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PubMed1978

Chronic lead poisoning in horses.

Lead acetate was fed to 4 groups of 2 horses each to study chronic lead intoxication. A 5th group of 3 horses was maintained as controls. The leas was fed in capsules, with the minimum dosage of 6.25 mg/kg/day of lead as lead acetate (group I). The dose was increased from group I through group IV in an approximate geometric series, with each group being given about 125% of the dose given the previous group. These doses were given for 105 days, a period designated as phase 1. Since clinical signs were not observed after 105 days, the doses were increased and fed for an additional 190 days (days 106 to 295). This period was designated phase 2. The smallest daily dose in phase 2 was set at about 125% of the largest daily dose in phase 1. The doses in each group was increased by about 125% of that of the previous group, as was done in phase 1. Seven horses died or were euthanatized after 18 to 190 days of phase 2 (123 to 295 days after the 1st dose). One horse in group I did not develop any clinical signs of intoxication. Dose-related responses were unnoticed with doses larger than 15.3 mg/kg/day. All horses given lead had increased blood lead and serum iron concentrations. During phase 2, the hematocrit (erythrocyte volume) and hemoglobin contents were depressed. The lead concentration in kidney, liver, spleen, pancreas, brain, bone, and heart was increased in the treated horses. The dose level required to produce lead intoxication was greater than that reported for cattle and that estimated in epizootiologic studies of horses.

Animals↗
PubMed1982

Lead poisoning: neurophysiological aspects.

Lead causes peripheral neuropathy, which may lead to radial palsy or other peripheral palsy. In milder cases weakness has been reported especially in the wrist extensors. Several reports have confirmed that even in neurologically symptom-free lead workers motor and sensory conduction velocities slow down and also electromyographic abnormalities like denervation activity and loss or changes in the motor unit potentials appear. When individual exposure to lead has been monitored for long term, an exposure-effect relationship and also an exposure-response relationship have been shown concerning lead exposure and slowing of nerve conduction velocities and also concerning frequency of abnormally slow conduction velocities.

Adult↗
PubMed1996

Longitudinal assessment for lead poisoning.

In a previous study, we showed that in our region the prevalence of lead poisoning (Pb > or = 10 micrograms/dL [0.483 mumol/L]) was high (29%) among urban infants. The objectives of this study were to assess the prevalence of lead poisoning over time in this cohort to determine the best screening strategy. Eighty-nine percent (115/129) of infants who were initially screened for lead poisoning between 6 and 12 months of age had a repeat venous lead level by age 3 years (mean = 19.8 months). The majority (70%) lived in a major city and had private medical insurance (80%). The initial and repeat mean venous lead levels were similar for the overall population (lead1 = 8.7 micrograms/dL +/- 6.2 [0.420 +/- 0.299 mumol/L] and lead2 = 7.7 micrograms/dL +/- 6.8 [0.371 +/- 0.328 mumol/L]). However, the percentage of lead-poisoned (Pb > or = 10 micrograms/dL or 0.483 mumol/L) children whose levels were > or = 15 micrograms/dL (0.724 mumol/L) increased from 28% to 48% on repeat. The utility of the initial screen in predicting a second elevated lead level > or = 20 micrograms/dL (0.966 mumol/L) was as follows: sensitivity = 33%, specificity = 97%, positive predictive value = 40%, negative predictive value = 96%. We conclude that in this population, a single screen at 18-24 months of age would reduce the need for multiple venipunctures and would detect those children in need of an intervention.

Child, Preschool↗
PubMed1997

Childhood lead poisoning and vinyl miniblind exposure.

OBJECTIVE: To determine the contribution of vinyl miniblinds to childhood lead poisoning. DESIGN: A descriptive investigation was undertaken to estimate attributable risk among all reported childhood lead poisoning cases in North Carolina for which home environmental sampling was conducted between March and August 1996. PARTICIPANTS: Ninety-two children, aged 6 to 72 months, identified through a statewide screening program were included. Blood lead and environmental sampling test results were obtained from routine surveillance data collected for all lead-poisoned children. RESULTS: Exposure to vinyl miniblinds with dust lead levels of 100 micrograms/ft2 or more occurred for 44 (48%) of the lead-poisoned children; 25 (27%) of the children were exposed to levels of 500 micrograms/ft2 or more. Vinyl miniblinds were the predominant source (ie, other major sources of lead were not identified) for 8 (9%) of the children. Overall, the median dust lead level for vinyl miniblind field samples was 590 micrograms/ft2, and the highest level reported was 73,302 micrograms/ft2. Even new vinyl miniblinds manufactured before July 1996 contained dust lead levels that on average exceeded 100 micrograms/ft2. The levels for recently available nonleaded vinyl miniblinds were below the limits of detection. CONCLUSIONS: Vinyl miniblinds, introduced into this country 10 years ago, with sales estimated at 30 million sets a year, include brands containing lead. Although new formulations with no lead added are available, millions of children may still be at risk because a product recall has not been issued (ie, lead-contaminated vinyl miniblinds are still in general use). In addition, the risk assessment evaluations proposed in lieu of universal blood lead screening for low-risk communities could overlook children with exposure to this source.

Air Pollution, Indoor↗
PubMed1993

Hemolytic anemia associated with lead poisoning from shotgun pellets and the response to Succimer treatment.

Symptomatic lead poisoning with severe hemolytic anemia was observed in a patient with retained shot gun pellets. Surgical resection of the retained pellets and the use of a newer chelating agent, Succimer (2,3-dimercaptosuccinic acid) successfully lowered blood lead level. Hemolytic anemia was associated with deficient erythrocyte pyrimidine 5'-nucleotidase, and lowering of the lead level corrected the deficiency, suggesting that the enzyme deficiency is responsible for the hemolysis associated with lead poisoning. This case illustrates that retained lead pellets from shotgun wounds can cause severe lead poisoning.

Adult↗
PubMed1982

Fluorometric assay of erythrocyte protoporphyrin: simple screening test for lead poisoning and iron deficiency.

Erythrocyte protoporphyrin levels are high in lead poisoning, iron deficiency and erythropoietic porphyria. On-site fluorometric assay was used to screen for raised blood levels in three groups of children in one city: 166 who were severely mentally retarded and lived in an institution, 88 who were moderately to severely mentally retarded and attending special schools but lived at home, and 128 who were of normal intelligence and attended a regular school. High erythrocyte protoporphyrin levels (40 micrograms/dl [0.7 mumol/l] or greater) were found in 14 of the children, each of whom was tested for further evidence of lead poisoning and iron deficiency. The two children found to have high blood lead levels (above 30 micrograms/dl [1.5 mumol/l]) were both living in the institution, were ambulatory and had pica. Of the other 12 children 8 had evidence of iron deficiency, though in 4 the probability of a true deficiency was low. The fluorometric assay of erythrocyte protoporphyrin may prove to be a simple method of screening for lead poisoning and iron deficiency.

Adolescent↗
PubMed1992

Is eye cosmetic a source of lead poisoning?

Kohl is a lead-containing eye cosmetic applied to many infants in Israel and in other countries in the Middle East. Seven samples of kohl used in our region contained 17.3%-79.5% lead. We assessed 24 kohl users and 30 non-kohl users, aged 6-16 months, for blood lead, zinc protoporphyrin, hemoglobin, mean corpuscular volume (MCV), serum iron and calcium. Blood lead levels were significantly higher in the infants to whom kohl was applied (11.2 vs. 4.3 micrograms/dl, P less than 0.001) and were greater than 20 micrograms/dl in three of them. In the non-kohl users, blood lead levels were significantly higher in infants whose mothers used kohl (5.2 vs. 2.8 micrograms/dl, P less than 0.02). No significant differences were found in the other parameters. The kohl-using infants were significantly shorter at 3-5 weeks of age (P less than 0.005) but not at the time of the study. No significant differences were found in weight and head circumference at birth or at the time of the study between kohl-using infants and controls. Regression analysis showed that among the analyzed variables the infant's blood lead level was related only to the use of kohl. We conclude that application of kohl to the infant's or mother's eyes is associated with a significant increase in the infant's blood lead levels and in the minority of cases with asymptomatic lead poisoning.

Birth Weight↗
PubMed1984

Industrial lead poisoning in China over the past 33 years.

This paper is a review of the 48 articles in scientific journals and special reports of investigations emanating from the author's department involving 2504 subjects. During the past 33 years, as a result of the establishment of health and antiepidemic stations throughout the country, the enactment of hygienic standards, and the setting up of the reporting system for industrial poisoning and occupational diseases, the air lead level has been reduced from 10 mg/m3 in the years soon after liberation (1949) to below 0.03 mg/m3 at present. Severe plumbism has disappeared. Some mild cases, however, could still be found among workers in lead smelters and electric battery plants. Great advances have been made in techniques for early diagnosis of lead poisoning. Blood lead, urine lead, aminolevulinic dehydrase, free erythrocyte protoporphyrin, and zinc protoporphyrin (ZnPP) have been used as criteria for lead exposure. For the purpose of preventive monitoring, ZnPP as a screening index is the first choice. Behavioral function and sensory and motor nerve conduction velocity measurements of median nerve might also be used for the investigation of lead exposure. The maximum allowable concentration of 0.03 mg/m3 for air lead level in the workshop, in agreement with the results of a nationwide lead industry investigation, has been proven safe. There is also the need to monitor the air lead level and blood lead level in the general population and children living adjacent to a lead industry.

Adult↗
PubMedDate not supplied

[Ultrastructure of the cells of the peripheral blood in experimental lead poisoning].

In rabbits exposed to lead poisoning electron microscopy revealed the presence in reticulocytes and erythrocytes of differently sized vacuoles, an amassment of ferritin granules in the mitochondria along with autophaging vacuoles; leucocytes evidenced turgescence of the mitochondria, up to and including their destruction and emptiness; the blood platelets showed an abundant vacuolization with disordered distribution of the serotonin and glycogen granules. The above changes become most spectacular on the 7-21st day after poisoning and by the 50th day they are encountered but in isolated cells.

Animals↗
PubMed1996

Lead poisoning caused by contaminated Cordyceps, a Chinese herbal medicine: two case reports.

Two cases of lead poisoning, caused by the Chinese herbal medicine Cordyceps, were reported to the Department of Health in a laboratory-based blood lead surveillance program. Such unusual cases of lead poisoning have not been previously reported. These two patients took Cordyceps herbal medicine for treatment of underlying diseases. Loss of appetite and anemic signs of lead poisoning were manifested in one patient with a blood lead level of 130 microg/dl, while the other patient was asymptomatic with a blood lead level of 46 microg/dl. The lead content in the Cordyceps powder was found to be as high as 20 000 ppm. After cessation of intake in the asymptomatic patient, and cessation of intake and treatment with chelating agents in the symptomatic patient, the blood lead levels returned to normal range. This report raises concerns about lead poisoning from unusual herbal medicine worldwide.

Aged↗
PubMed1995

Childhood lead poisoning in Massachusetts communities: its association with sociodemographic and housing characteristics.

OBJECTIVES: The purpose of the study was to examine the relationship between communities' sociodemographic and housing characteristics and incidence of lead poisoning. METHODS: This was a population-based correlational study of 238,275 Massachusetts children from birth through 4 years of age who were screened for lead poisoning in 1991-1992. A logistic regression model was developed with the community as the unit of analysis, the case identification rate for lead poisoning (newly identified children with venous blood lead > or = 25 micrograms/dL per 1000 children) as the dependent variable, and US census variables as independent variables. RESULTS: A significant independent relationship with the community case identification rate of lead poisoning was found for seven variables: median per capita income, percentage of housing built before 1950, percentage of the population who were Black, percentage of children screened, and a "poverty index." Rates of iron deficiency and percentage of Hispanics were not associated with the case identification rate of lead poisoning. CONCLUSIONS: Massachusetts communities' incidence of lead poisoning is correlated with sociodemographic and housing characteristics. In states similar to Massachusetts and without screening data, this model may help target screening programs.

Black or African American↗
PubMed1993

Diagnosis and treatment of chronic lead poisoning in CAPD patients.

In order to screen for abstruse lead poisoning in continuous ambulatory peritoneal dialysis (CAPD) patients, delta-aminolevulinic acid dehydratase (ALAD) levels were measured in 18 CAPD patients, 156 patients treated with hemodialysis (HD), and 420 control patients with normal renal function (NRF). An EDTA (ethylenediamine tetraacetic acid) mobilization test was performed in patients with low levels of ALAD (< 0.40 mumol of porphobilinogen formed per milliliter of red blood cells): 1 g of EDTA was infused IV followed by 20 L of hemofiltrate in HD patients and four bags of dialysate in CAPD patients. Lead was assayed in the ultrafiltrate liquid, the bags of dialysate, and in the 24-hour urine. ALAD levels were significantly lower in CAPD and HD patients than in the NRF subjects. ALAD was significantly correlated with EDTA mobilized lead in both dialysis and NRF patients. Using the usual criteria (EDTA mobilized lead > 800 micrograms/24 hours), the rate of lead poisoning observed was similar in the two groups. These results suggest that ALAD assay followed by the EDTA mobilization test is as effective in CAPD patients as in NRF subjects to diagnose and to treat chronic abstruse lead poisoning.

Chronic Disease↗
PubMedDate not supplied

[Role of the laboratory in the diagnosis and treatment of lead poisoning].

A case of therapeutic lead poisoning in a six-week old child is reported, this aetiology being very common in paediatrics. The role of the laboratory in treatment is described, the latter having involved the addition of disodium calcitetracemate to the peritoneal dialysis fluid.

Aminolevulinic Acid↗
PubMed1989

Repeated surveillance of lead poisoning among children.

In 1980, a survey of lead poisoning was carried out among 592 children aged 1 to 9 years living within 900 m of a lead smelter in Santo Amaro, Brazil. From 1980 to 1985, the lead smelter carried out a number of major improvements aimed at reducing environmental pollution. In January, 1985, a second survey was carried out among a sample of 250 children living in this same geographical area. The geometric mean of zinc protoporphyrin (ZPP) concentration in whole blood was 1.17 (standard deviation = 1.5) mumol l-1. Blood lead concentrations (PbB) determined in a subsample of 53 children had an arithmetic mean and standard deviation of 1.77 +/- 1.00 mumol l-1, with 22 children showing PbB greater than or equal to 1.68 mumol l-1. Twenty-nine (11.6%) of the 250 children lived in houses where the lead content of the soil was greater than 10,000 ppm, and they presented higher ZPP levels than the rest of the population. Children with the habit of pica for soil had elevated ZPP levels. Comparing the results from the 1980 and 1985 surveys, slight improvements in ZPP and PbB levels were observed. However, new cases of lead poisoning are still occurring in the area. The soil is highly contaminated by lead and represents a long-lasting risk factor for child intoxication.

Anemia↗
PubMed2004

Childhood lead poisoning from commercially manufactured French ceramic dinnerware--New York City, 2003.

Lead poisoning adversely affects children worldwide. During 1999-2000, an estimated 434,000 children aged 1-5 years in the United States had elevated blood lead levels (BLLs) >/=10 microg/dL. Glazes found on ceramics, earthenware, bone china, and porcelain often contain lead and are a potential source of lead exposure. Children are especially vulnerable to the neurotoxic effects of lead. Exposures to lead in early childhood can have adverse effects on the developing nervous system, resulting in decreased intelligence and changes in behavior. In addition, certain behaviors (e.g., thumb sucking) place children at greater risk for exposure to lead. In 2003, the New York City Department of Health and Mental Hygiene's Lead Poisoning Prevention Program (LPPP), and the Mount Sinai Pediatric Environmental Health Specialty Unit (PEHSU) investigated a case of lead poisoning in a boy aged 20 months. This report summarizes that case investigation, which identified ceramic dinnerware imported from France as the source of lead exposure. This case underscores the susceptibility of children to a toxic exposure associated with 1) the high proportion of time spent in the home and 2) dietary habits that promote exposure to lead leached from ceramic ware.

Ceramics↗
PubMed1990

Lead poisoning and thalassemia trait or iron deficiency. The value of the red blood cell distribution width.

The cause of microcytosis and anemia in lead poisoning was investigated using red blood cell distribution width as a screening parameter in 21 consecutive patients with lead poisoning and seven nonrandomly selected patients with iron deficiency and lead poisoning. Of the 21 consecutive patients, 11 had microcytosis as defined by a mean corpuscular volume of less than 72 fL, nine had thalassemia trait (alpha or beta), one had both alpha thalassemia trait and iron deficiency, and one had iron deficiency. The red blood cell distribution width was less than 17.0 in those with thalassemia trait and greater than 17.0 in the iron-deficient subjects. Results of our study suggest that microcytosis in children with lead poisoning is due to coexistent iron deficiency or thalassemia trait. The red blood cell distribution width may be of value in the rapid assessment of the cause of microcytosis in children with lead poisoning.

Anemia, Hypochromic↗
PubMed1996

Chronic lead poisoning, renal function and immune response.

The aim of this study was to investigate possible correlations between chronic, recurrent lead poisoning, renal function and immune response. The study involved 74 patients with a history of at least one lead poisoning. Fifty-three patients were occupationally poisoned, and 21 were poisoned accidentally after consumption of alcohol beverages or food from lead glazed pottery. In all patients glomerular filtration rate (GFR) was determined by measuring creatinine and DTPA clearances, and T- and B-lymphocytes were assessed as indicators of cellular and humoral immunity. A significant negative correlation was found between the number of past lead poisonings indicating increased lead body burden, and both creatinine and DTPA clearances. There was a significant positive correlation between the number of poisonings and the percentage of B-lymphocytes (r = 0.31; P < 0.05), and no correlation at all with the T-lymphocyte count. Our results show that chronic, recurrent lead poisoning with a consequently increasing lead body burden can cause an impairment in renal function and a concomitant stimulation of humoral immunity.

Adult↗