Time trend and determinants of blood lead levels in a Swiss population over a transition period (1984-1993) from leaded to unleaded gasoline use.

This study analyzes the trend and determinants of blood lead levels in a Swiss region (population 770,000) over the 10-year period following the introduction of unleaded gasoline in 1985. The consumption of unleaded fuel increased rapidly, accounting in 1988 for 36% and in 1992 for 65% of all gasoline sales. Blood lead levels were measured in three representative samples (n = 1700) of the adult population within the framework of a health examination survey carried out in 1984/1985, 1988/1989, and 1992/1993. The geometric mean blood lead levels were, respectively, 0.59, 0.42, and 0.33 mumole/liter in men, 0.41, 0.29, and 0.25 mumole/liter in women. Similar trends have been observed across all age groups, occupational classes, and categories based on smoking, drinking, and dietary habits. The overexposure of city residents, in comparison to village residents, fades out over the observation period. These findings suggest that the changeover from leaded to unleaded gasoline has been the major cause of the blood lead decline. Wine drinking, cigarette smoking, and age appear to be significant determinants of blood lead for both sexes in all three surveys. In contrast, the association is inverse for milk consumption. The multivariate regression analysis shows that wine drinking remains the most important predictor of blood lead, whereas the influence of age increases with time and overcomes the effect of smoking in the third survey.