Occupational Exposure Clinical Trial
Official title:
Study for Promotion of Health in Recycling Lead
Study for Promotion of Health in Recycling Lead (SPHERL) is a prospective 2-year follow-up
study of lead workers with exposure levels varying between and within individuals. SPHERL
addresses to what extent between-subject differences or within-subject changes in lead
exposure may have a measurable impact on blood pressure, the cardiovascular system, renal
function, the autonomic nervous system, peripheral nervous conduction velocity, and
neurocognitive function.
At the beginning of December 2015, 70 participants were included in the study.
Background
- Whether low-level lead exposure impacts on blood pressure, regulation of the
cardiovascular system, glomerular or tubular renal function, sympathetic nervous
modulation, peripheral nervous conduction velocity, and neurocognitive function remains
uncertain.
Study Population
- SPHERL will enroll 500 lead recycling workers with changing lead exposure, who will be
examined at baseline (2014-2015) and followed up at annual intervals for 2 years
(2016-2017).
Methods
- Volunteers eligible for the study are (i) new and existing hires without previous
occupational lead exposure who will be performing tasks with or without occupational
lead exposure and (ii) existing hires with occupational lead exposure who will be
transitioning to job tasks without occupational lead exposure within the next 2 years.
- Blood lead concentration will be the main biomarker of exposure.
- The main outcome variables are (i) blood pressure measured conventionally and by
ambulatory monitoring, and analyzed as continuous or categorical variable, both
cross-sectionally and longitudinally; (ii) indexes of glomerular and tubular renal
function, (iii) heart rate variability analyzed in the frequency domain as measure of
autonomous sympathetic modulation, (iv) peripheral nerve conductivity, (v)
neurocognitive performance, (vi) and quality of life [the EuroQOL five dimensions
(EQ-5D) questionnaire].
Expected Outcomes
- Assuming a 4-fold or higher surge in the blood lead concentration, the study is powered
to demonstrate over 2 years an acceleration in the age-related rise of systolic blood
pressure by 1 to 4 mm Hg or an increase of the coefficient of multiple determination
(R2) from 0.22 to 0.24 by adding the change in the blood lead concentration to models
relating changes in blood pressure to three other covariables. The longitudinal design
of our study complies with the temporality principle of the Bradford-Hill criteria for
assessing possible causality between outcomes and exposure.
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