Occupational Lead Exposure and Longitudinal Decline in Neurobehavioral Test Scores :

To determine whether adults with past exposure to neurotoxicants have progressive declines in cognitive function years after exposure has ceased, and whether tibia lead is a predictor of the magnitude of change. A total of 535 former organolead manufacturing workers with a mean age of 55.6 years, a mean duration of 16 years since last occupational lead exposure, and low blood lead levels at the first study visit and 118 controls were evaluated with neurobehavioral tests two to four times over 4 years. "Peak" tibia lead levels, estimated from current levels measured by X-ray fluorescence, were used to predict changes in cognitive function over time. In former lead workers, peak tibia lead ranged from -2.2 to 98.7 microg Pb/g bone mineral. Compared to controls, former lead workers performed worse over time for three tests of visuo-constructive ability and verbal memory and learning (p < 0.05). In former lead workers, peak tibia lead predicted declines for six tests of verbal memory and learning, visual memory, executive ability, and manual dexterity (p < 0.05 for four tests and < 0.10 for two additional tests). On average, for these six tests, an increase of 15.7 microg/g of peak tibia lead was equivalent in its effects on annual test decline to 5 more years of age at baseline. These are the first data to suggest that cognitive function can progressively decline due to past occupational exposures to a neurotoxicant. Show more

A prospective follow-up study on new lead workers who began work at a storage battery factory was carried out between 1975 and 1981. Psychological performances (eg, intelligence, memory, visuomotor functions, vigilance, and personality) were assessed before the commencement of exposure and after one, two, and four years of work. Of an initial number of 89 workers, 24 were available for the one-year, 16 for the two-year, and 11 for the four-year reexamination. The time-weighted average blood lead values ranged between 0.68 and 2.17 mumol/l (14 and 45 micrograms/100 ml, respectively). A reference group, nonexposed workers in a cable manufacturing plant and an electrical power plant, was similarly followed. Initially the average psychological performances were similar among the lead workers and the referents. For some of the psychological tests learning effect, which was clearly evident among the referents during the follow-up, was almost absent among the lead workers. The lead worker's visual intelligence and visuomotor functions in particular were impaired significantly after the first two years of follow-up. When the lead workers were divided into two groups according to the median time-weighted average of the blood lead values (1.30 mumol/l), the Block Design and the Santa Ana coordination tests were those which best separated the subgroups. Although the impairment of the lead workers' performance was rather slight and the dispersion in the psychological changes was wide, it was evident that some higher nervous functions were affected by lead levels above about 1.45 mumol/l. Show more