Clinical analysis of 129 children with lead poisoning

Abstract

Objective To assess the distribution of blood lead levels and the sources of lead exposure in children with lead poisoning, and thus to offer recommendations for clinical diagnosis and treatment of childhood lead poisoning. Methods The clinical data of 129 patients with lead poisoning was collected and analyzed at the Out-patient Department of Lead Poisoning Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine during Sep.2012 and Aug.2013 were collected and analyzed.All children were required to fill out the outpatient questionnaire on heavy metal (including children's demographic data, growth assessment, frequency of hand-mouth behavior, and the behavior of washing hands before eating, dietary, sources of lead exposure, and the family environment, etc.). Other data of medical history, physical examinations(height, weight, growth and development) were also collected.Blood samples were collected to measure blood lead level by graphite furnace atomic absorption spectrometry. Results (1)The above 129 patients were from 14 provinces (municipalities and autonomous regions), including 64 cases in Zhejiang (49.6%), 30 cases in Shanghai (23.0%), 13 cases in Jiangsu (10.1%), 6 cases in Jiangxi (4.7%), 5 cases in Hebei (3.9%), 2 cases in Anhui and Guangdong (1.6%); and 1 case in Fujian, Henan, Hunan, Jilin, Inner Mongolia, Heilongjiang and Shandong (0.8%), respectively.(2) In the patients, the blood lead level was 17.0-892.0 μg/L[(251.5±155.8) μg/L] and the median was 235.0 μg/L.(3)The mean age of the children was 4.3 years.Fifteen cases were less than 1 year old, and the mean blood lead level was (367.8±137.7) μg/L.Thirty-seven cases were 1-3 years old children, and the mean blood lead level was (250.5±116.3) μg/L.Fifty cases were 3-6 years old children, and the mean blood lead level was (237.7±179.7) μg/L.Twenty-seven cases were over 6 years old, and the mean blood lead level was (213.9±141.8) μg/L.(4)One hundred and eleven cases of the children could find the definite sources of lead exposure, mainly from industrial pollution (35.7%) and domestic pollution (64.3%). The blood lead levels in 18 cases were less than 100 μg/L, and their definite lead pollution source was not found.(5) Most of the children had the symptoms of inattention, hyperactivity, aggressive behavior, constipation and abdominal pain, and so on.(6)Logistic regression analysis of children with blood lead levels ≥ 235.0 μg/L showed that lead pollutants and age were the main risk factors for lead poisoning. Conclusions Industrial pollution are associated with higher blood lead levels among children aged 0-6 years old(occupying one-third of the pollutants). The younger children tend to have higher blood lead levels, and the data also suggest that greater attention should be paid to children who used red powder. Key words: Lead poisoning; High-risk factors; Lead exposure; Child