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THE ASSOCIATION OF LEAD BIOMARKERS WITH HEALTH EFFECTS IN COMMUNITY RESIDING WOMEN AND AN OCCUPATIONAL MALE COHORT

Khalil, Naila (2007) THE ASSOCIATION OF LEAD BIOMARKERS WITH HEALTH EFFECTS IN COMMUNITY RESIDING WOMEN AND AN OCCUPATIONAL MALE COHORT. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Although environmental and occupational lead exposure has decreased over the recent decades, the health outcomes associated with past lead exposure continue to be a significant clinical and public health issue. Lead is a multitargeted toxicant, that effect skeletal, cardiovascular and nervous system. Mounting evidence supports a link between lead at levels previously considered safe, to morbidity and mortality.The objective of this dissertation was to examine association of lead biomarkers with changes in bone mineral density (BMD), incident fractures and falls, cognition and mortality. We utilized data from two epidemiological studies: a) The Study of Osteoporotic Fractures (SOF) that enrolled a population of elderly women (age 65-87), and b)The Lead Occupational study that followed a cohort of male lead exposed and control workers through middle age (40-76 years,63% exposed, 37% controls).In the longitudinal SOF analysis, baseline total hip BMD was lower in women with high blood lead levels. The annualized rate of decline in hip BMD was greater among women with the high blood lead level, who also experienced a two-fold increased risk of fracture and falls.In the longitudinal SOF mortality analysis, women with higher blood lead levels at baseline had increased risk of all cause, and cardiovascular mortality compared to women with lower blood lead levels. No association with cancer mortality was found. These relationships were independent of age and shared risk factors between blood lead levels and BMD, fractures, falls and mortality. In the Lead Occupational study, compared to controls, lead exposed workers had lower total cognitive scores cross sectionally. In longitudinal analysis, cognitive scores of lead exposed workers declined more in compared to controls. Age and important risk factors of lead exposure and cognitive change did not explain this association.Overall, our findings provide epidemiological evidence of an association between lead exposure, morbidity, and mortality in community residing elderly women as well as a male occupational cohort. A more stringent control of lead exposure and better understanding of the mechanism of its effects may help reduce the public health burden of disease.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Khalil, Nailakhalil_naila@yahoo.com,nak37@pitt.eduNAK37
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairCauley, Jane Ajcauley@edc.pitt.eduJCAULEY
Committee MemberTalbott, Evelyn Oeot1@pitt.eduEOT1
Committee MemberNeedleman, Herberthlnlead@pitt.eduHLNLEAD
Committee MemberWilson, John Wjww@pitt.eduJWW
Committee MemberMorrow, Lisa Amorrowla@upmc.eduLAMORROW
Date: 27 June 2007
Date Type: Completion
Defense Date: 19 March 2007
Approval Date: 27 June 2007
Submission Date: 13 April 2007
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: cognition; falls; fractures; lead; mortality
Other ID: http://etd.library.pitt.edu/ETD/available/etd-04132007-160216/, etd-04132007-160216
Date Deposited: 10 Nov 2011 19:37
Last Modified: 19 Dec 2016 14:35
URI: http://d-scholarship.pitt.edu/id/eprint/7111

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