Reevaluation of urinary excretion of coproporphyrins in lead-exposed workers.

Urinary concentrations of coproporphyrin I and III (CP I and III) were determined by high-performance liquid chromatography in 131 male workers exposed to lead, and the relationships between lead exposure and urinary coproporphyrins were reevaluated. CP I had a statistically significant correlation with lead in the blood (Pb-B), but it was not useful as an indicator of the effect of lead on heme metabolism. On the other hand, CP III had a good correlation with Pb-B and markedly increased when Pb-B levels exceeded 40 to 50 micrograms/100 ml. Both sensitivity and specificity were more than 80% when the health-based Pb-B limit and the screening level of CP III were fixed at 50 micrograms/100 ml and 50 micrograms/g creatinine, respectively. In conclusion, measurement of CP III is sufficiently sensitive and specific enough in practice for the early detection of health effects due to lead exposure in the same way as the measurement of delta-aminolevulinic acid in urine.