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The ceramics industry and lead poisoning. Lead poisoning in relation to technology and jobs.

The investigation evaluates the risk of lead absorption for 288 ceramics industry workers. Cases were studied in relation to sex, type and length of exposure, production plant characteristics, and jobs performed. The difference linked with sex was amplified by the fact that men usually performed the decidedly higher risk jobs, such as those connected with the direct use of ceramic glazes, in which--although to a variable extent--high percentages of lead are used. In fact, decreasing amounts of lead absorption were found for workers engaged in the operations of glazing, kiln work, maintenance and decoration, selection coming last. It was concluded that, in the Italian ceramics industry, lead exposure is linked to the use of lead-rich glazes and that this exposure may thus vary according to the different jobs or different technological cycles. Although female workers primarily carry out decoration and selection jobs, they nonetheless show high levels of lead in their blood, exceeding 1.9 mu mol/l--the limit currently recommended for women.

Adult↗

[Chronic lead poisoning: Lead gout with giant tophi on the skin, nephrophathy and porphyrinopathy].

Chronic lead nephtropathy, secondary gout (lead-gout) and porphyrinuria may develop after long lasting professional exposure to lead. A printer with giant tophi on his hands and feet excreted a significantly higher amount of lead after infusion of calcium EDTA in comparison with a normal control person. This result indicates an increased mobilization of lead from skeletal deposits. Furthermore, the laboratory findings showed renal insufficency and porphyrinuria up to 1316 mug/l (elevation of total porphyrins with slight or no elevation of delta-amino-levulic acid and porphobilinogene). The clinical triad nephropathy, secondary gout and porphyrinuria seems to be a variant of chronic lead poisoning.

Aged↗

Childhood lead poisoning.

Lead poisoning has been referred to as the most important environmental health hazard for children in New England. Medical professionals are in a unique position to perform a number of interventions that could make a lasting impact. First, physicians and nurses, particularly in the areas of pediatrics and family medicine, can provide anticipatory guidance to all families with young children. Lead poisoning, in contrast to long held beliefs, is an affliction that affects all socioeconomic groups. Parents should thus be informed regarding sources of lead, including occupational and hobby sources, and basic nutritional and abatement information should be provided. Second, health care workers should encourage lead screening in appropriately aged children at recommended intervals based on known risk factors. Once a blood lead concentration greater than 20[symbol: see text]g/dl has been obtained in a child, treatment or referral to an established lead clinic should be undertaken in a timely fashion. For children with low or moderate lead levels, many pediatricians or family physicians prefer to supervise their patients' treatment, including chelation therapy. For children with higher levels or in instances when the health care professional elects to refer, there are several lead clinics throughout New England whose clinicians are experienced in the treatment of childhood lead poisoning. Finally the medical profession needs to publicly recognize, as child advocates, that lead poisoning is one of the most common pediatric health problems in the United States and that it is entirely preventable. Fortunately, after many years and much hard work, Rhode Island finally has laws that start to deal with the lead problem in an appropriately aggressive fashion.(ABSTRACT TRUNCATED AT 250 WORDS)

Chelation Therapy↗

The gastrointestinal manifestations of gunshot-induced lead poisoning.

Lead poisoning associated with gunshot is not unknown but, unless suspected, can be easily missed. We describe a patient with lead intoxication following a gunshot injury, who presented with abdominal colic, anorexia, and weight loss as initial manifestations. He had extremely high blood lead levels and the onset of lead poisoning was comparatively rapid. We review the recent English language literature (1980-1993) related to lead poisoning due to lead projectiles with particular emphasis on mechanisms responsible for its gastrointestinal manifestations.

Adult↗

Lead poisoning.

Lead poisoning is the most common disease of environmental origin in the United States today. Adult lead poisoning results primarily from exposure by inhalation in the workplace. Pediatric lead poisoning results principally from the ingestion of lead from environmental media, including paint chips, dust, soil, drinking water, ceramics, and medications. Lead is toxic to many organ systems, among them developing erythrocytes, the kidneys, and the nervous system. Lead-induced toxicity to the central nervous system causes delayed development, diminished intelligence, and altered behavior. In young children, this effect has been demonstrated convincingly to occur at blood lead levels between 10 and 20 micrograms per dl. The Centers for Disease Control and Prevention has recommended that a blood lead level of 10 micrograms per dl or higher be considered evidence of increased lead absorption, and the National Academy of Sciences has concurred in that recommendation. Unresolved issues in need of further study include the frequency of screening young children for lead, the question of whether women should be offered screening for lead before conceiving a pregnancy, the role of x-ray fluorescence analysis in assessing lead in bone, and the appropriate legislative response of the United States government to lead-based paint abatement.

Adult↗

Meso-2,3-dimercaptosuccinic acid in the diagnosis and treatment of lead poisoning.

Lead poisoning remains one of the hazards of industrialized civilization. CaNa2 EDTA and dimercaprol, the usual therapeutic measures, have many side effects and can be given by parenteral route alone. The authors present a case of chronic lead poisoning caused by ingestion of contaminated flour ground in a primitive flour mill. The diagnosis was confirmed by the CaNa2 EDTA provocative test. Dimercaptosuccinic acid (DMSA) was given orally as a further provocation and resulted in an 11-fold increase in urinary lead excretion. A 5-day course of treatment with DMSA was instituted, during which symptoms abated, urinary lead excretion increased and the blood lead level decreased. No side effects were noticed. There has been no relapse over several months of follow-up. The authors conclude that the oral use of DMSA is effective, safe and convenient both as a provocative test in establishing the diagnosis of lead poisoning and as a therapeutic tool.

Adult↗

A review of a preventable poison: pediatric lead poisoning.

PURPOSE: A review of lead poisoning in pediatric populations enables nurses to increase their knowledge base about lead poisoning and to further the work on the Healthy People 2010 goal of eliminating childhood lead poisoning as a public health issue in the United States. CONCLUSION: Nurses should be aware of and use the variety of primary, secondary, and tertiary prevention strategies that are available to address pediatric lead poisoning. PRACTICE IMPLICATIONS: Prevention, education, and evidence-based treatment plans can decrease the occurrence of pediatric lead poisoning.

Chelating Agents↗

Lead exposure, lead poisoning, and lead regulatory standards in China, 1990-2005.

This article presents a summary of lead exposure levels and lead poisoning at workplaces in China reported in the Chinese medical literature between 1990 and 2005. A comprehensive literature search identified 618 papers reporting lead exposure and lead poisoning data. The data were analyzed in terms of time period, type of industry, size of factory, and task or process. In 2002 the new Occupational Diseases Prevention and Control Act was passed in China, with new provisions specifically for regulatory enforcement. Therefore, a comparison of lead exposure levels and lead poisoning rates before and after the 2002 Act will shed some light on the effectiveness of the new regulation. The reported lead exposure levels covered a wide range; some measurements were in excess of 250 mg/m(3), which was orders-of-magnitude higher than the occupational exposure levels (OELs) for lead in China. The overall arithmetic mean, median, and geometric mean were 0.92, 0.25, and 0.24 mg/m(3), respectively. Approximately 53.7% of the averages reported in the papers were above the national OELs. The data demonstrated that many facilities in the lead industries reported in the literature were not in compliance with the OELs. Similarly, there appeared to be only a minor impact of the 2002 Act on the reduction of occupational lead poisoning in China. The lead poisoning rates reported in the literature were well above 30%. Judging by the lead exposure levels and the lead poisoning rates, the current overall occupational health monitoring system appears inadequate, lacking the necessary enforcement. The 2002 Act, without the necessary enforcement, did not appear to have a major impact on either lead exposures or lead poisoning in China. Much work in enforcing the 2002 Act remains to be done.

China↗

Screening for chronic lead poisoning in lead factory workers.

One hundred and forty-nine lead factory workers comprising of 46 fume exposed, 78 handling lead materials and 25 controls were screened for chronic lead poisoning. Blood lead level was determined by atomic absorption spectrometery and urinary ALA by ion-exchange chromatography. Fume exposed workers had significantly higher (P < 0.01) blood lead (median 61.20 micrograms/dl, range 21.20-171.10 micrograms/dl) and urinary ALA levels (median 4.10 mg/l, range 01.0-22.9 mg/l) than workers handling lead materials and controls. Urinary ALA was found to be a more sensitive and specific test for lead poisoning than estimation of blood lead levels.

Adult↗

[Current diagnosis and treatment of lead poisoning].

Lead may be an industrial and an environmental hazard which becomes of greater importance every year. Classical symptoms of plumbism are rare, whenever minor clinical signs increase in frequency. Erythrocyte zinc protoporphyrin and delta-aminolaevulinic acid dehydratase are reliable indicators of the importance of the lead poisoning in individuals. The concentration of lead in blood is also a suitable biological indicator as is EDTA mobilization test. The treatment is based on the use of chelating agents such as calcium EDTA or DMSA, but the only solution is reduction or removal of the sources of lead exposure.

Accidents↗

Art in relation to lead poisoning.

Lead poisoning is an ancient and modern problem. Since many artists have had exposure to lead, it is appropriate to use some of their works as a vehicle to depict the symptoms of the variable syndromes associated with lead exposure.

Art↗

Burton's line in lead poisoning.

Lead poisoning in both its acute and chronic forms has been recognised since the second century BCE. Lead colic, anaemia, renal tubulopathies and motor neuropathies are well recognised. This paper sketches the early history and remembers the important contribution of Henry Burton, who described the gums to be bordered by a narrow leaden-blue line, about the one-twentieth part of an inch in width, whilst the substance of the gum apparently retained its ordinary colour and condition. The sign though inconstant, is still a valuable clinical clue.

Gingiva↗