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Pam Factor-Litvak,^1,2 Vesna Slavkovich,¹ Xinhua Liu,³ Dusan Popovac,⁵ Emine Preteni,⁶ Sabat Capuni-Paracka,⁷ Suzana Hadzialjevic,⁷ Vojkan Lekic,⁶ Nancy LoIacono,¹ Jennie Kline,² and Joseph Graziano^1,4

Divisions of ¹Environmental Health Sciences, ²Epidemiology, and ³Biostatistics, Columbia School of Public Health, and ⁴Department of Pharmacology, Columbia University, College of Physicians & Surgeons, New York, NY 10032 USA
⁵University of Pristina, Pristina, Yugoslavia
⁶Medicinski Centar, Kosovska Mitrovica, Yugoslavia
⁷Dom Zdravlja, Pristina, Yugoslavia

Abstract

Lead (Pb) poisoning has numerous effects on the erythropoietic system, but the precise mechanism whereby high dose exposure causes anemia is not entirely clear. We previously reported that Pb exposure is associated with depressed serum erythropoietin (EPO) in pregnant women residing in a Pb mining town and in a nonexposed town in Kosovo, Yugoslavia. In a prospective study, we tested the hypothesis that blood Pb concentration (BPb) may be associated with depressed EPO in children. BPb, hemoglobin (Hgb) , and serum EPO were measured at ages 4.5, 6.5, and 9.5 years in 211, 178, and 234 children, respectively. At 4.5 years of age, mean BPbs were 38.9 and 9.0 µg/dl in the exposed and nonexposed towns, respectively ; BPbs gradually declined to 28.2 and 6.5 µg/dl, respectively, by age 9.5 years. No differences were found in Hgb at any age. At age 4.5 years, a positive association between BPb and EPO (ß = 0.21 ; p = 0.0001) , controlled for Hgb, was found. The magnitude of this association declined to 0.11 at age 6.5 years (p = 0.0103) and 0.03 at age 9.5 years (p = 0.39) . These results were confirmed using repeated measures analyses. We concluded that in Pb-exposed children, the maintenance of normal Hgb requires hyperproduction of EPO. With advancing age (and continuing exposure) , this compensatory mechanism appears to be failing, suggesting a gradual loss of renal endocrine function due to Pb exposure. Key words: erythropoietin, hematopoiesis, lead, red cell survival. Environ Health Perspect 106:361-364 (1998) . [Online 15 May 1998]

http://ehpnet1.niehs.nih.gov/docs/1998/106p361-364factor-litvak/ abstract.html

Address correspondence to J.H. Graziano, Columbia University, School of Public Health, Division of Environmental Health Sciences, 630 West 168th Street, New York, NY 10032 USA.

This study was supported by grant ES 03460 from the National Institute of Environmental Health Sciences.

Received 26 January 1998 ; accepted 24 March 1998.