Korean J Fam Pract 2020; 10(6): 474-479  https://doi.org/10.21215/kjfp.2020.10.6.474
Correlation Analysis of Ascorbic Acid Intake and Blood Lead Levels in Korean Adults: Results from the Korean National Health and Nutritional Examination Survey, 2016
Min Young Chu, Jong Lull Yoon, Jung Jin Cho, Mee Young Kim*, Mi Jeong Park, Ju Hye An
Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
Mee Young Kim
Tel: +82-31-8086-3790, Fax: +82-31-8086-2709
E-mail: doctorkmy@hallym.or.kr
ORCID: https://orcid.org/0000-0002-1724-2175
Received: August 14, 2020; Revised: November 18, 2020; Accepted: November 23, 2020; Published online: December 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Lead is a toxic heavy metal that affects multiple body systems. Few human and animal studies have suggested that oral intake of ascorbic acid may decrease the risk of lead toxicity and blood lead levels. Therefore, this study examined the relationship between ascorbic acid intake and blood lead levels in the general Korean population.
Methods: This study analyzed 1,415 Koreans aged ≥19 years who participated in the 2016 Korea National Health and Nutrition Examination Survey (KNHANES). The participants were divided into two groups according to their daily ascorbic acid intake (≥100 mg/day, <100 mg/day). We assessed the association between the intake of ascorbic acid and blood lead levels using linear regression analysis after adjusting for confounding variables such as age, sex, smoking status, high-risk alcohol consumption, body mass index, and occupation.
Results: Male sex, young age (in their 20s), low income, smoking, high-risk drinking, and manual work were significantly associated with low intake of ascorbic acid (<100 mg/day) (P<0.05). Older age, male sex, smoking, high-risk drinking, obesity, and manual work were related to higher blood lead levels (P<0.05). A significant negative relationship was found between ascorbic acid intake and blood lead levels after adjusting for age, sex, smoking status, high-risk drinking, body mass index, and occupation (B=-0.12, P=0.021).
Conclusion: Compared with the group that ingested less than the recommended daily intake of ascorbic acid (<100 mg/day), the group with adequate daily ascorbic acid intake (≥100 mg/day) was associated with decreased blood lead levels.
Keywords: Ascorbic Acid; Lead; Metals, Heavy; Nutrition Surveys
  1. National Institute of Food and Drug Safety Evaluation. Risk assessment of lead [Internet]. Cheongju: National Institute of Food and Drug Safety Evaluation; 2016 [cited 2020 Jul 22].
  2. U.S. Department of Health and Human Services. Toxicological profile for lead [Internet]. Atlanta: ATSDR; 2020 [cited 2020 Oct 31].
  3. Oh SE, Kim GB, Hwang SH, Ha M, Lee KM. Longitudinal trends of blood lead levels before and after leaded gasoline regulation in Korea. Environ Health Toxicol 2017; 32: e2017019.
    Pubmed KoreaMed CrossRef
  4. Mannino DM, Albalak R, Grosse S, Repace J. Second-hand smoke exposure and blood lead levels in U.S. children. Epidemiology 2003; 14: 719-27.
    Pubmed CrossRef
  5. Lee PK, Youm SJ, Bae BG. Geochemical characteristics and pollution level of heavy metals of Asian dust in Daejeon area, 2007 (spring season). Econ Environ Geol 2012; 45: 217-35.
  6. Liou SH, Wu TN, Chiang HC, Yang T, Yang GY, Wu YQ, et al. Three-year survey of blood lead levels in 8828 Taiwanese adults. Int Arch Occup Environ Health 1996; 68: 80-7.
    Pubmed CrossRef
  7. Lee B, Ha J. The effects of smoking and drinking on blood lead and cadmium levels: data from the Fourth Korea National Health and Nutrition Examination Survey. Korean J Occup Environ Med 2011; 23: 31-41.
  8. Mitra P, Sharma S, Purohit P, Sharma P. Clinical and molecular aspects of lead toxicity: an update. Crit Rev Clin Lab Sci 2017; 54: 506-28.
    Pubmed CrossRef
  9. Koo MJ. Relationship between blood lead level and mortality among Korean adults [dissertation]. Seoul: Hanyang Univ.; 2019. Korean.
  10. Lanphear BP, Hornung R, Khoury J, Yolton K, Baghurst P, Bellinger DC, et al. Low-level environmental lead exposure and children's intellectual function:an international pooled analysis. Environ Health Perspect 2005; 113: 894-9.
    Pubmed KoreaMed CrossRef
  11. Kim HC, Jang TW, Chae HJ, Choi WJ, Ha MN, Ye BJ, et al. Evaluation and management of lead exposure. Ann Occup Environ Med 2015; 27: 30.
    Pubmed KoreaMed CrossRef
  12. Lihm H, Kim H, Chang H, Yoon M, Lee K, Choi J. Vitamin C modulates lead excretion in rats. Anat Cell Biol 2013; 46: 239-45.
    Pubmed KoreaMed CrossRef
  13. Dawson EB, Evans DR, Harris WA, Teter MC, McGanity WJ. The effect of ascorbic acid supplementation on the blood lead levels of smokers. J Am Coll Nutr 1999; 18: 166-70.
    Pubmed CrossRef
  14. Sundari LPR, Dinata IMK, Adiputra LMISH, Tunas IK. Oral administration of 250 mg vitamin C reduces the blood level of lead in female street sweepers of Denpasar city. Biomed Pharmacol J 2017; 10: 985-9.
  15. Ghanwat G, Patil AJ, Patil J, Kshirsagar M, Sontakke A, Ayachit RK. Effect of vitamin C supplementation on blood lead level, oxidative stress and antioxidant status of battery manufacturing workers of Western Maharashtra, India. J Clin Diagn Res 2016; 10: BC08-11.
    Pubmed KoreaMed CrossRef
  16. Simon JA, Hudes ES. Relationship of ascorbic acid to blood lead levels. JAMA 1999; 281: 2289-93.
    Pubmed CrossRef
  17. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans 2015. Sejong: Ministry of Health and Welfare;2015. p. 360-71.
  18. Friedrich W. Vitamins. Berlin: W. de Gruyter; 1988. p. 978-9.
  19. Dhawan M, Kachru DN, Tandon SK. Influence of thiamine and ascorbic acid supplementation on the antidotal efficacy of thiol chelators in experimental lead intoxication. Arch Toxicol 1988; 62: 301-4.
    Pubmed CrossRef
  20. Ministry of Health and Welfare. Korea health statistics 2016: Korea National Health and Nutrition Examination Survey (KNHANES VII-1) [Internet]. Cheongju: Ministry of Health and Welfare; 2017 [cited 2020 Jul 22].
  21. Kristal AR, Peters U, Potter JD. Is it time to abandon the food frequency questionnaire? Cancer Epidemiol Biomarkers Prev 2005; 14: 2826-8.
    Pubmed CrossRef
  22. Korea Environment Corporation. Real-time air quality data [Internet]. Incheon: Korea Environment Corporation; 2020 [cited 2020 Jul 22].

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