The use of K X-ray fluorescence for measuring lead burden in epidemiological studies: high and low lead burdens and measurement uncertainty.

X-ray fluorescence (XRF), a rapid, noninvasive, low-radiation-dose method of measuring bone lead content, has emerged as a promising tool for providing an integrated estimate of low-level lead accumulation in epidemiological studies. Our group has settled on an XRF instrument that utilizes K X-rays (K-XRF) and normalizes the measurement to bone calcium. The unit of measurement provided is in micrograms of lead/gram bone mineral, an accurate proxy for micrograms of lead/gram bone ash. An estimate of measurement uncertainty is generated from the counting statistics and is theoretically dependent on several factors, primarily duration of measurement and bone mass. Data from pilot studies of community-exposed adults and workers with varying degrees of occupational lead exposure demonstrated that the K-XRF instrument can easily distinguish between populations with occupational versus environmental lead exposures. Among all subjects, bone lead increased with age. Larger measurement uncertainty was significantly associated with being female, greater subject weight, and smaller lead burdens.