The epidemiology of lead toxicity in adults: measuring dose and consideration of other methodologic issues.

The epidemiology of lead toxicity in adults: measuring dose and consideration of other methodologic issues.
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成人铅毒性的流行病学:测量剂量和考虑其他方法论问题。

DOI:
10.1289/ehp.9783
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发表时间:
2007-03
影响因子:
10.4
通讯作者:
Schwartz, Brian S.
Schwartz, Brian S.
中科院分区:
环境科学与生态学1区
文献类型:
--
作者:
Hu, Howard;Shih, Regina;Rothenberg, Stephen;Schwartz, Brian S.

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我们审查了几个问题的广泛相关的流行病学证据的解释有关的铅在成人中的毒性,特别是关于认知功能和心血管系统,这是两个系统性评价的主题,也是这个迷你专著的一部分。在方法学进展的最新发展中,最主要的是测量个体铅剂量的概念和方法的改进,即在慢性病的流行病学研究中,在近期剂量与累积剂量之间的区别以及使用生物标志物来测量这些参数方面。注意力特别集中在骨铅水平测量的K-壳层X射线荧光作为一个相对较新的生物标志物的累积剂量,已被用于在许多最近的流行病学研究中产生的见解铅的认知和高血压的风险的影响,以及估计累积剂量的替代方法使用可用的重复测量血铅计算个人的累积血铅指数。我们审查的相关性和解释这些铅的毒性动力学的背景下,铅的生物标志物。此外,我们还讨论了在职业和环境暴露的主题和那些有关种族/民族和社会经济地位和其他重要的协变量的研究中出现的方法学挑战。
We review several issues of broad relevance to the interpretation of epidemiologic evidence concerning the toxicity of lead in adults, particularly regarding cognitive function and the cardiovascular system, which are the subjects of two systematic reviews that are also part of this mini-monograph. Chief among the recent developments in methodologic advances has been the refinement of concepts and methods for measuring individual lead dose in terms of appreciating distinctions between recent versus cumulative doses and the use of biological markers to measure these parameters in epidemiologic studies of chronic disease. Attention is focused particularly on bone lead levels measured by K-shell X-ray fluorescence as a relatively new biological marker of cumulative dose that has been used in many recent epidemiologic studies to generate insights into lead’s impact on cognition and risk of hypertension, as well as the alternative method of estimating cumulative dose using available repeated measures of blood lead to calculate an individual’s cumulative blood lead index. We review the relevance and interpretation of these lead biomarkers in the context of the toxico-kinetics of lead. In addition, we also discuss methodologic challenges that arise in studies of occupationally and environmentally exposed subjects and those concerning race/ethnicity and socioeconomic status and other important covariates.
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