Influence of abatement of lead exposure in Croatia on blood lead and ALAD activity.

We evaluated the effect of lead (Pb) abatement measures in Croatia on blood lead (BPb) concentrations, and delta-aminolevulinic acid dehydratase (ALAD) activity in blood, as a sensitive indicator of early Pb effect. Data on BPb and ALAD activity were obtained from 829 Croatian men (19-64 years of age), with no known occupational exposure to metals. Data obtained in 2008-2009, after the ban of leaded gasoline in Croatia in 2006, were compared with similar data collected in 1981 and 1989, when the concentration of Pb in gasoline was 0.6 g/L. Our results showed a highly significant (p < 0.001) decrease in median BPb from 114.5 (range, 46.0-275.0) μg/L in 1981/1989 to 30.3 (range, 3.2-140.8) μg/L in 2008-2009 and an increase in median ALAD activity from 49.8 (range, 24.9-79.4) EU in 1981/1989 to 60.9 (range, 35.8-84.0) EU in 2008-2009. Individual factors influencing BPb values were, in the order of decreasing importance, Pb in ambient air (APb), alcohol consumption, age, and smoking. Increased ALAD activity was significantly associated with the decrease of APb, alcohol consumption, and smoking. These results show that lead abatement measures had a positive impact on both BPb concentrations (73.5% decrease) and the activity of ALAD (22.1% increase) in general population. Our results contribute to growing evidence that ALAD activity may be used as one of the earliest and sensitive diagnostic biomarkers of low-level Pb exposure.