Cumulative concentrations of blood lead and postural stability.

OBJECTIVE: To study the association in a group of battery manufacturing workers between computerised postural sway parameters and present concentrations of blood lead (PPb), index of cumulative blood lead years (CBI), and cumulative blood lead at different years of exposure (CPbYs). METHODS: Postural stability was investigated with a computerised postural sway measurement system in 60 workers exposed to lead with exposure duration of 84 (range 3-366) months and in 60 control subjects. An index of CBIs in 55 workers (previous blood lead results of five workers were not available) and CPbYs were computed for each worker by calculating the area under the curve of concentrations of blood lead against time. RESULTS: The mean (SD) PPb was 36.0 (11.7) (range 6.4 to 64.5) micrograms/dl for the exposed workers and 6.3 (2.4) (range 3.1-10.9) micrograms/dl for the 14 randomly selected control subjects. Significant differences between groups for the postural sway parameters obtained when the eyes were closed were found for length of sway path (L); mean velocity of the centre of pressure along its path (Vel); area included within the path of the centre of pressure (Ao); 95% confidence elliptical area (Ae). The Romberg ratio (the relation between eyes closed and open) for the Vel, L, Ao, and Ae of the exposed group were also significantly different from those of the controls. The postural sway parameters (eyes closed) were not significantly correlated with PPb or CBI. However, the cumulative blood lead for the past two years before the postural sway assessment, CPbY2, was significantly correlated with all the postural sway parameters. CONCLUSION: The study showed that workers exposed to lead had significantly poorer postural stability than a control group. Lead may affect certain parts of the somatosensory system resulting in postural instability when the visual input is cut off. The CPbY2 was significantly positively correlated with most of the postural sway parameters. Effects of lead on postural stability may be related to recent increases in blood lead concentration among the exposed workers rather than to cumulative body burden.     

Critical dose of lead affecting postural balance in workers

BACKGROUND: The threshold blood lead (BPb) level for nervous system dysfunction in adults has been estimated to be 30-40 microg/dl. This study was carried out to estimate the critical dose of lead affecting the neuromotor function in workers by introducing the benchmark dose (BMD) approach, as well as to identify the specific postural sway to lead exposure. METHODS: Postural sway parameters with spectral analysis were compared between 121 lead workers with BPb levels of 6-89 (mean 40) microg/dl and 60 unexposed controls. RESULTS: All sway parameters, except for sagittal sways with eyes open, were significantly larger in the lead workers than in the controls; also, the Romberg quotient for sagittal sway was significantly higher in the lead workers. The BPb level in the lead workers was significantly related to sagittal sways at 1-2 Hz and 2-4 Hz with eyes open, and sagittal and transversal sways at 1-2 Hz and 2-4 Hz with eyes closed. The BMD levels of BPb (i.e., lower 95% confidence limits of BMD) were estimated to be 12.1-17.3 (mean 14.4) microg/dl for postural sway. CONCLUSIONS: Neuromotor dysfunction in lead workers may be initiated at BPbs below the level previously accepted as effectless, and be characterized mainly by an increased sway of high frequency (1-4 Hz) in the sagittal direction with eyes closed (high Romberg quotient).     

Effect of exposure to lead on postural control in workers

OBJECTIVES—To examine the effect of lead on postural control of workers who have been exposed to lead.
METHODS—63 Male, lead battery workers mean (SD) age 41.0 (7.4) were compared with 48 age matched male controls after excluding those with acute or chronic diseases. Exposed workers had mean (SD) past blood lead concentrations of 37.5 (9.2) µg/dl and 11.2 (5.7) years of employment. Postural control was measured with a computerised postural sway measurement system which measured both sway and total movements.
RESULTS—Workers standing straight with eyes open on the bare plates had sway and total movements which were not notably different from controls. On the other hand increased movements were needed in the exposed workers to maintain stability (the general stability quotient 18.2 (5.4) v 15.4 (4.4) in controls, p<0.01) when standing directly on the footplates with closed eyes,, and with the head tilted (15.0 (3.8) v 11.5 (3.0) in controls, p<0.001). Exposed workers also had a trend for less ability to synchronise anterior posterior and lateral sway in the stress positions (0.0625) than had non-exposed workers . Significant but low correlations were found between the estimate of the chronic internal dose of lead and three of 10 of the postural control measurements, and present lead blood concentrations and only one of the 10 measurements and (r values ranged from 0.21 to 0.31, p0.03).
CONCLUSIONS—These findings suggest that lead affects postural control in asymptomatic workers. Further studies are warranted to find whether workers with decreased postural control are at increased risk of accidents and the relation, if any, of these measurements with subsequent morbidity.


Keywords: postural stability; equilibrium; exposure to lead     

Subclinical cerebellar anterior lobe,vestibulocerebellar and spinocerebellar afferent effects in young female lead workers in China: computerized posturography with sway frequency analysis and brainstem auditory evoked potentials

By computerized static posturography with sway frequency analysis, subclinical effects of lead on postural balance was examined in 29 female workers (lead workers) employed at a glass factory for 3-17 (mean 7.9) years in Beijing, China, in relation to brainstem function assessed by brainstem auditory evoked potential (BAEP). Their blood lead concentrations ranged from 26 to 79 (mean 55.7) microg/dl; ages were 21-30 (mean 28) years. Control subjects, aged 22-29 (mean 27.0) years, were 14 healthy female workers at a textile factory located in the same district. With eyes closed, power of the sway of high (2-4 Hz) and low (1 Hz or less) frequencies in lead workers was significantly larger than that in controls; with eyes open, their power of the sway of low frequency was significantly larger (p<0.05). The multiple regression analysis showed that the power of high frequency sway with eyes closed and of low and high frequencies with eyes open were significantly related to blood lead concentrations in lead workers (p<0.05). On the other hand, no significant differences in BAEP latencies between lead workers and controls were observed. The low frequency sway with eyes open was significantly correlated with the high frequency sway with eyes closed in the lead workers. The pattern of changes in postural balance suggested that the anterior cerebellar lobe, vestibulo-cerebellar and spinocerebellar afferent systems were affected asymptomatically in female lead workers; the sway of vestibulo-cerebellar and anterior cerebellar lobe types were simultaneously affected by lead. It appears that a computerized static posturography with sway frequency analysis is useful technique for assessment of subclinical lead neurotoxicity.     

Effects of mercury vapor exposure on neuromotor function in Chinese miners and smelters

Objectives Current risk assessment of elemental mercury vapor is based on the tremor toxicity. To clarify the neuromotor effects of occupational exposure to mercury vapor, hand tremor and postural sway were measured in 27 miners and smelters (i.e., exposed workers) and 52 unexposed subjects. Methods Urine samples were collected and total mercury and creatinine concentrations were determined. Data of the tremor and postural sway were analyzed using the fast Fourier transformation. Results The geometric means of the urinary mercury level (UHg) were 228 (range 22.6–4,577) μg/g creatinine for the exposed workers and 2.6 (1.0–17.4) μg/g creatinine for the unexposed subjects. Total tremor intensity and frequency-specific tremor intensities at 1–6 and 10–14 Hz were significantly larger in the exposed workers than in the unexposed subjects (P < 0.05), but they were not significantly related to the UHg among the exposed workers (P > 0.05). In contrast, there were no significant differences in any postural sway parameters between the above two groups (P > 0.05), but the transversal sway with eyes open was positively related to the UHg among the exposed workers in using multiple regression analysis (P < 0.05). Conclusions These findings suggest that postural sway, as well as hand tremor, may be affected by elemental mercury vapor exposure, but the former test seems to be less sensitive to mercury than the latter one.     

Male endocrine functions in workers with moderate exposure to lead.

Evidence for the effect of occupational exposure to lead on the male endocrine system is conflicting. This study evaluated the primary (testicular) and secondary (hypothalamo pituitary testicular) effects of exposure to lead in 122 current lead workers and 49 non-exposed workers. The mean current blood lead concentration was 35.2 (range 9.6-77.4) micrograms/dl in the exposed workers, and 8.3 (range 2.6-14.8) micrograms/dl in the non-exposed workers. Concentrations of plasma luteinising hormone (LH) and follicle stimulating hormone (FSH) were both significantly higher in the exposed workers, but testosterone (T) was not significantly different between the two groups. In older exposed workers, however (greater than or equal to 40 years), plasma T concentrations were significantly lower, but LH and FSH concentrations were not significantly different. Compared with non-exposed workers, those exposed for less than 10 years had significantly raised LH and FSH and normal T concentrations whereas those exposed for 10 or more years had significantly lower T, and normal LH and FSH concentrations. The concentrations of LH and FSH showed a moderate increase in relation to blood lead concentrations in the range of 10 micrograms/dl to 40 micrograms/dl and thereafter reached a plateau or declined. No apparent trend for plasma T concentrations occurred. No significant difference in prolactin (PRL) concentration was noted. It is concluded that moderate exposure to lead was associated in dose related fashion with small but measurable changes in male endocrine functions that reflected both primary and secondary effects of lead on the testes and the hypothalamo pituitary testicular axis.     

Male endocrine functions in workers with moderate exposure to lead

Evidence for the effect of occupational exposure to lead on the male endocrine system is conflicting. This study evaluated the primary (testicular) and secondary (hypothalamo pituitary testicular) effects of exposure to lead in 122 current lead workers and 49 non-exposed workers. The mean current blood lead concentration was 35.2 (range 9.6-77.4) micrograms/dl in the exposed workers, and 8.3 (range 2.6-14.8) micrograms/dl in the non-exposed workers. Concentrations of plasma luteinising hormone (LH) and follicle stimulating hormone (FSH) were both significantly higher in the exposed workers, but testosterone (T) was not significantly different between the two groups. In older exposed workers, however (greater than or equal to 40 years), plasma T concentrations were significantly lower, but LH and FSH concentrations were not significantly different. Compared with non-exposed workers, those exposed for less than 10 years had significantly raised LH and FSH and normal T concentrations whereas those exposed for 10 or more years had significantly lower T, and normal LH and FSH concentrations. The concentrations of LH and FSH showed a moderate increase in relation to blood lead concentrations in the range of 10 micrograms/dl to 40 micrograms/dl and thereafter reached a plateau or declined. No apparent trend for plasma T concentrations occurred. No significant difference in prolactin (PRL) concentration was noted. It is concluded that moderate exposure to lead was associated in dose related fashion with small but measurable changes in male endocrine functions that reflected both primary and secondary effects of lead on the testes and the hypothalamo pituitary testicular axis.     

Effects of mixed organic solvents on neuromotor functions among workers in Buddhist altar manufacturing factories

To clarify the neuromotor effects of long-term exposure to mixed organic solvents, postural sway and tremor were measured in 62 solvent workers of four Buddhist altar manufacturing factories who had worked for 1-46 (mean 12) yr. By using the passive gas sampler, 8-h time-weighted average concentrations in the workers were estimated to be 0.02-8.7 ppm for toluene, 0.02-7.7 ppm for xylene, 0.02-5.5 ppm for styrene and 0.02-40.5 ppm for n-hexane. Sagittal sway and sway area of the posturography with eyes closed were significantly larger in the solvent workers than in 35 age-matched controls (p<0.05), and there was a significant difference in Romberg quotient of sagittal sway between the two groups (p<0.05). Also, tremor intensities at 1.0-5.9 Hz, 6.0-9.9 Hz and 10.0-13.9 Hz with the right hand, and at 6.0-9.9 Hz with the left hand were significantly stronger in the solvent workers than in the controls. Among the solvent workers, transversal and sagittal sways with eyes open and tremor intensity at 10.0-13.9 Hz were significantly related to toluene exposure (p<0.05), which may have been due to the acute effects of such solvents. These findings suggest that long-term exposure to mixed organic solvents may impair neuromotor functions as measured by postural sway and tremor.     

Lipid peroxidation and concentration of glutathione in erythrocytes from workers exposed to lead

Lipoperoxide concentration in erythrocytes from workers occupationally exposed to lead (mean blood lead concentration 57.1 (SD 17.6) micrograms/dl) was significantly higher than that in controls. It was not different in plasma from the two groups. The activity of superoxide dismutase (SOD) and catalase in erythrocytes from workers exposed to lead was significantly lower than that of control subjects. The effect of lead was also seen in the glutathione concentration of erythrocytes from lead exposed workers, which was reduced to 69% of that found in erythrocytes from control workers. The increase in methaemoglobin content of erythrocytes from workers exposed to lead was less than expected and not significantly different from that of controls. A positive correlation between lipoperoxide concentration in erythrocytes and lead concentration in blood and a negative correlation between glutathione concentration in erythrocytes and blood lead concentration were found. Incubation of erythrocytes for 24 hours at 37 degrees C in the presence of lead (100 micrograms/dl) produced no changes in glutathione and lipoperoxide concentrations, although there was inhibition of activity of SOD (14.3%), catalase (10.1%), and glutathione peroxidase (35.1%). A similar experiment with heparinised whole blood showed increased haemolysis with no changes in membrane lipid peroxidation of erythrocytes. It is postulated that the lowered concentration of glutathione and decreased activity of SOD, catalase, and glutathione peroxidase in erythrocytes from workers exposed to lead may play a part in the increased membrane lipid peroxidation. Furthermore, the results suggest the possibility that leucocytes, or platelets, or both, may induce haemolysis in the presence of lead.     

Lipid peroxidation and concentration of glutathione in erythrocytes from workers exposed to lead.

Lipoperoxide concentration in erythrocytes from workers occupationally exposed to lead (mean blood lead concentration 57.1 (SD 17.6) micrograms/dl) was significantly higher than that in controls. It was not different in plasma from the two groups. The activity of superoxide dismutase (SOD) and catalase in erythrocytes from workers exposed to lead was significantly lower than that of control subjects. The effect of lead was also seen in the glutathione concentration of erythrocytes from lead exposed workers, which was reduced to 69% of that found in erythrocytes from control workers. The increase in methaemoglobin content of erythrocytes from workers exposed to lead was less than expected and not significantly different from that of controls. A positive correlation between lipoperoxide concentration in erythrocytes and lead concentration in blood and a negative correlation between glutathione concentration in erythrocytes and blood lead concentration were found. Incubation of erythrocytes for 24 hours at 37 degrees C in the presence of lead (100 micrograms/dl) produced no changes in glutathione and lipoperoxide concentrations, although there was inhibition of activity of SOD (14.3%), catalase (10.1%), and glutathione peroxidase (35.1%). A similar experiment with heparinised whole blood showed increased haemolysis with no changes in membrane lipid peroxidation of erythrocytes. It is postulated that the lowered concentration of glutathione and decreased activity of SOD, catalase, and glutathione peroxidase in erythrocytes from workers exposed to lead may play a part in the increased membrane lipid peroxidation. Furthermore, the results suggest the possibility that leucocytes, or platelets, or both, may induce haemolysis in the presence of lead.     

Erythrocyte deformability in workers exposed to lead.

Erythrocyte deformability and other hematological indicators were determined in 17 male workers exposed to lead at a secondary lead refinery and 13 controls. Blood lead, urine lead, urine coproporphyrin, delta-aminolevulinic acid and erythrocyte zinc protoporphyrin were determined to evaluate the degree of lead exposure in the lead workers above. For the measurement of erythrocyte deformability, the microfilter method was used. The results were summarized as follows: 1. The mean values of blood lead, urine lead, urine coproporphyrin, urine delta-aminolevulinic acid and erythrocyte zinc protoporphyrin levels in lead workers were 53.5 micrograms/100g, 141.4 micrograms/l, 115.9 micrograms/l, 12.0 mg/l and 68.9 micrograms/dl respectively, suggesting a moderate influence of lead exposure. 2. The mean values of erythrocyte count, hematocrit and hemoglobin were significantly lower in lead workers than those in controls. No significant differences were found in the mean values of mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and corpuscular natrium and potassium between lead workers and controls. 3. Erythrocyte deformability was significantly reduced in lead workers compared with controls.     

Occupational lead exposure aboard a tall ship

To evaluate occupational exposures to lead in shipfitters cutting and riveting lead-painted iron plates aboard an iron-hulled sailing vessel, we conducted an environmental and medical survey. Lead exposures in seven personal (breathing zone) air samples ranged from 108 to 500 micrograms/m3 (mean 257 micrograms/m3); all were above the Occupational Safety and Health Administration (OSHA) standard of 50 micrograms/m3. In two short-term air samples obtained while exhaust ventilation was temporarily disconnected, mean lead exposure rose to 547 micrograms/m3. Blood lead levels in ten shipfitters ranged from 25 to 53 micrograms/dl (mean, 37.8 micrograms/dl); levels in three of these workers exceeded the upper normal limit of 40 micrograms/dl. Blood lead levels in shipfitters were significantly higher than in other shipyard workers (mean 10.0 micrograms/dl; p less than 0.001). Smoking shipfitters (mean, 47 micrograms/dl) had significantly higher lead levels than nonsmokers (mean, 32 micrograms/dl; p = 0.03). Lead levels in shipfitters who wore respirators were not lower than in those who wore no protective gear (p = 0.68). Four shipfitters had erythrocyte protoporphyrin (EP) concentrations above the adult upper normal limit of 50 micrograms/dl. A close correlation was found between blood lead and EP levels (r = 0.70). Prevalence of lead-related symptoms was no higher in shipfitters than in other workers. No cases of symptomatic lead poisoning were noted. These data indicate that serious occupational exposure to lead can occur in a relatively small boatyard.     

Influence of alcohol on the behavior of dose and effect indicators in workers exposed to inorganic lead: unexpected behavior of ZPP]

A study was carried out on 65 male workers heavily exposed to lead in the ceramic tile manufacturing industry in order to assess the effects of alcohol on the biological indicators of lead (PbB, ALA-D, ALA-U, ZPP). All subjects selected for the study had PbB levels greater than or equal to 60 micrograms/dl, normal levels of serum iron and no haemoglobin disorders. The subjects were divided into three groups according to alcohol intake checked by anamnestic investigation, mean corpuscular volume (MCV) values and liver function parameters, as follows: Group A--27 subjects, controls, with daily alcohol intake less than 80 ml, MCV less than or equal to 95 mu 3, normal GGT, AST and ALT levels; Group B--20 subjects, heavy drinkers, with daily alcohol intake greater than or equal to 80 ml, MCV greater than 95 mu 3, occasionally high GGT, but normal AST and ALT values; Group C--18 subjects, heavy drinkers, with daily alcohol intake greater than or equal to 80 ml, MCV greater than 95 mu 3, abnormal GGT, AST and ALT levels. The length of lead exposure did not significantly differ in the three groups. The well-known effects of ethanol intake on PbB, ALA-D and ALA-U values were confirmed, with the following mean values in the three groups: Group A: PbB = 66.0 (micrograms/dl), ALA-D = 10.3 (mU/ml r.c.), ALA-U = 8.4 (mg/l); Group B: PbB = 68.3 (micrograms/dl), ALA-D = 6.7 (mU/ml r.c.), ALA-U = 9.1 (mg/l); Group C: PbB = 71.5 (micrograms/dl), ALA-D = 4.6 (mU/ml r.c.), ALA-U = 12.7 (mg/l).(ABSTRACT TRUNCATED AT 250 WORDS)     

No adverse effects of lead on renal function in lead-exposed workers

A cross-sectional study was performed on 165 male lead-exposed workers to clarify the quantitative relationships between less severe exposure to lead and its effects on renal function in 1985. Mean and range of blood lead concentration (Pb-B) were 36.5 micrograms/dl and 6-73 micrograms/dl, respectively. Duration of lead exposure was 0.1 to 26.3 years. No lead-related changes were detected in serum creatinine concentration, beta-2 microglobulin in urine, creatinine clearance, beta-2 microglobulin clearance, and uric acid clearance. Twenty of the 165 workers had been exposed to lead for more than 10 years with mean duration of 21.0 years. Average concentrations of Pb-B in each individual during 1972 to 1984 were 26.1-66.6 micrograms/dl. Renal function indices of these 20 workers were not different from those of remaining lead-exposed workers whose lead exposure duration were 10 years or less. These results suggest that long-term less severe exposure to lead up to 70 micrograms/dl of Pb-B may not cause adverse effects on renal glomerular function and proximal tubular function.     

Visual field dependence is associated with reduced postural sway,dizziness and falls in older people attending a falls clinic

Moving visual fields can have strong destabilising effects on balance, particularly when visually perceived motion does not correspond to postural movements. This study investigated relationships between visual field dependence (VFD), as assessed using the roll vection test, and reported dizziness, falls and sway under eyes open, eyes closed and optokinetic conditions. Ninety five falls clinic attendees undertook the roll vection test (i.e. attempted to align a rod to the vertical while exposed to a rotating visual field). Sway was assessed under different visual conditions by centre of pressure movement. Participants also completed questionnaires on space and motion discomfort, fear of falling, depression and anxiety. Thirty four (35.8%) participants exhibited VFD, i.e. had an error >6.5º in the roll vection test. Compared to participants without VFD, participants with VFD demonstrated less movement of the centre of pressure across all visual conditions, were more likely to report space and motion discomfort and to have suffered more multiple falls in the past year. VFD was independent of fear of falling, anxiety and depression. VFD in a falls clinic population is associated with reduced sway possibly due to a stiffening strategy to maintain stance, dizziness symptoms and an increased risk of falls.     

1989 Alice Hamilton lecture. Lead and human health: background and recent findings

This paper, prepared in tribute to Dr. Alice Hamilton on her 120th birthday, reviews her pioneering studies of occupational lead poisoning and its control, her largely unheeded warnings about the possible consequences of widespread lead exposure to the general public through the use of leaded fuel, and the results of recent studies of human exposure to and health effects of lead in the general environment. Evidence is presented for dose-related non-threshold effects for children with blood lead concentrations below 25 micrograms/dl for a variety of effects including verbal IQ; mental development; physical size; and age at physical milestones such as first steps, hearing thresholds, and postural sway. For adults, various studies have produced associations between blood pressure and blood lead concentrations below 35 micrograms/dl, suggesting possible effects on cardiovascular health. While the biological mechanisms responsible for these effects remain poorly understood, recent and current efforts to reduce exposure to lead by the virtual elimination of lead in gasoline and food packaging show that we have learned one of Dr. Hamilton's important lessons, i.e., that the most effective means of reducing excessive exposures are through control of the environmental sources.     

Blood lead levels in incinerator workers.

Questions have been raised concerning the safety of mass burn incineration and its role in solid waste management. In 1989, the New York City Office of Occupational Safety and Health examined air levels of metals in New York City incinerators and found that workers were exposed to air lead levels as high as 2500 micrograms/m3 while cleaning the electrostatic precipitators in the plant. In order to determine the biologic significance of these exposures to the workers, blood samples were taken from 56 incinerator workers and 25 controls and analyzed for lead and erythrocyte protoporphyrin levels. Incinerator workers were found to have a mean blood lead of 11.0 micrograms/dl as compared to the control group level of 7.4 micrograms/dl. Risk factors for increased blood lead levels were analyzed using multiple regression analyses. Wearing a personal protective device "always" or not and the interaction of smoking and cleaning the precipitator more than seven times in the past year were found to be significant predictors for blood lead. These results indicate that lead in municipal incinerator ash from electrostatic precipitators is bioavailable and that the effects of such exposure can be minimized by wearing personal protective devices, not smoking, and rotating the work force to minimize precipitator ash contact.     

Evaluation of lead exposure in workers at a lead-acid battery factory in Korea: with focus on activity of erythrocyte pyrimidine 5''-nucleotidase (P5N).

OBJECTIVE--To evaluate lead exposure among lead-acid battery workers in Korea, to evaluate in more detail the erythrocyte pyrimidine 5'-nucleotidase (P5N) test for lead exposure, and to evaluate the abnormal accumulation of erythrocyte pyrimidine nucleotides in the battery workers. METHODS--Activity of P5N and other biological variables were examined in 66 exposed workers in a lead-acid battery factory and in 26 non-exposed workers in Korea. RESULTS--At the factory the time-weighted average of 13 (72%) of 18 air samples for lead exceeded 0.05 (range 0.012-0.468) mg/m3. Blood lead concentration (PbB) in 39 of the 66 exposed workers was above 40 micrograms/dl, and the mean (SD) PbB in the exposed group was 45.7 (15.7) micrograms/dl. Compared with the nonexposed group, free erythrocyte protoporphyrin in the exposed group was significantly increased, whereas erythrocyte P5N activity and activity of erythrocyte delta-aminolevulinic acid dehydratase (ALAD) were significantly inhibited. Erythrocyte P5N activity had valid correlation biologically with PbB and with other biological variables, such as ALAD activity. In 28 exposed workers, the concentration of erythrocyte pyrimidine nucleotides (uridine 5'-diphosphate-glucose and cytidine 5'-triphosphate) correlated inversely with P5N activity and positively with PbB. CONCLUSIONS--These findings show that the depression of erythrocyte P5N activity by lead exposure results in the accumulation of erythrocyte pyrimidine nucleotides. In general, the standard analysis of PbB performed in laboratories around the world remains the most useful index of recent exposure. The results indicate that the erythrocyte P5N activity test provides supporting evidence of lead exposure and shows the effect of lead on nucleotide metabolism.     

Lead exposure among lead-acid battery workers in Jamaica

To assess lead exposure in the Jamaican lead-acid battery industry, we surveyed three battery manufacturers (including 46 production workers) and 10 battery repair shops (including 23 battery repair workers). Engineering controls and respiratory protection were judged to be inadequate at battery manufacturers and battery repair shops. At manufacturers, 38 of 42 air samples for lead exceeded a work-shift time-weighted average concentration of 0.050 mg/m3 (range 0.030-5.3 mg/m3), and nine samples exceeded 0.50 mg/m3. Only one of seven air samples at repair shops exceeded 0.050 mg/m3 (range 0.003-0.066 mg/m3). Repair shop workers, however, had higher blood lead levels than manufacturing workers (65% vs. 28% with blood lead levels above 60 micrograms/dl, respectively). Manufacturing workers had a higher prevalence of safe hygienic practices and a recent interval of minimal production had occurred at one of the battery manufacturers. Workers with blood lead levels above 60 micrograms/dl tended to have higher prevalences of most symptoms of lead toxicity than did workers with lower blood lead levels, but this finding was not consistent or statistically significant. The relationship between zinc protoporphyrin concentrations and increasing blood lead concentrations was consistent with that described among workers in developed countries. The high risk of lead toxicity among Jamaican battery workers is consistent with studies of battery workers in other developing countries.     

Changes in postural sway during a period of sustained wakefulness in male adults.

Nocturnal variations in postural sway during a period of sustained wakefulness were studied in seven healthy male adults. Postural sways with the subject's eyes open and with them closed were measured every hour from 22:00 to 04:00 h the following day. Parameters of postural sway [rectangle area (RA), root mean square of length in the anterior-posterior direction (RMSL-y), and medium-frequency-band (0.2-1.0 Hz) power of postural sway in the lateral (MF-x) and anterior-posterior (MF-y) directions] showed significant nocturnal variations. RA, RMSL-y, MF-x and MF-y increased after midnight and reached peaks at 04:00 h. Moreover, changes in RA and MF-y depended on visual conditions. The increases in RA and MF-y were larger with the eyes closed than with them open. These postural sway parameters showed positive correlations with subjectively rated sleepiness and negative correlations with electroencephalographic alpha activity. The results suggest that changes in postural sway during the night are influenced by the increase in sleepiness.