Pre-designed questionnaires and forms were then used to record demographic data, past medical histories and clinical manifestations of lead poisoning in workers of the car battery industry. Validated questionnaires from previous

studies,12,13 were used. Workers who were treated by Decitabine clinical trial chelating agents, such as Meso-2,3-dimercaptosuccinic acid (Succimer), calcium disodium EDTA (CaNa2EDTA), 2,3-dimercaptopropanol or british anti lewisite and D-penicillamine, during the last 6 months were not included in this study. Besides, those with any cardiac, hepatic and renal diseases as well as workers who took drugs that could alter hematological, biochemical and renal Inhibitors,research,lifescience,medical indices were excluded. A clinical toxicologist examined the workers just before taking blood and urine samples and prior to start working Inhibitors,research,lifescience,medical in the morning. Clinical signs and symptoms were recorded in a nominal YES/NO scale. For example, fatigue was recorded for a worker if his tiredness did not alleviate with rest; or increased excitability was considered with exaggerated response to social stressors. To Inhibitors,research,lifescience,medical evaluate workers’ concentration, they were asked to count backwards from 100 to 0 in sevens, “100, 93, 86, 79 …” or fours “100, 96, 92 …” Also, short-term memory was assessed by recalling 3 to 5 most recently learned words of a list.

At the same time, vital signs were evaluated by a clinical research assistant. Brachial venous blood samples (10 ml) from each worker were collected into heparinized tubes ,in order to analyze their blood lead concentration(BLC) cell blood count (CBC), fasting blood sugar

(FBS), Cholesterol, low-density lipoprotein Inhibitors,research,lifescience,medical (LDL), high-density lipoprotein (HDL) and triglycerides (TG). Lead-free syringes and lead-free polyethylene containers were used to minimize the risk of lead contamination throughout the study. Blood and urine lead concentrations were determined by an experienced technician in the toxicology laboratory of the research center using an atomic absorption spectrometer (Perkin-Elmer, Model 3030, USA) with heated graphite atomization technique. Hematologic Chlormezanone test was performed Inhibitors,research,lifescience,medical in the hematology laboratory of Imam Reza University Hospital using Cell Counter Sysmex; Model KX21N to measure CBC. Auto Analyzer; Model BT3000 was applied to measure biochemical parameters in the biochemistry laboratory of the hospital. Workers diagnosed with lead poisoning were treated according to the guidelines.14 Finally, clinical and laboratory data were analyzed by the Statistical Package for Social Sciences (SPSS 18, IBM Corporation, New York, USA). Results were expressed as mean±standard deviation. Pearson correlation was applied to evaluate association between hematologic, biochemical and toxicological parameters. Besides, linear models were used to perform multivariate analysis, and a 2-sided P value<0.05 was considered statistically significant.