Bone mineral density (BMD) and osteoporosis risk factor in Egyptian male and female battery manufacturing workers Bassem M Raafat, Nahed S Hassan and S W Aziz Abstract The study was conducted to estimate the relation between lead exposure and the risk of various symptoms of osteoporosis in male and female battery manufacturing workers by using dual energy X-ray absorptiometry. A total of 18 female and 24 male workers were chosen with the same age range, duty hours per day, work history and weight. A total of 15 healthy controls were chosen with no previous history of bone illness and normal blood lead concentration. Blood lead concentration was measured in all workers and controls. Non-lead elevated subjects were excluded. Bone mineral density was measured by X-ray-based dual-energy X-ray absorptiometry scan machine. Spine, femur neck and radius sites were studied. Results showed that both male and female workers recorded significant elevated levels of lead concentration accompanied by osteo- porosis when compared with control. Interestingly, the data revealed that fracture risk in female was significantly higher than male workers. It was concluded that lead poisoning may act as osteoporosis risk factor or co-factor in female workers by activating the conversion of osteopenia to osteoporosis. Keywords Battery workers, lead poisoning, osteoporosis, osteopenia, bone mineral density (BMD) Introduction Understanding of lead toxicity has advanced substan- tially over the past three decades, and focus has shifted from high-dose effects in clinically sympto- matic individuals to the consequences of exposure at lower doses that cause no symptoms (Abelsohn and Sanborn, 2010). The availability of more sensitive analytic methods has made it possible to measure lead at much lower concentrations (Roy et al., 1997). This advance, along with more refined epidemiological techniques and better outcome measures, has lowered the least observable effect level until it approaches zero (Payne et al., 2010). As a consequence, the seg- ment of the population who are diagnosed with expo- sure to toxic levels has expanded. At the same time, environmental efforts, most importantly the removal of lead from gasoline, have dramatically reduced the amount of lead in the biosphere (Rosen et al., 1991). Workers exposed to elevated lead levels as those in paints factories and battery manufacturing are approx- imately in the maximum risk (Brian et al., 2009). Measurement of Pb in blood is the most widely used laboratory indicator of excessive Pb exposure in humans (Somervaille et al., 1988). In instances where current Pb exposure can be reliably assumed to be at an excessive level, such as in occupationally exposed adults and in children living in deteriorating housing containing leaded paint, measurement of blood Pb is of considerable public health relevance as a screening method (Manton et al., 2000). However, for general populations, particularly with undocumented or suspected exposure histories, blood Pb values provide limited toxicological information, Biophysics Group, Biochemistry Department, Genetic Engineering and Biotechnology Division, National Research Center, Dokki, Giza, Egypt Corresponding author: Bassem M Raafat, Genetic Engineering and Biotechnology Division, National Research Center, Tahrir Street, Giza 11421, Egypt Email: bassemraafat@hotmail.com Toxicology and Industrial Health 2012, Vol. 28(3) 245-252 ª The Author(s) 2011 Reprints and permission: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0748233711410912 tih.sagepub.com