Annals of Occupational and Environmental Medicine

Hwa Sung Kim

6 Articles

Effect of Cumulative Blood Lead and Cumulative Blood ZPP as Lead Body Burden on Renal Lead Biomarkers: Gang Ho Yoon, Nam Soo Kim, Jin Ho Kim, Hwa Sung Kim, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 2006;18(4):298-306. Published online December 31, 2006; DOI: https://doi.org/10.35371/kjoem.2006.18.4.298

Abstract PDF: OBJECTIVE: To evaluate the possibility of cumulative blood lead and blood ZPP as surrogates of lead body burden and to investigate their association with renal function as an index of lead body burden.
METHODS
The study subjects comprised 678 lead workers with past blood lead and blood ZPP data from their employment. Cumulative blood and ZPP were calculated by accumulating the every year mean value of both indices from the new employment since 1983. To assess the cumulative data of lead workers who started their lead work before 1983, the years before 1983 were simulated with the first available data from 1983. Study variables for lead body burden were tibia bone lead and DMSA chelatable lead, whereas those for current lead biomarkers were blood lead and blood ZPP. BUN and serum creatinine were selected as clinical renal biomarkers, while NAG (N-acetyl-D-glucosamine) and RBP (Retinol binding protein) were selected as early renal biomarkers.
RESULTS
The association between cumulative blood lead and blood ZPP with tibia bone lead was statistically significant with determinant coefficients (r(2)) of 0.72 and 0.567, respectively, and their relationships were better explained by the curvilinear regression model. In multiple regression analysis of current lead biomarkers on the renal biomarkers after controlling for possible confounders (age, sex, job duration, smoking and drinking status), blood lead was associated only with log-transformed NAG, whereas blood ZPP was associated with 3 other renal biomarkers. On the other hand, in multiple regression analysis of biomarkers of lead body burden on renal biomarkers after controlling for possible confounders (age, sex, job duration, smoking and drinking status), cumulative blood ZPP and tibia bone lead were associated with all 4 renal function biomarkers, whereas cumulative blood lead and DMSA chelatable lead were associated with 3 renal biomarkers except BUN.
CONCLUSION
Cumulative blood and ZPP were demonstrated to be good surrogates of lead burden. Furthermore, the cumulative blood ZPP was confirmed to have a better association than the cumulative blood lead.

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The Effect of ALAD and VDR Polymorphism on the Hematopoietic Biomarkers in Lead Exposed Workers: Sung Soo Lee, Nam Soo Kim, Jin Ho Kim, Yong Bae Kim, Young Hwangbo, Hwa Sung Kim, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 2005;17(4):343-351. Published online December 31, 2005; DOI: https://doi.org/10.35371/kjoem.2005.17.4.343

Abstract PDF: OBJECTIVES
This study was conducted with new workers who entered lead industries from 1992 to 2001 to evaluate the genetic susceptibility of ALAD (delta-aminolevulinic acid dehydratase) and VDR (vitamin D receptor) gene on health effect of lead exposure.
METHODS
Among the subjects of the database of lead industries at the Soonchunhyang University Institute of Industrial Medicine, only new workers were selected for this study. The total of eligible workers for this category was 3,540 workers, including non lead exposed workers of same lead industries. From stored blood in specimen bank of Soonchunhyang University, genotype of ALAD and VDR were measured using PCR method. Variables for this study were blood lead as an index of lead exposure, ZPP (zinc protoporphyrin in blood), urine ALA (delta-aminolevulinic acid), and hemoglobin as an index of hematopoietic effect of lead. Information on sex, job duration, and weight were collected for personal information. The data were analyzed using SAS (version 8.2) with descriptive analysis of t-test and multiple regression analysis.
RESULTS
Among 3,540 new employed study subjects during period of 1992-2001, 3,204 workers (90.5%) had ALAD genotype 1-1, while 336 workers (9.5%) had variant type of ALAD (1-2 or 2-2). For VDR genotype, 2,903 workers (89.7%) out of total tested 3,238 workers were belonged to type bb and 335 workers (10.5%) were type bB or BB. The distribution of genotype of ALAD and VDR were not different according to the job duration in male workers, but were different in female workers. The effect of ALAD and VDR genotype on blood lead were positively significant in the analysis of all cumulative data of new employed workers for 10 years. The effect of VDR genotype on blood lead were stronger than that of ALAD. While the variant ALAD gene made decrease of mean ZPP and ALA in urine after controlling for blood lead and other covariate, the variant VDR gene made increased the mean ZPP and ALA in urine in all cumulative data analysis and cross sectional analysis by job duration. For hemoglobin, ALAD and VDR genotype did not affect the mean value.
CONCLUSIONS
From the above our results, we found that ALAD and VDR genotype exerted significant effect in various way. We confirmed that the finding of a cross sectional study of protective effect of variant ALAD on the effect of blood lead on blood ZPP in our retrospective study design. It was found that VDR did not exert protective effect for lead exposure as the variant ALAD did.

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Associations of ALAD Genotype with Renal Function Indices in Lead Workers: Sung Soo Lee, Jin Ho Kim, Nam Soo Kim, Hwa Sung Kim, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(2):200-209. Published online June 30, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.2.200

Abstract PDF

OBJECTIVES
delta-Aminolevulinic acid dehydratase (ALAD) is a polymorphic enzyme that has two alleles, ALAD1 (ALAD1-1 as genotype) and ALAD2 (ALAD1-2 or ALAD2-2 as genotype). ALAD genotype has been reported to modify the pharmacokinetics and toxicity of lead. The authors investigated the influence of ALAD genotype polymorphism on renal function in lead workers METHODS: We studied 935 male lead workers and 87 male non-lead workers in the same industries. For cross-sectional renal indices, blood urea nitrogen (BUN), serum creatinine, serum uric acid and urine total protein were selected. Blood lead level was also measured an index of lead exposure. Information on weight, age, job duration, and smoking and drinking habits was collected.
RESULTS
Whereas the mean blood lead level of lead workers was 25.4+/-10.9 microgram/dL, that of non-lead workers in the same premise was 10.1+/-2.8 microgram/dL, and the difference between the two groups was statistically significant. Whereas the prevalence of the variant allele, ALAD2 in 935 lead workers was 10.6%, that in 87 non-lead workers was 4.6%. However there was no difference of prevalence between the two groups. The mean blood lead level of subjects with ALAD1 was 23.9+/-11.4 microgram/dL, which was slightly lower than that of subjects with ALAD2 (25.8+/-10.7 microgram/dL). However, this difference was not statistically significant. After adjustment for the covariates, the subjects with ALAD2 allele were 12.8% less likely to have a median value or more of BUN than subject with ALAD1. The adjusted odds ratio was 0.59 (95% confidence interval; 0.38-0.91). After adjustment for the covariates, the subjects with ALAD2 allele were 9.3% less likely to have a median value or more of serum creatinine than subject with ALAD1. The adjusted odds ratio was 0.64 (95% confidence interval; 0.41-0.98).
CONCLUSIONS
From the above results, it was found that the variant allele, ALAD2 appeared to modify the association of lead and renal function, and that ALAD2 genotype may be supportive for the protective effect of lead.

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Effects of Factors Associated with Urine Hippuric Acid Correction Values in Urinary Creatinine by HPLC and Jaffe Method and Specific Gravity HPLC Jaffe Method
Key-Young Kim, Jong-Gyu Kim, Ki-Nam Yoon, Wha-Me Park, Hun-Hee Park
Journal of Korean Society of Occupational and Environmental Hygiene.2015; 25(4): 493. CrossRef
Environmental Exposure to Lead (Pb) and Variations in Its Susceptibility
Jina Kim, Youngeun Lee, Mihi Yang
Journal of Environmental Science and Health, Part C.2014; 32(2): 159. CrossRef

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The Effect of ALAD Polymorphism on the Relationship of Blood and Bone Lead with Hematologic Biomarkers in Lead Exposed Workers: Hwa Sung Kim, Sung Soo Lee, Yong Bae Kim, Young Hwangbo, Gap Soo Lee, Kyu Dong Ahn, Bong Ki Jang, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 2001;13(1):75-86. Published online March 31, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.1.75

Abstract PDF: OBJECTIVES
To evaluate the effect of ALAD polymorphism on the relationship of blood and bone lead with hematologic biomarkers in lead exposed workers, 450 lead exposed workers and 85 non-lead exposed workers were selected.
METHODS
Blood lead and tibia bone lead were selected as parameters of lead exposure and blood ZPP, urinary ALA (ALAU), hemoglobin (Hb) and hematocrit (Hct) were chosen as parameters of hematologic effect of lead exposure. Genotype of each subject was assayed and expressed as ALAD1 and ALAD2. Demographic information such as sex, age and personal habit of smoking and drinking were collected. Job duration of lead exposed workers was also obtained.
RESULTS
The overall prevalence of the variant allele, ALAD2 in lead exposed workers was 9.6 %(43 out of 450 lead workers) which was not differed from control workers (9.4 % : 8 out of 85). The means of tibial lead and blood ZPP in lead workers with ALAD2 were lower than those of lead workers with ALAD1, but the differences were not statistically significant. After adjusting for possible confounders (sex, job duration, BMI, drinking and smoking status) only blood lead and bone lead contributed negatively to the level of hemoglobin with statistical significance without any contribution of ALAD genotype. On the other hand, no significant effect of blood lead, bone lead and ALAD genotype were observed on the level of hematocrit after controlling possible confounder. ALAD genotype in the multiple regression analysis of blood lead and bone lead with log transformed urinary ALA (LogALAU) after adjusting for possible confounders showed significant main and interaction effect on LogALAU simultaneously, which resulted lower LogALAU in lead exposed workers of ALAD2 than ALAD1. It was also observed only main effect of ALAD gene type on blood ZPP after adjusting possible confounder resulting lower ZPP in lead workers of ALAD2 than ALAD1.
CONCLUSIONS
With above results, it was found that ALAD polymorphism did not affect on the level of hemoglobin and hematocrit, but ALAD polymorphism made significant effect on the association of blood and bone lead with urinary ALA and blood ZPP. The lower urinary ALA and blood ZPP in ALAD2 lead workers suggested that ALAD2 genotype may be supportive for the protective effect of lead.

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Occupational Lead Exposure of Storage Battery Industry Workers in Korea: Pil Kyu Kang, Yong Bae Kim, Ik Soo Ahn, Jong Kyu Lee, Ku Seok Han, Hwa Sung Kim, Kyu Yoon Hwang, Gap Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 1998;10(4):438-449. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.438

Abstract PDF

In order to investigate the level of lead absorption of lead workers and to evaluate the effect of blood lead on blood zinc protoporphyrin (ZPP) and prevalence of lead related symptoms, 1,782 lead workers(male: 1,506, female: 276) from 8 storage battery industries were studied. Selected variables as indices of lead exposure were blood lead, blood ZPP, and hemoglobin (HB). Fifteen questionnaires of lead related symptoms were provided to all lead workers and filled up by themselves and confirmed by medical doctors. Personal variables such as age, work duration, smoking and drinking habits were also collected. The results were follows : 1. While the mean blood lead of lead workers of all lead companies was 31.0+/-3.0 ug/100ml (male: 31.5+/-2.9 ug/100ml, female: 27.9+/-3.3 ug/100m1), the mean blood ZPP of all lead workers was 66.7+/-4.1 ug/100ml (male: 59.6+/-3.3, female: 105.3+/-3.0 ug/100ml). The mean hemoglobin of male lead workers was 15.7+/-.3 gm/100ml and that of female lead workers was 13.0+/-.3 gm/100ml. 2. The percentage of lead workers whose blood lead was over 60.0 ug/100m1 and 40.0-59.9 ug/100ml was 2.81 % and 19.08 %, respectively. On the other hand, the percentage of lead workers whose blood ZPP was over 150 ug/100ml and 100-149 ug/100ml was 5.89 % and 8.31 %, respectively. 3. The slopes of simple linear regression of blood lead (independent variable) and blood ZPP in female lead workers was significantly steeper than that of male lead workers. The slope of storage battery industries with better working condition in terms of low air concentration of lead were less steeper than those with poor working condition with high mean air concentration of lead. 4. Stepwise multiple regression analysis, using overall symptom prevalence as a dependent variables, blood lead, blood ZPP, hemoglobin, age, work duration, drinking and smoking habits as independent variables, indicated that only drinking habit and age were significantly contributed to the dependent variable.

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Occupational Lead Exposure from Indoor Firing Ranges in Korea
Won-Ju Park, Suk-Ho Lee, Se-Ho Lee, Hye-Sik Yoon, Jai-Dong Moon
Journal of Korean Medical Science.2016; 31(4): 497. CrossRef
Blood lead levels of Korean lead workers in 2003–2011
Ji-Hye Kim, Eun-A Kim, Dong-Hee Koh, Kiwhan Byun, Hyang-Woo Ryu, Sang-Gil Lee
Annals of Occupational and Environmental Medicine.2014;[Epub] CrossRef

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Some Renal Function Indices in Workers Occupationally Exposed to Lead: Je Sung Nam, Yong Bae Kim, Hyun Cheol Ahn, Hwa Sung Kim, Gap Soo Lee, Kyu Yoon Hwang, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 1998;10(2):139-148. Published online May 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.2.139

Abstract PDF

The influence of lead exposure on renal function was studied. Three hundred forty two male lead exposed workers who worked in 3 storage battery factories, 5 secondary smelting factories and 3 litharge making factories, and 60 male control workers who were not exposed to lead occupationally were chosen for this study. Blood lead (PbB), zinc protoporphyrin in whole blood (ZPP) and delta-aminolevulinic acid in urine (DALA) were selected as indicators of lead exposure. As indicators of renal function blood urea nitrogen(BUN) , serum creatinine(S-Cr), serum uric acid (S-UA), N-acetyl-beta-D-glucosaminidase in urine (NAG) and urine protein (U-TP) were selected. While the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of renal function indicators of exposed except S-UA were significantly different from non-exposed. The frequency of workers whose value of renal function indicators were over the nor mal criteria (BUN>20 mg/dl ; S-Cr>1.2 mg/dl ; S-UA>7.0 mg/dl ; NAG>8.0 U/liter; U-TP>8.0 mg/dl) by the level of lead absorption in terms of PbB, ZPP and DALA were calculated. Age adjusted odds ratio of over the normal value of BUN and NAG were statistically significant by the level of ZPP and that of BUN only showed the dose-dependant relationship. But the frequency of over the normal criteria of renal function indicators were not increased by the level of PbB and DALA. On stepwise multiple regression using renal function indicators as a dependent variable and each lead exposure indicator and age as independent variables, only BUN, NAG and U-TP were contributed by the lead exposure indicators. It was found that only NAG of renal function indices was most reliable indicator who showed dose-response relationship with lead exposure and the measurement of NAG for lead workers whose relatively high exposure is highly recommended.

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Effect of Pork Consumption on Renal and Hematochemical Indices in Workers Occupationally Exposed to Unclean Environments
Chan-Kyu Han, Jeong-Hae Rho, Bog-Hieu Lee
Korean Journal for Food Science of Animal Resources.2008; 28(1): 91. CrossRef

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