Six children with lead poisoning

Article Abstract:

Exposure to environmental lead can cause kidney disease, peripheral nerve disease, and severe damage to the central nervous system. Recent studies show that moderate exposure to lead causes abnormal development of the nervous system, and results in deficits in behavioral and intellectual skills. The Centers for Disease Control have published guidelines concerning the diagnosis and treatment of lead poisoning, follow-up, and environmental interventions. In addition, the American Academy of Pediatrics has recently emphasized that physicians must become aware of the adverse effects of lead poisoning during the period before and after birth. A treatment center for lead poisoning was established in 1970 at the University Hospital in Syracuse, New York. The objectives of the center are to identify and treat children with lead exposure and to educate training physicians about the hazards of environmental lead exposure. At the center, each patient is evaluated by obtaining detailed records about exposure to lead through pica, peeling paint, and household dust, as well as job-related lead exposure. The red blood cell protoporphyrin levels are continuously monitored, and children are treated with a substance that chelates or removes the excess lead. Protoporphyrin is a derivative of hemoglobin, the iron-containing pigment of red blood cells that carries oxygen. Cases are described of six children with lead poisoning. These representative cases illustrate the short- and long-term management of children with lead poisoning. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Evaluation, Causes of, Environmental health

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A 50-year follow-up of childhood plumbism: hypertension, renal function, and hemoglobin levels among survivors

Article Abstract:

The effects of acute exposure to high levels of lead are known. However, the long-term effects of such exposure, and the effects of long-term exposure to low lead levels, are unclear. Lead that accumulates in the bones may be metabolically active and exert effects over a long period. Studies of lead have generally addressed the effects on nerve and brain function, while less attention has been paid to effects on the kidneys, blood vessels, and hematopoietic (blood cell) effects. Of 192 subjects with lead poisoning (plumbism), which occurred from 1930 to 1942, 72 survivors living near Boston were contacted, and 35 participated in this study. Twenty-two matched control subjects were also studied. Proportionally more survivors with plumbism were taking drugs for high blood pressure, but there were no significant differences in blood pressure between those with plumbism and the controls. Elevated creatinine clearance rates in survivors suggested that blood flow through the kidney was increased, which is inconsistent with the idea that lead exposure leads to kidney dysfunction. One survivor had kidney failure for which the cause was unknown. Lead-exposure survivors had significantly lower levels of hemoglobin (oxygen-carrying protein in red blood cells) and hematocrit measurements (proportion of blood cells in a blood sample). (Consumer Summary produced by Reliance Medical Information, Inc.)

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Prevalence of lead exposure in a clinic using 1991 Centers for Disease Control and Prevention recommendations

Article Abstract:

More children may be diagnosed with lead poisoning since the US Centers for Disease Control (CDC) lowered its standard for toxic blood lead levels. In 1991, the CDC determined that blood lead levels above 0.48 micromoles per liter can be harmful to children. It also recommended that screening be done by testing for blood lead level rather than for erythrocyte protoporphyrin (EP) level. Researchers in a pediatric clinic screened 233 children aged nine to 24 months to determine the prevalence of lead poisoning using the new standard. Seventy-six children were diagnosed with lead poisoning because they had blood lead levels over the standard. The EP test was not an accurate measure of lead poisoning. Thirty-three percent of children with normal EP levels had blood lead levels over the standard. The lower standard should lead to more rigorous monitoring of children at risk for lead poisoning and increase preventive measures.

Diagnosis, Measurement, Medical examination, Children, Lead in the body

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