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Recent studies indicate that lead may exert actions both directly on osteoblast and osteoclast function, and indirectly via kidney dysfunction on bone turnover. The main focus of this study was to investigate whether occupational lead exposure is associated with low bone mass in a population working in a storage battery plant.Monophoton absorptiometry was used to measure bone mineral density (BMD) in the population and the Z score was introduced to define osteoporosis (Z score < —2). Lead concentration of urine and blood was determined by graphite-furnace atomic absorption spectrophotometry as an exposure biomarker. A total of 249 persons (191 males and 58 females) participated and completed a questionnaire in order to obtain information on height, weight, age, medical and drug history, cigarette smoking, alcohol consumption, job position, work year, physical exercise, etc.The BMD was significantly decreased in the groups of the high urinary lead (UPb) level compared with the low UPb level with a significant difference (P < 0.05) in both genders, but no such significant difference was observed in the relationship between blood lead (BPb) and BMD. The prevalence of osteoporosis would increase significantly with the increase of the UPb (P < 0.01) in the linear correlation manner (P < 0.01). There was also such a significant relationship between BPb and osteoporosis (P < 0.01). There was a dose-response relationship between lead exposure and prevalence of osteoporosis.In contrast to BPb, UPb had a more close relationship with osteoporosis caused by lead. It was concluded that occupational exposure to lead is associated with osteoporosis.