Significantly increased serum IgE Male battery-manufacturing workers in Korea Mean BLL ≥30 μg/dL p < 0.05 for IgE levels compared with controls. IgE is classic hallmark of type I hyersensitivity, and increase is associated with allergies. Heo et al. 2004
Significantly increased memory T cells, increased CTL cells Male lead workers (33-67 y old) Mean BLL = 19 μg/dL (range = 7-50 μg/dL) p < 0.05 for changes in memory T, CTL cells (age, smoking covariates). Relevant to BLL of firing-range instructors. Sata et al. 1998
Significantly reduced percentage of CD3+, CD4+ cells; reduced proliferation of T lymphocytes; decreased HLA responsiveness Firearms instructors High-exposure group (≥25 μg/dL), mean BLL = 31.4 (± 4.3) μg/dL; low-exposure group (<25 μg/dL), mean BLL = 14.6 (± 4.6) μg/dL p < 0.002 for changes in CD3+ cells, CD4+ cells, CD4:CD8 ratio in lowexposure group; p < 0.01 for changes in HLA in lowexposure group; extent of change was greater in highexposure group. Same occupation as DOD population. Fischbein et al. 1993
Significant decrease in percentage of CD8+ cells; increased CD4+:CD8+ ratio Portuguese workers employed in inorganic lead plants for different durations Average BLL = 32 μg/dL; average ALAD activity = 42 U; average ZPP = 52 μg/dL p < 0.05 for changes in CD8+ lymphocytes, CD4+:CD8+ ratio. Most recent study with BLLs similar to those measured in firing-range instructors. Garcia-Leston et al. 2011
Significantly reduced neutrophil function (chemotaxis, random movement); reduced neutrophil-associated oxidative stress Male workers employed in storage-battery plants for average of 4 y Average BLL = 41.1 ± 12.6 μg/dL in 22 workers; urinary ALAD <6 mg/L p < 0.001 for chemotaxis. Relevant to BLL of firing-range instructors; changes in neutrophil function noted as key indicator of leadinduced changes in animal models. Queiroz et al. 1993

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