Blood Lead Research Articles

Relationship between blood lead levels and clinical and physiological factors in Bonelli's eagle

AbstractLead is a toxic metal that produces effects on the overall health of animals, resulting in mortality at high exposures, adverse physiological and behavioral effects at lower concentrations, and population declines in many species. Scavengers and predators are more susceptible to lead toxicity because of behavioral and physiologic factors, and long lifespans increase the risk of exposure cumulatively. Bonelli's eagle (Aquila fasciata) is a long‐living predator that may have reduced breeding success because of lead exposure. We analyzed the blood lead levels of 54 wild and captive Bonelli's eagles admitted to a recovery center in Spain from May 2014 to July 2015 and the lead relationship among physiological, clinical, and environmental variables. We detected blood lead using anodic stripping voltammetry. Lead levels were below the limit of quantification (3.3 μg/dL) in 100% of captive animals (n = 22); in contrast, 21.9% of wild birds (n = 32) had higher lead levels than captive birds (P = 0.020). Among wild animals, the 2 adults tested had detectable lead, the only eagle sampled in autumn had the highest lead levels of the study (14.7 μg/dL), and 16.7% of nestlings had detectable lead levels. There is no evidence that the lead levels differ between sexes. There were no symptoms associated with lead intoxication or any correlation between lead levels and hematological or biochemical values; however, subclinical lead exposure at early ages can be harmful and could influence neurological and body development. Researchers should determine if lead could be causing damage to wildlife from early ages to determine if lead exposure affects the conservation of the threatened population of Bonelli's eagles in Spain and elsewhere.

Effect of tetrapeptide Acetyl-(D-Lys)-Lys-Arg-Arg-amide on immunological and biochemical parameters of Wistar rats using passive smoking models

Tetrapeptides, the homologues of adrenocorticotropic hormone fragment (15-18), play a special role among the bioregulators of the immune system. These compounds have cerebroprotective, neuroprotective and antioxidant properties. However, no available studies concerned the immunotropic properties of tetrapeptides in the models with exposure to xenobiotics, thus making such research quite relevant. Our study concerned the effects of tetrapeptide Acetyl-(D-Lys)-Lys-Arg-Arg-amide (laboratory code KK1) on the immunological and biochemical parameters of 72 female Wistar rats exposed to passive smoking. The experimental animals were fumigated with tobacco smoke for 8 hours. Synthetic peptide KK1 was administered intranasally at a dose of 40 g/kg/day five times a day for 10 days. Cotinine was detected only in blood serum of rats from experimental groups, thus confirming a contribution of this tetrapeptide to the trend for normalization of some immunological parameters in experimental animals subjected to passive tobacco smoking, expressed as an increase in thymus mass and the number of splenocytes, and a decrease in the circulating immune complexes compared to the parameters of smoking rats of the group. We revealed that passive tobacco smoking in rats was accompanied by a general tendency to accumulation of iron, lead and nickel in peripheral blood. There was a marked increase in the concentration of cadmium, lead and cobalt in rats of the experimental group compared with the content of these trace elements in the liver of smoking animals injected with tetrapeptide KK1. The revealed shifts in immunological indices may be based, firstly, on hepatotoxic effect of ecotoxicants, The lymphoid lineage is mostly affected thus causing hypoplasia of the central and peripheral immunity organs. An evident sign of such pathology is a decreased cellularity of hematopoietic and lymphoid organs found in the present study. Secondly, the tobacco smoke components with prooxidant action may disrupt cellular redox homeostasis, causing damage to cell membranes, resulting in necrosis or apoptosis, thus explaining the revealed decrease in the number of thymocytes, splenic karyocytes and a decrease in the weight of organs. Thus, our results suggest usage of experimental passive smoking in order to evaluate efficiency of the tetrapeptides. Administration of Acetyl-(D-Lys)-Lys-Arg-Arg-amide peptide to the passively smoking rats is associated with tendency to normalize the mass of the thymus and spleen, the number of thymocytes and splenocytes, and a decrease in circulating immune complexes. Further studies are required to elucidate the effects of tetrapeptides upon the immune system.

Development of a physiologically based toxicokinetic model for lead in pregnant women: The role of bone tissue in the maternal and fetal internal exposure

Epidemiological studies have shown associations between prenatal exposure to lead (Pb) and neurodevelopmental effects in young children. Prenatal exposure is generally characterized by measuring the concentration in the umbilical cord at delivery or in the maternal blood during pregnancy. To assess internal Pb exposure during prenatal life, we developed a pregnancy physiologically based pharmacokinetic (p-PBPK) model that to simulates Pb levels in blood and target tissues in the fetus, especially during critical periods for brain development. An existing Pb PBPK model was adapted to pregnant women and fetuses. Using data from literature, both the additional maternal bone remodeling, that causes Pb release into the blood, and the Pb placental transfers were estimated by Bayesian inference. Additional maternal bone remodeling was estimated to start at 21.6 weeks. Placental transfers were estimated between 4.6 and 283 L.day−1 at delivery with high interindividual variability. Once calibrated, the p-PBPK model was used to simulate fetal exposure to Pb. Internal fetal exposure greatly varies over the pregnancy with two peaks of Pb levels in blood and brain at the end of the 1st and 3rd trimesters. Sensitivity analysis shows that the fetal blood lead levels are affected by the maternal burden of bone Pb via maternal bone remodeling and by fetal bone formation at different pregnancy stages. Coupling the p-PBPK model with an effect model such as an adverse outcome pathway could help to predict the effects on children's neurodevelopment.

Assessment of lead exposure in indoor shooters in central Poland

A steady increase in shooting practices is observed worldwide. Potential lead exposure at shooting ranges poses a risk to their employees and users, which is not widely reported outside of the USA, especially in Poland. Exposure to lead results from the use of bullets containing lead and the main route of exposure to this metal at shooting ranges is inhalation, i.e., during shooting or cleaning. The aim of this study was to assess lead exposure of employees and users in selected indoor shooting ranges in central Poland. Airborne lead concentrations at all locations in the shooting ranges were above Polish occupational exposure limit (OEL, 0.05 mg m−3). Elevated blood and urine lead levels, and decreased 4-aminolevulinic acid dehydratase activity (ALA-D) were found in subjects participating in shooting even for only a few (< 10) hours per week. Lead exposure at shooting ranges in central Poland, as indicated by elevated blood lead levels and decreased ALA-D activity, could represent an elevated risk for adverse health effects. Thus, information on the possible health consequences of lead exposure should be provided at these sites, and biomonitoring appears to be reasonable for regular workers and shooters.

The association between lead exposure and crime: A systematic review.

Prior research has demonstrated an association between lead exposure and criminal behavior at the population-level, however studies exploring the effect of lead exposure on criminal behavior at the individual-level have not been reviewed systematically. The intent of this study is to complete a systematic review of all studies assessing individual-level exposures to lead and the outcomes of crime and antisocial behavior traits. We included peer reviewed studies that were published prior to August 2022 and were classified as cohort, cross-sectional, or case-control. Studies measuring the outcomes of crime, delinquency, violence, or aggression were included. The following databases were searched using a standardized search strategy: ProQuest Environmental Science Database, PubMed, ToxNet and the Public Affairs Information Service (PAIS). Seventeen manuscripts met our inclusion criteria. Blood lead was measured in 12 studies, bone lead in 3 studies, and dentine lead levels in 2 studies. This systematic review identified a wide range of diverse outcomes between exposure to lead at multiple windows of development and later delinquent, criminal and antisocial behavior. A review of all potential confounding variables included within each study was made, with inclusion of relevant confounders into the risk of bias tool. There is limited data at the individual level on the effects of prenatal, childhood, and adolescent lead exposure and later criminal behavior and more evidence is necessary to evaluate the magnitude of the associations seen in this review. Our review, in conjunction with the available biological evidence, suggests that an excess risk for criminal behavior in adulthood exists when an individual is exposed to lead in utero or in the early years of childhood. The authors report no conflict of interest and no funding source. Clinical trial registration: PROSPERO ID: CRD42021268379.

Independent and Combined Associations of Blood Manganese, Cadmium and Lead Exposures with the Systemic Immune-Inflammation Index in Adults.

Manganese (Mn), cadmium (Cd) and lead (Pb) have toxic effects on the immune system. However, their independent and combined effects on immune-inflammation responses are unclear. In recent years, the systemic immune-inflammation index (SII) has been developed as an integrated and novel inflammatory indicator. A retrospective cross-sectional study of 2174 adults ≥20 years old from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 was conducted. Generalized linear models were used to evaluate the independent and combined associations of SII with blood Mn, Cd and Pb levels. As continuous variables, both blood Cd and Mn showed dose-dependent relationships with the SII before and after adjusting for all potential confounding factors. Metal concentrations were then converted into categorical variables. Compared with the adults in the lowest Cd or Mn tertile, those in the highest tertile had higher risks of elevated SII. Furthermore, co-exposure to Mn and Cd also showed a positive relationship with the SII after adjusting for all confounding factors. However, the single effect of Pb exposure and the joint effect of Pb and other metal exposures on the SII were not observed. This study provides important epidemiological evidence of the associations of SII with single and co-exposure effects of blood Mn, Cd, and Pb.

Serum levels of lead are associated with venous thromboembolism: a retrospective study based on the NHANES database (1999 to 2018).

Venous thromboembolism (VTE) is a common clinical problem. While lead toxicity is known to affect the nervous, hematopoietic system, skeletal, and cardiovascular system, the relationship between blood lead levels and VTE remains unclear. This study explored whether there is a correlation between the levels of serum lead and VTE through a retrospective analysis based on data from the National Health and Nutrition Examination Survey (NHANES), so as to provide a reference for follow-up research and clinical practice. According to the inclusion and exclusion criteria, subjects were enrolled from the NHANES (1999 to 2018) database and divided into a VTE group and a non-VTE group. The factors related to VTE were analyzed by single factor and multiple factor logistic regression analysis. A total of 31,081 subjects were included, of which 59 had VTE (0.19%). The higher the levels of serum lead, the higher the incidence of VTE. The univariate analysis revealed that age, male sex, history of cigarette use, hypertension, diabetes, and serum lead levels were factors associated with VTE in the population from the NHANES database. Further multivariate analysis revealed that age, history of cigarette use, hypertension, diabetes, and serum lead levels were factors associated with VTE. The findings of this study suggest that higher serum levels of lead may be associated with VTE.

Trends in Blood Lead Levels Quantified by ICP-MS: A Reference Laboratory Retrospective Study.

Exposure to lead may cause severe adverse effects such as anemia, neurologic damage, developmental disorders, and reproductive disorders. Consequently, in 2021, the Centers for Disease Control and Prevention (CDC) reduced its blood lead reference value from 5 µg/dL to 3.5 µg/dL in pediatric patients, 1 to 5 years old. The objective of this study was to perform a retrospective analysis of patient blood lead concentrations reported by ARUP Laboratories to evaluate the frequency of blood lead concentrations greater than 3.5 µg/dL. The analysis of blood lead concentration was performed in venous whole blood specimens using inductively coupled plasma mass spectrometry (ICP-MS). In addition, retrospective data analysis was performed to evaluate zinc protoporphyrin (ZPP) concentrations in adult patients with corresponding lead results, using the lead industrial exposure panel. The analysis for ZPP was performed using quantitative hematofluorometry. Retrospective data analysis identified a decline in blood lead concentrations from 2012 to 2021 for pediatric and adult patients. The calculated nonparametric 95% range for ZPP blood was 15 to 43 μg/dL and the ZPP heme ratio 26 to 74 μmol ZPP/mol heme. Lowering the blood lead reference value (BLRV) to 3.5 μg/dL presents an opportunity for healthcare providers and public health agencies to extend medical or environmental interventions for lead exposure in pediatric patients.

Extending Regulatory Biokinetic Lead Models towards Food Safety: Evaluation of Consumer Baby Food Contribution to Infant Blood Lead Levels and Variability.

The U.S. Food and Drug Administration released proposed lead (Pb) action levels for foods intended for babies and young children in January 2023 based on the agency's interim reference value of 2.2 µg/day for dietary Pb. Since the 1980s, biokinetic models have estimated blood lead levels (BLLs) associated with environmental contamination, but their use in food safety assessment has been limited. We compared three recent biokinetic models (IEUBK Model, ICRP Model Version 5, and AALM) to develop insights on contributors to variability in potential exposures to Pb in consumer baby food products. While modest variation was observed for babies, the predictions trended to convergence for children aged 3 and older, approaching the U.S. FDA dietary conversion factor of 0.16 µg Pb/dL blood per µg Pb intake/day. We applied the IEUBK model in a probabilistic exposure assessment framework characterizing the distribution of Pb in soil, dust, water, and food intake in the United States. Soil and dust were the primary contributors to variance in infant BLLs, while food and water contributed <15% combined. Thus, reductions in upper-bound soil and dust concentrations will be necessary before achieving appreciable reductions in the frequency of BLLs greater than the BLRV of 3.5 µg/dL.

Relationship between Lead Exposure and Genotoxic Effect in Paint Industry Workers

Lead-based paint is a main source of lead exposure to paint industry workers and causes an imbalance of Reactive Oxygen Species (ROS) and antioxidants, causing a genotoxic effect. Pb in the blood (PbB) level and DNA damage are frequently used as exposure and effect biomarker of lead. The purpose of this study to determine the relationship between PbB level and DNA damage due to occupational lead exposure in paint industry workers. The research design uses a cross-sectional epidemiological study involving 52 workers from three paint manufacturers in Indonesia. Blood samples were taken for PbB analysis using ICP-MS, while DNA damage was analyzed using the Comet Assay method. The PbB average obtained was 4.36±1.60 µg.dL-1, where 17 workers (32.69%) exceeded the safe limit value of PbB (5 µg.dL-1). Meanwhile, the influential factors of PbB are the working period and alcohol consumption (p=0.029). The level of DNA damage was represented as Tail DNA (%), and the average was 9.62±0.19 %. All respondents in this study were categorized as under low damage (Class 2). There was no significant relationship between PbB and Tail DNA (%) and has a negative correlation (p=0.878; r=-0.022). The study concludes that there was no difference in Tail DNA (%) between PbB ≥ 5 µg.dL-1 and PbB &lt; 5 µg.dL-1 (p=0.876). It means that lead exposure in this finding has not reached a level that can significantly cause DNA damage. However, it is necessary to monitor PbB levels in workers to minimize genotoxic or other effects.

Amelioration of intestinal barrier function and reduction of blood lead level in adult women with recurrent spontaneous abortion by a novel product of dietary fiber mixture, Holofood

BackgroundThe elevated circulating toxins secondary to the impairment of intestinal barrier integrity commonly elicit a chronic inflammatory response and finally contribute to multiple diseases. These toxins, including bacterial by-products and heavy metals, are the potent risk factors for the development of recurrent spontaneous abortion (RSA). Preclinical evidence suggests that several dietary fibers can restore intestinal barrier function and decrease the accumulation of heavy metals. However, it is uncertain whether treatment with a newly developed blend of dietary fibers product (Holofood) benefits patients with RSA.MethodsIn this trial, we enrolled 70 adult women with RSA, who were randomly assigned into the experiment group and the control group in a 2:1 ratio. Upon the basis of conventional therapy, subjects in the experiment group (n = 48) received 8 weeks oral administration with Holofood three times daily at a dose of 10 g each time. Subjects without Holofood consumption were set as the control (n = 22). Blood samples were collected for the determinations of metabolic parameters, heavy mental lead, and the indices related to intestinal barrier integrity (d-lactate, bacterial endotoxin, and diamine oxidase activity).ResultsThe reduction amplitude in blood lead from baseline to week 8 was 40.50 ± 54.28 (μg/L) in the experiment group as compared with 13.35 ± 36.81 (μg/L) in the control group (P = 0.037). The decreased level of serum d-lactate from baseline to week 8 was 5.58 ± 6.09 (mg/L) in the experiment group as compared with − 2.38 ± 8.90 (mg/L, P < 0.0001) in the control group. The change in serum DAO activity from baseline to week 8 was 3.26 ± 2.23 (U/L) in the experiment group as compared with − 1.24 ± 2.22 (U/L, P < 0.0001) in the control group. Participants who received Holofood had a greater decline in blood endotoxin from baseline to week 8 than those in the control group. Moreover, by comparing with the self-baseline, Holofood consumption significantly decreased the blood levels of lead, d-lactate, bacterial endotoxin, and DAO activity.ConclusionOur results suggest that Holofood affords a clinically relevant improvements in blood lead level and intestinal barrier dysfunction in patients with RSA.

Preparation of Fe3O4/SiO2@CDS@Pt Micromotors for Dual‐Mode Detection of Blood Lead

AbstractIt is necessary to accurately detect the content of lead in blood. Here, we investigate the preparation of magnetic mesoporous silica tubular (MMST) micromotors and their application in blood lead detection. Specifically, a magnetic MMST/Carbon dots (CDs)/Pt tubular micromotor with fluorescence property and autonomous motion ability was prepared. Results show that the micromotor has a dual response of fluorescence and speed to trace lead ions in blood. In the blood lead concentration range (0.001 ng/mL–31.62 ng/mL), the fluorescence intensity and movement speed of the micromotor have a linear relationship with the blood lead concentration, respectively. This dual‐detection platform provides a new idea for the detection of blood lead. It is the first time to combine the quantum dots and the motion rate of motor to detect lead ions in blood. It may have some potential value in the field of biosensors in the future.

Identifying the Blood Lead Reference Value Based on the Advisory Committee on Childhood Lead Poisoning Prevention Guidelines and Factors Associated with Elevated Blood Lead Levels among Preschool Children in Thailand, 2019

The blood lead reference value (BLRV) is used for guiding lead prevention and control measures. It is usually defined as the 97.5th percentile of the population-based blood lead level in each country. This study aims to determine the BLRV and factors associated with elevated (≥5 µg/dL) blood lead levels among children aged 1–5 years in Thailand. A cross-sectional study was conducted using secondary data extracted from a national survey, implemented in 171 hospitals during October 2018–September 2019. Demographic characteristics and potential risk factors including lead-related industries were collected. Multilevel logistic regression was used. Of 3,184 children included in the survey, the BLRV was 6.9 µg/dL. Three significant risk factors were identified: living near a lead factory (adjusted odds ratio (AOR) 2.09, 95% CI 1.27–3.42), exposure to the manufacture of fishing tackle (AOR 4.39, 95% CI 1.54–12.50), and exposure to the manufacture of shot and ammunition (AOR 6.30, 95% CI 1.81–21.93). Despite a calculated BLRV of 6.9 µg/dL, we propose a BLRV of 5 μg/dL in Thailand based on guidelines from the United Kingdom. Surveillance of blood lead levels should be established among children at high risk of lead exposure.

Concurrent Assessment on Blood Lead in Young Children and Toy Lead in Shanghai

Concurrent Assessment on Blood Lead in Young Children and Toy Lead in Shanghai

The risk of dental restoration-related lead exposure on renal function

ObjectiveTo explore the relationship between oral restoration count, blood lead (PbB) level, and renal function as potential heavy metal releases, and the related toxicity of dental restorative materials. MethodsA total of 3682 participants from the National Health and Nutrition Examination Survey (January 2017 to March 2020) were included in this cross-sectional analysis. We utilized multivariable linear regression models to investigate the associations between the number of oral restorations and PbB levels or renal function. The mediating effect of PbB on renal function indicators was analyzed using the R mediation package. ResultsBased on the indicators of 3682 participants, we found that the elderly, females, and whites were fit with more oral restoration, which was accompanied by increased PbB levels and decreased renal function. Meanwhile, oral restoration count was positively associated with PbB level (β = 0.023, 95% CI: −0.020 to 0.027), renal function-related urine albumin creatinine ratio (β = 1.541, 95% CI: 0.615–2.468), serum uric acid level (β = 0.012, 95% CI: 0.007 to 0.017), and serum creatinine level, and negatively associated with estimated glomerular filtration rate (eGFR) (β = −0.804, 95% CI: −0.880 to −0.728). Furthermore, the mediation effect test confirmed that PbB played a mediating role in the relationship between restoration count and serum uric acid or eGFR, with mediation effects accounting for 98.0% and 71.0%, respectively. ConclusionsOral restoration negatively affects renal function. Oral restoration-related PbB level is a potential mediating factor.

Assessment of Blood Lead and Its Determinants among Cables Industry Workers at 10th of Ramadan City in Egypt

Assessment of Blood Lead and Its Determinants among Cables Industry Workers at 10th of Ramadan City in Egypt

A rare case report of lead encephalopathy due to high blood lead level

AbstractHere we report a case of lead poisoning having a serum lead level of 412 mcg dL−1 who presented with decreasing level of consciousness and recurrent seizures. He responded well to treatment with chelation therapy.

Analysis of blood lead level and its clinical significance among occupational exposed painters in chennai based population: A cross sectional study

Introduction and aimLead is a ubiquitous element found in the earth crust. There is no known physiologic role of lead in human body and hence any amount of lead present in human tissue considered as a contamination. Several studies on lead toxicity show that, occupational exposure remains the main source for lead toxicity and is emerging as important public health problem. Burden and severity of occupational exposure of lead and its clinical significance are gaining more interest in the field of toxicology. Only limited studies are available and there is scarcity of epidemiology data to assess the blood lead levels of workers and the contribution of common workplace practices to lead exposure in India especially from our region. So, the current study is designed to assess the blood lead levels (BLL) and its clinical significance among high risk workers especially painters working in the construction and public private sector in Chennai based population. Materials and methodsThis cross-sectional case control study included 122 painters and 122 healthy individuals. A detailed questionnaire about demographic details, personal habits, work related safety precautions, presenting symptoms of lead toxicity were given to painter followed by detailed medical examination and blood investigations including blood lead levels were collected and statistically analyzed. The t-test were used to compare mean blood lead levels and to investigate the associations between specific job type, use of self-protection device,sex, service years and occurrence of non-specific symptoms with BLLs. ResultsThe mean BLL of the painters were less than the recommended threshold level. Among painters 13.1% were categorized under BLL > 10 μg/dL. The higher BLL among the painters were directly proportional to year of experience and poor usage of personal protective materials. The levels of Hb, HCT and eosinophil were much correlated with lead toxicity. A marginal significance were observed in some parameters especially urea and creatinine when compared with control. The Cognitive dysfunction, hypertension and renal dysfunction were also observed among the painters. ConclusionThe BLL in painters among our group were minimal compared to biological reference value. Duration of exposure and association of patient’s clinical features like cognitive dysfunction, hypertension and renal dysfunction conditions were observed and this should be carefully monitored and study on huge population of painters with longitudinal aspect is recommended to rule out the clinical correlation of lead toxicity.

Sources, blood concentrations, and approaches for reducing exposure to lead: A critical appraisal on lead poisoning

Lead, a non-essential metal, enters the body in various ways, making it a major public health issue. Painters and smelters report lead poisoning in children and staff. Mining and battery workers risk lead exposure. Traditional and cultural remedies may include dangerous quantities of lead, producing lead poisoning. These drugs must be properly understood and regulated to avoid toxicity. Lead poisoning symptoms vary by duration and severity. Lead first impairs cognition, development, and behaviour by damaging the neural system. Time degrades reproductive and haematological systems. Lead's quiet entry into the body makes it deadly. Acute lead nephropathy damages kidneys at 100mg/dL. Lead levels exceeding 150mg/dL may induce encephalopathy. Blood lead levels indicate lead poisoning severity. Lead levels over 10g/dL in children and 40g/dL in adults are hazardous. Lead toxicity affects various organs. Lead may induce hypertension and cardiovascular disease. It may also cause chronic kidney disease and renal failure. Lead exposure may impede fertility, cause miscarriages, and alter foetal development; hence the reproductive system is vulnerable. Symptoms and lead levels may be treated with different approaches. Lead chelation treatment is frequent. Other vitamins and medications may enhance organ function and treat lead poisoning. Lead poisoning prevention requires widespread awareness. Strict standards and education regarding lead-contaminated products and conventional remedies should reduce occupational lead exposure. Regular blood lead level monitoring, especially in youngsters and lead workers, may help detect and treat lead poisoning early. Lead poisoning has serious health consequences. Understanding lead exposure pathways, identifying symptoms, and preventing lead poisoning is essential to public health and organ system protection.

The Relationship between Blood Lead Level and Chronic Pain in US Adults: A Nationwide Cross-Sectional Study.

Lead toxicity has been a major public health problem worldwide, yet no study has investigated the association between lead exposure and chronic pain. We used data from three cycles of National Health and Nutrition Examination Survey (NHANES) with chronic pain status. We conducted univariate and multivariate logistic regression analyses to investigate the association between chronic pain and blood lead level (BLL). Subgroup analyses were performed to explore which confounding factor modified the association between chronic pain and BLL. A total of 13,485 participants were included in our final analysis, out of which 1950 (14.46%) had chronic pain. In the fully adjusted model, a 1μg/dL increase of BLL was associated with 3% higher risk of chronic pain. The highest BLL quartile (BLL > 2.40μg/dL) was associated with a 32% increase in the risk of chronic pain compared with the lowest BLL quartile (BLL < 0.90μg/dL). In the subgroup analyses, hypertension (P for interaction = 0.018) and arthritis (P for interaction = 0.004) status modified the association between BLL and chronic pain. Higher quartiles of BLL were associated with a higher risk of chronic pain only in individuals with hypertension or arthritis but not those without these conditions. A higher BLL was associated with a higher risk of chronic pain. Further research is warranted to investigate whether a causal relationship exists between the two, as well as potential underlying mechanisms.