Workers' Behavior and Hygienic Parameters Related to Blood Lead Levels: A Cross-Sectional Biomonitoring Study in an Italian Automotive Plant

Occupational lead exposure is a relevant health concern, but the relationships between lead exposure, biomarkers, and individual, occupational, and hygienic characteristics remain incompletely understood. This study investigated associations between blood lead (Pb) and zinc-protoporphyrin (ZnPP) levels and occupational, clinical, individual, lifestyle, and hygiene-related characteristics in 464 exposed workers. Occupational and individual data were collected and statistically analyzed to identify associations between biomarkers and categorical or continuous variables. Blue-collar and maintenance workers showed significantly higher blood Pb levels than white-collar workers (11.07 and 10.42 vs. 4.81 µg/dL). Unadjusted analyses showed higher blood Pb levels among forklift users and workers in production units 1 and 2. No statistically significant differences in ZnPP were observed across the occupational categories examined. Female sex, non-smoking status, and longer hair were associated with lower Pb levels. Exploratory multivariable analyses identified associations of ZnPP with hypertension and physical activity, but the model explained only 3.65% of its variance. As expected, due to the low concentrations of xenobiotics detected, a weak association was observed between blood Pb and ZnPP. Overall, the findings suggest modest associations between biomarker levels and select individual/occupational characteristics (such as hair length and forklift use). Given the low proportion of explained variance, these exploratory observations should be interpreted with caution and warrant further research.