Blood Lead Levels in San Diego Policemen

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1 ANNALS OP' CLINICAL AND LABORATORY SCIENCE, Vol. 7, No. 3 Copyright 1977, Institute for Clinical Science Blood Lead Levels in San Diego Policemen ALFRED ZETTNER, M.D., ARNOLD R. JOSSELSON, M.D., DONALD G. RAMRAS, M.D., M.P.H., and J. B. ASKEW, M.D., M.P.H. Division of Clinical Pathology, Department of Pathology, School of Medicine, University of California, San Diego and Department of Public Health, County of San Diego, San Diego, CA ABSTRACT Blood lead levels were measured by atomic absorption spectrophotometry in 86 San Diego policemen to see if they would reflect the known high atmospheric lead levels in San Diego. The mean blood lead for the entire group was 27.0 fig per dl, a level very similar to that found in the general population of other cities. Work exposure to heavy traffic, area of residence, work shift and smoking did not significantly influence blood lead. Thus, an ambient atmospheric lead load ranging from 2 to 5 fig per cubic m does not demonstrably cause higher blood lead levels in persons exposed to such air. Surprisingly, the youngest group, 21 to 25 years, had the highest mean (32.2 fig per dl) while the oldest, 46 to 55 years, had the lowest mean (20.9 fig per dl), a difference statistically highly significant. However, length of work as a policeman per se did not influence blood lead levels. Exposure to other known high-risk factors (hobbies, ceramics, old dwellings) was associated with higher levels (mean 30.6 fig per dl). Introduction Concern has arisen in recent years in San Diego County over the health hazards of lead in the atmosphere. Surveys of air pollution in major United States cities have shown that the City of San Diego has one of the highest maximum quarterly composite atmospheric lead levels.3,4 The average daily value of atmospheric lead in San Diego is 2.1 fig per cubic m with peak levels reaching in excess of 5 fig per cubic m on days of atmospheric inversion layers.3,4 Gasoline combustion is by far the largest contributor to the ambient lead in the atmosphere.3 In conjunction with 352 the San Diego County Health Department, a study was made of a group of 100 San Diego policemen known to be assigned regular duty on traffic patrol as representative of a population sample regularly exposed to heavy concentrations of automobile exhausts. Material and Methods A questionnaire was designed to obtain information potentially relevant for assessing factors influencing the blood lead levels of these individuals. Questions included in the questionnaire are shown in table I. One hundred policemen were

2 asked to volunteer for participation in the study by filling out the questionnaire and by allowing venous blood samples to be drawn. Blood samples of 10 ml were collected in heparinized Vacutainers* which are specifically manufactured for trace metal studies and are considered lead free. The blood samples were drawn after cleansing the subjects arms with alcohol sponges known to be lead free. Care was taken to avoid other external sources of lead contamination of the blood samples. The blood samples were analyzed by an atomic absorption spectrophotometric method.1the S.D. of the method was 1.4 xg per dl. Student s t test was applied in the statistical analysis of the data to evaluate the significance of the difference of the means in the blood lead values of the various subgroups of subjects when paired according to the various factors listed in the questionnaire. The relationship between blood lead and age was also statistically evaluated by regression analysis using the least squares method. Results Of the 100 policemen asked to volunteer for this study, 86 participated. Blood was drawn on three different days from various police divisions in the city. The mean values are listed in table II. The mean blood lead value of the entire group was 27.0 ± 8.1 (S.D.) pig per dl of whole blood, the lowest value being 13.0 /xg per dl and the highest 45.5 fxg per dl. The age range was 21 to 53 years. Since it was of interest to separate the effect of the length of employment as policemen from that of chronological age, the participants were divided into groups according to age as well as duration of their occupation. BLOOD LEAD LEVELS IN SAN DIEGO POLICEMEN 353 * Becton, Dickinson and Company, Columbus, NB; Butherford, NJ. T ABLE I Lead Study Questionnaire Name Badge N o. Age 1. How long have you worked as a policeman? How much of this time was in S.D.? 2. Have you worked more days or more nights in the S.D. Police Department? 3. How much of the work was in heavy traffic? 4. Do you live in S.D.? Elsewhere? 5. Do you live in a residence built before 1940? If so, how many years? 6. Do you use imported pottery for eating or storing food? If so, from what country? 7. Do you have any known exposure to lead, such as battery burning, smelting, etc? 8. Do you smoke? How many packs per day? How long? Indicate any other pertinent information. County of San Diego, Dept, of Public Health 1600 Pacific Highway, San Diego, CA Six age groups were arranged in increments of five years from 21 to 55 years. Because only one participant fell into the group years, the two oldest groups were combined (46-55 years). The results are shown in table II. The youngest men had the highest mean blood lead (32.2 ftg per dl), while the oldest had the lowest mean (20.9 /xg per dl). The means of the intermediate age groups lay between these extremes. The differences between the means for all policemen and the youngest and oldest age groups were statistically highly significant, but those of the intermediate age groups were not. Regression analysis of the relationship between blood lead and age have a coefficient of correlation (r) of 0.26 and a coefficient of determination (r2) of indicating that only 6.8 percent of the variation of the blood lead levels was due to an age related decline. The participants were then divided into six groups according to their length of employment on the police force, ranging from less than two years to longer than 20 years. The results are listed in table II. The mean blood lead of the longest career group (>20 years on police force) was statistically significantly lower than the mean of all policemen, but the means of

3 354 ZETTNER, JOSSELSON, RAMRAS AND ASKEW the other groups were not significantly different. Finally, participants who had been with the police force less than two years were arranged according to age, and their mean lead values calculated. Higher levels (mean 30.9 /ag per dl) were seen in the younger group and lower levels (mean 23.7 fig per dl) in the older groups, the difference being statistically borderline significant. Furthermore, these values were statistically not significantly different from the means of the respective age groups including all policemen regardless of their length of occupation. Nonsmokers had a mean level of 28.5 fig per dl, and smokers had a mean level of 26.0 fig per dl. The difference statistically was considered not to be significant. Those smokers who had provided the relevant information in the questionnaire were divided into two groups according to the length and severity of their smoking habit. Those smoking less than 10 packyears had a mean level of 28.8 fig per dl and those smoking more than 10 packyears had a mean level of 24.7 fig per dl. The difference was statistically not significant. Blood lead levels showed no statistically significant difference whether policemen worked more days or nights, worked in heavy traffic or not, or lived in or outside the city limits. T A B L E II Blood Lead Levels in San Diego Policemen Number of Blood Lead Range of p Values for Observed o f Mean Cone. Observed Differences Between Group Subjects vg/dl S.D. Values Means o f Blood Lead All policemen Age of policemen (years) All policemen & age subgroup > > > > Years as policemen All policemen & career subgroup < > > > > >0.20 >20 Policeman <2 years Pairs in subgroup years of age >29 years of age Nonsmoker Smoker >0.10 <10 Pack-years >10 Pack-years Worked more days Worked more nights >0.20 Worked in heavy traffic Worked in light traffic >0.50 Live in city Live outside city >0.50 Known high-risk factors Deny high-risk factors

4 BLOOD LEAD LEVELS IN SAN DIEGO POLICEMEN 355 Policemen exposed to high-risk factors (living in dwellings built before 1940, using imported ceramic glazed pottery for eating or storing food, or other known lead exposure) as a group had a mean blood lead level of 30.6 fig per dl. Those who denied any such exposure had a mean blood lead level of 26.1 fig per dl. The difference was statistically borderline significant. Of the youngest group (11 participants), only 2 (18 percent) admitted high-risk factors, while of all the other (older) 75 participants, 15 (20 percent) did so. The highest value found in the entire high-risk group (45.5 fig per dl) occurred in a policeman who lived in a dwelling built before 1940 and was using Mexican pottery for eating and storing food. Seven policemen lived in homes built before Their mean blood lead level was 34.1 ± 8.7 (S.D.) fig per dl. Three policemen were using Mexican ceramic glazed pottery. Their mean blood lead level was 30.3 ± 15.5 (S.D.) fig per dl. Seven policemen stated other known exposures to lead in the form of welding, smelting, etc. Their mean blood lead level was 32.2 ± 9.4 (S.D.) fig per dl. There were no significant differences between the age distributions in the pairs of subgroups comparing smokers with nonsmokers, day with night shift workers, urban with rural dwellers and other risk factor groups. Discussion The mean value for blood lead of 27.0 ± 8.1 fig per dl in San Diego policemen is similar to those observed in policemen in Cincinnati and Philadelphia, where the levels were 25 fig per dl and 26 fig per dl, respectively, and are higher than those found in Los Angeles policemen, whose mean blood level was 21 fig per dl.9these values are also very similar to those observed in normal populations in other large U.S. cities, i.e., downtown Philadelphia5(mean blood lead levels for males was 24 fig per dl) and New York City (mean blood lead level was 21 fig per dl). In a study of 50 London taxi drivers, a mean value for blood lead of 28.7 ± 7.4 fig per dl was found.8 These differences in the mean values reported from various localities may, of course, be caused entirely or partially by differences in environmental exposure; however, they are of such relatively small magnitude that they may be due largely to variations in technique between laboratories.2 It was somewhat surprising to find a correlation between age and blood lead levels, in that younger men had a higher value than older men. The possibility that this in some way was related to the duration of their career as policemen (conceivably greater exposure to lead during their training and initial years) is unlikely because of the lack of discernable correlation of blood lead and length of employment. Groups with different career duration but of the same mean age had the same mean blood lead levels. Vice versa, groups with the same career duration but of differing mean ages exhibited differing mean blood lead levels that were essentially identical to those of the corresponding age groups including all career lengths. The percentage of men admitting other high-risk exposures was the same in all age groups; in other words, young age per se was not related to more frequent engagement in the high-risk factors as defined by the questionnaire. Since lead in blood is mostly bound to erythrocytes, the well-known decrease of the hematocrit with age may have contributed to the slight age-related decline in blood lead levels as shown in our study by regression analysis. Other studies have not found such a correlation.7at this time no definitive explanation can be offered for the correlation of blood lead level and age in our survey. It would appear that this question deserves further investigation.

5 3 56 ZETTNER, JOSSELSON, RAMRAS AND ASKEW Smoking of tobacco apparently had no influence on blood lead. Smokers as a group had a slightly lower mean blood level than nonsmokers, but this was not statistically significant. The two groups had similar ages (smokers a mean age of 34.1 years, nonsmokers a mean age of 33.8). The finding that men smoking less than 10 pack-years had a higher mean blood lead level (28.8 ig per dl) than those smoking more than 10 pack-years (24.7 [ag per dl) in all likelihood is related to the fact that the former group is younger (mean age 29.6) than the latter group (mean age 36.5). Jones et al8found no difference in the mean blood lead of smokers and nonsmokers, but other studies showed small but statistically significant higher levels in smokers.7,9,11 Whether or not policemen worked in heavy traffic did not seem to affect their blood lead level. This is at variance with other reports? and maybe explained by the fact that San Diego has no policemen regularly standing in the middle of the street directing traffic, as all traffic policemen cruise in their police cars which are not air-conditioned. As expected, the group with high-risk factors had a higher mean blood lead level than the policemen not similarly exposed. This study has been of specific health interest in San Diego because of the earlier mentioned levels of lead found in ambient air. The data provide some evidence that these air concentrations do not result in elevations of blood lead to levels which generally are recognized as being indicative of lead toxicity. This, of course, is not to imply that a still higher lead content of the atmosphere may not result in demonstrable increases of blood lead in the subjects so exposed. On the contrary, the main body of the accumulating experimental data indicates that blood lead in man progresses monotonically with increasing lead in the ambient air5,6 7,9,10,11 in addition to other environmental sources of lead. It has been suggested11 that blood lead in present-day man may be 100 times higher than that inferred under natural conditions free of any industrial pollution. The presently prevalent mean blood lead values in man (21 to 28 /ug per 1^5,6,8.9,11 are onjy approximately onehalf of the values indicative of lead toxicity. Such a precariously appearing narrow margin of safety obviously would call for the utmost vigilance in checking the accumulating lead burdens in our environment. Acknowledgement The authors wish to thank Margaret C. Shea for her assistance with the statistical analyses presented in this paper. References 1. B e r m a n, E.: The determination of lead in blood and urine by atomic absorption spectrophotometry. Atomic Absorp. Newsletter 3: , 1964, 2. B r o w n e, B. C., E l l i s, B. W. and W e ig h t m a n, D.: Inter-laboratory variation in measurement of blood-lead levels. Lancet 2: , C h o w, T. J. and E a r l, J. L.: Lead aerosols in the atmosphere: Increasing concentrations. Science 169: , C h o w, T. j.: Our daily lead. Chemistry in Britain 9: , G o l d s m it h, J. R. and H e x t e r, A. C.: Respiratory exposure to lead: Epidemiological and experimental dose-response relationships. Science 158: , G o l d w a t e r, L. J. and H o o v e r, A. W.: An international study of normal levels of lead in blood and urine. Arch. Environ. Health 15:60-63, H o f r e u t e r, D. H., C a t c o t t, E. J., Ke e x a n, R. G. and X in t a r a s, C.: The public health significance of atmospheric lead. Arch. Environ. Health 3:82-88, J o n e s, R. D., C o m m in s, B. T. and C e r n ik, A. A.: Blood lead and carboxyhaemoglobin levels in London taxi drivers. Lancet 2: , L u d w i g, J. H., D ig g s, D. R., H e s s e l b e r g, H. E., M a y a, J. A.: Survey of lead in the atmosphere of three urban communities: a summary. Amer. Ind. Hyg. Assoc. J. 26: , M c I n t ir e, M. S. and A n g l e, C. R.: Air lead: Relation to lead in blood of black school children deficient in glucose-6-phosphate dehydrogenase. Science 177: , Patterson, C. C.: Contaminated and natural lead environments of man. Arch. Environ. Health 11: , 1965.

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