The relationship of biological indices of lead exposure to the health status of workers in a secondary lead smelter.

The fidelity with which common indices of lead exposure correlate with renal and hematopoietic function and with frequency of symptoms was studied. The subjects were men working in a secondary lead smelter. Among several indices of renal function, only serum urea nitrogen (SUN) was consistently correlated with any of the indices of lead exposure. The concentration of lead in blood(PbB), the rate of urinary excretion of lead (PbU) and of alpha aminolevulinic acid in the urine (ALAU) correlated with SUN. By contrast, erythrocytic porphyrin concentration (EP) did not correlate with SUN. Similarly, the frequency of occurrence of symptoms correlated well with PbB and ALAU but did not correlate with EP. All of the above indices of lead exposure, with the exception of PbU, correlated well with hemoglobin (Hb) status. In summary, these results suggest that PbB rather than EP is the best single exposure index for biological monitoring of lead workers. This measurement should be supplemented by peiodic determination of SUN and Hb.