Measuring Lead Exposure in Infants, Children, and Other Sensitive Populations (1993) / Chapter Skim
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6 SUMMARY AND RECOMMENDATIONS
6 SUMMARY AND RECOMMENDATIONS
Pages 253-262
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From page 253... ...
. This chapter presents recommendations on such matters as sources and pathways of lead exposure, the environmental epidemiology of lead in sensitive populations, methods of assessing exposure to lead with reference to markers of both exposure and effect, and adverse health effects of lead.
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From page 254... ...
as sensitive populations at risk for the subtle adverse health effects of chronic low-dose lead exposure. In addition, adults occupationally exposed to lead and others having potentially large exposures face the risk of various forms of lead toxicity, including risk of lead-induced increases in blood pressure.
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From page 255... ...
, such as teacher rating scales, reaction-time tests with an attention-span component, brain stem auditory evoked potentials, hearing thresholds, and other electroencephalographic measures. Some have found balance to be a sensitive early indicator of lead toxicity.
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From page 256... ...
Molecular biologic markers for assessing individual differences in responsiveness to lead exposure are of increasing interest, because of the welI-known individual variations in susceptibility at a given blood lead concentration. Radioimmunoassays for marker proteins, such as He renal and brain lead-binding proteins that have been found in the blood and urine of rodents, are of great potential value in elucidating He underlying causative factors of susceptibility to lead toxicity at the molecular level.
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From page 257... ...
Biologic markers of exposure-such as blood lead, urinary lead, and bone lead- have always involved measurement of total lead in epidemiologically and clinically relevant biologic media. The existence of specific biochemical forms of lead in accessible physiologic media, their role in lead toxicokinetics and toxicity, and their comparative diagnostic value in in situ biochemical behavior are important and perhaps require more attention in the fixture.
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From page 258... ...
Clearly, the new methods have the potential to revolutionize public-health strategies in dealing with lead. The committee concludes that, at the current blood lead concentrations of concern, accurate and precise blood lead values can be obtained with current techniques, given strict attention to contamination control and other principles of quality assurance and quality control (QA/QC)
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From page 259... ...
· The committee recommends that federal agencies consider He need for further L-line and K-line XRF instrument development to decrease
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From page 260... ...
Federal agencies, which are mandated to clear new medical devices for clinical use, should be cognizant of the sequence of XRF instrument assessments that are necessary to ensure radiologic safety and clinical utility of these instruments in sensitive populations. Recent advances in mass spectrometry have demonstrated the applicability of stable lead isotopes for investigating sources of environmental lead.
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From page 261... ...
· To understand further lead's mechanistic effects at the cellular level, the committee recommends that studies be conducted to explore He feasibility of applying ultraclean lead-free techniques to in vitro studies.
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