Blood lead concentration, renal function, and blood pressure in London civil servants

Blood lead concentration was measured in 398 male and 133 female London civil servants not subject to industrial exposure to heavy metals. The relation between blood lead and serum creatinine concentrations and blood pressure were examined. Blood lead concentration ranged from 0.20 to 1.70 mumol/l with a geometric mean concentrations of 0.58 mumol/l in men and 0.46 mumol/l in women (p less than 0.001). In women blood lead concentration increased with age (r = +0.27; p = 0.002). In the two sexes blood lead concentration was positively correlated with the number of cigarettes smoked a day (men r = +0.17 and women r = +0.22; p less than or equal to 0.01), with the reported number of alcoholic beverages consumed a day (men r = +0.34 and women r = 0.23; p less than 0.01), and with serum gamma-glutamyltranspeptidase (men r = +0.23 and women r = +0.14; for men p less than 0.01). Blood lead concentration was not correlated with body weight, body mass index, and employment grade. In men 14% of the variance of blood lead concentration was explained by the significant and independent contributions of smoking and alcohol intake and in women 16% by age, smoking, and alcohol consumption. In men serum creatinine concentration tended to rise by 0.6 mumol/l (95% confidence interval from -0.2 to +1.36 mumol/l) for each 25% increment in blood lead concentration. In men and women the correlations between blood lead concentration and systolic and diastolic blood did not approach statistical significance. In conclusion, in subjects not exposed to heavy metals at work gender, age, smoking, and alcohol intake are determinants of blood lead concentration. At a low level of exposure, lead accumulation may slightly impair renal function, whereas blood pressure does not seem to be importantly influenced. Alternatively, a slight impairment of renal function may give rise to an increase in blood lead concentration.     

Blood cadmium in London civil servants

Blood cadmium was measured in 466 randomly selected London civil servants not exposed to heavy metals at work. Blood cadmium ranged from 3.6 to 75.6 nmol/L (0.4 to 8.5 micrograms/L) with a geometric mean of 6.4 nmol/L (0.7 micrograms/L) in nonsmokers and 13.6 nmol/L (1.5 micrograms/L) in smokers (p less than 0.001). Blood cadmium was higher in women than in men (9.5 versus 7.8 nmol/L) and was inversely correlated with employment grade (p less than 0.001). The associations with age, body weight and alcohol intake were not significant. After adjusting for gender and the number of cigarettes smoked per day, 36% of the variance of blood cadmium was explained, while the contribution of employment grade was not significant. There was an unexpected negative relationship between serum creatinine and blood cadmium in men (r = -0.16; p less than 0.01). This was not true in women (r = +0.03), but the correlation remained present in men after adjustment for age, body mass index and smoking. In contrast, in the two sexes, the correlations between blood pressure and blood cadmium were weak and not statistically significant. In conclusion, in unexposed subjects, gender and smoking are important determinants of blood cadmium. In addition, a low level of environmental exposure to cadmium is not associated with a deterioration of renal function or an increase in blood pressure.     

Urinary cadmium and lead concentrations and their relation to blood pressure in a population with low exposure

The 24 hour urinary excretion of cadmium (U-Cd) and lead (U-Pb), and the excretion of beta-2- microglobulins and retinol binding protein concentration in spot urines, were determined in a random 4% sample of the population of a small Belgian town. Blood pressure and body weight were measured on two separate occasions. U-Cd averaged 2.4 nmol/24 h in 46 youths, increased with age, and was significantly higher in 57 adult men as compared with 59 women (9.3 v 7.2 nmol/24 h; p less than 0.01). U-Pb averaged 28 nmol/24 h in youths and similarly increased with age: adult men excreted more lead than women (64 v 40.0 nmol/24 h; p less than 0.001). Among men, manual workers excreted more cadmium (12.6 v 7.5 nmol/24 h; p less than 0.05) but a similar amount of lead (62 v 61 nmol/24 h) compared with office workers. After adjusting for sex and age, U-Cd and U-Pb were not related to body weight and cigarette consumption. In simple regression analysis, U-Cd was positively correlated with both systolic (r = +0.30; p less than 0.05) and diastolic (r = +0.38; p less than 0.01) blood pressure in women. After adjusting for other contributing variables, however, a weak but negative relation became apparent between systolic pressure and U-Cd in women (t = -2.21; p = 0.033) and between diastolic pressure and U-Cd in men (t = -2.04; p = 0.047). In women urinary beta-2-microglobulin was related to diastolic pressure (r-0.44; p<0.01) and after adjusting for age to both systolic (t=2.75; p=0.009) and diastolic (t=-3.07; p=0.004) pressure. In none of the sex-age groups did U-Pb and retinol binding protein contribute to the blood pressure variability.     

Urinary cadmium and lead concentrations and their relation to blood pressure in a population with low exposure.

The 24 hour urinary excretion of cadmium (U-Cd) and lead (U-Pb), and the excretion of beta-2- microglobulins and retinol binding protein concentration in spot urines, were determined in a random 4% sample of the population of a small Belgian town. Blood pressure and body weight were measured on two separate occasions. U-Cd averaged 2.4 nmol/24 h in 46 youths, increased with age, and was significantly higher in 57 adult men as compared with 59 women (9.3 v 7.2 nmol/24 h; p less than 0.01). U-Pb averaged 28 nmol/24 h in youths and similarly increased with age: adult men excreted more lead than women (64 v 40.0 nmol/24 h; p less than 0.001). Among men, manual workers excreted more cadmium (12.6 v 7.5 nmol/24 h; p less than 0.05) but a similar amount of lead (62 v 61 nmol/24 h) compared with office workers. After adjusting for sex and age, U-Cd and U-Pb were not related to body weight and cigarette consumption. In simple regression analysis, U-Cd was positively correlated with both systolic (r = +0.30; p less than 0.05) and diastolic (r = +0.38; p less than 0.01) blood pressure in women. After adjusting for other contributing variables, however, a weak but negative relation became apparent between systolic pressure and U-Cd in women (t = -2.21; p = 0.033) and between diastolic pressure and U-Cd in men (t = -2.04; p = 0.047). In women urinary beta-2-microglobulin was related to diastolic pressure (r-0.44; p<0.01) and after adjusting for age to both systolic (t=2.75; p=0.009) and diastolic (t=-3.07; p=0.004) pressure. In none of the sex-age groups did U-Pb and retinol binding protein contribute to the blood pressure variability.     

Appraisal for Selection,Placement, and Development

We investigated the influence of various lifestyle factors on blood lead levels in a representative sample from the general adult population (i.e., ≥ 18 y of age) of West Germany in 1987–1988. The overall mean blood lead level was 73 μg/l (standard deviation = 41.4 μg/l) in 834 men and 54 μg/l (standard deviation = 26.8 μg/l) in 1 065 women. In a multiple linear regression analysis, alcohol consumption accounted for the largest proportion of variability in blood lead levels, followed by both age and smoking. Other significant contributing factors were gender, hematocrit, calcium intake, and consumption of milk and milk products. Wine had a greater effect on blood lead levels than beer (i.e., per g of alcohol consumed). With respect to cigarette smoking (i.e., no. of cigarettes smoked/d), filterless cigarettes were associated with higher blood lead levels than filter-tipped cigarettes. In addition, smoking cigars, cigarillos, or a pipe resulted in higher blood lead levels than smoking only cigarettes. Alcohol consumption and smoking were independent contributors to blood lead levels in both men and women, but effects of alcohol consumption were stronger in women than in men. We concluded that consumption of alcohol and tobacco represent major avoidable sources of lead exposure.     

Relationships between body fatness, adipose tissue distribution and blood pressure in men and women

The relationships between body fatness, fat distribution and blood pressure (BP) were studied in 234 women and 238 men, aged 18-50 years. In both sexes, subcutaneous (s.c.) fat (assessed by the measurement of s.c. skinfolds) and percent body fat (measured by underwater weighing) were correlated significantly with diastolic (0.27 less than or equal to r less than or equal to 0.37, p less than 0.0005) and systolic (0.17 less than or equal to r less than or equal to 0.29, p less than 0.01) BP. In either sex, the proportion of s.c. trunk fat as reflected by the ratio of trunk/extremity skinfolds showed significant associations with diastolic (men: r = 0.35, women: r = 0.20, p less than 0.01) and systolic BP (men: r = 0.15, women: r = 0.17, p less than 0.05). Control for the effects of covariables potentially affecting BP (energy intake, energy expenditure, maximal oxygen consumption, cigarette smoking, alcohol intake and age) revealed significant effects of age and alcohol intake on BP in men. In women, only age appeared to be associated with BP variation. Partial correlations after control for age and alcohol intake indicated a significant association between the trunk/extremity skinfolds ratio and diastolic BP in men. Such a correlation was not found in women after control for the effect of age. Analysis of variance (2 x 2 factorial with fixed effects) confirmed that, in men, the distribution of s.c. body fat was, per se, associated with diastolic BP (F = 8.43, p less than 0.01), whereas the proportional of s.c. trunk fat was not related to systolic BP in both sexes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Decreasing blood lead in Swedish children, 1978-1988

The geometric mean of the blood lead concentrations in 1,781 samples obtained from children during 1978 to 1988 was 46.9 micrograms/l (0.23 mumol/l) (range: 14-250 micrograms/l [0.07-1.2 mumol/l]). There was a significant (p less than .001) decrease in blood lead concentrations of 7%/y in rural and urban areas. In 134 children who were sampled twice, the decrease over 2-y periods was 14%. The striking decrease in blood lead levels is most likely the result of a reduction of lead additives in motor fuel during this period.     

Diet, alcohol, body mass, and social factors in relation to blood pressure: the Caerphilly Heart Study.

Data for 387 men who had completed seven-day weighed dietary records as part of the Caerphilly Heart Study were examined for relations of alcohol, diet, body mass index (BMI), and other variables to blood pressure. These included age, smoking, exercise, and social class. For men not on antihypertensive treatment (n = 356) regression analysis showed that age (p less than 0.001), BMI (p less than 0.05), and alcohol intake (p less than 0.01) were significantly related to systolic blood pressure, and BMI (p less than 0.001) and alcohol intake (p less than 0.01) to diastolic blood pressure. In addition, protein intake (p less than 0.05) was significantly and inversely related to the risk of being hypertensive, but other dietary variables were not related to blood pressure. For men on antihypertensive treatment (n = 31) significant inverse correlations were observed between diastolic blood pressure and the intakes of potassium (p less than 0.01), fibre (p less than 0.001), polyunsaturated fat (p less than 0.01), and a number of other dietary variables. Reasons for these differences are discussed.     

Nonoccupational determinants of blood lead concentrations in a general population.

We investigated the influence of various nonoccupational factors on blood lead levels (PbB) in a sample from the general population of southern Germany. Some 1703 men and 1661 women, aged 28-67 years, were examined in the first follow-up examination of the MONICA Augsburg cohort study in 1987-1988. Their mean PbB was 90 micrograms/l (SD:35.9) for men and 65 micrograms/l (26.4) for women. Only 5% of the men and 1% of all women exceeded a PbB level of 150 micrograms/l indicating low-level lead exposure in this population. Blood lead was significantly associated with haematocrit values (P < 0.001) and the shape of this association was curvilinear. Per gram of alcohol consumed, intake of beer had a lower impact on PbB than wine, presumably due to differential lead content in these alcoholic beverages. The alcohol-PbB associations were stronger for women than for men. The impact of smoking was generally moderate but again more prominent in women. In particular, the covariate adjusted odds ratios for women of childbearing age (28-47 years) to have PbB levels above 100 micrograms/l were 2.5 (95% confidence interval (CI): 1.3-4.7) for smoking versus non-smoking females, 2.6 (95% CI: 1.1-6.0) for women drinking up to 40 g alcohol/day compared to abstainers, and 8.9 (95% CI: 3.2-25.1) for those drinking more than 40 g alcohol/day. Other factors like age, body mass, rural place of residence, and education or job position, had only minor influences on PbB. We conclude that haematocrit values should always be considered as potential confounders in low-level lead exposure research. High alcohol consumption and cigarette smoking are strongly related to elevated blood lead concentrations in the general population and may thereby convey additional health hazards such as impaired child development or blood pressure elevations. This deserves proper public health recognition [corrected].     

Effects of age, BMI, smoking and contraception on levels of Cu, Se and Zn in the blood of the population in the Czech Republic

Variations in the levels of Cu, Se and Zn in blood were analyzed in relation to gender, age, BMI, smoking and hormonal contraception. The blood samples were collected from 3,207 blood donors (2,362 men, 845 women) during years 1996-2003. Blood concentrations of these elements were in the same range as those found for populations of other European countries. Significant differences exist between men and women, in blood concentration, for Cu (840 microg Cu.l(-1) vs. 970 microg Cu.l(-1), p<0.01) and Zn (6,780 microg Zn.l(-1) vs. 6,235 microg Zn.l(-1), p<0.01) only. The level of Cu in relation to age is increasing in men, but decreasing in women. The level of Se in relation to age increases regardless of sex. Concentrations of Zn rise with age in women group, only. Positive correlation was found between BMI and level of Cu only for group of men. For Se levels and BMI differences exist only in men namely between groups <20 and >35 (82 microg Se.l(-1) vs. 92 microg Se.l(-1)). Slight positive correlations exist between Zn concentration and BMI in women only. The significant differences were found between smokers and non-smokers for Cu in men (850 microg Cu.l(-1) vs. 830 microg Cu.l(-1)) and Se (81 microg Se.l(-1) vs. 84 microg Se.l(-1)). The smoking has not significant influence on concentration of Zn in the blood. The hormonal contraception significantly increases the concentration of Cu in blood (920 microg Cu.l(-1) vs. 1,270 microg Cu.l(-1), p<0.01). The levels of Se and Zn in blood are not influenced using hormonal contraception.     

Increased meal frequency associated with decreased cholesterol concentrations; Rancho Bernardo, CA, 1984-1987.

The hypothesis that meal frequency is associated with plasma cholesterol was tested in a population-based sample of 2034 white men and women aged 50-89 y. Total, low-density-lipoprotein (LDL) and high-density-lipoprotein (HDL) cholesterol and triglycerides were measured after a 12-h fast in a Lipid Research Clinic laboratory and meal frequency was obtained by questionnaire. The age-adjusted total cholesterol concentrations for men and women reporting greater than or equal to 4 meals/d averaged 0.23 mmol/L lower than for those who reported 1-2 meals/d (P = 0.01). Similarly, LDL concentrations were lower in those reporting higher meal frequency (0.16 mmol/L, P = 0.06). These associations persisted after adjustment for smoking, alcohol, waist-to-hip ratio, systolic blood pressure, body mass index, and dietary nutrients. These results suggest that cholesterol reductions might be achieved by modest increases in meal frequency without an increase in caloric intake.     

Exposure of Prague's homeless population to lead and cadmium, compared to Prague's general population

Homelessness is a growing problem in the Czech Republic where homeless people represent a specific minority group beset by many problems linked to their divergent lifestyle. It was therefore expected that the homeless population would be at greater risk of exposure to environmental pollutants than the general population. The aim of our study was to compare blood lead (B-Pb) and blood cadmium (B-Cd) levels in the homeless population (HP) with those obtained from the Human Biomonitoring Project (CZ-HBM), which used blood donors considered representative of the general population (GP). We present data obtained between 2004 and 2006 for B-Pb and B-Cd in 257 Prague homeless adults and compare them to B-Pb and B-Cd levels in 104 Prague adult blood donors from the CZ-HBM project in 2005. The mean (geometric) B-Pb levels in men were 36.5 (HP) and 35.4microg/l (GP), which is not significantly different. However, statistically significant differences were observed between men and women in the GP (P<0.001), but not in HP; B-Pb levels in women (34.8microg/l) did not differ from those of HP men (36.5microg/l), but were significantly (P<0.001) higher than those of GP women (25.8microg/l). B-Pb levels were not influenced by smoking. B-Cd levels in the homeless nonsmokers (geometric means 1.06 and 1.18microg/l in men and women, respectively) were more than 2.5 times higher than in the nonsmoking GP (0.36 and 0.38microg/l for men and women, respectively). B-Cd levels were significantly (P<0.001) influenced by smoking in both groups, but, surprisingly, the values in GP smokers (men=0.96microg/l, women=0.93microg/l) were lower than those in HP nonsmokers (men=1.06microg/l, women=1.18microg/l). A positive correlation was found between cadmium and lead in both men (P<0.05) and women (P<0.01). Our results indicate that the homeless population under study might be exposed to lead and cadmium more extensively than the general population of Prague and that homeless women represent a particularly vulnerable population group.     

Selenium intake, age, gender, and smoking in relation to indices of selenium status of adults residing in a seleniferous area

Duplicate meals, serum, whole blood, and toenails were collected every 3 mo for 1 y from a group of 44 free-living adults residing in high-selenium areas of South Dakota and Wyoming to assess the relation of selenium intake to indices of selenium status. The average selenium values for the group were as follows: dietary intake, 174 +/- 91 micrograms/d (mean +/- SD), 2.33 +/- 1.08 micrograms/kg body wt; serum, 2.10 +/- 0.38 mumol/L; whole blood, 3.22 +/- 0.79 mumol/L; and toenails, 15.2 +/- 3.0 nmol/g. Selenium intake (micrograms/kg body wt) was strongly correlated (all values, P less than 0.01) with selenium concentration of serum (r = 0.63), whole blood (r = 0.62), and toenails (r = 0.59). Men and women had similar mean values of serum, whole blood, and toenail selenium despite higher selenium intakes in men. Smokers had lower tissue selenium concentrations than did nonsmokers due, at least in part, to lower selenium intake. Age was not associated with tissue selenium content. Of the variables examined selenium intake was clearly the strongest predictor of tissue selenium concentration.     

Exposure of the Inuit population of Nunavik (Arctic Quebec) to lead and mercury

The authors conducted a survey during 1992 to evaluate blood levels of lead and mercury in Inuit adults of Nunavik (Arctic Quebec, Canada). Blood samples obtained from 492 participants (209 males and 283 females; mean age = 35 yr) were analyzed for lead and total mercury; mean (geometric) concentrations were 0.42 micromol/l (range = 0.04-2.28 micromol/l) and 79.6 nmol/l (range = 4-560 nmol/l), respectively. Concentrations of omega-3 fatty acid in plasma phospholipids--a biomarker of marine food consumption--were correlated with mercury (r = .56, p < .001) and, to a lesser extent, with blood lead levels (r = .31, p < .001). Analyses of variance further revealed that smoking, age, and consumption of waterfowl were associated with lead concentrations (r2 = .30, p < .001), whereas age and consumption of seal and beluga whale were related to total mercury levels (r2 = .30, p < .001). A significant proportion of reproductive-age women had lead and mercury concentrations that exceeded those that have been reportedly associated with subtle neurodevelopmental deficits in other populations.     

Correlations of vitamin A and E intakes with the plasma concentrations of carotenoids and tocopherols among American men and women.

The authors investigated the association of diet and other factors with the plasma concentrations of carotenoids, retinol and tocopherols in a sample of 121 men and 186 women participating in two prospective investigations of dietary etiologies of chronic diseases. Lycopene (mean concentration, 0.82 mumol/L in men, 0.76 mumol/L in women), beta-carotene (mean 0.46 mumol/L in men, 0.58 mumol/L in women) and lutein (mean 0.28 mumol/L in men, 0.27 mumol/L in women) were the major circulating carotenoids. Among nonsmokers, dietary carotenoid, as typically calculated in epidemiologic studies, was significantly correlated with plasma beta-carotene (r = 0.34 in men, r = 0.30 in women), alpha-carotene (r = 0.52 in men, r = 0.37 in women) and lutein (r = 0.36 in men, r = 0.19 in women), but not with plasma zeaxanthin (r = 0.11 and r = 0.02) or lycopene (r = 0.13 and r = 0.01) after adjusting for plasma cholesterol and triglycerides, body mass index and energy intake. Total vitamin E intake was positively associated with plasma concentrations of alpha-tocopherol (r = 0.51 in men, r = 0.41 in women) and inversely associated with plasma concentrations of gamma-tocopherol (r = -0.51 in men r = -0.42 in women), but this was primarily due to use of vitamin E supplements. Measurements of specific carotenoids can provide independent information beyond the usual calculation of carotene intake in epidemiologic studies.     

Biochemical and anthropometric evaluation of the nutritional status of 35-year-old Dutch men with reference to smoking and drinking habits

In 1986, sixty 35-year-old Dutch men (response 87%) provided information on medications, alcohol consumption and smoking habits. Length, body weight and blood pressure were determined. A blood sample was taken to determine serum cholesterol, HDL cholesterol and biochemical parameters of the vitamin, iron and trace element status (hematology, ferritin, vitamins A, B6, B12, folate, Zn, Se). Prevalence of overweight (body mass index greater than 27 kg/m2) was 15%, whereas 12% had high-risk cholesterol levels (greater than 6.4 mmol/l). Except for possibly selenium, no marginal values for the vitamin, iron and trace element status were found. Smokers had a higher hematocrit reading and mean corpuscular volume and lower mean corpuscular hemoglobin concentration (p less than 0.05). The nutritional status was not negatively influenced by (predominantly moderate) alcohol consumption (mean = 21 g/day). Positive associations with alcohol consumption were found for plasma folic acid (p less than 0.01) and plasma pyridoxal-5'-phosphate (p less than 0.001). This study shows that the most important nutritional risks in 35-year-old Dutch men are related to cardiovascular disease.     

Association between Blood Lead and Walking Speed in the National Health and Nutrition Examination Survey (NHANES 1999–2002)

Background: Walking speed is a simple and reliable measure of motor function that is negatively associated with adverse health events in older people, including falls, disability, hospital admissions, and mortality. Lead has adverse affects on human health, particularly on the vascular and neurological systems.Objective: We explored the hypothesis that lead is associated with slower walking speed.Methods: We used U.S. National Health and Nutrition Examination Survey (NHANES) cross-sectional data from 1999–2002. The time to walk 20 ft (walking speed) was measured among 1,795 men and 1,798 women ≥ 50 years of age. The association between walking speed and quintiles of blood lead concentration was estimated separately in men and women using linear regression models adjusted for age, education, ethnicity, alcohol use, smoking status, height, and waist circumference.Results: Mean blood lead concentrations and walking speeds were 2.17 μg/dL and 3.31 ft/sec in women, and 3.18 μg/dL and 3.47 ft/sec in men, respectively. Among women, walking speed decreased with increasing quintiles of blood lead, resulting in an estimated mean value that was 0.11 ft/sec slower (95% CI: –0.19, –0.04; p-trend = 0.005) for women with blood lead concentrations in the highest versus lowest quintile. In contrast, lead was not associated with walking speed in men.Conclusion: Blood lead concentration was associated with decreased walking speed in women, but not in men. Our results contribute to the growing evidence that lead exposure, even at low levels, is detrimental to public health.     

Epidemiology of vitamins A, E, D and C in rural villages in Finland: biochemical, nutritional and socioeconomical aspects.

We carried out an extensive health profile analysis in spring-winter 1986 in four Eastern Finnish rural villages as a part of the Healthy Village Study. Altogether, 793 people at working age (20-64 years of age, 427 men and 366 women) participated (80%). Serum lipids (total cholesterol, HDL-cholesterol and triglycerides) and plasma vitamins (vitamin A, D, E and C) were measured as biochemical indicators of health. The dietary habits were reflected in high serum total cholesterol, and in low plasma vitamin C (ascorbic acid, mean 34.4 mumol/l in men, and 51.2 mumol/l in women). The plasma levels of the other vitamins studied were, in general, satisfactory. The mean plasma concentration of vitamin A (retinol) was 2.70 mumol/l in men, and 2.23 mumol/l in women. The gender, high body weight and the use of animal fats had the strongest association to apparent plasma retinol concentrations. The corresponding plasma concentrations of vitamin D (25-hydroxy-D) were 34.1 nmol/l and 35.4 nmol/l, and vitamin E (d-alpha-tocopherol) 22.1 mumol/l and 22.2 mumol/l. Vitamin D deficiency (plasma 25-OHD less than 12.5 nmol/l) was seen in 5% of the subjects. A good vitamin D status was correlated with the use of vitamin supplements, and, surprisingly, with the frequent consumption of alcohol.     

Energy intake and other determinants of relative weight

The relationships of relative weight to energy intake and to physical activity were studied among 141 females aged 34-59 y. As observed in previous studies Quetelet index (wt/ht2) was inversely related to energy intake (r = -0.11). However, obese women tended to be older (r = 0.16), exercise less (r = -0.30), and drink less alcohol (r = -0.16) than nonobese women. Older women had lower energy intake (r = -0.23) and exercised less (r = -0.12) than younger women. Energy intake and physical activity were positively related (r = 0.23). After adjustment for age, physical activity, alcohol, and smoking, the inverse correlation between relative weight and energy intake was significantly reduced (p = 0.04) from r = -0.11 to r = -0.02. Obese women reported higher intakes of total fat, and relative weight was significantly correlated with intakes of total fat (r = 0.20) and saturated fatty acids (r = 0.16). These data highlight the importance of considering factors that may confound the relationship between energy intake and obesity, and they suggest that fat intake may play a role in obesity that is independent of total energy intake.     

Effects of tap water lead, water hardness, alcohol, and cigarettes on blood lead concentrations.

A survey of middle-aged men in 24 British towns has found pronounced geographical variation in blood lead concentrations. Towns with the highest mean blood lead concentrations have soft water supplies and have the highest water lead concentrations. Individual blood lead can be considerably increased by raised household tap water lead concentrations. Mean blood lead is estimated to be 43% higher for men when the concentration of lead in first-draw domestic tap water is 100 micrograms/l compared with a zero concentration. Individual blood lead is also affected by alcohol consumption and cigarette smoking, such that on average these two life-style habits together contribute an estimated 17% to the blood concentration of lead in middle-aged men. Lead in water should be given greater priority in any national campaign to reduce lead exposure.