• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.6 no.1
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• pp.77-87
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• 1996

In order to compare the difference of the measurement of delta aminolevulinic acid(${\delta}$-ALA) in urine between HPLC method(HALA) and colorimetric method(CALA), and also to provide useful information for the new diagnostic criteria of ${\delta}$-ALA in urine in lead poisoning, if at all possible in the future, authors studied 234 male lead workers who were selected from 7 storage battery factories, 3 secondary smelting industries, and 2 litharge making industries. Study subjects were selected on the basis of blood Zinc protoporphyrin(ZPP) level from low to high concentration to cover wide range of lead exposure. Study variables for this study were ${\delta}$-ALA measured by two different methods, blood lead(PbB), and blood ZPP. The results were as follows: 1. There was very high correlation between ${\delta}$-ALA measured by two method(r = 0.989 : HALA = -0.8194 + 0.8110 ${\times}$ CALA), but the value of CALA was measured about 2mg/L greater than HALA. 2. While the correlations of ${\delta}$-ALA by two method with blood lead and blood ZPP were 0.46 and 0.37 respectively, they were increased to 0.63 and 0.57 if ${\delta}$-ALA values were log-transformed. 3. Simple linear regression of ${\delta}$-ALA measured by two method on ZPP were as follows: CALA = 2.0421 + 0.0341 ${\times}$ ZPP ($R^2=0.1385$ p = 0.0001) HALA = 0.8006 + 0.0280 ${\times}$ ZPP ($R^2=0.1389$ p = 0.0001) 4. Simple linear regression of ${\delta}$-ALA measured by two method on PbB were as follows: CALA = - 0.4134 + 0.1545 ${\times}$ PbB ($R^2=0.2085$ p = 0.0001) HALA = -1.2893 + 0.1287 PbB ($R^2=0.2154$ p = 0.0001), 5. Simple linear regression of log-transformed ${\delta}$-ALA by two method on ZPP and PbB were as follows: logHALA = 0.3078 + 0.0060 ZPP ($R^2=0.3329$ p = 0.0001) logCALA = 1.0189 + 0.0044 ZPP ($R^2=0.3290$ p = 0.0001) logHALA = -0.0221 + 0.0246 PbB ($R^2=0.4046$ p = 0.0001) logCALA = 0.7662 + 0.0184 PbB ($R^2=0.4108$ p = 0.0001) 6. The cumulative percent of colorimetric method to detect lead workers whose value of PbS and ZPP were over screening level such as $40{\mu}/dl$ and $100{\mu}/dl$ respectively was higher than HPLC method if cut-off level of ${\delta}$-ALA for screening of lead poisoning was 5 mg/L. But if cut-off level of ${\delta}$-ALA measured by HPLC was reduced to 3 mg/L which is compatible to 5 mg/L of ${\delta}$-ALA measured by colorimetric method, there were good agreement between two methods and showed dose-response relationship with other lead exposure indices such as PbB and ZPP.

• Journal of Preventive Medicine and Public Health
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• v.29 no.4 s.55
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• pp.747-764
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• 1996

This study intended to obtain an useful information for health management of lead exposed workers and determine biological monitoring interval in early period of exposure by measuring the lead exposure indices and work duration in all male workers (n=433 persons) exposed less than 1 year in 6 storage battery industries and in 49 males who are not exposed to lead as control. The examined variables were blood lead concentration (PBB), Zinc-protoporphyrin concentration (ZPP), Hemoglobin (HB) and personal history; also measured lead concentration in air (PBA) in the workplace. According to the geometric mean of lead concentration in the air, the factories were grouped into three categories: A; When it is below $0.05mg/m^3$, B; When it is between 0.05 and $0.10mg/m^3$, and C; When it is above $0.10mg/m^3$. The results obtained were as follows: 1. The means of blood lead concentration (PBB), ZPP concentration and hemoglobin(HB) in all male workers exposed to lead less than 1 year in storage battery industries were $29.5{\pm}12.4{\mu}g/100ml,\;52.9{\pm}30.0{\mu}g/100ml\;and\;15.2{\pm}1.1\;gm/100ml$. 2. The means of blood lead concentration (PBB), ZPP concentration and hemoglobin(HB) in control group were $5.8{\pm}1.6{\mu}g/100ml,\;30.8{\pm}12.7{\mu}g/100ml\;and\;15.7{\pm}1.6{\mu}g/100ml$, being much lower than that of study group exposed to lead. 3. The means of blood lead concentration and ZPP concentration among group A were $21.9{\pm}7.6{\mu}g/100,\;41.4{\pm}12.6{\mu}g/100ml$ ; those of group B were $29.8{\pm}11.6{\mu}g/100,\;52.6{\pm}27.9{\mu}g/100ml$ ; those of group C were $37.2{\pm}13.5{\mu}g/100,\;66.3{\pm}40.7{\mu}g/100ml$. Significant differences were found among three factory group(P<0.01) that was classified by the geometric mean of lead concentration in the air, group A being the lowest. 4. The mean of blood lead concentration of workers who have different work duration (month) was as follows ; When the work duration was $1\sim2$ month, it was $24.1{\pm}12.4{\mu}g/100ml$, ; When the work duration was $3\sim4$ month, it was $29.2{\pm}13.4{\mu}g/100ml$ ; and it was $28.9\sim34.5{\mu}g/100ml$ for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 5. The mean of ZPP concentration of workers who have different work duration (month) was as follows ; When the work duration was $1\sim2$ month, it was $40.6{\pm}18.0{\mu}g/100ml$, ; When the work duration was $3\sim4$ month, it was $53.4{\pm}38.4{\mu}g/100ml$ ; and it was $51.5\sim60.4{\mu}g/100ml$ for the workers who had longer work duration than other. Significant differences were found among work duration group(P<0.05). 6. Among total workers(433 person), 18.2% had PBB concentration higher than $40{\mu}g/100ml$ and 7.1% had ZPP concentration higher than $100{\mu}g/100ml$ ; In workers of factory group A, those were 0.9% and 0.0% ; In workers of factory group B, those were 17.1% and 6.9% ; In workers of factory group C, those were 39.4% and 15.4%. 7. The proportions of total workers(433 person) with blood lead concentration lower than $25{\mu}g/100ml$ and ZPP concentration lower than $50{\mu}g/100ml$ were 39.7% and 61.9%, respectively ; In workers of factory group A, those were 65.5% and 82.3% : In workers of factory group B, those were 36.1% and 60.2% ; In workers of factory group C, those were 19.2% and 43.3%. 8. Blood lead concentration (r=0.177, P<0.01), ZPP concentration (r=0.135, P<0.01), log ZPP (r=0.170, P<0.01) and hemoglobin (r=0.096, P<0.05) showed statistically significant correlation with work duration (month). ZPP concentration (r=0.612, P<0.01) and log ZPP (r=0.614, P<0.01) showed statistically significant correlation with blood lead concentration 9. The slopes of simple linear regression between work duration(month, independent variable) and blood lead concentration (dependent variable) in workplace with low air concentration of lead was less steeper than that of poor working condition with high geometric mean air concentration of lead. The study result indicates that new employees should be provided with biological monitoring including blood lead concentration test and education about personal hygiene and work place management within $3\sim4$ month.

• Nutrition Research and Practice
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• v.5 no.1
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• pp.40-45
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• 2011

Hemoglobin and zinc protoporphyrin (ZPP) tests are commonly used to screen for iron deficiency, but little research has been done to systematically evaluate the sensitivity and specificity of these two tests. The goal of this study was to evaluate the effectiveness of zinc protoporphyrin/heme (ZPP/H) ratio as a point-of-service screening test for iron deficiency among preschool-aged children by comparing the sensitivity and specificity of hemoglobin, ZPP/H ratio, and serum ferritin (SF). Also completed were assessments for the prevalence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) with indicators of ferritin models. This study was carried out with 95 children ages 3 to 6 y. Anthropometric measurements were assessed and blood samples were analyzed for hemoglobin, SF, transferrin saturation (TS), and ZPP. Anemia was common and the prevalences of anemia, ID, and IDA were 14.7%, 12.6%, and 5.2%, respectively. The ZPP/H ratio was strongly and significantly correlated with hemoglobin. And ZPP/H ratio was a more sensitive test for ID than hemoglobin or SF measurement, correctly identifying more than twice as many iron-deficient children (sensitivity of 91.7%, compared to 41.7% for hemoglobin and SF). However, ZPP/H ratio had lower specificity (60.2%, compared to 89.1% for hemoglobin or 96.4% for SF) and resulted in the false identification of more subjects who actually were not iron deficient than did hemoglobin or SF. Low hemoglobin concentration is a late-stage indicator of ID, but ZPP/H ratio can detect ID at early stages and can be performed easily at a relatively low cost. Therefore, ZPP/H ratio can serve as a potential screening test for pre-anemic iron deficiency in community pediatric practices.

• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.499-504
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• 1999

Objectives : To evaluate whether a relation between blood lead and zinc proto porphyrin(ZPP) was modified by gender in Korean lead workers. Methods : A cross-sectional study was conducted with 1,304 male and 101 female subjects in 1997. The relation between blood lead and ZPP were evaluated with linear, exponential, and quadratic models. Then, the different effect of gender on the relation was examined by adding the interaction terms in the each model. Results : $Mean{\pm}SD$ of blood lead and ZPP level was different between male$(27.7{\pm}10{\mu}g/dl\;and\;51.3{\pm}23.4{\mu}g/dl)$ and female subjects$(22.5{\pm}9.2{\mu}g/dl\;and\;78.7{\pm}38.6{\mu}g/dl)$. After adjusting for possible confounders, the effect modification by gender was significant in linear$(\beta=1.119,\;p<0.001)$, exponential$(\beta=Exp(0.008),\;p<0.05)$, and quadratic model$(\beta=1.388,\;p<0.001)$. In separate analysis, a quadratic relation between blood lead and ZPP was shown in male lead workers$(\beta=0.036,\;p<0.001)$, but an exponential relation in female lead workers$(\beta=Exp(0.029), p<0.001)$. Conclusion : Our data showed that the increasing rate of ZPP in female were always higher than in male lead workers, suggesting that females were more susceptible to occupational lead exposure than males.

• Journal of Preventive Medicine and Public Health
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• v.28 no.2 s.50
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• pp.421-432
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• 1995

The influence of lead exposure on renal function was studied. Eighty nine lead exposed workers who worked in 2 storage battery factories, and seventy one control workers were chosen for this study. Blood lead(PbB) and zinc protoporphyrin in whole blood(ZPP) were selected as indicators of lead exposure. As indicators of renal function, urinary N-acetyl-$\beta$-D-glucosaminidase(NAG), blood urea nitrogen(BUN), serum creatinine(S-Cr), total protein in urine(U-TP),and serum uric acid(S-Ua) were selected. The results obtained were as follows: 1. While the mean values of lead exposure indicators of lead workers were significantly different from non-exposed ones, the mean values of NAG, U-TP, BUN and S-Cr of renal function indicators of exposed were also significantly different from non-exposed but their mean values were all within normal limits. 2. BUN, logarithmic U-TP, logarithmic NAG and S-Cr showed statistically significant correlation with PbB. 3. The proportion of workers whose values of renal function indicators were over the normal limits(NAG7.5 U/g Cr ; U-TP10.9 mg/dl ; BUN20 mg/dl ; S-Crl.2 mg/dl ; S-Ua7.0 mg/dl) by the level of lead absorption in terms of PbB and ZPP were calculated. The proportion of workers with over the normal limits of U-TP among total workers showed the dose-response relationship. When age is adjusted, U-TP showed significantly strong dose-response relationship with the level of PbB and ZPP.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.23 no.2
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• pp.65-74
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• 2013

Objectives: This study attempted to develop a method to measure ultra-trace lead concentrations in plasma using Inductively Coupled Plasma Mass Spectrometry(ICP-MS) and to test whether plasma lead can be used as a biomarker for the biological monitoring of exposure to lead. Methods: Lead concentrations in 160 plasma samples of field workers and 42 plasma samples from the control group were measured by ICP-MS. Blood zinc protophorphyrin(ZPP) concentrations and urinary ${\delta}$-aminolevulinic acid${\delta}-ALA$) were measured for correlation analysis with plasma lead. Results: The mean lead level in the plasma of the workers exposed to lead at work were 786.1 ng/L. Plasma lead levels were not correlated with blood ZPP or urinary ${\delta}-ALA$ concentrations. Otherwise, plasma lead levels showed a good correlation coefficient of 0.400 with blood lead levels, and their correlation coefficient had a better value of 0.552 for the non-smoking and drinking group. In the general population group which was not exposed to lead in the workplace and was considered the control group, the mean concentration of plasma lead was 123.1 ng/L. The plasma lead levels for the general population group showed a good correlation coefficient of 0.520 with blood ZPP and urinary ${\delta}-ALA$ concentrations.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.10 no.2
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• pp.165-172
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• 2000

This study was carried out to investigate relationship between plasma $\delta$ - aminolevulinic acid (ALAP) and lead exposure indices in exposure to lead. The subjects were 218 male workers in 2 storage battery companies and 2 secondary smelting companies. Blood lead(PbB), blood zinc-protoporphyrin( ZPP), urinary $\delta$ - aminolevulinic acid (ALAU), hemoglobin(Hb), and hematocrit(Hct) were measured as lead exposure indices. The results were as follows, 1. The means of blood lead and blood ZPP concentration of subjects were $27.2{\pm}14.0{\mu}g/d{\ell}$ and $55.1{\pm}47.6{\mu}g/d{\ell}$, respectively. The means of plasma $\delta$ - ALA and urinary $\delta$ - ALA concentration were $18.9{\pm}25.1{\mu}g/d{\ell}$ and $2.1{\pm}4.6mg/{\ell}$, respectively. 2. The concentration of ALAP was $11.2{\mu}g/{\ell}$ for below $20{\mu}g/d{\ell}$ PbB, $12.8{\mu}g/{\ell}$ for from $21-40{\mu}g/d{\ell}$ PbB, and $51.2{\mu}g/{\ell}$ for over $40{\mu}g/d{\ell}$ PbB, respectively. 3. ALAP was significantly correlated with ALAU(r=0.829, p<0.01), ZPP(r=0.724, p<0.01) and PbB(r=0.552, p<0.01).

• Journal of Preventive Medicine and Public Health
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• v.19 no.2 s.20
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• pp.167-176
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• 1986

For the purpose of determinating the normal values of some parameters relevant to lead exposure, a study was carried out from April 1 to June 30, 1986 on 258 healthy Korean adults who have had no apparant lead exposure. The lead indices subjected to this study were as follows; blood lead (PbB), hemoglobin (Hb), zinc protoporphyrin in blood (ZPP), delta-aminolevulinic acid dehydratase (ALAD) activity in blood, coproporphyrin in urine (CPU), delta-aminolevulinic acid in urine (ALAU). 1) The mean value of PbB was $17.17{\pm}7.87{\mu}g/100ml$, and there was no statistically significant difference by age & sex. The distribution of PbB fitted to the log-normal distribution ($x^2=7.38$, p>0.1). 2) The mean value of Hb in male ($15.17{\pm}1.56g/100ml$) was higher than in female ($13.22{\pm}1.51g/100ml$)(p<0.01). The distribution of Hb fitted to the normal distribution ($x^2=9.40$, p>0.1). 3) The mean value of ZPP was $32.61{\pm}8.78{\mu}g/100ml$, and there was no statistically significant difference by age & sex. The distribution of ZPP fitted to the normal distribution ($x^2=13.93$, p>0.05). The correlation of ZPP & ALAD (r=-0.229), CPU (r=0.183) was statistically significant respectively. 4) The mean value of ALAD was $30.20{\pm}10.96{\mu}mol$ ALA/min/L of R.B.C., and there was no statistically significant difference by age & sex. The distribution of ALAD activity did not fit to the normal distribution. The correlation between ALAD & PbB (r=-0.219) was statistically significant 5) The mean value of CPU was $36.10{\pm}24.54{\mu}g/L$, and there was no statistically significant difference by age & sex. The distribution of CPU did not fit to the normal distribution. The correlation between CPU & PbB (r=0.185), ZPP (r=0.183) was statistically signinificant respectively. 6) The mean value of ALAU was $1.94{\pm}0.96mg/L$, and there was no statistically significant difference by age & sex. The distribution of ALAU fitted to the normal distribution ($x^2=9.76$, p>0.1).

• 대한예방의학회:학술대회논문집
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• 1994.02a
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• pp.549-559
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• 1994

A subgroup or workers from a secondary lead smelter was defined to include those with blood lead levels not exceeding $80{\mu}g/100\;ml$ and with no pest history of elevated blood lead. Central nervous system symptoms (tiredness, sleeplessness, irritability, headache) were reported by 55% of the group and muscle and joint pain by 39%. Zinc proteporphyrin (ZPP) levels were elevated in 71% or cases. Low hemoglobin levels (less than 14 gm/l00 ml) were round in more than a third of the workers. While BUN and creatinine were mostly in the normal range, there - nevertheless n correlation between ZPP and both BUN and creatinine. Reduced nerve-conduction velocities were present in 25% or the group; this was not significantly different from findings in Ii control group. The data indicate that n blood level of $80{\mu}g/100\;ml$ is an inappropriate biological guide in the prevention or lead disease.

• Journal of Preventive Medicine and Public Health
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• v.25 no.3 s.39
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• pp.287-302
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• 1992

Hemoglobin (Hb), zinc protoporphyrin(ZPP) and blood lead (PbB) levels were determined for 1,851 blood samples collected from healthy urban population to establish reliable baselines for Hb, ZPP and PbB levels by age and sex. ZPP values were analyzed with a hematofluorometer and PbB determinations were concurrently carried out using flameless atomic absorption spectrophotometry. The blood sampling period was about 6 months from May, 1991 and the summarized results were as follows ; 1. The mean value of Hb in male and female were $14.55{\pm}1.81g/dl$ and $12.61{\pm}1.18g/dl$ respectively and there was statistically significant difference(p<0.05). 2. The mean value of ZPP in pre-schoolchildren was $37.49{\pm}13.31{\mu}g/dl$ for male, $35.77{\pm}11.85{\mu}g/dl$ for female and that of ZPP in after 7 years groups was $31.91{\pm}8.23{\mu}g/dl$ for male, $30.11{\pm}9.11{\mu}g/dl$ for female and there was statistically significant difference(p<0.05). 3. The mean value of PbB in pre-schoolchildren was $25.10{\pm}5.21{\mu}g/dl$ for male, $24.45{\pm}4.18{\mu}g/dl$ for female and that of PbB in after 7 years groups was $24.28{\pm}3.00{\mu}g/dl$ for male, $21.99{\pm}5.05{\mu}g/dl$ for female and there was statistically significant difference(p<0.05).