Skip to main content
PMC home page
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 1993 Apr;100:177–187. doi: 10.1289/ehp.93100177

Lead toxicity: current concerns.

R A Goyer 1
PMCID: PMC1519587  PMID: 8354166

Abstract

Over the 20-year period since the first issue of Environmental Health Perspectives was published, there has been considerable progress in the understanding of the potential toxicity of exposure to lead. Many of these advances have been reviewed in published symposia, conferences, and review papers in EHP. This brief review identifies major advances as well as a number of current concerns that present opportunities for prevention and intervention strategies. The major scientific advance has been the demonstration that blood lead (PbB) levels of 10-15 micrograms/dL in newborn and very young infants result in cognitive and behavioral deficits. Further support for this observation is being obtained by prospective or longitudinal studies presently in progress. The mechanism(s) for the central nervous system effects of lead is unclear but involve lead interactions within calcium-mediated intracellular messenger systems and neurotransmission. Effects of low-level lead exposure on blood pressure, particularly in adult men, may be related to the effect of lead on calcium-mediated control of vascular smooth muscle contraction and on the renin-angiotensin system. Reproductive effects of lead have long been suspected, but low-level effects have not been well studied. Whether lead is a carcinogen or its association with renal adenocarcinoma is a consequence of cystic nephropathy is uncertain. Major risk factors for lead toxicity in children in the United States include nutrition, particularly deficiencies of essential metals, calcium, iron, and zinc, and housing and socioeconomic status. A goal for the year 2000 is to reduce prevalence of blood lead levels exceeding 15 micrograms/dL.

Full text

PDF
177

Images in this article

180FIGURE 2.
on p.180

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baker E. L., Jr, Goyer R. A., Fowler B. A., Khettry U., Bernard D. B., Adler S., White R. D., Babayan R., Feldman R. G. Occupational lead exposure, nephropathy, and renal cancer. Am J Ind Med. 1980;1(2):139–148. doi: 10.1002/ajim.4700010204. [DOI] [PubMed] [Google Scholar]
  2. Barry P. S. A comparison of concentrations of lead in human tissues. Br J Ind Med. 1975 May;32(2):119–139. doi: 10.1136/oem.32.2.119. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Barry P. S. Concentrations of lead in the tissues of children. Br J Ind Med. 1981 Feb;38(1):61–71. doi: 10.1136/oem.38.1.61. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bellinger D., Leviton A., Waternaux C., Needleman H., Rabinowitz M. Longitudinal analyses of prenatal and postnatal lead exposure and early cognitive development. N Engl J Med. 1987 Apr 23;316(17):1037–1043. doi: 10.1056/NEJM198704233161701. [DOI] [PubMed] [Google Scholar]
  5. Bellinger D., Sloman J., Leviton A., Rabinowitz M., Needleman H. L., Waternaux C. Low-level lead exposure and children's cognitive function in the preschool years. Pediatrics. 1991 Feb;87(2):219–227. [PubMed] [Google Scholar]
  6. Bernstein J., Evan A. P., Gardner K. D., Jr Epithelial hyperplasia in human polycystic kidney diseases. Its role in pathogenesis and risk of neoplasia. Am J Pathol. 1987 Oct;129(1):92–101. [PMC free article] [PubMed] [Google Scholar]
  7. Buchet J. P., Roels H., Bernard A., Lauwerys R. Assessment of renal function of workers exposed to inorganic lead, calcium or mercury vapor. J Occup Med. 1980 Nov;22(11):741–750. [PubMed] [Google Scholar]
  8. Cantor K. P., Sontag J. M., Heid M. F. Patterns of mortality among plumbers and pipefitters. Am J Ind Med. 1986;10(1):73–89. doi: 10.1002/ajim.4700100109. [DOI] [PubMed] [Google Scholar]
  9. Cerklewski F. L., Forbes R. M. Influence of dietary zinc on lead toxicity in the rat. J Nutr. 1976 May;106(5):689–696. doi: 10.1093/jn/106.5.689. [DOI] [PubMed] [Google Scholar]
  10. Chai S. S., Webb R. C. Effects of lead on vascular reactivity. Environ Health Perspect. 1988 Jun;78:85–89. doi: 10.1289/ehp.887885. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Choie D. D., Richter G. W. Cell proliferation in mouse kidney induced by lead. I. Synthesis of deoxyribonucleic acid. Lab Invest. 1974 May;30(5):647–651. [PubMed] [Google Scholar]
  12. Choie D. D., Richter G. W. Cell proliferation in rat kidney induced by lead acetate and effects of uninephrectomy on the proliferation. Am J Pathol. 1972 Feb;66(2):265–275. [PMC free article] [PubMed] [Google Scholar]
  13. Columbano A., Ledda-Columbano G. M., Lee G., Rajalakshmi S., Sarma D. S. Inability of mitogen-induced liver hyperplasia to support the induction of enzyme-altered islands induced by liver carcinogens. Cancer Res. 1987 Nov 1;47(21):5557–5559. [PubMed] [Google Scholar]
  14. Cooper W. C., Wong O., Kheifets L. Mortality among employees of lead battery plants and lead-producing plants, 1947-1980. Scand J Work Environ Health. 1985 Oct;11(5):331–345. doi: 10.5271/sjweh.2215. [DOI] [PubMed] [Google Scholar]
  15. Cramér K., Goyer R. A., Jagenburg R., Wilson M. H. Renal ultrastructure, renal function, and parameters of lead toxicity in workers with different periods of lead exposure. Br J Ind Med. 1974 Apr;31(2):113–127. doi: 10.1136/oem.31.2.113. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. De la Burdé B., Choate M. S., Jr Does asymptomatic lead exposure in children have latent sequelae? J Pediatr. 1972 Dec;81(6):1088–1091. doi: 10.1016/s0022-3476(72)80236-1. [DOI] [PubMed] [Google Scholar]
  17. Dees J. H., Heatfield B. M., Reuber M. D., Trump B. F. Adenocarcinoma of the kidney. III. Histogenesis of renal adenocarcinomas induced in rats by N-(4'-fluoro-4-biphenylyl)acetamide. J Natl Cancer Inst. 1980 Jun;64(6):1537–1545. doi: 10.1093/jnci/64.6.1537. [DOI] [PubMed] [Google Scholar]
  18. Dietrich K. N., Succop P. A., Berger O. G., Hammond P. B., Bornschein R. L. Lead exposure and the cognitive development of urban preschool children: the Cincinnati Lead Study cohort at age 4 years. Neurotoxicol Teratol. 1991 Mar-Apr;13(2):203–211. doi: 10.1016/0892-0362(91)90012-l. [DOI] [PubMed] [Google Scholar]
  19. Egle P. M., Shelton K. R. Chronic lead intoxication causes a brain-specific nuclear protein to accumulate in the nuclei of cells lining kidney tubules. J Biol Chem. 1986 Feb 15;261(5):2294–2298. [PubMed] [Google Scholar]
  20. Ernhart C. B., Morrow-Tlucak M., Wolf A. W., Super D., Drotar D. Low level lead exposure in the prenatal and early preschool periods: intelligence prior to school entry. Neurotoxicol Teratol. 1989 Mar-Apr;11(2):161–170. doi: 10.1016/0892-0362(89)90055-x. [DOI] [PubMed] [Google Scholar]
  21. Foster W. G. Reproductive toxicity of chronic lead exposure in the female cynomolgus monkey. Reprod Toxicol. 1992;6(2):123–131. doi: 10.1016/0890-6238(92)90113-8. [DOI] [PubMed] [Google Scholar]
  22. Goldstein G. W. Lead poisoning and brain cell function. Environ Health Perspect. 1990 Nov;89:91–94. doi: 10.1289/ehp.908991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Goyer R. A., Falk H. L., Hogan M., Feldman D. D., Richter W. Renal tumors in rats given trisodium nitrilotriacetic acid in drinking water for 2 years. J Natl Cancer Inst. 1981 May;66(5):869–880. [PubMed] [Google Scholar]
  24. Goyer R. A. Lead toxicity: a problem in environmental pathology. Am J Pathol. 1971 Jul;64(1):167–182. [PMC free article] [PubMed] [Google Scholar]
  25. Goyer R. A. Lead toxicity: from overt to subclinical to subtle health effects. Environ Health Perspect. 1990 Jun;86:177–181. doi: 10.1289/ehp.9086177. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Goyer R. A., Leonard D. L., Moore J. F., Rhyne B., Krigman M. R. Lead dosage and the role of the intranuclear inclusion body. An experimental study. Arch Environ Health. 1970 Jun;20(6):705–711. doi: 10.1080/00039896.1970.10665647. [DOI] [PubMed] [Google Scholar]
  27. Goyer R. A., Rhyne B. C. Pathological effects of lead. Int Rev Exp Pathol. 1973;12:1–77. [PubMed] [Google Scholar]
  28. Harlan W. R., Landis J. R., Schmouder R. L., Goldstein N. G., Harlan L. C. Blood lead and blood pressure. Relationship in the adolescent and adult US population. JAMA. 1985 Jan 25;253(4):530–534. doi: 10.1001/jama.253.4.530. [DOI] [PubMed] [Google Scholar]
  29. Hinton D. E., Lipsky M. M., Heatfield B. M., Trump B. F. Opposite effects of lead on chemical carcinogenesis in kidney and liver of rats. Bull Environ Contam Toxicol. 1979 Nov;23(4-5):464–469. doi: 10.1007/BF01769988. [DOI] [PubMed] [Google Scholar]
  30. Holtzman D., DeVries C., Nguyen H., Olson J., Bensch K. Maturation of resistance to lead encephalopathy: cellular and subcellular mechanisms. Neurotoxicology. 1984 Fall;5(3):97–124. [PubMed] [Google Scholar]
  31. Landrigan P. J., Silbergeld E. K., Froines J. R., Pfeffer R. M. Lead in the modern workplace. Am J Public Health. 1990 Aug;80(8):907–908. doi: 10.2105/ajph.80.8.907. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Lilis R. Long-term occupational lead exposure, chronic nephropathy, and renal cancer: a case report. Am J Ind Med. 1981;2(3):293–297. doi: 10.1002/ajim.4700020309. [DOI] [PubMed] [Google Scholar]
  33. Lippmann M. 1989 Alice Hamilton lecture. Lead and human health: background and recent findings. Environ Res. 1990 Feb;51(1):1–24. doi: 10.1016/s0013-9351(05)80179-3. [DOI] [PubMed] [Google Scholar]
  34. Mahaffey K. R. Environmental lead toxicity: nutrition as a component of intervention. Environ Health Perspect. 1990 Nov;89:75–78. doi: 10.1289/ehp.908975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Mao P., Molnar J. J. The fine structure and histochemistry of lean-induced renal tumors in rats. Am J Pathol. 1967 Apr;50(4):571–603. [PMC free article] [PubMed] [Google Scholar]
  36. Markovac J., Goldstein G. W. Lead activates protein kinase C in immature rat brain microvessels. Toxicol Appl Pharmacol. 1988 Oct;96(1):14–23. doi: 10.1016/0041-008x(88)90242-6. [DOI] [PubMed] [Google Scholar]
  37. McMichael A. J., Baghurst P. A., Wigg N. R., Vimpani G. V., Robertson E. F., Roberts R. J. Port Pirie Cohort Study: environmental exposure to lead and children's abilities at the age of four years. N Engl J Med. 1988 Aug 25;319(8):468–475. doi: 10.1056/NEJM198808253190803. [DOI] [PubMed] [Google Scholar]
  38. Medical aspects of childhood lead poisoning. Pediatrics. 1971 Sep;48(3):464–468. [PubMed] [Google Scholar]
  39. Moore J. F., Goyer R. A., Wilson M. Lead-induced inclusion bodies. Solubility, amino acid content, and relationship to residual acidic nuclear proteins. Lab Invest. 1973 Nov;29(5):488–494. [PubMed] [Google Scholar]
  40. Moore M. R., Meredith P. A. The carcinogenicity of lead. Arch Toxicol. 1979 Jun 8;42(2):87–94. doi: 10.1007/BF00316488. [DOI] [PubMed] [Google Scholar]
  41. Needleman H. L., Gatsonis C. A. Low-level lead exposure and the IQ of children. A meta-analysis of modern studies. JAMA. 1990 Feb 2;263(5):673–678. [PubMed] [Google Scholar]
  42. Needleman H. L. The future challenge of lead toxicity. Environ Health Perspect. 1990 Nov;89:85–89. doi: 10.1289/ehp.908985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  43. Needleman H. L. The persistent threat of lead: a singular opportunity. Am J Public Health. 1989 May;79(5):643–645. doi: 10.2105/ajph.79.5.643. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Oski F. A., Honig A. S., Helu B., Howanitz P. Effect of iron therapy on behavior performance in nonanemic, iron-deficient infants. Pediatrics. 1983 Jun;71(6):877–880. [PubMed] [Google Scholar]
  45. Oyasu R., Battifora H. A., Clasen R. A., McDonald J. H., Hass G. M. Induction of cerebral gliomas in rats with dietary lead subacetate and 2-acetylaminofluorene. Cancer Res. 1970 May;30(5):1248–1261. [PubMed] [Google Scholar]
  46. Pirkle J. L., Schwartz J., Landis J. R., Harlan W. R. The relationship between blood lead levels and blood pressure and its cardiovascular risk implications. Am J Epidemiol. 1985 Feb;121(2):246–258. doi: 10.1093/oxfordjournals.aje.a113995. [DOI] [PubMed] [Google Scholar]
  47. Pounds J. G., Long G. J., Rosen J. F. Cellular and molecular toxicity of lead in bone. Environ Health Perspect. 1991 Feb;91:17–32. doi: 10.1289/ehp.919117. [DOI] [PMC free article] [PubMed] [Google Scholar]
  48. Rabinowitz M. B. Toxicokinetics of bone lead. Environ Health Perspect. 1991 Feb;91:33–37. doi: 10.1289/ehp.919133. [DOI] [PMC free article] [PubMed] [Google Scholar]
  49. Roberts P. F. Bilateral renal carcinoma associated with polycystic kidneys. Br Med J. 1973 Aug 4;3(5874):273–274. doi: 10.1136/bmj.3.5874.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  50. Rosen J. F., Markowitz M. E., Bijur P. E., Jenks S. T., Wielopolski L., Kalef-Ezra J. A., Slatkin D. N. Sequential measurements of bone lead content by L X-ray fluorescence in CaNa2EDTA-treated lead-toxic children. Environ Health Perspect. 1991 Feb;91:57–62. doi: 10.1289/ehp.919157. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Rossouw J., Offermeier J., van Rooyen J. M. Apparent central neurotransmitter receptor changes induced by low-level lead exposure during different developmental phases in the rat. Toxicol Appl Pharmacol. 1987 Oct;91(1):132–139. doi: 10.1016/0041-008x(87)90200-6. [DOI] [PubMed] [Google Scholar]
  52. Rummo J. H., Routh D. K., Rummo N. J., Brown J. F. Behavioral and neurological effects of symptomatic and asymptomatic lead exposure in children. Arch Environ Health. 1979 Mar-Apr;34(2):120–124. doi: 10.1080/00039896.1979.10667381. [DOI] [PubMed] [Google Scholar]
  53. Schwartz J. Lead, blood pressure, and cardiovascular disease in men and women. Environ Health Perspect. 1991 Feb;91:71–75. doi: 10.1289/ehp.919171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Selevan S. G., Landrigan P. J., Stern F. B., Jones J. H. Mortality of lead smelter workers. Am J Epidemiol. 1985 Oct;122(4):673–683. doi: 10.1093/oxfordjournals.aje.a114146. [DOI] [PubMed] [Google Scholar]
  55. Sharp D. S., Osterloh J., Becker C. E., Bernard B., Smith A. H., Fisher J. M., Syme S. L., Holman B. L., Johnston T. Blood pressure and blood lead concentration in bus drivers. Environ Health Perspect. 1988 Jun;78:131–137. doi: 10.1289/ehp.8878131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  56. Silbergeld E. K. Lead in bone: implications for toxicology during pregnancy and lactation. Environ Health Perspect. 1991 Feb;91:63–70. doi: 10.1289/ehp.919163. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Smith M., Delves T., Lansdown R., Clayton B., Graham P. The effects of lead exposure on urban children: the Institute of Child Health/Southampton Study. Dev Med Child Neurol Suppl. 1983;47:1–54. [PubMed] [Google Scholar]
  58. Stoner G. D., Shimkin M. B., Troxell M. C., Thompson T. L., Terry L. S. Test for carcinogenicity of metallic compounds by the pulmonary tumor response in strain A mice. Cancer Res. 1976 May;36(5):1744–1747. [PubMed] [Google Scholar]
  59. Thomas B. J. Equipment design issues for the in vivo X-ray fluorescence analysis of bone lead. Environ Health Perspect. 1991 Feb;91:39–43. doi: 10.1289/ehp.919139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  60. Turani H., Levi J., Zevin D., Kessler E. Acquired cystic disease and tumors in kidneys of hemodialysis patients. Isr J Med Sci. 1983 Jul;19(7):614–618. [PubMed] [Google Scholar]
  61. Van Esch G. J., Kroes R. The induction of renal tumours by feeding basic lead acetate to mice and hamsters. Br J Cancer. 1969 Dec;23(4):765–771. doi: 10.1038/bjc.1969.95. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Vander A. J. Chronic effects of lead on the renin-angiotensin system. Environ Health Perspect. 1988 Jun;78:77–83. doi: 10.1289/ehp.887877. [DOI] [PMC free article] [PubMed] [Google Scholar]
  63. Winneke G., Brockhaus A., Ewers U., Krämer U., Neuf M. Results from the European multicenter study on lead neurotoxicity in children: implications for risk assessment. Neurotoxicol Teratol. 1990 Sep-Oct;12(5):553–559. doi: 10.1016/0892-0362(90)90022-5. [DOI] [PubMed] [Google Scholar]
  64. Zelikoff J. T., Li J. H., Hartwig A., Wang X. W., Costa M., Rossman T. G. Genetic toxicology of lead compounds. Carcinogenesis. 1988 Oct;9(10):1727–1732. doi: 10.1093/carcin/9.10.1727. [DOI] [PubMed] [Google Scholar]
  65. de la Burdé B., Choate M. L. Early asymptomatic lead exposure and development at school age. J Pediatr. 1975 Oct;87(4):638–642. doi: 10.1016/s0022-3476(75)80845-6. [DOI] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES