RAPID PROTOPORPHYRIN QUANTITATION FOR DETECTION OF LEAD POISONING

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 625-631
Author(s):  
Larry P. Kammholz ◽  
L. Gilbert Thatcher ◽  
Frederic M. Blodgett ◽  
Thomas A. Good
Keyword(s):  
Lead Poisoning ◽  
Glacial Acetic Acid ◽  
Blood Lead ◽  
Deficiency Anemia ◽  
Blood Lead Levels ◽  
X Ray ◽  
Fluorescent Method ◽  
Lead Levels ◽  
Fluorescence Test

A rapid fluorescent method for estimation of free erythrocyte protoporphyrin (FEP) is described. Simple ethyl acetate-glacial acetic acid extractions are performed, fluorescence quantitated in a fluorimeter and expressed numerically by comparison with known coproporphyrin standards. Fifty-six children were studied and the extent of lead poisoning was evaluated initially and at different follow-up intervals. A clear relationship was shown between FEP fluorescence and blood lead levels. A correlation was also seen for the intensity of fluorescence and evidence for increased absorption of lead, as estimated by x-ray evidence of ingested lead and deposits in bone. Children with iron deficiency anemia also showed elevations of FEP fluorescence. This FEP fluorescence test allows for a rapid, numerical determination which appears to be useful as a screening test for lead intoxication. It can quickly select patients that may have markedly increased lead absorption and need prompt therapy or select those that at least require further studies for possible lead exposure or the presence of anemia.

scholarly journals Against lead poisoning: effectiveness of housing first and counselling in the home

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Laporte ◽  
H Barberin de Barberini ◽  
E Jouve ◽  
K Hadji ◽  
S Gentile
Keyword(s):  
Lead Poisoning ◽  
Lead Exposure ◽  
Blood Lead Level ◽  
Lead Level ◽  
Blood Lead ◽  
Housing First ◽  
Blood Lead Levels ◽  
Stable Housing ◽  
Lead Levels

Abstract Background Removing lead sources is the main measure against child lead poisoning. Medical treatment is ineffective for most mild cases and particularly against long-term complications in neurological development. However, the effectiveness of interventions to eliminate sources of lead exposure has not been fully established, mainly because of the diversity of situations. The objective of this study was to determine the influence of several interventions (housing counselling, rehabilitation and relocation) on blood lead levels in two situations (stable unhealthy housing with old flaked lead paints, slums with family recycling practices by incineration). Methodology A historical cohort of lead poisoning in children has been established in Marseille, France. Medical follow-up followed national guidelines. Environmental interventions followed legal procedures, where available. In slums, counselling was adapted to the exposure. A generalized mixed model was developed to study the kinetics of blood lead levels after the interventions. Results 151 children were included; age = 5.4 (SD = 7.8) years; 85 (56%) lived in stable unhealthy housing, others lived in slums. Medical follow-up included 492 blood lead levels. For children living in stable unhealthy housing, blood lead level decrease was significantly associated with every intervention: housing counselling, rehabilitation and relocation (respectively p < 0.005; p < 0.05 and p < 0.005). For children living in slums, blood lead level decrease was only associated with relocation in a stable housing (p < 0.005). Conclusions Several interventions are effective to decrease blood lead levels in unhealthy housing. In slums, access to a stable housing first is a prerequisite for any intervention against child lead poisoning, even when related to family practices. Key messages In stable unhealthy housing, several interventions against lead exposure can be effective to raise a strategy. But, environmental health and access to housing first needs to be addressed for their implementation.

Blood lead levels and risk factors for lead poisoning among children in Jakarta, Indonesia

2003 ◽  
Vol 301 (1-3) ◽  
pp. 75-85 ◽  
Author(s):  
Rachel Albalak ◽  
Gary Noonan ◽  
Sharunda Buchanan ◽  
W.Dana Flanders ◽  
Carol Gotway-Crawford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lead Poisoning ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Lead Levels

Question Regarding Need for Treatment

PEDIATRICS ◽  
1975 ◽  
Vol 56 (4) ◽  
pp. 621-622
Author(s):  
Arthur W. Kaemmer ◽  
Byron R. Johnson
Keyword(s):  
Mass Screening ◽  
Lead Poisoning ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Elevated Blood ◽  
Screening Programs ◽  
Environmental Lead ◽  
Need For Treatment ◽  
Lead Levels ◽  
Elevated Blood Lead Levels

Dr. Greensher and his colleagues are to be congratulated for bringing to the readers' attention a most unusual source of lead poisoning. Inasmuch as many localities are initiating city-wide lead screening programs, it is obvious that pediatricians in this country will be seeing many children with abnormally elevated blood lead levels, and in many cases diligent efforts such as this will have to be undertaken to determine the exact source of the environmental lead. biggest problems with mass screening programs for lead poisoning are well outlined by Moriarty's article.2

Too Much Lead, Too Little Iron

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 395-395
Author(s):  
MARGARET CLARK
Keyword(s):  
Public Health ◽  
Iron Deficiency ◽  
Lead Poisoning ◽  
Predictive Value ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
The Public ◽  
Erythrocyte Protoporphyrin ◽  
Lead Levels

In Reply.— We appreciate the work of Carraccio et al which confirms our findings that the anemia found in children with lead poisoning results from coexistent iron deficiency. The discrepancy between the two studies concerning the predictive value of blood lead in elevations of erythrocyte protoporphyrin bears further exploration. What is striking, however, is that in both series more than 50% of the variability in erythrocyte protoporphyrin remains unexplained. Now the public health focus is on detecting children with low blood lead levels—before even subtle CNS damage has occurred.

INCIDENCE OF HIGH BLOOD LEAD LEVELS IN CHICAGO CHILDREN

PEDIATRICS ◽  
1969 ◽  
Vol 44 (5) ◽  
pp. 661-667
Author(s):  
Lorry A. Blanksma ◽  
Henrietta K. Sachs ◽  
Edward F. Murray ◽  
Morgn J. O'Connell
Keyword(s):  
Seasonal Variation ◽  
Atomic Absorption ◽  
Lead Poisoning ◽  
Atomic Absorption Spectroscopy ◽  
Screening Program ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Children At Risk ◽  
Lead Levels ◽  
Poisoning In Children

The Chicago Board of Health in October 1986 began a mass-screening program using a blood lead test to detect lead poisoning in children. Atomic absorption spectroscopy made it possible to screen 5,000 specimens in 1 month, and to test a total of 68,744 children in 2 years. The incidence of high blood lead values was variable and seasonal it was lowest in November through January and highest in June. Control children exhibited the same seasonal variation in lead levels as did the children at-risk for lead poisoning. As a result of this program, 1,154 children were treated with chelates for lead poisoning in 1967 and 1968 at the Lead Poisoning Clinic, and the incidence of high blood lead levels among children living in the same areas declined from 8.5% in 1967 to 3.8% in 1968.

Lead Levels in Cord Blood

PEDIATRICS ◽  
1972 ◽  
Vol 49 (4) ◽  
pp. 606-608
Author(s):  
Paul Harris ◽  
Marshall R. Holley
Keyword(s):  
Cord Blood ◽  
Lead Poisoning ◽  
Whole Blood ◽  
Blood Lead ◽  
Mean Value ◽  
Diagnosis And Treatment ◽  
Normal Blood ◽  
Blood Lead Levels ◽  
Lead Levels ◽  
The Mean

Blood lead levels were determined on 24 mothers during labor and on the blood of their newborn offspring. The mean value for the mother's blood lead was 13.2 µg/100 gm (range 10 to 20) and for the cord blood 12.3 (range 10 to 20) µg/100 gm whole blood. These levels are lower than "normal" blood lead standards usually accepted in the diagnosis and treatment of childhood lead poisoning.

Screening to Prevent Lead Poisoning

PEDIATRICS ◽  
1974 ◽  
Vol 54 (5) ◽  
pp. 626-628
Author(s):  
Richard W. Moriarty
Keyword(s):  
Natural History ◽  
Lead Poisoning ◽  
Diagnostic Tests ◽  
Chelating Agents ◽  
Clinical Evidence ◽  
Clinical Symptoms ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Lead Levels ◽  
Lead Encephalopathy

The absence of fully effective treatment for lead encephalopathy, and the suggestive evidence that lead poisoning may cause brain damage even in the absence of overt encephalopathy, have led to massive efforts to prevent such damage. These preventive efforts have been directed toward screening to identify children who have absorbed an undue amount of lead from their environment, reducing their further exposure to lead, and removing already absorbed lead from those most in danger of developing ill effects. This approach has been codified in the Surgeon General's Report of 19701 which makes the following recommendations: 1. All young children who live in or visit old dilapidated buildings should have periodic blood lead determinations. 2. Any child with repeated blood lead levels over 40µg/100 ml whole blood should be considered to be at risk of lead poisoning, h ave current sources of exposure to lead investigated and corrected, and be followed closely to ensure that he does not develop higher blood lead levels or clinical symptoms. 3. All children with blood lead levels between 50 and 79µg/100 ml should have diagnostic tests for metabolic and clinical evidence of lead poisoning and be treated immediately if such evidence is present. 4. All children with blood lead levels over 80µg/100 ml should be hospitalized immediately and treated with chelating agents. Many aspects of this approach are subjects of current controversey, and the last word will not be written until much better knowledge of the natural history and ecology of lead poisoning is available.

Prevalence of Radiographic Evidence of Paint Chip Ingestion Among Children with Moderate to Severe Lead Poisoning, St Louis, Missouri, 1989 Through 1990

PEDIATRICS ◽  
1992 ◽  
Vol 89 (4) ◽  
pp. 740-742
Author(s):  
Michael D. McElvaine ◽  
Thomas D. Matté ◽  
Sue Binder ◽  
Estilita G. DeUngria ◽  
Charles G. Copley
Keyword(s):  
Confidence Interval ◽  
Lead Poisoning ◽  
Prevalence Ratio ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Radiographic Evidence ◽  
Exposure Data ◽  
Treatment Clinic ◽  
Abdominal Radiographs ◽  
Lead Levels

Although experts once believed that ingesting chips of lead-based paint was the major cause of lead poisoning among children, conventional wisdom now holds that lead-contaminated dust and soil are the major routes of exposure. Data from a Childhood lead-poisoning treatment clinic were examined to assess the frequency with which children ingest paint chips. For this study, the reports on abdominal radiographs of 90 children with moderate to severe lead poisoning who had received their first chelation treatment during 1989 or 1990 were reviewed. According to a radiologist's evaluation, 13 of 90 abdominal radiographs (14%; 95% confidence interval [CI] 7% to 22%) showed evidence of paint chip ingestion. Of 46 children with blood lead levels ≥ 55 µg/dL, 12 (26%) had radiographs that showed paint chips, whereas only 1 (2%) of 44 children with blood lead levels <55 µg/dL had such radiographs (prevalence ratio = 11.5; 95% CI 1.6 to 84.6). The actual proportion of children with moderate to severe lead poisoning who have consumed leaded-paint chips is likely to be higher than this estimate based on radiographic evidence. While lead-contaminated dust is a major source of lead exposure, ingestion of leaded-paint chips clearly remains an important source of exposure among children with moderate to severe lead poisoning.

scholarly journals Assessment of a Screening Questionnaire to Identify Exposure to Lead in Pregnant Women

2020 ◽  
Vol 17 (24) ◽  
pp. 9220
Author(s):  
Eléna Coiplet ◽  
Marine Freuchet ◽  
Claire Sunyach ◽  
Julien Mancini ◽  
Jeanne Perrin ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Lead Exposure ◽  
Blood Lead ◽  
Blood Lead Levels ◽  
Cross Sectional ◽  
Lead Levels ◽  
Risk Of Exposure ◽  
Exposure During Pregnancy ◽  
Systematic Identification

Lead readily crosses the placenta and displays adverse effects on birth outcomes and neurodevelopment. Systematic identification of the risk of exposure during pregnancy is essential but rarely performed, probably due to hospital staff’s workload and their lack of awareness. We aimed to evaluate the relevance of a questionnaire to screen pregnant women for lead exposure. A cross-sectional, multicentre study was carried out on a population of 792 pregnant women from February 2018 to May 2020. A total of 596 women had a blood lead test: 68.5% had blood lead levels below 10 μg/L. The estimated prevalence above 25 µg/L was 4% (95% confidence interval (CI) [2.6–5.9]) and 1.3% had levels above 50 µg/L (95% CI [0.6–2.6]). Multivariate analysis showed that three risk factors significantly increased the probability of blood lead levels above 25 µg/L: the use of traditional cosmetics (adjusted odds ratio [aOR]: 3.90; 95% CI [1.65–9.21]; p = 0.002), degraded old housing (aOR: 2.67; 95% CI [1.19–6.038]; p = 0.018), and (marginally) eating bread more than twice a day (aOR: 2.40; 95% CI [0.96–6.11]; p = 0.060). Our study reveals that a three-question tool can be used to quickly screen for the risk of lead exposure in our population and to trigger lead blood tests and special vigilance during pregnancy follow-up.

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