The epidemiology of lead toxicity in adults: Measuring dose and consideration of other methodologic issues

Howard Hu, Regina Shih, Stephen Rothenberg, Brian S. Schwartz

Research output: Contribution to journalReview articlepeer-review

208 Scopus citations


We review several issues of broad relevance to the interpretation of epidemiologic evidence concerning the toxicity of lead in adults, particularly regarding cognitive function and the cardiovascular system, which are the subjects of two systematic reviews that are also part of this mini-monograph. Chief among the recent developments in methodologic advances has been the refinement of concepts and methods for measuring individual lead dose in terms of appreciating distinctions between recent versus cumulative doses and the use of biological markers to measure these parameters in epidemiologic studies of chronic disease. Attention is focused particularly on bone lead levels measured by K-shell X-ray fluorescence as a relatively new biological marker of cumulative dose that has been used in many recent epidemiologic studies to generate insights into lead's impact on cognition and risk of hypertension, as well as the alternative method of estimating cumulative dose using available repeated measures of blood lead to calculate an individual's cumulative blood lead index. We review the relevance and interpretation of these lead biomarkers in the context of the toxico-kinetics of lead. In addition, we also discuss methodologic challenges that arise in studies of occupationally and environmentally exposed subjects and those concerning race/ethnicity and socioeconomic status and other important covariates.

Original languageEnglish (US)
Pages (from-to)455-462
Number of pages8
JournalEnvironmental health perspectives
Issue number3
StatePublished - Mar 2007


  • Adults
  • Biomarkers
  • Epidemiologic methods
  • Epidemiology
  • Lead
  • Toxicity

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'The epidemiology of lead toxicity in adults: Measuring dose and consideration of other methodologic issues'. Together they form a unique fingerprint.

Cite this