P-443 Introduction: Results of the pilot study reported to the ISEE 17 Conference suggested that a sub-clinical renal damage in 89 children dwellers of industrialized urban areas could be associated with the combined toxicity of cadmium and lead. The aim of the present study was to try and find this association in a bigger group of children living in other towns of the same region. Methods: We examined children aged 3–7 years in two neighboring towns in the Middle Urals polluted with emissions of a big copper smelter. We collected morning urine samples from 184 children in apparent good health who had no history or symptoms of renal or urological disease. Concentrations of cadmium and lead, both well established renal toxins, and beta-2-microglobulin (B2u), a physiological marker for renal damage, were measured, along with usual clinical laboratory indices. Results: The B2u levels in the cohort ranged from 10 to 1200 ug/L. Only twelve children had levels >300 ug/L. To facilitate evaluation of the association between sub-clinical renal damage and body burdens (in particular, impacts on kidneys) of lead and cadmium the cohort was divided into two halves: those above the median B2u level of 120 ug/L (“cases”), and those at or below the median (“controls”). The cases had the following mean concentrations (in ug/L): 241.5±19.7 B2u, 6.5±0.7 cadmium, and 62.1±2.7 lead. The control group had mean concentrations (in ug/L) of: 82.1±3.0 B2u, 4.9±0.6 cadmium, and 41.9±2.01 lead. The t scores for B2u, cadmium, and lead were 8.0, 1.90, and 5.5, respectively. (All the values are higher than they were in the previous study due to higher levels of the environmental pollution.) Within the control group, there was an increase in both metals’ mean concentration in the 2nd quartile of the B2u data distribution as compared with the 1st quartile. Odds ratios (OR) obtained through one-metal regression models that incorporated adjustments only for gender and area were (per 1 ug/L of a metal)1.13 (95% CI 1.05–1.22) for cadmium and 1.03 (1.02–1.05) for lead, with P<0.005 and <0.001, respectively. Additional adjustment for frequent respiratory infections (the only IRF proved significant in the univariate modeling) has not changed these ORs. Dwelling in the town located closer to the copper smelter proved a significant risk factor for both metals, especially for cadmium. When we made the same adjustment in a two-metals regression model, a statistically significant OR ≠ 1.0 was found only for lead: 1.04 (1.02–1.05), P<0.001. It can be explained by the fact that, unlike previous study, cadmium and lead urine concentrations were significantly correlated (r=0.49. P<0.001) due to the common source of environmental pollution with them. Conclusion: Taken as a whole, the results obtained in both studies demonstrate that in children even moderate body burdens of cadmium and lead increase probability of an incipient renal damage.
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