In this study, the cytogenetic response to lead exposure in storage battery manufacturing workers carrying different alleles of δ-aminolevulinic acid dehydratase (ALAD 1 and ALAD 2) was evaluated. The cytogenetic response was measured by analysis of the frequency of sister chromatid exchange (SCE) and the number of high-frequency cells (HFCs) in peripheral blood lymphocytes from workers occupationally exposed to lead. A total of 71 voluntary male workers were enrolled in the study. According to our genotype analysis, 50 workers had the ALAD 1-1 genotype and 21 workers had the ALAD 1-2 genotype. In spite of the statistically insignificant difference in mean values of SCE per cell between ALAD 1-1 and ALAD 1-2 workers, the percentage of HFC (HFC (%)) was statistically (χ 2-test, P<0.05) higher in ALAD 1-1 workers. The control group was selected among voluntary male office workers (n=20) and genotyping was also performed for this group in order to rule out the possibility that ALAD 1-1 subjects had a higher HFC (%) than ALAD 1-2 carriers, independent of the exposure to lead. Accordingly, 11 control workers had the ALAD 1-1 genotoype and 9 workers had ALAD 1-2. The differences in mean values of SCE per cell and HFC (%) were not statistically significant when the two genotypes in the control group were compared. On the basis of this result we suggest that ALAD 1-1 subjects might be more susceptible to cytogenetic effects of lead exposure than ALAD 1-2 subjects. There were no ALAD 2-2 subjects in the exposed and control groups.