Measuring Lead Exposure in Infants, Children, and Other Sensitive Populations -- Copyright -- Other Recent Reports of the Board on Environmental Studies and Toxicology -- Preface -- Contents -- Measuring Lead Exposure in Infants, Children, and Other Sensitive Populations -- Executive Summary -- CHARGE TO THE COMMITTEE AND STRUCTURE OF THE REPORT -- CONCLUSIONS -- Sensitive Populations -- Quantitative Methods for Analysis -- Exposure -- Sources and Accumulation -- RECOMMENDATIONS -- Sensitive Populations -- Quantitative Methods for Analysis -- Exposure -- Sources and Accumulation -- Measuring Lead Exposure in Infants, Children, and Other Sensitive Populations -- 1 Introduction -- PERSPECTIVE ON ISSUES -- HISTORICAL BACKGROUND -- Beginning of Public-Health Interest in Lead -- History of U.S. Childhood Lead-Screening Programs -- Sensitive Populations -- SCOPE AND ORGANIZATION OF THE COMMITTEE REPORT -- 2 Adverse Health Effects of Exposure to Lead -- CLINICAL INTOXICATION IN CHILDREN -- Central Nervous System Effects -- Renal Effects -- Hematologic Effects -- INTOXICATION IN ADULTS -- Central Nervous System and Other Neuropathic Effects -- Renal Effects -- Hematologic Effects -- REPRODUCTIVE AND DEVELOPMENTAL EFFECTS -- Reproductive and Early Developmental Toxicity -- Cognitive and Other Neurobehavioral Effects -- Prospective Longitudinal Studies -- Cross-sectional and Retrospective Studies -- CARDIOVASCULAR EFFECTS -- Hypertension and Pregnancy -- Animal Models of Lead and Blood Pressure -- Population-Based Epidemiology Studies -- MECHANISMS OF TOXICITY -- Effects on Heme Biosynthesis and Erythropoiesis -- Effects on Vitamin D and Calcium Metabolism -- Carcinogensis -- Nephropathy -- SUMMARY -- 3 Lead Exposure of Sensitive Populations -- HISTORICAL OVERVIEW OF ANTHROPOGENIC LEAD CONTAMINATION -- SOURCE-SPECIFIC LEAD EXPOSURE OF SENSITIVE POPULATIONS.

Lead in Paint -- Physicochemical and Environmental Considerations -- General Characteristics of Exposure -- Scope of the Problem -- Lead in Air -- Physicochemical and Environmental Considerations -- General Characteristics of Exposure -- Scope of the Problem -- Lead in Dust and Soil -- Physicochemical and Environmental Considerations -- General Characteristics of Exposure -- Scope of the Problem -- Lead in Drinking Water -- Physicochemical and Environmental Considerations -- General Characteristics of Exposure -- Scope of the Problem -- Lead in the Diet -- Physicochemical and Environmental Considerations -- Characteristics of General Exposure -- Scope of the Problem -- SUMMARY -- 4 Biologic Markers of Lead Toxicity -- BIOLOGIC MARKERS OF EXPOSURE -- Lead Absorption -- Lead Distribution -- Lead Retention and Excretion -- Interactions of Lead with Nutrients -- Mathematical Models -- Linear Models -- Nonlinear Models -- Biologic Monitoring -- Whole Blood -- Plasma -- Teeth -- Bone -- Milk -- Placenta -- Chelatable and Urinary Lead -- BIOLOGIC MARKERS OF EFFECT -- Markers Based on Disturbance of Heme Synthesis -- Markers of Other Biologic Systems -- Relevance of Current Markers of Effect for Low-Dose Exposures -- Potential Markers of Effect -- Enzyme Systems -- Lead-Binding Proteins -- Metabolites -- Identification of Toxicity Mechanisms -- Inhibition of 1,25-Dihydroxyvitamin D Formation -- Impairment of Heme Synthesis -- BIOLOGIC MARKERS OF SUSCEPTIBILITY -- SUMMARY -- 5 Methods for Assessing Exposure to Lead -- INTRODUCTION -- SAMPLING AND SAMPLE HANDLING -- MEASUREMENT OF LEAD IN SPECIFIC TISSUES -- Whole Blood -- Plasma -- Urine -- Teeth -- Milk -- Placenta -- MASS SPECTROMETRY -- Isotope-Dilution Mass Spectrometry -- Lead Isotopic Composition in the Identification of Lead Sources -- Stable Lead Isotopic Tracers in Metabolic Studies.

Inductively Coupled Plasma Mass Spectrometry -- Secondary-Ion Mass Spectrometry -- Glow-Discharge Mass Spectrometry -- Laser-Microprobe Mass Spectrometry -- ATOMIC-ABSORPTION SPECTROMETRY -- ANODIC-STRIPPING VOLTAMMETRY AND OTHER ELECTROCHEMICAL METHODS -- NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY -- THE CALCIUM-DISODIUM EDTA PROVOCATION TEST -- X-RAY FLUORESCENCE MEASUREMENT -- Dosimetry -- Volume Sampled -- Precision -- Accuracy -- Practical XRF Systems -- Validation -- Clinical Uses of X-Ray Fluorescence -- Research Needs -- QUALITY ASSURANCE AND QUALITY CONTROL -- SUMMARY -- 6 Summary and Recommendations -- SOURCES OF LEAD EXPOSURE -- ADVERSE HEALTH EFFECTS OF LEAD -- MARKERS OF LEAD EXPOSURE AND EFFECT -- TECHNIQUES TO MEASURE LEAD EXPOSURE AND EARLY TOXIC EFFECTS -- References.