smelter area). The biological responses of the children were also compared with those observed in adults similarly exposed to lead (Pb-B: 10-40 mug/100 ml). Compared with the rural children, children living less than 1 km from the smelter exhibited a significant increase of Pb-B and FEP, a significant inhibition of ALAD, and a slight positive correlation of ALAU with Pb-B; however, they showed no biological signs of anemia. In children living approximately 1.5 km from the smelter, there was still a significant increase of Pb-B and a concomitant inhibition of ALAD, but no change in FEP concentration. Comparison of the dose-response curves between Pb-B and FEP in adult males, adult females, and children indicates that the sensitivity to lead is in the order of children larger than or equal to women greater than men. Based on the FEP response, it is proposed that 25 mug Pb/100 ml blood be regarded as the maximum biologically allowable concentration of lead in blood of school-age children.

External quality assessment scheme in Belgium. Heavy metal analyses.

An external quality assessment scheme for heavy metal analyses has been implemented in Belgium (quality control in Belgium, QCB) by the Epidemiology Unit of the Institute of Hygiene and Epidemiology since 1993. Aims of the scheme are to improve laboratories performances by means of interlaboratory comparisons and to provide national authority with information about the dispersion of results for heavy metal analyses in Belgium. The analytes included in the QCB are lead, cadmium and selenium in blood. Control samples are in-house prepared from human blood, spiked with appropriate amounts of Pb, Cd and Se. Four exercises are performed every year and participants receive three samples to analyze. Target values are calculated for each element from the regression lines obtained by plotting the results of a reference laboratory against the added amounts. The QCB does not yet include acceptability criteria of the results and no measures are taken against poor performers at this stage, although advice is available by personal contacts with the organisers.

Exposure to lead of the Belgian population.

According to the Council Directive of 29 March 1977 on biological screening of the population for lead, the blood-lead levels (PbB) were determined in samples of the Belgian population not occupationally exposed to this metal. Two campaigns of sampling were performed: the first one in 1979 (1678 samples analysed) and the second in 1981 (1000 samples analysed). Sampling was done in urban and industrial zones, as well as in areas where lead risk could be present. Concerning the urban and industrial areas, the results obtained seem to indicate that a particular lead risk does not exist for the adult population if we consider the reference levels of the CEE Directive. Moreover, the results of the second campaign of sampling showed a decreasing trend: the median PbB values dropped from 183 to 156 micrograms/l in Brussels and from 192 to 139 micrograms/l in Liège. This could be partly due to the limitation of the lead content of gazoline. On the other hand, the results of the surveys clearly demonstrated the existence of two areas where an obvious lead risk exists. In one of those, the lead risk is of industrial origin (lead smelter) and concerns mainly children: median PbB value 260 micrograms/l, percentile 90 and 98 respectively 390 and 430 micrograms/l. In the other one, the lead risk is from a hydric source and concerns adults and children: median PbB value 258 micrograms/l, percentile 90 and 98 respectively 370 and 520 micrograms/l.

Exposure to lead and cadmium of the general population of Malta.

The blood levels of lead (PbB), cadmium (CdB), and zinc protoporphyrin (ZPP) were determined in 538 Maltese adult subjects. A relatively high level exposure to both metals was discovered. For lead, the median value is 274 micrograms/l with percentile 90 and 98 respectively 564 and 863 micrograms/l. These values are to be compared with the reference values proposed by a directive of the European Community, respectively 200, 300 and 350 micrograms/l. For cadmium, the median value is 2.2 micrograms/l with percentile 90 and 98 respectively 3.8 and 5.7 micrograms/l. These values are compared with those of a Belgian population which are respectively 1.7, 2.6 and 4.3 micrograms/l. The causes of this relatively high exposure are not known. A few tentative hypotheses, which are to be investigated, are made.

Assessment and comparison of human exposure to lead between Belgium, Malta, Mexico and Sweden.

This is a follow-up study of UNEP/WHO Pilot Project on Assessment of Human Exposure to Lead and Cadmium through Biological Monitoring, carried out in 1983/1984. The main objectives of the follow-up study were: to study whether differences in blood-lead levels found between countries in the Biological Monitoring Project were confirmed and were primarily due to exposure via ingested lead (oral intake) or via inhaled lead; to make a preliminary survey, in selected areas, of the possible sources of high exposure (Malta, Belgium). Four countries participated: Belgium, Malta, Mexico, Sweden. To insure comparability between the populations, certain categories were monitored: teachers for socio-economic status, non smoking males, aged between 25 and 50 years old. The blood-lead concentration (PbB) was measured to determine the current exposure and the feces-lead excretion (PbF) was determined to find out the part of the exposure due to ingestion. Blood-lead levels and feces-lead excretion were very different between the four countries. Median values for PbB, in micrograms Pb/1, were, in decreasing values 247 in Malta, 188 in Mexico, 135 in Belgium and 53 in Sweden. Median values for PbF, in micrograms Pb/day, were 361 in Malta, 159 in Mexico, 82 in Belgium and 22 in Sweden. Oral intake seems to be the major exposure route in the four countries. The relationship between PbB and PbF is curvilinear. To investigate the possible source of high exposure, a preliminary survey was made in Malta and Belgium; lead in air suspended and sedimenting particles was monitored as well as the lead concentration in some food and street dust samples. Concerning the comparison of lead concentrations in these environmental samples between Belgium and Malta, no major differences were detected. The high internal exposure to lead in Maltese people, as measured by PbB, is probably due to a combination of several factors.