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Current issues in human lead exposure and regulation of lead.

Concern about lead as a significant public health problem has increased as epidemiological and experimental evidence has mounted regarding adverse health effects at successively lower levels of lead exposure. This concern has led to downward revision of criteria for acceptable blood lead concentrations to the 10 micrograms/dL mark now designated by EPA as a target level for regulatory development and enforcement/clean-up purposes. Much progress has been made in reducing lead exposures during the past 10-15 years, with marked declines evident both in air lead and blood lead concentrations in parallel to the phase-down of lead in gasoline and notable decreases in food lead exposure due to elimination of lead soldered cans by U.S. food processors. With the lessening of exposure from these sources, the importance of other components of multimedia exposure pathways has grown and stimulated increasing regulatory attention and abatement efforts to reduce health risks associated with lead exposure from drinking water, from lead-based paint, and from household dust and soil contaminated by deteriorating paint, smelter emissions, or various other sources. Increasing attention is also being accorded to reduction of occupational lead exposures (including those related to lead abatement activities), with particular concern for protection of men and women during their reproductive years.

Air Pollutants↗
PubMed1991

Assessment of myocardial ischemia by 12-lead electrocardiography and Frank vector system during coronary angioplasty: value of a new orthogonal lead system for quantitative ST segment monitoring.

The optimal number and placement of electrocardiographic (ECG) leads to detect myocardial ischemia induced by coronary balloon inflation was assessed by analyzing ST segment changes in the standard 12-lead ECG and Frank X, Y, Z leads at 90-s intervals during 34 consecutive coronary angioplasty procedures. Mean occlusion time during angioplasty was 218 +/- 65 s. Myocardial ischemia, defined as transient angina or ST segment deviation greater than or equal to 1 mm in at least one lead, occurred in 33 (97%) of the 34 procedures. The most sensitive single leads (V2 or V3) detected 17 (51%) of 33 ischemic episodes. The best dual-lead combinations (leads V2 and V5, leads a VF and V3 and leads V3 and Y) increased the sensitivity of 69% (23 of 33). The three-lead combination V2, V5, Y had the highest detecting power (78% [26 of 33]). The X, Y, Z leads by themselves had a sensitivity of only 60% (20 of 33). From this proposed orthogonal lead system (V2, V5, Y), which combines anteroposterior (V2), left to right (V5) and inferosuperior (Y) forces, the spatial ST vector magnitude was calculated and monitored during balloon inflations. A good correlation was observed between this ST vector magnitude and the sum of ST deviations on the standard ECG (r = 0.940, p less than 0.00001), and these data were reproducible over sequential balloon inflations. The results of the study suggest that this orthogonal lead system is of considerable value in the detection and quantification of acute myocardial ischemia and, in this respect, is more useful than the Frank orthogonal vector system.

Adult↗
PubMed1991

Value of electrocardiographic leads MCL1, MCL6 and other selected leads in the diagnosis of wide QRS complex tachycardia.

To compare the modified precordial leads MCL1 and MCL6 with the conventional precordial leads V1 and V6 and assess the diagnostic accuracy of selected leads for continuous bedside electrocardiographic (ECG) monitoring, 121 wide QRS complex tachycardias were recorded from 92 patients during cardiac electrophysiologic study. As ascertained from intracardiac recordings, 86 tachycardias were ventricular and 35 were supraventricular with aberrant conduction. Early or late peaking of the predominant QRS deflection in lead MCL6 or V6 proved valuable in diagnosing wide complex tachycardia. An interval of less than or equal to 50 ms from the onset of the QRS complex to the predominant peak (or nadir) indicated supraventricular tachycardia; an interval of greater than or equal to 70 ms indicated ventricular tachycardia. The QRS complexes in leads MCL1 and MCL6 were comparable to those in leads V1 and V6 during sinus rhythm. Significant discrepancies in QRS configuration occurred between the modified and conventional precordial leads during ventricular tachycardia, especially between leads MCL1 and V1; however. these differences did not affect diagnostic accuracy. A single MCL1, V1, MCL6 or V6 lead was equally valuable in the diagnosis of wide complex tachycardia and far superior to a single lead II. A combination of leads (MCL1 + MCL6), (V1 + V6), (V1 + I + aVF) or (V1 + V6 + I + aVF) was superior to a single lead or the routinely monitored lead V1 + II combination.

Bundle-Branch Block↗
PubMed2003

Venous occlusion of the access vein in patients referred for lead extraction: influence of patient and lead characteristics.

The aim of this study was to determine the effect of patient and lead characteristics on occlusion of the access vein in pacemaker and ICD patients. Contrast venography of the access vein was obtained in 89 patients (17 patients with an ICD) scheduled for lead extraction. The indication for extraction was infection in 57 patients (systemic infection in 9) and lead malfunction in 32 patients. In 6 of the 89 patients, leads were introduced in both the right and left subpectoral area, resulting in a total of 95 venous entry sites. In 22 of these entry sites one lead was present, in 61 two leads, in 11 three, and in 1 four leads. The vessel patency was graded open or occluded. Occlusion of the subclavian vein occurred in four (13%) patients with lead malfunction versus 18 (32%) patients with infection (P = 0.07). In patients with systemic infection, 5 of 9 showed venous occlusion (P = 0.01 when compared to patients with malfunction, odds ratio 8.75, 95% confidence interval 1.21-64.11). Considered per entry site, the incidence of occlusion was 7 of 22 with one lead present, 17 of 61 with two leads, 0 of 11 with three leads, and 0 of 1 with four leads (P = 0.13). No patient had a superior vena caval occlusion. Patients with systemic infection have an increased risk of occlusion of the access vein. On the contrary, the study found no support for the concept that the risk of venous occlusion increases with a higher number of leads present.

Angiography, Digital Subtraction↗
PubMed2000

Decreasing the number of leads required for an implantable atrial defibrillator: use of a new 2-lead system.

BACKGROUND: The purpose of this study was to evaluate the use of a new 2-lead system for detection of atrial fibrillation (AF) and atrial defibrillation. METHODS: In 16 patients undergoing elective cardioversion of AF, a 2-lead system was compared with the conventional 3-lead system in a randomized trial. The new 2-lead system consisted of a catheter with a distal bipolar right ventricular electrode pair and a proximal right atrial shock electrode coil and a separate decapolar defibrillation catheter in the coronary sinus. For the 3-lead system, an additional decapolar catheter was placed in the right atrium. AF and sinus rhythm signal amplitude detection and atrial defibrillation threshold (ADFT) were compared in each patient with both systems. RESULTS: Successful defibrillation was obtained in all patients. ADFT for the 2-lead system was significantly higher compared with the 3-lead system (370 +/- 112 vs 316 +/- 100 V, P < .05; 9.3 +/- 5.2 vs 6.8 +/- 4.2 J, P < .05). In contrast, there was an increase in impedance for the 3-lead system (77 +/- 16 ohms vs 68 +/- 13 ohms; P < .05). AF had a lower signal amplitude compared with sinus rhythm for both systems (P < .05), and the 2-lead system had a lower signal amplitude compared with the 3-lead system for both rhythms (P < .05). CONCLUSION: The use of a 2-lead system with this configuration is not superior to the 3-lead system regarding AF signal amplitude detection and ADFT. Further study is needed with implantable-quality leads in place of the temporary catheters used in this study.

Adult↗
PubMed1994

Five-years experience with intravascular lead extraction. U.S. Lead Extraction Database.

From December 1988 to April 1994, the extraction of 2,195 intravascular pacing leads from 1,299 patients was attempted at 193 centers. Indications were: infection (54%, including 10% septicemia), pacemaker reoperation with removal of nonfunctional or incompatible leads (40%), and other causes (6%). Extraction was attempted via the implant vein using locking stylets and dilator sheaths, via the femoral vein using snares, retrieval baskets, and sheaths, or via both approaches. Leads had been implanted for 0.2 months to 24 years (mean 56 months). At the conclusion of the intravascular procedure, 86.8% of the leads were completely removed, 7.5% were partially removed, and 5.7% were not removed. For physicians performing their first case, 12% of leads were not removed; for physicians who had performed more than 10 cases, only 2% of leads were not removed. Of the 189 leads where extraction attempts had previously failed, 75.1% were completely removed, 14.8% were partially removed, and 10.1% were not removed. Scar tissue increased in severity with implant duration, was a complicating factor, and was the main cause of failure to remove leads. Use of the femoral approach increased with implant duration (5% of leads implanted 12 months or less, 11% of leads 13 months to 3 years, 20% of leads 4-7 years, and 31% of leads 8-24 years), primarily because of increasingly abundant scarring and prior lead damage. Fatal and near fatal complications occurred in 2.5%, including 8 (0.6%) deaths (3 hemopericardium/tamponade, 1 hemothorax, 3 pulmonary embolus, 1 stroke).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2000

Body surface distribution and response to drugs of ST segment elevation in Brugada syndrome: clinical implication of eighty-seven-lead body surface potential mapping and its application to twelve-lead electrocardiograms.

INTRODUCTION: Body surface distribution and magnitude of ST segment elevation and their reflection in 12-lead ECGs have not been clarified in Brugada syndrome. METHODS AND RESULTS: Eighty-seven-lead body surface potential mapping and 12-lead ECGs were recorded simultaneously in 25 patients with Brugada syndrome and 40 control patients. The amplitude of the ST segment 20 msec after the end of QRS (ST20) was measured from all 87 leads, and an ST isopotential map was constructed. The maximum ST elevation (maxST20) was distributed in an area of the right ventricular outflow tract in all Brugada patients, and it was larger than that in control patients (0.37 +/- 0.13 vs 0.12 +/- 0.04 mV; P < 0.0005). The maximum was observed on the level of the parasternal fourth intercostal space, on which the V1 and V2 leads of the standard 12-lead ECG were located, in 18 of the 25 Brugada patients in whom typical coved- or saddleback-type ST elevation was seen in leads V1 and V2. The maximum was located on the second intercostal space in the remaining seven Brugada patients in whom only a mild saddleback-type ST elevation was seen in leads V1 and V2 of the 12-lead ECG. Typical ST segment elevation was recognized in leads V1 and V2, which were recorded on the second or third intercostal space. ST elevation in Brugada patients was dramatically normalized by isoproterenol, a beta-adrenergic agonist (maxST20 = 0.17 +/- 0.08 mV; P < 0.0005 vs control conditions), and accentuated by disopyramide, an Na+ channel blocker (maxST20 = 0.50 +/- 0.15 mV; P < 0.0005 vs control conditions), without any change in the location of the maxST20. CONCLUSION: Our data indicate that recordings of leads V1-V3 of the 12-lead ECG on the parasternal second or third intercostal space would be helpful in diagnosing suspected patients with Brugada syndrome. The data suggest that Na+ channel blockers are capable of accentuating ST elevation in leads V1-V3.

Action Potentials↗
PubMed2002

Reuse of occluded veins during permanent pacemaker lead extraction: a new indication for femoral lead extraction.

OBJECTIVES: This study examined the utility of a novel technique for reuse of thrombosed veins when extracting permanent pacemaker leads via a femoral vein approach. BACKGROUND: Although lead extraction permanent pacemaker using a femoral approach has advantages over the subclavian approach, it cannot be used to provide access for a new lead using currently employed techniques. This is important because up to 23% of patients have occluded veins after permanent pacemaker implantation. METHODS: The pacemaker lead to be extracted was released from the generator and retaining sutures at the implantation site. The lead was then grabbed from below using a needle-eye-snare or basket. The lead was then cut short and a drag through technique performed where a guide wire was pushed into the gap between the insulation and the coil. This guide wire was then drawn into the right atrium as the lead was pulled down from below. This guide wire was then used to introduce a sheath through which a replacement lead could be inserted. RESULTS: A total of 34 consecutive patients (21 male, aged 63+/-14 years, mean+/-SD) had 57 (1.7/patient) leads extracted. Fourteen patients required implantation of a new system and were suitable for immediate lead replacement using the drag through technique. All leads were successfully extracted, with 5 partial successes (9.1% of leads). The drag-through technique was successful in all, including 4 with subclavian vein occlusion. Procedure and fluoroscopy times, including the time required for implantation of a new system, were 143+/-65 mins and 31+/-23 mins respectively. There were no complications and hospital stay was 1.6+/-1.2 days for patients undergoing the drag-through procedure. CONCLUSION: The drag-through technique can be successfully used to provide access in order to replace pacemaker leads removed using a femoral approach.

Journal Article↗
PubMed1980

Lead exposure and behavioral changes: comparisons of four occupational groups with different levels of lead absorption.

The association between lead absorption and objective psychological performance tests in five groups with different levels of lead absorption was studied in the following groups: (1) a control, non-lead-exposed group; (2) cable splicers, (3) cable manufactures, and (4) secondary lead smelter workers. The following performance tests were used: Block Design, Digit Symbol, and Embedded Figures. Age-corrected performance test scores and the average of three test scores (INDEX) were used throughout. A significant association between performance tests scores and increased lead absorption was found. Zinc protoporphyrin level was a more "powerful" (in the statistical sense) indicator of lead-induced CNS effects than blood lead levels. This study provides additional evidence that neurotoxic effects associated with occupational exposure to lead can be demonstrated by means of performance tests. It has been known and widely accepted that increased lead absorption is associated with "non-specific" subjective symptoms: tiredness, sleep disturbance, irritability, etc. Psychometric techniques (including an appropriate statistical analysis strategy) are highly sensitive for the early detection of CNS neurotoxicity, such as metal toxicity. Moreover, even in lead-exposed but asymptomatic individuals, a significant correlation (negative) between test scores and levels of lead absorption could be detected. It is concluded that workers exposed to lead at levels considered "safe" might be at risk of developing brain dysfunction with long term exposure.

Humans↗
PubMed1991

Effect of repeated occupational exposure to lead, cessation of exposure, and chelation on levels of lead in bone.

A sensitive K-X-ray fluorescence (K-XRF) instrument was used to measure lead levels in the tibia and patella on a series of twelve subjects who had relatively well-documented histories of lead exposure and blood lead levels. For some subjects, K-XRF measurements were taken at multiple points in time, and before and after chelation with EDTA (ethylenediamine tetraacetic acid). Results confirm that K-XRF measured bone lead levels correspond to cumulative blood lead indices and not to current blood lead levels. Moreover, the data suggest that bone lead levels; (1) correspond to urinary lead following the EDTA mobilization test unless previous chelation has occurred; (2) rise initially after lead exposure ceases and blood lead levels decrease, probably from redistribution from soft tissue, and then fall; and (3) do not decrease with a 3- to 5-day course of therapeutic EDTA chelation. K-XRF levels in the patella were noted to decrease more rapidly than levels in the tibia after cessation of lead exposure, a finding that probably reflects the greater turnover of lead in trabecular bone than in cortical bone.

Adult↗
PubMed1994

Increased lead absorption caused by working next to a lead recycling factory.

The objective of this study was to determine whether workers at a factory in Taiwan, adjacent to lead recycling plant, were affected by lead contamination. Workers at the lead recycling plant itself were found to suffer from lead poisoning; air and soil outside the plant were heavily contaminated by lead. Forty-one of the 45 workers in a forging factory next to the lead recycling plant were enrolled as the exposed group. A comparison group of 51 workers were selected from another forging factory about 20 km away. Each subject was interviewed about his lifestyle, work history, and residence, and blood was drawn for lead measurement by graphite furnace atomic absorption spectrometry. The results showed that two groups were compatible in age, sex, and smoking patterns. Blood lead of the exposed group was significantly higher than that of the comparison group (mean +/- SD: 20.4 +/- 9.4 micrograms/dl vs. 5.9 +/- 2.9 micrograms/dl). The difference was independent of sex and working zones. Blood lead levels were lower among exposed workers who had been employed less than 2 months compared with those employed longer. There was no difference among exposed workers in different outdoor working zones. Five months after improvement of pollution control and decrease in the production volume of the lead factory, 30 exposed workers were retested for blood lead. The blood lead of outdoor workers had an average decrease of 4.2 micrograms/dl while that of indoor workers showed no significant difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Environmental Exposure↗
PubMed1989

Dose and time effects of combined exposure to lead and ethanol on lead body burden and some neuronal, hepatic and haematopoietic biochemical indices in the rat.

Ethanol (1, 2 or 5 g kg-1) and lead (0.55 g l-1 in drinking water) were given either alone or in combination for 4 months to rats. The uptake of lead in tissues, some lead-sensitive variables, the levels of biogenic amines in different brain regions, hepatic lipid peroxidation, glycogen and blood glucose concentrations were measured. Ethanol or lead when given alone inhibited the activity of blood delta-aminolevulinic acid dehydratase (ALAD). The co-administration of 5 g kg-1 but not 1 or 2 g kg-1 ethanol significantly enhanced the lead-induced inhibition of blood delta-ALAD activity and the elevation of delta-aminolevulinic acid (ALA) excretion. Co-exposure to lead and ethanol (5 g kg-1) produced a more pronounced increase in hepatic lipid peroxidation and blood glucose level than either ethanol or lead alone. This combination also caused a significant increase in the dopamine (DA) contents of striatum, midbrain and pons medulla, norepinephrine (NE) contents in midbrain and 5-hydroxytryptamine (5-HT) contents of hypothalamus, striatum, midbrain and pons medulla over levels produced by lead alone. However, the level of NE in hypothalamus decreased upon co-administration. The uptake and retention of lead was significantly higher in blood, liver, kidney and brain in animals co-exposed to lead and 5 g kg-1 ethanol. Blood and kidney lead was also increased by 2 g kg-1 ethanol. The results suggest that prolonged and heavy consumption of alcohol may increase the toxicity of lead.

Animals↗
PubMed1982

High medical consultation rates of lead workers after industrial dispute over lead effects.

Medical consultation rates were compared between a group of lead workers (346 males) and two groups of non-lead workers (317 and 329 males) in a newspaper company where a serious industrial dispute took place over health effects of lead three years before this study. The comparison was also made within the group of lead workers. Maximal blood lead concentrations (PbBs) ranged from 0.1 mumol/kg to 3.6 mumol/kg (74 microgram/100 g) with an average of 1.3 mumol/kg in the past three years. Ages averaged 35 years in lead workers, and 34 and 30 years in non-lead workers, the ranges being 19-55 years in all. The consultation rate of lead workers was significantly higher than that of both the non-lead workers (P less than 0.001), when the number of workers who consulted physicians or dentists once or more for a year per 100 workers (general consultation rate) was compared. Disease-specific consultation rates were also higher in lead workers for seven categories of diseases and injuries such as hypertensive disease and peptic ulcers. When lead workers were divided into three groups by PbB or erythrocytes delta-aminolevulinic acid dehydratase (ALAD) levels, however, no significantly high rate was found in the higher PhB groups not lower ALAD groups in terms of general and disease-specific consultation rates. It was concluded that the industrial dispute might have been a major cause of the high consultation rate of lead workers.

Adult↗
PubMed1988

Increased lead uptake and inhibition of ALAD-activity in isolated rat hepatocytes incubated with lead-diethyldithiocarbamate complex.

Dithiocarbamates can form lipid soluble complexes with lead and are known to markedly increase tissue uptake of lead and potentiate toxic effects of lead in rats. Cellular effects of the interactions between lead and diethyldithiocarbamate were studied in primary cultures of rat hepatocytes. The cells were incubated with lead acetate (PbAc) or lead-diethyldithiocarbamate complex (Pb(DTC)2), labelled with 203Pb. The lipid soluble Pb(DTC)2 was rapidly taken up in the cells and after 30 min incubation the cellular levels of lead were approximately 40 times higher in cells incubated with Pb(DTC)2 than in cells incubated with a similar concentration of PbAc. The maximal cellular uptake of lead was reached after 4 h incubation with Pb(DTC)2, while incubation with PbAc caused a slow continuously increasing uptake of lead during the 20 h incubation. The enzyme delta-aminolevulinic acid dehydratase (ALAD) was inhibited to a much higher extent by Pb(DTC)2 compared to PbAc after incubations with similar concentrations of lead. Maximal inhibition of ALAD activity was reached at a cellular concentration of 0.5-1 nmol Pb/mg protein, irrespective of which form of lead was used in the incubation. Pb(DTC)2 was shown to inhibit ALAD activity also in vitro when incubated with purified ALAD enzyme. The rapid and high intracellular uptake and cellular response of Pb(DTC)2, shown in the present study, may explain the drastic effects of dithiocarbamates on lead distribution and toxicity previously shown in vivo.

Animals↗
PubMed1991

Review of lead toxicology relevant to the safety assessment of lead acetate as a hair colouring.

The literature on lead toxicology has been critically reviewed to provide a safety assessment of lead acetate as a hair colouring. The main objectives were: (i) to determine the additional lead contribution from hair-colouring use to the total daily environmental lead intake; and (ii) to assess the toxicological significance of this additional contribution. The review also focuses attention on newer issues of concern over the effects of environmental lead on human health. Data available in animals and humans (including occupational exposure), mainly on lead acetate and other inorganic lead salts, have been presented and evaluated in respect of the following: absorption, distribution and excretion following ingestion; percutaneous absorption; carcinogenicity; genotoxicity; reproductive toxicity; neurological/behavioural status with particular reference to neuropsychological effects in children; and effects on other systems (e.g. cardiovascular). It is concluded that the absorption of lead from hair-colouring use represents about 0.5% of the lead absorption from the current average daily environmental lead intake. No convincing evidence could be found of any deleterious effect of current environmental lead levels on human health and thus the tiny contribution of lead acetate exposure from hair-colouring use can be regarded unequivocally as being toxicologically insignificant.

Animals↗
PubMed2006

Environmental and childhood lead contamination in the proximity of boat-repair yards in southern Thailand--I: pattern and factors related to soil and household dust lead levels.

High blood lead levels have recently been documented in schoolchildren living in communities adjacent to boat-repair yards in southern Thailand. In this study, the spatial pattern of lead contamination of soil and household dust in an area surrounding several boat-repair yards is described, and household factors associated with elevated dust lead are identified. A cross-sectional spatial study was conducted in a coastal residential area within a distance of 2 km from three major boat-repair yards situated on the east coast of peninsular Thailand. Household dust specimens were collected from an undisturbed position in the residences of children, aged 4-14 years, sampled randomly from all children living in the study area. Soil specimens were obtained from the interstices of a square grid, 70 x 70 m2, superimposed on the area. Geographic coordinates of residence and soil sampling positions were recorded and semivariograms and kriging used to contour the spatial distribution of lead in dust and soil. Environmental lead levels were also modeled in terms of direction and minimum distance from a boat-repair yard and, for household dust lead content, in terms of household variables, including occupation of household members in boat-repair work, type of house construction, and general cleanliness. Household dust and soil lead content ranged from 10 to 3025 mg/kg and from 1 to 7700 mg/kg, respectively. The distribution of soil lead peaked at the location of the boat-repair yards, but outside the yards the distribution was generally below 400 mg/kg and irregular. About 24% of household dust lead specimens were equal to or above 400 mg/kg, but showed significant decrease with increasing distance from the boat-repair yards, at rates of between 7% and 14% per 100 m. In houses where a family member was a worker in one of the major boatyards and in houses where occasional repair of small boats was undertaken, household dust lead levels were significantly elevated, by 65% (95% CI: 18-130%) and 31% (95% CI: 5-63%), respectively. Siting of boat-repair yards at a distance from residential areas and measures to reduce the spread of lead-containing dust are recommended to alleviate the problem of elevated household dust lead levels.

Adolescent↗
PubMed2005

The association between lead contamination on the hand and blood lead concentration: a workplace application of the sodium sulphide (Na2S) test.

OBJECTIVES: Lead is one of the major causes of workplace poisoning and lead contamination on skin is a possible route of lead absorption. Using a colourimetric method with sodium sulphide (Na2S), we examined whether the lead on skin represents longer-term lead exposure. METHODS: This cross-sectional study of 119 lead-handling workers in a battery recycling plant in Japan was conducted in July 2004. The main outcome measure was skin-colour darkening on the workers' hands, visualised by wetting the seemingly clean hands of the workers with 1% Na2S solution (128 mmol/L): the Na2S test. This study then examined the relationships between the Na2S test results and workers' blood lead concentration (BLC) and hygiene activities. RESULTS: The Na2S test produced skin-colour darkening of the hands of 92 (77%) of the lead workers, although 88 of them had washed their hands with soap and 50 had bathed before taking the test. In the bivariate analyses, a positive result in the Na2S test was associated with not washing hands (p=0.009), not bathing (p=0.061), and a higher BLC (p=0.008). The association between the results of the Na2S test and BLC was still significant in the multivariate linear regression analysis adjusted for age and hand washing (p<0.001). CONCLUSIONS: Lead contamination on workers' hands, otherwise unapparent, was clearly demonstrated by the Na2S test. The result of this test was associated with BLC in addition to the hygiene activities after the last work with lead. As the lead contamination on the hand is persistent, simply encouraging hand washing may not be sufficient to reduce lead intake into body.

Cross-Sectional Studies↗
PubMed2003

Comparative toxicity of tetra ethyl lead and lead oxide to earthworms, Eisenia fetida (Savigny).

Leaded gasoline contains tetra ethyl lead (TEL) as an antiknocking agent, which produces major amounts of lead oxide in automobile exhaust along with traces of TEL. To minimize the lead contamination, methyl tertiary butyl ether (MTBE) is used as a substitute for producing unleaded gasoline. It has become increasingly apparent that young children are highly susceptible to the harmful effects of lead. Hence, a study was carried out to monitor lead toxicity in soil, using adult earthworms (Eisenia fetida, Savigny). Leaded gasoline (TEL) and lead oxide are 383- and 211-fold more toxic than unleaded gasoline (MTBE) in 7 days of exposure and 627- and 290-fold more toxic in 14 days, respectively. Results indicate that the presence of TEL in leaded gasoline and lead oxide has a significant effect on behavior, morphology, and histopathology of earthworms. Absorption of TEL into the tissues is comparatively less than that of lead oxide but toxic effects were severe. Rupture of the cuticle, extrusion of coelomic fluid and inflexible metameric segmentation were observed, causing desensitization of the posterior region leading to fragmentation in earthworms.

Animals↗