Table 5.

Attributes of four studies evaluated for use with the HIM.

Attribute of interest	Menke et al. 2006	Aoki et al. 2016	Ruiz-Hernandez et al. 2017	Lanphear et al. 2018
Data set	NHANES III	NHANES 1999–2010	NHANES III and NHANES 1999–2004	NHANES III
Year of blood Pb collection	1988–1994	1999–2010	1988–1994 and 1999–2004	1988–1994
Sample size and population	$>\mathrm{13,900}$ adults $\ge 20\text{\hspace{0.17em}years}$ of age with blood $\mathrm{Pb}<10\mathrm{\mu }\mathrm{g}/\text{dL}$	$>\mathrm{18,600}$ adults $\ge 40\text{\hspace{0.17em}years}$ of age with no cutoff for blood Pb level	$>\mathrm{15,400}$ adults $\ge 40\text{\hspace{0.17em}years}$ of age with no cutoff for blood Pb level	All participants: $>\mathrm{14,200}$ adults $\ge 20\text{\hspace{0.17em}years}$ of age with no cutoff for blood Pb level Participants with blood $\mathrm{Pb}<5\mathrm{\mu }\mathrm{g}/\text{dL}$ only: $>\mathrm{10,600}$ adults $\ge 20\text{\hspace{0.17em}years}$ of age
Number of CVD-related deaths	766	985	890	All participants: 1,801 Participants with blood $\mathrm{Pb}<5\mathrm{\mu }\mathrm{g}/\text{dL}$ only: not reported
Geometric mean Pb (SE)	2.58 $\mathrm{\mu }\mathrm{g}/\text{dL}$ (SE not given)	1.73 $\mathrm{\mu }\mathrm{g}/\text{dL}$ (0.02)	NHANES III: 3.2 $\mathrm{\mu }\mathrm{g}/\text{dL}$ (SE not given) NHANES 1999–2004: 1.9 $\mathrm{\mu }\mathrm{g}/\text{dL}$ (SE not given)	All participants: 2.71 $\mathrm{\mu }\mathrm{g}/\text{dL}$ (0.131) Blood $\mathrm{Pb}<5\mathrm{\mu }\mathrm{g}/\text{dL}$ only: not reported
Participant age: arithmetic mean (SE)	44.4 (0.5)	57.5 (0.2)	Not given	All participants: 44.1 (not reported) Blood $\mathrm{Pb}<5\mathrm{\mu }\mathrm{g}/\text{dL}$ only: not reported
Pb biomarker	Whole blood Pb	Hematocrit-corrected blood Pb	Whole blood Pb	Whole blood Pb
Confounders considered in key analysis	Age, race/ethnicity, sex, smoking status, education, alcohol consumption, CRP, physical activity, low income, total cholesterol, urban residence, postmenopausal status, hypertension, level of kidney function, diabetes mellitus, body mass index	Race, Hispanic origin, sex, smoking status, education, alcohol intake, CRP, blood cadmium, serum iron, serum calcium	Age, sex, race, smoking status, physical inactivity, obesity, hypertension, diabetes, high total cholesterol, low HDL cholesterol, lipid-lowering medication and survey period, log-transformed cadmium	All models are adjusted for age, sex, household income, ethnic origin, body mass index, smoking status, hypertension, urinary cadmium, alcohol consumption, physical activity in previous month, healthy eating index, serum cholesterol, and glycated hemoglobin
ICD codes for CVD	ICD-9 codes: 390–434, 436-459; ICD-10 codes: I00–I99	ICD-10 codes: I00–I99	ICD-10 codes: I00–I78	ICD-9 codes: 390–459; ICD-10 codes: I00–I99
Limits of detection	$1.0\mathrm{\mu }\mathrm{g}/\text{dL}$	$0.25–0.3\mathrm{\mu }\mathrm{g}/\text{dL}$	NHANES III: $1.0\mathrm{\mu }\mathrm{g}/\text{dL}$ NHANES 1999–2004: $0.25–0.3\mathrm{\mu }\mathrm{g}/\text{dL}$	$1.0\mathrm{\mu }\mathrm{g}/\text{dL}$
Maximum length of follow-up	13 y	13 y	8–9 y	24 y
Dates of follow-up	Through 31 December 2000	Through 31 December 2011	NHANES III: through 31 December 1996 NHANES 1999–2004: through 31 December 2006	Through 31 December 2011

Source: Menke A, personal communication. Note: CRP, C-reactive protein; CVD, cardiovascular disease; HDL, high-density lipoprotein; HIM, health impact model; ICD, International Classification of Diseases; NHANES, National Health and Nutrition Examination Survey; Pb, lead; SE, standard error.