Low level lead exposure: the clinical implications of current research. Needleman HL, ed. New York: Raven Press, 1980 Jan; :267-278
Criteria for lead (7439921) exposure standards in the workplace are discussed. The earliest demonstrated effect of lead involved inhibition of the heme biosynthetic pathway; indicators include the enzyme aminolevulinic-acid-dehydrase, aminolevulinic-acid in urine, and erythrocyte protoporphyrin activity. There is evidence that peripheral motor disease may be related to a history of increased lead exposure. Kidneys are an important target organ for lead effects. Irreparable damage occurs by the time renal damage is detectable by available clinical tests. Workers with moderately increased lead absorption show spermatic aberrations; lead has an adverse effect on learning ability in offspring, with both maternal and paternal lead exposure. Behavioral problems related to lead exposure include hyperactivity, difficulty in task performance, deficiency in intelligence quotient, and nerve conduction deficits. Studies of lead in maternal and fetal blood suggest that lead may increase the incidence of early membrane rupture and premature deliveries. Lead brought into the home as dust on shoes, clothing, and the body can contaminate the home environment, resulting in elevated blood lead concentrations in children. Studies conducted to assess community lead exposure by both clinical and epidemiologic methods may be applicable in predicting an occupational exposure situation over comparable air lead ranges. The author suggests that the critical issue most in need of further study involves the adverse effects of maternal and paternal lead exposure upon the reproductive process. Careful studies for both male and female lead workers involving pregnancy histories which include spontaneous abortions, birth outcomes, and growth and development of children are needed.