Screening for Lead Poisoning: Measurements and Methodology

Piomelli et al.1 have presented an extensive experience in comparison of free erythrocyte porphyrin (FEP) levels with blood lead concentrations. Their finding that an FEP ≥ 250µg/100 ml RBC was invariably associated with a blood lead concentration ≥ 6Oµg/100 ml is consistent with data obtained in our laboratory2 using a somewhat different microfluorometric method for FEP determination.3 We must, however, take issue with the conclusion of Piomelli et al.1 that only FEP levels above 250µg/100 ml RBC should be considered "positive."

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Lead Poisoning and Toxicokinetics in a Heifer and Fetus Treated with CaNa2 EDTA and Thiamine

Journal of Veterinary Diagnostic Investigation ◽

10.1177/104063879500700419 ◽

1995 ◽

Vol 7 (4) ◽

pp. 531-537 ◽

Cited By ~ 15

Author(s):

Todd M. O'hara ◽

Lloyd Bennett ◽

Pat C. McCoy ◽

S. W. Jack ◽

Sherrill Fleming

Keyword(s):

Lead Poisoning ◽

Lead Concentration ◽

Clinical Signs ◽

Blood Lead ◽

In Utero ◽

Blood Lead Concentration ◽

Electron Densities ◽

Muscle Twitching ◽

Thiamine Therapy

Lead (Pb) poisoning of a pregnant heifer was diagnosed based upon clinical signs (head pressing, blindness, muscle twitching) and a blood lead concentration of 1.73 ppm. Blood and urinary Pb half-lives with CaNa2 EDTA/thiamine therapy were determined to be 2.08 and 1.38 days, respectively. Many cations (Ca, Fe, Zn, Na, Cu), including Pb, were excreted at higher concentrations in urine during therapy. Blood (0.425 ppm) and liver (4.85 ppm) Pb concentrations in the fetus were 71.7% and 84.3% of the same tissue Pb concentrations of the dam, indicating a significant transfer of Pb in utero. Severe polioencephalomalacia was described in the adult, and hepatic lysosomes with metallic electron densities were present in the fetus.

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Statement on Childhood Lead Poisoning

PEDIATRICS ◽

10.1542/peds.79.3.457 ◽

1987 ◽

Vol 79 (3) ◽

pp. 457-465 ◽

Cited By ~ 1

Author(s):

◽

Keyword(s):

United States ◽

Early Detection ◽

Lead Poisoning ◽

Lead Concentration ◽

Blood Lead ◽

The United States ◽

Blood Lead Concentration ◽

Childhood Lead Poisoning ◽

Lead Absorption ◽

Erythrocyte Protoporphyrin

Patterns of childhood lead poisoning have changed substantially in the United States. The mean blood lead level has declined, and acute intoxication with encephalopathy has become uncommon. Nonetheless, between 1976 and 1980, 780,000 children, 1 to 6 years of age, had blood lead concentrations of 30 µg/L or above. These levels of absorption, previously thought to be safe, are now known to cause loss of neurologic and intellectual function, even in asymptomatic children. Because this loss is largely irreversible and cannot fully be restored by medical treatment, pediatricians' efforts must be directed toward prevention. Prevention is achieved by reducing children's exposure to lead and by early detection of increased absorption. Childhood lead poisoning is now defined by the Academy as a whole blood lead concentration of 25 µg/L or more, together with an erythrocyte protoporphyrin level of 35 µg/dL or above. This definition does not require the presence of symptoms. It is identical with the new definition of the US Public Health Service. Lead poisoning in children previously was defined by a blood lead concentration of 30 µ/dL with an erythrocyte protoporphyrin level of 50 µg/dL. To prevent lead exposure in children, the Academy urges public agencies to develop safe and effective methods for the removal and proper disposal of all lead-based paint from public and private housing. Also, the Academy urges the rapid and complete removal of all lead from gasoline. To achieve early detection of lead poisoning, the Academy recommends that all children in the United States at risk of exposure to lead be screened for lead absorption at approximately 12 months of age by means of the erythrocyte protoporphyrin test, when that test is available. Furthermore, the Academy recommends follow-up erythrocyte protoporphyrin testing of children judged to be at high risk of lead absorption. Reporting of lead poisoning should be mandatory in all states.

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