119 Renal effects induced by occupational co-exposure to cadmium and lead in metallurgy workers
研究122名冶金工人镉铅联合暴露对早期肾损伤标志物的影响，发现铅会增强镉与肾损伤的关联。
<h3>Objectives</h3> Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on early renal biomarkers. <h3>Methods</h3> Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers i.e., microalbumin (µ-Alb), beta-2-microglobulin (β<sub>2</sub>-MG), retinol binding protein (RBP), N-acetyl-β-D-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey. In order to explore the effect of Pb on the association between Cd and renal biomarkers (i.e., effect modification or interaction), we performed a multiple linear regression analysis (adjusting for age and pack-years of smoking) including an interaction term Pb x Cd. <h3>Results</h3> The median Cd-B, Cd-U, Pb-B were: 0.8 µg/l (IQR = 0.5, 1.2), 0.5 µg/g creatinine (IQR = 0.3, 0.8) and 158.5 µg/l (IQR = 111.0, 219.3), respectively. The statistically significant interaction term Pb-B x Cd-B indicates that the impact of Cd-B on the enzymes NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75<sup>th</sup> percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75<sup>th</sup> percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., µ-Alb and β2-MG). <h3>Conclusions</h3> Our findings indicate that Pb modifies (increases) the strength of the association between Cd and early renal biomarkers.