Journal
ENVIRONMENTAL HEALTH PERSPECTIVES
Volume 115, Issue 3, Pages 455-462Publisher
US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE
DOI: 10.1289/ehp.9783
Keywords
biomarkers; epidemiologic methods; epidemiology; lead; toxicity
Funding
- NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES [R01ES010798, R01ES007821, P30ES000002, P42ES005947, R01ES005257] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [R01AG010785, R01AG019604] Funding Source: NIH RePORTER
- Intramural NIH HHS Funding Source: Medline
- NIA NIH HHS [R01 AG010785, R01 AG019604, R01-AG19604, R01-AG10785] Funding Source: Medline
- NIEHS NIH HHS [P30-ES00002, R01 ES007821, R01 ES010798, R01-ES10798, R01-ES07821, R01-ES05257, P30 ES000002, P42 ES005947, P42-ES05947, R01 ES005257] Funding Source: Medline
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We review several issues of broad relevance to the interpretation of epidemiologic evidence concerning the toxicity of lead in adults, particularly regarding cognitive function and the cardiovascular system, which are the subjects of two systematic reviews that are also part of this mini-monograph. Chief among the recent developments in methodologic advances has been the refinement of concepts and methods for measuring individual lead dose in terms of appreciating distinctions between recent versus cumulative doses and the use of biological markers to measure these parameters in epidemiologic studies of chronic disease. Attention is focused particularly on bone lead levels measured by K-shell X-ray fluorescence as a relatively new biological marker of cumulative dose that has been used in many recent epidemiologic studies to generate insights into lead's impact on cognition and risk of hypertension, as well as the alternative method of estimating cumulative dose using available repeated measures of blood lead to calculate an individual's cumulative blood lead index. We review the relevance and interpretation of these lead biomarkers in the context of the toxicokinetics of lead. In addition, we also discuss methodologic challenges that arise in studies of occupationally and environmentally exposed subjects and those concerning race/ethnicity and socioeconomic status and other important covariates.
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