scholarly journals A CASE REPORT ON CHRONIC LEAD POISONING FROM OCCUPATIONAL EXPOSURE

2017 ◽  
Vol 10 (6) ◽  
pp. 1
Author(s):  
Dhivya K ◽  
Nazma M ◽  
Divya Sree P ◽  
Lakshmi Prasanna S
Keyword(s):  
Lead Poisoning ◽  
Chelation Therapy ◽  
Lead Level ◽  
Age Groups ◽  
Blood Lead ◽  
Toxic Heavy Metals ◽  
The World ◽  
Education And Awareness ◽  
Lead Hazards ◽  
Upper Abdomen

The hazard to public health from lead continues to be a matter of concern. It is one of the most serious environmental poisons among the toxic heavy metals all over the world. Lead poisoning is seen in all age groups, especially in adults working in lead-based industries. We report the case of a 28-year-old man working in an unorganized lead-based manufacturing unit admitted with the complaints of giddiness, excessive tiredness, pain in the upper abdomen, decreased appetite, excessive body pains, increased sweating, and oliguria. Investigations carried out during the admission showed hemoglobin levels of 8.5 g/dl and blood lead level (BLL) of 115 μg/dl. The patient was subjected to chelation therapy. After repeated course of chelation therapy, he has shown the signs of improvement. The paucity of a safe workplace and awareness among workers results in high BLLs. Therefore, education and awareness related to lead hazards is considered necessary.

scholarly journals Lead Toxicity due to Ingestion of Lead-Contaminated Opium in a Patient Presenting with Motor Neuropathy and Upper Limb Paresis: A case report

2019 ◽  
Vol 18 (4) ◽  
pp. 529 ◽  
Author(s):  
Seyed M. M. Mirzaei ◽  
Ayob Akbari ◽  
Omid Mehrpour ◽  
Nasim Zamani
Keyword(s):  
Nervous System ◽  
Case Report ◽  
Lead Poisoning ◽  
Chelation Therapy ◽  
Lead Level ◽  
Lead Toxicity ◽  
Blood Lead ◽  
Motor Neuropathy ◽  
Upper Limbs ◽  
Gastrointestinal Complications

Opium users may present with central or peripheral nervous system-related symptoms, gastrointestinal complications and anaemia; in such cases, lead poisoning should be suspected and chelation therapy initiated as soon as possible. We report a 64-year-old male patient with a 20-year history of opium addiction who was referred to the Imam Reza Hospital, Birjand, Iran, in 2017 with severe motor neuropathy and paresis in both upper limbs. His primary symptoms were generalised weakness, abdominal and bone pain, constipation and lower limb paraesthesia that had started several months prior. In addition, he reported severe progressive bilateral paresis of the upper limbs of one month’s duration. A diagnosis of lead poisoning was confirmed by a blood lead level of 140 μg/dL. The patient underwent chelation therapy after which he improved significantly. At a one-year follow-up visit, he was neurologically intact and symptom-free.Keywords: Opium Dependence; Lead Poisoning; Lead-Induced Nervous System Diseases; Paresthesia; Case Report; Iran.

Effects of Calcium Disodium Versenate (CaNa2EDTA) Chelation in Moderate Childhood Lead Posioning

PEDIATRICS ◽  
1993 ◽  
Vol 92 (2) ◽  
pp. 265-271
Author(s):  
Morri E. Markowitz ◽  
Polly E. Bijur ◽  
Holly Ruff ◽  
John F. Rosen
Keyword(s):  
Lead Poisoning ◽  
Chelation Therapy ◽  
Controlled Trial ◽  
Lead Level ◽  
Chelating Agent ◽  
Blood Lead ◽  
Erythrocyte Protoporphyrin ◽  
Bone Lead ◽  
Sustained Reduction ◽  
The Relationship

Background. For children with asymptomatic moderate lead poisoning (Blood lead level [BPb] 25 to 55 µg/dL [1.21 to 2.66 µmol/L]), treatment with the chelating agent calcium disodium versenate (CaNa2EDTA) is recommended for all those children with a BPb level >45 µg/dL (2.17 µmol/L) and for those with a BPb level of 25 to 44 µg/dL (1.21 to 2.13 µmol/L) who also have a positive lead mobilization test. However, controlled studies demonstrating its efficacy at inducing a sustained reduction in BPb level or lead-related toxicity have not been performed in children with moderate lead poisoning. This study assesses the relationship between CaNa2EDTA chelation and measures of lead burden and toxicity in children with moderate lead poisoning. Methods. Two hundred one children with moderate lead poisoning were enrolled. Sequential changes in BPb concentrations, bone lead level as measured by Lα-x-ray fluorescence, and lead-induced toxicity as assessed by erythrocyte protoporphyrin levels were determined over a 7-week period. From this group, children with a positive lead mobilization test received CaNa2EDTA chelation therapy. Results. Children with positive lead mobilization tests had on average higher initial BPb, bone lead, and erythrocyte protoporphyrin concentrations. The chelated children decreased approximately 4.7 µg/dL (0.23 µmol/L), 41 corrected net counts, and 24 µg/dL (0.46 µmol/L) more than the unchelated children on BPb, bone lead, and erythrocyte protoporphyrin values, respectively. However, children with higher initial levels decreased the most, whereas children with lower initial levels showed the least decline, with or without treatment. When the initial values on the measures were controlled analytically, or when subgroups matched on initial levels were compared, there were no significant differences between the chelated and unchelated children. Conclusions. The apparent effectiveness of CaNa2EDTA at reducing lead burden and toxicity is no longer observed when the pretreatment levels are considered. The findings suggest that sufficient doubt about CaNa2EDTA efficacy now exists to warrant a randomized controlled trial of chelation therapy in moderately lead-poisoned children. However, until such studies are performed, it would be premature to withhold chelation treatment on the basis of this study alone.

Lead Poisoning: Twenty Years After

PEDIATRICS ◽  
1993 ◽  
Vol 92 (3) ◽  
pp. 505-505
Author(s):  
HENRIETTA SACHS ◽  
DONALD I. MOEL
Keyword(s):  
Disease Control ◽  
Lead Poisoning ◽  
Blood Lead Level ◽  
Scientific Evidence ◽  
Lead Level ◽  
Blood Lead ◽  
Neurobehavioral Development ◽  
Long Term Follow Up

To the Editor.— In October 1991, the Centers for Disease Control decreased the blood lead level PbB) from 25 to 10 µg/dL and designated it as abnormal because of "overwhelming and compelling scientific evidence"1 that 10 µg/dL is associated with adverse neurobehavioral development. We have evidence to the contrary, obtained in a long-term follow-up of severely lead-poisoned children whom we treated before 1972 for PbBs between 80 and 470 µg/dL (mean, 150.3 ± 77.1 µg/dL); their mean age was 28 months.

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.

scholarly journals Lead Exposure and Intellectual Function: Findings from Primary School Children in Bangladesh

2012 ◽  
Vol 11 (4) ◽  
pp. 292-297
Author(s):  
Mahbuba Haque ◽  
M H Faruquee ◽  
Suman Lahiry ◽  
Saira Tasmin ◽  
Rabeya Yasmin ◽  
...  
Keyword(s):  
Primary School ◽  
Lead Poisoning ◽  
School Children ◽  
Blood Lead Level ◽  
Lead Level ◽  
Medical Science ◽  
Blood Lead ◽  
Primary School Children ◽  
Background Information ◽  
The Impact

Backgrounds: About 120 million people around the world are overexposed to lead which is neurotoxic and 99 percent of the most severely affected children are in the developing world including Bangladesh. Methods and Materials: The present cross-sectional ecological study was carried out to explore the impact of lead poisoning on the intelligence level among 84 primary school children of a school of Bangladesh, aged between 8 and 14 years from September 2010 through January 2011. The research instrument was an interviewer questionnaire, questionnaire for IQ test and assessment of blood lead level (inductively-coupled plasma mass spectrometry with collision/reaction cells) of the study subjects after obtaining permission from their parents and the school authority. Results: Data were cross-checked and frequency distribution and association using chi-square test was accomplished. Background information depicted majority (69.1%) of the children aged10-11 years (mean = 10.25 ±1.177 yrs), female (51.2%), parents having primary level of education or below (73.8% in case of father and 77.4% in mother) and from lower socioeconomics (78.6% earned BDT 10,000 or below per month). Among all, majority (56%) were found to be moron, 27.4% in borderline, while 8.3% were imbecile with the same proportion with normal level. By their blood lead level. Majority (70.2%) had blood lead level up to 10 microgram/dl and the rest (29.8%) had more than 10 microgram/dl. Though no statistically significant association was found between IQ level of the children and their blood lead level (p>0.05), the health problems found among the respondents as abdominal pain (53.57%), impatience (14.29%), nausea (10.71%) and all other problems (loss of concentration to study, ear problem, anorexia and loss of weight) amounting for 21.43% are suggestive of chronic lead poisoning. Conclusion:Further studies in large scale with larger samples including comparative studies of inter-industrial areas have been strongly recommended. DOI: http://dx.doi.org/10.3329/bjms.v11i4.12599 Bangladesh Journal of Medical Science Vol. 11 No. 04 Oct’12  

The Association between Acute Lead Exposure from Indoor Firing Ranges and Iron Metabolism.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3747-3747
Author(s):  
Drorit Merkel ◽  
Nir Hirshhoren ◽  
Tzippora Shochat ◽  
Asaf Vivante
Keyword(s):  
Young Adults ◽  
Correlation Coefficient ◽  
Lead Poisoning ◽  
Lead Exposure ◽  
Lead Level ◽  
Blood Lead ◽  
Zinc Protoporphyrin ◽  
Short Term ◽  
Iron Depletion ◽  
Post Exposure

Abstract Objective: To assess the impact of short term indoor firing ranges lead exposure and its relationship to iron, ferritin, lead, zinc protoporphyrin and hemoglobin concentration among young adults. Methods: We report of a clinical observation that was carried out in 30 young and healthy soldiers serving in the Israel Defense Forces (IDF) Counter Terrorist Unit (CTU). Blood samples were drawn for Lead (Pb), Zinc Protoporphyrin (ZPP),Iron, Hemoglobin (Hb) and ferritin prior to and after a 6 weeks period of intensive shooting practice in indoor firing ranges. Results: A mean Blood lead level increase (p< 0.0001) with a mean Iron (p<0.0005) and mean ferritin (p<0.0625) decrease simultaneously after 6 weeks period of Lead dusts exposure were demonstrated. We found a trend for inverse correlation between pre-exposure low ferritin levels and post exposure high blood lead levels. Conclusion: We found decreased iron and ferritin levels after short term lead exposure among young adults. This can be explained by competition of iron and lead absorption viatransporters like DMT1 suggesting that lead poisoning can cause iron depletion and that iron depletion can aggravate lead poisoning. This synergistic effect should come to every physicians mind especially when treating patients with a potential risk for each problem separately. Lead (Pb), Zinc Protoporphryn (ZPP), Hemoglobin (Hb), Iron and Ferritin among the CTU soldiers before and after the indoor firing ranges lead exposer variable N Pre-exposure N Post-exposure Difference *P value Pb (mcg/dl) 29 10.3±2.3 30 18.9±3.6 8.8±2.6 0.0001 ZPP(mcg/dl) 29 42±7.5 30 42.9±8.1 0.03±6.5 NS Hb (g/dl) 30 15±0.7 30 14.8±0.9 0.2±0.2 NS MCV (fl) 30 88.7±2.5 30 89±2.7 0.3±0.2 NS Iron (mcg/dl) 29 108.5±43.6 30 77.4±24.4 −30.4±41.2 0.0005 Ferritin (mcg/l) 27 58.1±27.7 16 51±19.9 −6.1±10.7 0.0625 Correlation between Pre-exposure Ferritin levels and Post exposure Lead level.(Person correlation coefficient = −0.28 r=0.14 number of observations = 27) Correlation between Pre-exposure Ferritin levels and Post exposure Lead level.(Person correlation coefficient = −0.28 r=0.14 number of observations = 27)

scholarly journals THE COMPARATIVE ROLE OF ASCORBATE AND CHELATORS IN REVERSING OXIDATIVE STRESS, HEPATIC AND RENAL DYSFUNCTION IN SUB-ACUTE LEAD POISONING

2016 ◽  
Vol 14 (1) ◽  
pp. 89-102
Author(s):  
B. O. ONUNKWOR ◽  
R. N. UGBAJA ◽  
D. A. OMONIYI ◽  
A. O. DOSUMU
Keyword(s):  
Oxidative Stress ◽  
Body Weight ◽  
Lead Poisoning ◽  
Catalase Activity ◽  
Lead Level ◽  
Blood Lead ◽  
Therapeutic Interventions ◽  
Control Group ◽  
Male Wistar Rats ◽  
Species Production

Lead has been implicated in the induction of reactive species production, leading to organ dysfunctions. The ameliorative roles of ascorbate and chelators in acute lead poisoning were comparatively studied in thirty-five male Wistar rats (150-200g), segregated into 5 groups (n=7/Group): group 1(administered normal saline),ª¤? groups 2-5 were orally exposed to 75mg/kg body weight lead acetate (PbAc) daily for 14 days. Pre-therapy blood samples were collected to ascertain blood lead level (BLL) and catalase activity 24hours after the last PbAc exposure. Groups 3, 4, and 5 were then treated with 30mg/kg body weight D-penicillamine; 30mg/kg body weight succimer; and 500mg/kg body weight ascorbate respectively for 10 days, followed by the assay for indices of oxidative stress, hepatic and renal dysfunctions.ª¤? Results obtained showed significantly elevated BLL in the four groups exposed to PbAc. which were significantly reversed about 2 folds in groups 3-5 after therapeutic interventions. Pre-therapy blood catalase activity of the PbAc treated groups was significantly (p<0.05) reduced by 39% when compared with the control group, however ascorbate significantly (p<0.05) increased catalase activity by 2 folds above the control; decreased plasma activities of alanine transaminase and aspartate transaminase, blood urea nitrogen and creatinine among the groups administered therapeutics. These findings indicate that ascorbate is more effectiveª¤?

scholarly journals Utilizing Citizen Science to Reverse the Current Lead Testing Paradigm: Development of a Scalable, Low-cost Home Lead Test Kit

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Katlyn Sawyer ◽  
Chris Knaub ◽  
Meghanne Tighe ◽  
Danielle Forbes ◽  
Claire Marks ◽  
...  
Keyword(s):  
Lead Exposure ◽  
Blood Lead Level ◽  
Low Cost ◽  
Lead Level ◽  
Blood Lead ◽  
Average Completion Time ◽  
Test Kit ◽  
Lead Hazards ◽  
Paradigm Development ◽  
Lead Testing

Background: The Center for Disease Control recommends case management begin at a blood lead level of 5 μg/dL, yet Indiana does not take action until a blood lead level of 10 μg/dL. Low levels of lead can cause irreversible neurological damage in children. The goal of this study was to design a scalable, low-cost Home Lead Test Kit to proactively find lead in homes.  Methods: Individuals were recruited through community partnerships, community lead testing events, and flyers. Qualitative data was recorded during home visits as participants used the kit. An x-ray fluorescence analyzer was used in the field and laboratory to analyze lead levels of samples. Results were blinded during the analysis.  Results: To date, 40 homes have been recruited, and 20 have been completed. The average completion time of the kit was 23.45 minutes.  Of the 8 pre-1950 homes 100% had elevated lead results, of the 7 1950-1978 homes 43% had elevated lead results, and of the 5 post 1978 homes 0% had elevated lead results.   Conclusion and Potential Impact: The study is ongoing. Preliminary results support the hypothesis that pre-1950 homes have a high risk of lead exposure, and post 1978 homes have minimal to no levels of lead. Feedback from study participants regarding kit usability has been positive. Future plans are to produce a kit to be scaled up in St. Joseph County with the goal of a statewide model. This kit may allow citizens to identify lead hazards to prevent children from lead exposure. 

Treatment of adult lead poisoning with D-penicillamine

2019 ◽  
Vol 34 (2) ◽  
Author(s):  
Maryam Paeezi ◽  
Nasim Zamani ◽  
Hossein Hassanian-Moghaddam ◽  
Shahin Shadnia ◽  
Naghmeh Zamani ◽  
...  
Keyword(s):  
Lead Poisoning ◽  
Day Treatment ◽  
Lead Level ◽  
Case Series ◽  
Blood Lead ◽  
Signs And Symptoms ◽  
Outpatient Setting ◽  
Treatment Protocols ◽  
Case Series Study ◽  
Significant Difference

Abstract Background The aim of the current study was to evaluate the efficacy of D-penicillamine in the treatment of lead poisoning mainly in the outpatient setting. Methods In a case series study performed during the recent epidemic of lead poisoning in Iran, lead-poisoned patients referring to our outpatient clinic were treated with 250-mg D-penicillamine capsules administered every 6 h for 5 or 10 days based on availability of the medication. They were recommended to re-check blood lead level (BLL) 4 weeks after cessation of the treatment and refer to our clinic again. Results In 63 patients with lead poisoning but without signs and symptoms of lead encephalopathy, median BLL was 106 [84, 131] μg/dL on presentation, which declined to a mean of 52.6 ± 28.8 μg/dL after a median treatment period of 7 [5, 10] days (p < 0.001). There was no statistically significant difference between the 5- and 10-day treatment protocols regarding complications and recovery. Treatment had resulted in a median decrease of 54 μg/dL [33, 90] (range: −20 to 231 μg/dL) in the patients’ BLLs (33.9% declined in BLL measurements; range: −29.69% to 99.06%). Conclusions D-penicillamine may be an acceptable substitute treatment in adult lead poisoning. Although our sample size was limited, we could not detect any serious adverse effects in our cases showing that D-penicillamine resulted in acceptable recovery rates. This may be helpful especially in epidemics with limitations in antidote access.

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