A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs.
A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs.
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DOI：
10.1289/ehp.7917
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发表时间：
2005-12
影响因子：
10.4
通讯作者：
Parsons PJ
中科院分区：
文献类型：
--
作者：
Barbosa F Jr;Tanus-Santos JE;Gerlach RF;Parsons PJ
全血中的铅浓度（BPb）是用于监测这种金属元素暴露的主要生物标志物。美国疾病控制和预防中心和世界卫生组织将10 μg/dL（0.48 μmol/L）的BPb定义为幼儿的关注阈值。然而，最近的研究报告说，当BPb水平低于10微克/分升时，可能会对健康产生不利影响，包括幼儿的智力障碍，这表明没有安全的接触水平。似乎不可能区分低水平的慢性铅暴露和高水平的短期铅暴露的基础上，一个单一的BPb测量，因此，连续BPb测量提供了一个更好的估计可能的健康结果。评估铅暴露的确切性质的困难与其说是取决于当前分析方法的问题，不如说是取决于铅在各种身体隔室中的复杂毒理学（即，铅在骨、血液和软组织之间的循环）。如果我们要更有效地区分储存在体内多年的铅和最近暴露的铅，可能需要其他暴露生物标志物的信息。目前没有一个生物标志物的内部铅剂量尚未被接受的科学界作为一个可靠的替代BPb测量。本文综述了铅暴露生物标志物的局限性以及提高其测量准确性的必要性。我们在这里只介绍了目前使用的传统分析协议，我们试图评估混杂变量对BPb水平的影响。最后，我们讨论了解释的BPb数据与外部和内源性铅暴露，过去或最近的曝光，以及铅测定的意义，在人体标本，包括头发，指甲，唾液，骨骼，血液（血浆，全血），尿液，粪便，和脱落的牙齿。
Lead concentration in whole blood (BPb) is the primary biomarker used to monitor exposure to this metallic element. The U.S. Centers for Disease Control and Prevention and the World Health Organization define a BPb of 10 μg/dL (0.48 μmol/L) as the threshold of concern in young children. However, recent studies have reported the possibility of adverse health effects, including intellectual impairment in young children, at BPb levels < 10 μg/dL, suggesting that there is no safe level of exposure. It appears impossible to differentiate between low-level chronic Pb exposure and a high-level short Pb exposure based on a single BPb measurement; therefore, serial BPb measurements offer a better estimation of possible health outcomes. The difficulty in assessing the exact nature of Pb exposure is dependent not so much on problems with current analytical methodologies, but rather on the complex toxicokinetics of Pb within various body compartments (i.e., cycling of Pb between bone, blood, and soft tissues). If we are to differentiate more effectively between Pb stored in the body for years and Pb from recent exposure, information on other biomarkers of exposure may be needed. None of the current biomarkers of internal Pb dose have yet been accepted by the scientific community as a reliable substitute for a BPb measurement. This review focuses on the limitations of biomarkers of Pb exposure and the need to improve the accuracy of their measurement. We present here only the traditional analytical protocols in current use, and we attempt to assess the influence of confounding variables on BPb levels. Finally, we discuss the interpretation of BPb data with respect to both external and endogenous Pb exposure, past or recent exposure, as well as the significance of Pb determinations in human specimens including hair, nails, saliva, bone, blood (plasma, whole blood), urine, feces, and exfoliated teeth.