Annals of Occupational and Environmental Medicine

High lead exposure in two leaded bronze ingot foundry workers: Yoojun Song, Chunhui Suh, Shin-Ae Kim, Nami Kim, Sung-Min Kim, Seong-Wook Jeong, Se-Yeong Kim, Kun-Hyung Kim, Jeong-Ho Kim, Byung-Chul Son, Chae-Kwan Lee, Jong-Tae Lee; Ann Occup Environ Med 2014;26:38. Published online December 1, 2014; DOI: https://doi.org/10.1186/s40557-014-0038-8

Background

Awareness about lead poisoning in South Korea has increased; however, occupational exposures occurring in small-scale businesses have not been thoroughly investigated. We report two cases of high lead exposure in a leaded bronze ingot foundry.

Case presentation

Two employees, a 54-year-old primary operator and a 46-year-old assistant, at a small-scale metalworking company who had been employed for 18 years and 1 month, respectively, showed elevated blood lead levels (61.1 μg/dL and 51.7 μg/dL, respectively) at an occupational health checkup. Neither worker complained of abnormal symptoms nor signs related to lead poisoning. Health assessment follow-ups were conducted and biological exposure indices of lead were calculated every four weeks. After the initial follow-up assessment, both workers were relocated from the foundry process to the metalworking process. In addition, a localized exhaust system was installed after the second follow-up.

Conclusions

Foundry workers in a small-scale businesses might be at high risk of lead exposure because these businesses might be vulnerable to poor industrial hygiene. Therefore, regular occupational health checkups are required.

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Comparison of Blood Lead Levels in Children and Adolescents with and Without Functional Abdominal Pain
Fatemeh Famouri, Maryam Yazdi, Awat Feizii, Hossein Saneian, Peiman Nasri, Roya Kelishadi
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Association Between Blood Lead Level With High Blood Pressure in US (NHANES 1999–2018)
Ziyao Huang
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A systematic review of clinical and laboratory findings of lead poisoning: lessons from case reports
Saeed Samarghandian, Farshad M. Shirazi, Farhad Saeedi, Babak Roshanravan, Ali Mohammad Pourbagher-Shahri, Emad Yeganeh Khorasani, Tahereh Farkhondeh, Jan Olav Aaseth, Mohammad Abdollahi, Omid Mehrpour
Toxicology and Applied Pharmacology.2021; 429: 115681. CrossRef
Exposure to lead and other toxic metals from informal foundries producing cookware from scrap metal
Renee Anne Street, Walter Goessler, Saloshni Naidoo, Busisiwe Shezi, Nokulunga Cele, Jaqueline Rieger, Karl Ettinger, Tarylee Reddy, Angela Mathee
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Bayesian network model to diagnose WMSDs with working characteristics
Gilseung Ahn, Sun Hur, Myung-Chul Jung
International Journal of Occupational Safety and Ergonomics.2020; 26(2): 336. CrossRef
Challenges in diagnosing lead poisoning: A review of occupationally and nonoccupationally exposed cases reported in India
Monica Shirley Mani, Divyani Gurudas Nayak, Herman Sunil Dsouza
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Lead Poisoning at an Indoor Firing Range
Kyung Wook Kang, Won-Ju Park
Journal of Korean Medical Science.2017; 32(10): 1713. CrossRef
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

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Detection of Cases and a Cause of Lead Exposure in Korean Steel Company: Bon Hak Koo, Young Ki Kim, Sang Gil Lee, Dong Mug Kang, Jong Eun Kim; Korean Journal of Occupational and Environmental Medicine 2012;24(4):441-448. Published online December 31, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.4.441

Abstract PDF

BACKGROUND
We report cases of high lead exposure in a Korean steel manufacturing company and a likely cause for these cases.
CASE
REPORT: Neurological examinations, neurobehavioral tests, blood tests, and urine tests were performed to detect an association between high lead exposure and physical symptoms for workers in a steel manufacturing company. In order to determine the cause of high lead exposure, the work process and environment was assessed. The highest lead exposure was during the work process. We found that the interior of an oil storage tank was coated with lead-containing paint, leading to severe exposure during the cutting process. In two observations, 4 of 12 workers diagnosed with occupational disease were found to have high exposure to lead from the storage tank and three had increased beta-2 microglobulin levels in the blood (indicative of urinary tract damage).
CONCLUSIONS
Lead management, including routine measurements of the working environment and examinations of lead concentrations in workers, are needed in the korean scrap metal industry. In addition, rules requiring workers to wear personal protective equipment and receive education about lead exposure should be strictly enforced.

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Evaluation of Temporal Trends of Lead Exposure in Korean Workers Using Workplace Monitoring Data
Dong-Hee Koh, Sangjun Choi, Ju-Hyun Park, Sang-Gil Lee, Hwan-Cheol Kim, Inah Kim, Jong-Uk Won, Dae Sung Lim, Hoekyeong Seo, Dong-Uk Park
Journal of Korean Medical Science.2023;[Epub] CrossRef
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

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A Study on Thyroid Function among Male Workers Occupationally Exposed to Inorganic Lead: Hyeong Su Kim, Yun Cheol Park, Jae Wook Choi, Woo Whan Rho, Dae Seong Kim, Jong Tae Park; Korean Journal of Occupational and Environmental Medicine 1999;11(2):153-160. Published online June 30, 1999; DOI: https://doi.org/10.35371/kjoem.1999.11.2.153

Abstract PDF

This study was performed to evaluate the relationship between biological markers of lead exposure and thyroid functions among male workers occupationally exposed to inorganic lead. 30 male workers exposed to inorganic lead at smelting and battery factories were investigated, and 30 male control workers who were not exposed to inorganic lead occupationally were chosen for this study. The data were obtained using direct interview and assessment of biological markers of lead exposure and thyroid indices. As biological markers for lead exposure, blood ZPP. blood lead, urine lead and hemoglobin were measured. As thyroid indices. TSH and FT4were determined. The results of the study were summarized as follows 1. Levels of ZPP, blood lead, and urine lead were significantly higher in lead-exposed group than in nonexposed control group(p<0.01 all). Hemoglobin level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 2. Study subjects had normal values of TSH and FT4 But TSH level was insignificantly lower in lead-exposed group than in nonexposed control group(p=0.11) and FT4 level was significantly lower in lead-exposed group than in nonexposed group(p<0.01). 3. As the result of simple regression analysis in lead-exposed group. FT4 level was negatively correlated with the amount of smoke, blood ZPP, and blood lead(p < 0.05 all). 4. In lead-exposed group, FT4 was used as a independent variable and age, the amount of smoke, blood ZPP, and blood lead were entered as a dependent variables in the model. As the result of multiple regression analysis with stepwise selection method, the amount of smoke and blood ZPP were negative predictors of FT4(p=0. 04, p=0.09, respectively). In conclusion, levels of TSH and FT4were lower in lead-exposed group than in nonexposed control group. In lead-exposed group, FT4 level was negatively correlated with amount of smoke, blood ZPP, and blood lead in simple regression analysis. To clarify this relation, further research between lead exposure and thyroid function may be required for worker with long-term lead exposure or high lead exposure.

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Occupational Hearing Loss in Korea
Kyoo Sang Kim
Journal of Korean Medical Science.2010; 25(Suppl): S62. 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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A Study on the Lead Exposure of Workers in Secondary Smelting and Litharge Making Industries: Je Myung Chae, Gap Soo Lee, Sung Soo Lee, Kyu Dong Ahn, Byung Kook Lee; Korean Journal of Occupational and Environmental Medicine 1997;9(1):131-139. Published online February 28, 1997; DOI: https://doi.org/10.35371/kjoem.1997.9.1.131

Abstract PDF

Two hundred and six male lead workers (86 lead workers from secondary smelting industries and 120 lead workers from litharge making industries) and 212 office workers who were not exposed to lead occupationally were studied to investigate the effect of lead on the health of lead workers in high risk operation to lead. Blood lead (PbB), zinc protoporphyrin in whole blood (ZPP), delta-aminolevulinic acid in urine (ALAU), Hematocrit (Hct) and hemoglobin (Hb) were selected as an index of lead exposure. Questionnaires of 15 lead related symptoms were provided to all study subject and filled up by themselves and reconfirmed the symptom answers by interviewing medical doctor. While the mean value of PbB, ZPP and ALAU of lead workers in secondary smelting industries were 62.7+/-14.6 microgram/dl, 103.1+/-60.5 microgram/dl and 7.4+/-10.3 mg/liter, those of lead workers in litharge making industries were 58.8+/-14.1 microgram/dl, 74.2+/-45.2 microgram/dl and 5.3+/- 7.9 mg/liter respectively, and there were statistically significant difference of mean values between two groups. Simple linear regression analysis of PBB on ZPP and ALAU shoved the steeper slope in secondary smelting industries than litharge making industries. Higher symptom prevalence rates of lead exposed group were observed in lead colic related symptom (S4) and neuromuscular symptoms compared with non-exposed workers. The prevalence of neuromuscular symptoms only showed dose-response relationship by the increase of PBB and ZPP. But more statistical significances were observed in neuromuscular symptoms by the increase of PBB than ZPP. On stepwise multiple regression using total symptom score as a dependent variable and PBB, ZPP, ALAU, Hct, Hb, age and work duration as a independent variables only ZPP and age contributed to the lead related symptoms.

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The association between cadmium and lead exposure and blood pressure among workers of a smelting industry: a cross-sectional study
Hyun Chan An, Joo Hyun Sung, Jiho Lee, Chang Sun Sim, Sang Hoon Kim, Yangho Kim
Annals of Occupational and Environmental Medicine.2017;[Epub] 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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Renal Dysfunction Indicators in Lead Exposed Workers: Sang Ju Lee, Young Seoub Hong, Sung Ryul Kim, Dong Il Kim, Joon Youn Kim, Kap Yeol Jung; Korean Journal of Occupational and Environmental Medicine 1996;8(2):340-349. Published online September 30, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.2.340

Abstract PDF: A range of indicators is available to assess renal dysfunction in lead exposure. This study was undertaken to find out which indicators were most valuable as markers of renal dysfunction. We selected 75 male workers from the secondary lead smelter, plastic stabilizer and radiator manufacturing industries (the "exposed" group) and 64 male office workers (the "control" group). Blood lead; blood zinc protoporphyrin; urine lead; urine coproporphyrin; delta-aminolevulinic acid dehydratase activity; and urine delta-aminolevulinic acid were chosen as indicators of lead exposure. Blood urea nitrogen; serum creatinine; serum uric acid; urine N-acetyl-beta-D-glucosaminidase; urine albumin; urine alpha1-microglobu-lin; and urine beta2-microglobulin were used as indicators of renal dysfunction. Urine alpha1-microglobulin level was significantly associated with, the lead exposure level. Blood urea nitrogen, urine N-acetyl-beta-D-glucosaminidase and urine alpha1-microglobulin levels were highly correlated with indicators of lead exposure. Urine alpha1-microglobulin had the highest correlation with other indicators of renal function. In addition, the proportion of subjects with high urine alpha1-microglobulin levels showed a gradient with lead exposure. Conclusively, Blood urea nitrogen, urine N-acetyl-beta-D-glucosaminidase and urine alpha1-microglobulin are useful indicators, but urine alpha1-microglobulin is ; the early 'and the most valuable indicator of renal dysfunction related to lead exposure.

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A Study on the Activity of Erythrocyte Pryrimidine 5'-Nucleotidase in Workers Exposed to Lead: Soung Hoon Chang, Yong Tae Yum; Korean Journal of Occupational and Environmental Medicine 1994;6(1):85-97. Published online February 28, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.1.85

Abstract PDF: In this study, we measured the activity of the erythrocyte pyrimidine 5'-nucleotidase(P5N) for 83 workers exposed to lead in their workplace, and analyzed the correlation of the activity with other biological exposure indices of lead. The measurement was performed by using a high performance liquid chromatography (HPLC) with a reverse phased ODS column. The results are as follows; 1. The correlation of the erythrocyte P5N activity with the concentration of blood lead(PbB) was shown to be statistically significant (r=-0.71, p=0.0001). 2. For a group of subjects whose PbB was less than 10microgram/dl, the erythrocyte P5N activity was 14.9+/-1.5 micromole uridine/h/g Hb. 3. For medical surveillance, this study suggests the erythrocyte P5N activity of 12 micromole uridine/h/g Hb is equivalent to 40 microgram/dl of PbB. 4. The correlation coefficients of the erythrocyte P5N activity with other biological exposure indices of lead such as PbB, ZPP, ALA-U, PBU, CP-U, ALAD, and log ALAD were -0.71, -0.64, -0.57, -0.51, -0.50, 0.46 and 0.64, respectively. 5. The correlation coefficients of the PbB with other biological exposure indices of lead for ALAD, P5N, ZPP, PBU, CP-U, and ALA-U were -0.76, -0.71, 0.68, 0.59, 0.42, and 0.41, respectively. The erythrocyte P5N activity can be used as a reliable biological exposure index of lead.

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Lead Exposure of Tollgate Workers on Korea Expressway: Chung Yill Park, Jung Wan Koo, Young Man Roh, Seung Han Lee; Korean Journal of Occupational and Environmental Medicine 1990;2(2):134-141. Published online August 31, 1990; DOI: https://doi.org/10.35371/kjoem.1990.2.2.134

Abstract PDF

In order to evaluate possible effects of lead exposure, lead absorption and subjective symptoms in the expressway tollgate workers, 147 workers who have benn working at 4 expressway tollgates werer studied. Study variables were blood lead(PbB), urine lead(PbU), delta-aminolevulinic acid in urine (ALAU), coproporphyrin in urine (CPU), zinc protoporphyrin in whole blood (ZPP), hemoglobin, hematocrit, red blood cell count and symtom index of lead exposure. Subjective symptoms, 16 items, were investigated by a physician's interview. The results were as follows: 1. The most prevailing subjective symptom related to lead exposure were reported fatigue (41.5%), follow by abdominal discomfort (26.5%), loss of appetite (23.8%) and numbness (21.0%). 2. The mean air concentrations of lead at inside and outside of tollbooth were 6.8 (0.2~17.9) and 4.8 (0.2~17.5) microgram/m3, respectively. 3. The mean values of lead absorption indices (blood lead, urine lead, delta-aminolevulinic acid, coproporphyrin in urine and zinc protoporphyrin in blood) of workers were 19.99 (4.2~38.9) microgram/ dl, 29.82(6.3~68.6) microgram/l, 1.04(0.17~3.41) mg/l, 30.30(11.6~58.0) microgram/l and 10.51(1.0~31.0) microgram/l, respectively. And the mean values of hemoglobin, hematocrit and red blood cell count were 15.41 (10.2~18.9)g/dl, 45.88(33.9~54.7)%, 497.37(415~591)x10(4)/mm3, respectively. 4. The mean number of positive responses to subjective symptoms(16 items) was 2.08(13%) and tended to decrease with increasing work duration and age. 5. The number of positive responses of subjective symptoms did not show dose-response relationship with lead absorption indices.

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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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