The Relation Between Low-Level Lead Exposure and Oxidative Stress: a Review of the Epidemiological Evidence in Children and Non-Occupationally Exposed Adults.

Experimental studies in animals and observational studies in occupationally exposed adults indicate that higher lead exposure results in higher biomarkers of oxidative stress. However, this evidence cannot be extended to the general population who typically experience lower levels of lead exposure. This systematic review evaluates the epidemiological evidence on the association between lead and oxidative stress in non-occupationally exposed general population, with a particular focus on the pediatric population. Studies were identified through a systematic search of Medline and Web of Science. Ultimately, evidence from 15 studies conducted in children and 22 studies in adults from the general population was reviewed. Overall, the published findings are inconsistent, and there are very few well-designed studies on the relation between lead exposure and oxidative stress in the general population. The strength of the current evidence is discussed in light of the methodological approaches employed, and recommendations are made for future research directions. These include designing prospective studies with repeat measurements of clinically relevant oxidative stress markers to answer the question of causality and sensitive windows and reanalyzing previously published data, but using multivariable statistical approaches and adjustment for relevant explanatory factors.