We aimed to report environmental and blood lead level (BLL) in China, and investigate the relationship of BLL with body mass index (BMI) and obesity. 5558 subjects were enrolled from 16 sites in China. BLL was measured by atomic absorption spectrometry. Obesity was defined as BMI ‰ 30 kg/m 2. Median (interquartile range) of BLL was 44.00 1/4g/L (29.00-62.16) for men and 37.79 1/4g/L (25.13-54.35) for women, about twice higher than in U.S. population. Subjects in rural and high-economic-status areas had significantly greater BLL (P < 0.001). However, in these areas, the lead levels in drinking water, river water and rice were comparable to or significantly lower than those in urban and low-economic-status areas. After adjustment for age, urbanization, economic status and metabolic factors, BLL was independently associated with BMI in women (P for trend < 0.001), but not in men. In fully adjusted model, increased quartiles of BLL were associated with significantly increased odds ratios of obesity (P for trend < 0.01) in women. In conclusion, BLLs in Chinese adults were much higher than in developed countries. There was a sex-specific association between BLL and BMI. Elevated BLL does not appear to be associated with lead levels in drinking water or rice, suggesting some other exposure source.
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