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PubMed1989

[Lead poisoning due to drug addiction: a new source of poisoning with clinical interest and important epidemiological consequences].

Lead poisoning has accompanied the human being throughout history. Owing to the increasing levels of safety at work, the incidence of occupational poisoning has decreased and new forms of non-occupational poisoning have emerged. We present 3 cases of drug addicts, with lead poisoning, as a result of using adulterated drugs. One of them was an intravenous drug addict who had abdominal pain and anemia. The other 2 inhaled heroin, one being slightly anemic and the other without symptoms and with normal hemoglobin levels. The drug adulterated with lead had not been previously recognized as a source of lead poisoning, being likely to cause serious epidemiological effects.

Adult↗
PubMed1992

Management of childhood lead poisoning: a survey.

Published recommendations (1985) for the management of childhood lead poisoning suggest the use of ethylenediaminetetraacetic acid (EDTA) provocation testing and chelation as the mainstay of treatment for blood lead levels between 25 and 55 micrograms/dL. Since 1985 evidence has accumulated indicating that (1) levels of blood lead less than 25 micrograms/dL are detrimental to cognitive development, (2) EDTA provocation testing may result in potentially harmful shifts in the body lead burden, and (3) oral agents such as penicillamine and 2,3-dimercaptosuccinic acid are effective in reducing elevated lead levels. To determine how this evidence impacts on the management of childhood lead poisoning, the authors surveyed the lead poisoning clinics of pediatric departments in the cities estimated by the United States Public Health Service to have the largest number of children affected by lead poisoning. Thirty (70%) of 43 surveys were completed. Respondents indicated that the lowest blood lead level for which they would use a chelating agent to reduce the lead burden was as follows: 50 micrograms/dL (3%), 45 micrograms/dL (3%), 40 micrograms/dL (13%), 35 micrograms/dL (3%), 30 micrograms/dL (27%), 25 micrograms/dL (47%), and 20 micrograms/dL (3%). For all blood lead levels from 20 through 55 micrograms/dL, EDTA was the most frequently recommended chelating agent (chelation and provocation testing). Fifteen percent of responding lead clinics do not use the provocation test under any circumstances. For a child with a negative EDTA provocation test, the percentage of respondents recommending the use of any chelation therapy ranged from 16% for blood lead levels of 25 through 29 micrograms/dL to 66% for levels of 50 through 55 micrograms/dL.(ABSTRACT TRUNCATED AT 250 WORDS)

Chelating Agents↗
PubMed1983

A fatal case of lead poisoning due to a retained bullet.

Lead poisoning from a retained bullet or missile is rare and is usually dependent on the location of the missile in a bone or immediately adjacent to a joint. A review of the literature revealed only 14 cases in which there was adequate laboratory documentation of plumbism caused by a retained bullet or missile. Only one of these previously reported cases resulted in death. We report a second death due to lead poisoning from a retained bullet with elevated blood lead levels documented by toxicologic analysis.

Female↗
PubMed1998

Occupational lead poisoning.

The continued occurrence of occupational lead overexposure and lead poisoning in the United States remains a serious problem despite awareness of its adverse health effects. Lead exposure is arguably the oldest known occupational health hazard. It is a particularly insidious hazard with the potential for causing irreversible health effects, including hypotension, central nervous system problems, anemia and diminished hearing acuity before it is clinically recognized. Scientific evidence of subclinical lead toxicity continues to accumulate, making further reduction in workplace exposure, regular screening, and earlier diagnosis and treatment of critical importance in the prevention of this occupational hazard. For the most part, the diagnosis of lead poisoning in the adult worker is based on the integration of data obtained from the history, a physical examination, laboratory tests and tests of specific organ function. A blood level of 40 micrograms per dL (1.95 mumol per L) or greater requires medical intervention; a level of 60 micrograms per dL (2.90 mumol per L) or three consecutive measurements averaging 50 micrograms per dL (2.40 mumol per L) or higher indicate the necessity for employee removal. The decision to initiate chelation therapy is not based on specific blood levels but depends on the severity of clinical symptoms.

Adult↗
PubMed1995

[Evaluation of decontamination interventions in 59 homes of children with lead poisoning].

Old peeling paint with high content of lead has been identified as the main source of lead poisoning for children screened in Paris since 1985. In 1989, Médecins Sans Frontières and Migration Santé tested abatement methods in 59 homes of severely lead-poisoned children. The effectiveness of abatement is evaluated with respect to the evolution in dust lead contents and of the children's blood lead levels. Lead content wsas measured in dust samples collected from the floor of the homes before abatement, then every three months after abatement; results are available for 24 homes. Blood lead levels were assessed in the course of the children's medical follow-up; results are available before and after abatement for 78 children living in 41 of the abated homes. The effect of abatement on the children's blood lead level was assessed through multivariate analysis. The median decrease in dust lead contents was 365 micrograms/m2 one to two months after abatement and 300 micrograms/m2 three to six months after abatement. However, dust lead contents of more than 1,000 micrograms/m2 were found in more than half of the communal areas of the buildings six to twenty-eight months after abatement. For 2 of the families, abatement was associated with an increase in the children's blood lead-levels. For all of the other children, abatement was associated with a significant decrease in blood lead levels, controlling for the child's age and initial lead poisoning level, and for the overall downward trend in blood lead levels over time since the initial screening.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1981

Gingival pigmentation as the sole presenting sign of chronic lead poisoning in a mentally retarded adult.

A diagnosis of chronic lead poisoning in a mentally retarded adult with pica was initially proposed because of the presence of a "lead line" on the patient's gingiva. The patient had no other signs or symptoms suggestive of her toxic state. Lead poisoning is reviewed from the standpoint of epidemiology, pathophysiology, clinical and oral manifestations, and diagnostic procedures. Dentists working with children or mentally retarded patients should be aware of the increased incidence of lead poisoning in these patient populations and the importance of oral findings and lead-screening techniques in the detection of lead poisoning.

Chronic Disease↗
PubMed1984

Lead poisoning: hair analysis shows the calendar of events.

A woman was given frequent oral doses of lead nitrate over an extended time period. Diagnosis was finally made about 6 months after the first symptoms appeared. Analysis of hair taken at 2 different times was used as evidence in court. The hair lead concentrations exhibited rapid changes and normalised shortly after chelation treatment had been instituted. This finding suggests that the hair lead level may reflect a current absorption level rather than the lead content of whole blood which, in this case, changed much more slowly. Despite the extremely high blood lead levels and the severe clinical lead poisoning, lead concentrations in hair were relatively low in comparison to the concentrations found in hair of workers exposed to high levels of airborne lead. This observation suggests that a large proportion of the lead content of hair from individuals with respiratory lead exposure may be exogenous.

Adult↗
PubMed1988

Interaction of iron deficiency and lead and the hematologic findings in children with severe lead poisoning.

Microcytic anemia, long considered an effect of lead poisoning, may in fact result from coexisting iron deficiency. In this study, how RBC size, hemoglobin, and zinc protoporphyrin vary as a function of iron status in a group of children with high lead levels was examined. Charts of all children (N = 51) admitted to Cook County Hospital for treatment of lead poisoning in 1981 to 1983 were reviewed for data on age, blood lead level, hemoglobin concentration, MCV, transferrin saturation and zinc protoporphyrin level. The mean lead level was 86 micrograms/dL and the range was 63 to 190 micrograms/dL. Children with transferrin saturation values less than 7% had a mean MCV of 56 microL, hemoglobin of 8.9 g/dL, and zinc protoporphyrin of 693 micrograms/dL; for those with saturations of 7% to 16%, the values were 61 microL, 10.1 g/dL, and 581 micrograms/dL, respectively; the children with saturations greater than 16% had normal mean MCVs and hemoglobin concentrations (74 microL and 11.4 g/dL) and a mean zinc protoporphyrin value of 240 micrograms/dL (P less than .0005). Multiple linear regression was used to correct for effect of age, and transferrin saturation remained the most important predictor of MCV, hemoglobin, and zinc protoporphyrin levels; the addition of lead did not improve the models. Results of this study suggest that iron deficiency is strongly associated with some of the observed toxicities of lead. Also, lead poisoning can exist without producing microcytosis or anemia, and zinc protoporphyrin concentration may not be a sensitive indicator of lead level in the absence of iron deficiency.

Anemia, Hypochromic↗
PubMed1990

Lead poisoning in a dog.

A case of lead poisoning caused by ingestion of a lead roof-washer is described in a one-year-old, spayed Fox Terrier bitch, presented with nervous signs, and basophilic stippling of red blood cells. Blood concentrations of lead were in the low toxic range. Radiography of the abdomen revealed radio-dense objects in the stomach, which on gastrotomy included a lead roof-washer. Prior to removal of the foreign bodies, the dog showed remarkable improvement on non-specific symptomatic treatment alone, and recovered well after surgery, only to die unexpectedly several hours later. Concentrations of lead in the liver and kidneys were extremely high, and histology revealed typical intracellular inclusions and organ degeneration. In the light of these findings, it is suggested that all cases of suspected or confirmed lead poisoning be given specific chelation therapy.

Animals↗
PubMed2001

Treatment of lead poisoning with an immobilized chelator comparison with conventional therapy.

Lead poisoning is a global public health problem. In pregnant women it may result in developmental delays of the fetus, in children it my produce learning disability. Available chelators are nephrotoxic when eliminated as lead-chelator complexes. For safe removal of lead from the body we developed a "Lead-Hemopurifier" (L-HP), a device with an immobilized chelator. In vitro, applied to lead solutions, this device reduced the lead concentration. Applied to dogs with lead intoxication, Lead-HP-s removed lead from the blood; this was continuously replaced by lead from the bones until the skeleton was cleared from lead deposit. Treatment of lead poisoning in dogs with Lead-HP-s compared favorably with Versenate treatment of children with lead toxicity. This report demonstrates the in vivo efficiency and safety of this new detoxfication method. Methods to induce lead poisoning in dogs and procedures to identify lead released from skeletal deposits are described.

Animals↗
PubMed1985

Identification of community flour mills as the source of lead poisoning in West Bank Arabs.

Following the discovery of severe lead poisoning in members of several households in a West Bank village, studies were carried out to establish the magnitude of the problem in the community and to identify the source of lead poisoning. Forty-three patients with Centers for Disease Control risk group IV lead poisoning were identified and treated in three villages within a radius of about 10 km of each other. The prevalence of increased lead burden among 563 schoolchildren aged 10 to 18 years was 19% for Centers for Disease Control risk groups I and II and 11% for groups III and IV. A survey of potential sources excluded all items, except for locally ground flour, which was heavily contaminated in all affected households. Examination of community flour mills revealed that, in contrast to unprocessed grain, freshly ground flour contained large amounts of lead originating from lead fillings employed to fasten the housing of the driveshafts to the millstones. Systematic screening of 146 community stone mills in 92 West Bank villages showed significant lead contamination of flour in 33 mills (23%). In all cases, the source of lead contamination was identical. As methods of milling in the area are similar, a prompt investigation of this potential source of lead poisoning in other near-Eastern countries is indicated.

Adolescent↗
PubMedDate not supplied

Childhood lead poisoning: shifting to primary prevention.

Childhood lead poisoning remains a serious public health problem for millions of American children. Although adverse health effects related to elevated blood levels have been reported in children from all socioeconomic groups, the prevalence of serious lead poisoning remains highest among poor children in urban areas. The Centers for Disease Control has revised guidelines for intervention with an emphasis on primary prevention.

Child↗
PubMed1955

LEAD POISONING.

Explore the source record for details and available documents.

Acetates↗
PubMed2002

Lead poisoning and asthma: an examination of comorbidity.

OBJECTIVES: To determine the comorbidity of lead poisoning and asthma in urban children, and to examine associated clinical factors. METHODS: One-hundred-one patients at an inner-city clinic with blood lead levels (BLLs) of 25 microg/dL or higher (> or =1.2 micromol/L) (BLL25 group) were randomly selected from a tracking lead database and matched on age, sex, and primary language to 101 randomly selected patients with a first BLL recorded in the database of lower than 5 microg/dL (<0.2 micromol/L) (BLL5 group) and no subsequent BLLs of 10 microg/dL or higher (> or =0.5 micromol/L). Medical records were reviewed to determine diagnosis or symptoms of asthma or wheezing at any visit, immunization status, and number of visits. Analyses for matched pairs were conducted. RESULTS: The BLL25 and BLL5 groups did not differ on age at diagnostic BLL (26.6 months vs 24.2 months), sex (54% male), or language (12% Spanish). The BLL25 and BLL5 groups had a similar number of subjects with a diagnosis of asthma (6% vs 11%; odds ratio, 0.5; 95% confidence interval, 0.2-1.6); 26% of BLL25 and 34% of BLL5 subjects had either a diagnosis or symptoms of asthma or wheezing (odds ratio, 0.7; 95% confidence interval, 0.4-1.3). Subjects with BLL25 were more likely to have delayed immunization and a first clinic visit when older than subjects with BLL5. CONCLUSIONS: There was no increased likelihood of asthma diagnosis or symptoms among young children with lead poisoning. Children with lead poisoning also had delayed medical care. These data may help guide interventions aimed at preventing or reducing the impact of lead poisoning and asthma.

Asthma↗
PubMed1991

[Early tubular involvements in lead poisoning in children].

One of the main targets of lead poisoning is the kidney. Chronic poisoning can lead to kidney failure, and acute poisoning to tubulopathy with Toni-Debré-Fanconi syndrome. The primum movens of this tubulopathy is a distortion of mitochondrial energetic metabolism. We studied 27 children presenting with non symptomatic poisoning. Serum creatinine levels were normal. There was neither proteinuria nor glycosuria and only one child presented with hyperaminoaciduria. One third already presented with signs of tubulopathy, as shown by an increase in beta 2 microglobinuria in 36.5% of the cases studied (8 times in 22 samples) and enzymuria in 30.4% of the cases (23.5% if one excludes the children having had a chelation before the study). Kidney is therefore involved early in lead poisoning in children.

Acute Disease↗
PubMed1993

Lead poisoning of raptors in France and elsewhere.

Although lead poisoning, through the ingestion of gunshot embedded in prey, is known to have been a significant mortality factor for several raptor species in the United States (Haliaeetus leucocephalus and Gymnogyps Californianus), very little published information is available concerning raptors in Europe. This paper presents the results of liver lead analysis from 222 raptors collected throughout France and reviews other published and unpublished European information. Of the 11 diurnal and 6 nocturnal raptor species investigated in this study, elevated liver lead concentrations, suggestive of shot ingestion, were found in 3 (Accipiter nisus, A. gentilis, Buteo buteo). The likelihood of a species to ingest shot appears related to feeding habits, with scavengers and predators that take game species the most susceptible. Raptor species at risk from lead poisoning, including some of high conservation value, are described, and future priorities for lead poisoning research and policy are suggested.

Animals↗
PubMedDate not supplied

Lead poisoning--a family study.

OBJECTIVE: A family study is used to highlight the varied manifestations of lead poisoning and difficulties in diagnosis and treatment. CLINICAL FEATURES: A 42-year-old Italian woman with a known beta-thalassaemia trait presented with a two-year history of disabling pains and symptomatic anaemia, which were found to be caused by lead poisoning. INTERVENTION AND OUTCOME: Screening for lead poisoning among her immediate family members identified two others with different manifestations of plumbism. All three needed active chelating, which resulted in resolution of their symptoms. CONCLUSIONS: The similar haematological findings of beta-thalassaemia and lead poisoning may lead to a delay in diagnosis and treatment of lead poisoning when these two conditions coexist.

Adult↗