Association between acute lead exposure in indoor firing ranges and iron metabolism.
BACKGROUND
Iron deficiency and lead poisoning are common and are often associated. This association has been suggested previously, mainly by retrospective cross-sectional studies.


OBJECTIVE
To assess the impact of short-term lead exposure at indoor firing ranges, and its relationship to iron, ferritin, lead, zinc protoporphyrin, and hemoglobin concentrations in young adults.


METHODS
We conducted a clinical study in 30 young healthy soldiers serving in the Israel Defense Forces. Blood samples were drawn for lead, zinc protoporphyrin, iron, hemoglobin and ferritin prior to and after a 6 week period of intensive target practice in indoor firing ranges.


RESULTS
After a 6 week period of exposure to lead dust, a mean blood lead level increase (P < 0.0001) and a mean iron (P < 0.0005) and mean ferritin (P < 0.0625) decrease occurred simultaneously. We found a trend for inverse correlation between pre-exposure low ferritin levels and post-exposure high blood lead levels.


CONCLUSIONS
The decrease in iron and ferritin levels after short-term lead exposure can be attributed to competition between iron and lead absorption via divalent metal transport-1, suggesting that lead poisoning can cause iron depletion and that iron depletion can aggravate lead poisoning. This synergistic effect should come readily to every physician's mind when treating patients with a potential risk for each problem separately.
Vivante
Asaf
A
Israel Defense Force, Israel. asafvivante@gmail.com
Hirshoren
Nir
N
Shochat
Tzippora
T
Merkel
Drorit
D
D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D005293:Ferritins / Q000097:blood; D005389:Firearms; D006801:Humans; D007501:Iron / Q000097:blood / Q000378:metabolism*; D007557:Israel; D007855:Lead Poisoning / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008889:Military Personnel; D016273:Occupational Exposure / Q000009:adverse effects*
D005293:Ferritins; D007501:Iron