Association between Blood Concentrations of Lead and Total IgE in South Korean Adults: An Analysis of Data from the Fourth Korean National Environmental Health Survey

Abstract

Background: Long-term exposure to heavy metals may affect the human immune system in adult populations as well as children.Objectives: This study aimed to evaluate the association between blood concentrations of lead and mercury and total immunoglobulin E (IgE) level among South Korean adults.Data from the Fourth Korean National Environmental Health Survey (KoNEHS, 2018~2020) was used.Methods: Among the adult participants in the Fourth KoNEHS, those who had taken antiparasitic medications or traditional herbal medicine within the past year were excluded.A total of 2,655 subjects (2,688 when sampling design weights were applied) were included in the final analysis.All statistical analyses were conducted using the survey package in R (ver.4.4.1).General linear models (GLMs) were employed to assess the associations between blood concentrations of lead and mercury and total IgE levels, adjusting for age, sex, body mass index (BMI), education level, urinary cotinine concentration, alcohol consumption, physical activity, large fish (including tuna) consumption, and job classification. Results:The association between blood lead and total IgE was statistically significant in the multiple regression model after adjustment for covariates and blood mercury level (p=0.02).A similar result was observed when blood lead level was divided into quintiles (p trend =0.05).Stratified analysis by sex and smoking status showed that the association was significant among men and current smokers (p interaction =0.01, 0.002, respectively).In terms of blood mercury levels, the association between blood mercury and total IgE disappeared when its correlation with blood lead and other exposure markers such as per-and polyfluoroalkyl substances was considered (p>0.10). Conclusions:The findings of this study suggest a positive association between blood concentration of lead and total IgE levels among South Korean adults, especially men and smokers.However, further prospective studies are warranted to establish causal relationships.