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Electrocardiographic conduction disturbances in association with low-level lead exposure (the Normative Aging Study) - 09/09/11

Doi : 10.1016/S0002-9149(98)00402-0 
Yawen Cheng a,  : ScD, Joel Schwartz, PhD b, Pantel S Vokonas, MD c, Scott T Weiss, MD b, d, Antonio Aro, PhD b, d, Howard Hu, MD b, d : ScD
a Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA 
b Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA 
c Normative Aging Study, Department of Veterans Affairs Outpatient Clinic, and Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA 
d Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA 

*Address for reprints: Yawen Cheng, ScD, Channing Laboratory, 181 Longwood Ave, Boston, Massachusetts 02115

Abstract

Recent research indicates that cumulative exposure to lead may be more toxic than previously thought. This study was undertaken to examine the relation of low-level lead exposure to electrocardiographic (ECG) conduction disturbances among 775 men who participated in the Normative Aging Study (average age 68 years; range 48 to 93). We used K-x-ray fluorescence to measure lead levels in the tibia and patella, and graphite furnace atomic absorption spectroscopy to measure blood lead levels. The mean (SD) values for blood lead, tibia lead, and patella lead were 5.8 (3.4) μg/dl, 22.2 (13.4) μg/g, and 30.8 (19.2) μg/g, respectively. Bone lead levels were found to be positively associated with heart rate– corrected QT and QRS intervals, especially in younger men. Specifically, in men <65 years of age, a 10 μg/g increase in tibia lead was associated with an increase in the QT interval of 5.03 ms (95% confidence interval [CI], 0.83 to 9.22) and with an increase in the QRS interval of 4.83 ms (95% CI, 1.83 to 7.83) in multivariate regression models. In addition, an elevated bone lead level was found to be positively associated with an increased risk of intraventricular block in men <65 years of age and with an increased risk of atrioventricular (AV) block in men ≥65 years of age. After adjustment for age and for serum high-density lipoprotein (HDL) level, a 10 μg/g increase in tibia lead was associated with an odds ratio (OR) of 2.23 (95% CI, 1.28 to 3.90) for intraventricular block in men <65 years of age and with an OR of 1.22 (95% CI, 1.02 to 1.47) for AV block in men ≥65 years of age. Blood lead level was not associated with any of the ECG outcomes examined. The results suggest that cumulative exposure to lead, even at low levels, may depress cardiac conduction.

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Plan


 This study was supported by grants ES 05257-06A1 and P42-ES05947 Project 4 from the National Institute of Environmental Health Sciences (NIEHS), Research Triangle Park, North Carolina, by NIEHS Occupational and Environmental Health Center grant 2 P30 ES 00002, and by the Health Services Research and Development Service of the Department of Veterans Affairs, Boston, Massachusetts. Subjects were evaluated in the outpatient Clinical Research Center of the Brigham and Women’s Hospital with support from grant NCRR GCRC M01RR02635 from the National Institutes of Health (NIH), Bethesda, Maryland. The KXRF instrument used in this work was developed by ABIOMED of Danvers, Massachusetts, with support from NIH grant SBIR 2R44 ES03918-02.


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Vol 82 - N° 5

P. 594-599 - septembre 1998 Retour au numéro
Article précédent Article précédent
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