Cases Of Lead Poisoning Research Articles

Evaluation of lead poisoning in children age ranged 2-10 years old

Background: Lead poisoning is one of the major environmental diseases among children in developing countries. The present study was conducted to assess lead level in children. Materials & Methods: The present study was conducted on 156 cases of lead poisoning of both genders of age ranged 2-10 years. In all children, symptom suggestive of lead poisoning like pallor, unexplained fatigue, abdominal pain, constipation or anorexia, deteriorating school performance, and recently acquired irritability or hyperactive behaviour was recorded. Reasons for lead poisoning were recorded. Results: Out of 156 patients, boys were 80 and girls were 76. Age group 2-4 years had 26 children, 4-6 years had 67, 6-8 years had 35 and 8-10 years had 28 children. Possible reasons seen in children were thumb sucking (26), use of colored toys (68), pets (34), absence of hand washing (65), use of herbal medications (35) and pencil biting (82). The difference was significant (P< 0.05). Conclusion: Lead poisoning in children is a serious issue. The possible reasons found was thumb sucking, use of colored toys, pets, absence of hand washing, use of herbal medications and pencil biting.

Elevated lead level from a tobacco source requiring chelation in a 12-year-old child

Context: Across the world, tobacco is used in a variety of forms, including being smoked or added to a “quid” that is then chewed. We report a case of lead poisoning in a child from tobacco imported from Thailand.Case details: A 12-year-old Thai immigrant boy had a blood lead level (BLL) of 6 mcg/dL on routine testing upon arrival to the United States, but which increased to 72 mcg/dL six months after his arrival. He was asymptomatic with unremarkable workup. At this time his father, mother and two siblings were also found to have elevated BLLs of 53, 16, 22, and 11 mcg/dL, respectively. Water, paint, food and cookware sources tested negative for lead, whereas samples of the father’s dried tobacco leaves imported from Thailand contained 36.12 ppm (mcg/g) of lead. The mother admitted that both she and the patient used the tobacco as well. The child was chelated with oral succimer and his BLL decreased.Discussion: In our case, the source of the lead exposure was from the tobacco that the patient was chewing. Tobacco is often overlooked as a source of lead exposure, though it has been reported in the literature, both from direct smoking and from chewing, as well as through secondhand smoke. Toxicologists and health care professionals should consider cultural practices when evaluating patients with elevated BLLs.

First confirmed case of lead poisoning in the endangered Egyptian Vulture (&lt;i&gt;Neophron percnopterus&lt;/i&gt;) in the Balkans

First confirmed case of lead poisoning in the endangered Egyptian Vulture (&lt;i&gt;Neophron percnopterus&lt;/i&gt;) in the Balkans

Lead Gunshot Ingestion By A Peregrine Falcon

Summary. Lead ammunition represents a source of poisoning for raptors eating game. Although the Peregrine Falcon Falco peregrinus commonly preys on gamebirds, only a few cases of lead poisoning have been recorded, probably owing to the lack of specific investigations. We document an adult female found dead with many lead shot in the digestive tract, mixed with the remains of a feral Pigeon Columba livia domestica and a European Starling Sturnus vulgaris. Concentrations in heart blood clot, liver, kidney and bone suggest that lead poisoning was not the ultimate cause of death. However, lead levels in the blood clot suggest that a small amount of lead may have been absorbed from the shot. The two prey species involved cannot be hunted in Italy but they are intensively shot all year round to prevent damage to crops. —Andreotti, A., Fabbri, I., Menotta, S. & Borghesi, F. (2018). Lead gunshot ingestion by a Peregrine Falcon. Ardeola, 65: 53–58.

HUBUNGAN KADAR TIMBAL DALAM DARAH DENGAN JUMLAH ERITROSIT PADA SISWA SEKOLAH DASAR (Studi di SD Negeri Grinting 01 Kecamatan Bulakamba Kabupaten Brebes Jawa Tengah)

Title: The Association Between Blood Lead Levels and Eryhrocyte Counts in Elementary School Students.Background: Lead is a heavy metal that can cause both acute and chronic toxicity to human. Infant and children are usually more sensitive to lead toxicity than adults. The data of CDC (Centre for Desease Control and Prevention) showed that 49% of lead poisoning cases were happened to children with the age of under six year. Lead is known to affect the hematologic system by interfering with heme synthesis and caused anaemia. The aim of this research was to identify the association between blood lead level (BLL) and erythrocyte counts.Method: This research was an observational research using the analytical approach and cross sectional design with 52 students participated in purposive sampling. Blood level as the independent variable and the dependent variable was erythrocyte counts.Results: The research results showed that the mean of BLL was 31,52 µg/dl, the minimum value is 11,6 µg/dl and the maximum value is 48,89 µg/dl. The mean of erythrociyte count was 4,72x 1012/L. Chi Square Test showed that the value of p &gt;0,05, (PR=0,84, 95% CI=0,27-2,63) meaning that there was no association between blood lead level and erythrocyte counts.Conclusion: The children have been exposed to lead according to standards set by CDC, which 5 µg/dl average 31,52 µg/dl. There was no association between blood lead level and erythrocyte counts (p&gt;0.05).

Modeling the effect of succimer (DMSA; dimercaptosuccinic acid) chelation therapy in patients poisoned by lead

Context: Kinetic models could assist clinicians potentially in managing cases of lead poisoning. Several models exist that can simulate lead kinetics but none of them can predict the effect of chelation in lead poisoning. Our aim was to devise a model to predict the effect of succimer (dimercaptosuccinic acid; DMSA) chelation therapy on blood lead concentrations.Materials and methods: We integrated a two-compartment kinetic succimer model into an existing PBPK lead model and produced a Chelation Lead Therapy (CLT) model. The accuracy of the model’s predictions was assessed by simulating clinical observations in patients poisoned by lead and treated with succimer. The CLT model calculates blood lead concentrations as the sum of the background exposure and the acute or chronic lead poisoning. The latter was due either to ingestion of traditional remedies or occupational exposure to lead-polluted ambient air. The exposure duration was known. The blood lead concentrations predicted by the CLT model were compared to the measured blood lead concentrations.Results: Pre-chelation blood lead concentrations ranged between 99 and 150 μg/dL. The model was able to simulate accurately the blood lead concentrations during and after succimer treatment. The pattern of urine lead excretion was successfully predicted in some patients, while poorly predicted in others.Conclusions: Our model is able to predict blood lead concentrations after succimer therapy, at least, in situations where the duration of lead exposure is known.

Assessment of exposure to soils contaminated with lead, cadmium, and arsenic near a zinc smelter, Cassiopée Study, France, 2008.

After 150 years of industrial activity, significant pollution of surface soils in private gardens and locally produced vegetables with lead, cadmium, and arsenic has recently been observed in Viviez (Southern France). A public health intervention was conducted in 2008 to identify individual health risks of Viviez inhabitants and to analyze their environmental exposure to these pollutants. Children and pregnant women in Viviez were screened for lead poisoning. Urinary cadmium testing was proposed to all inhabitants. Those with urinary cadmium levels over 1 μg/g creatinine were then tested for kidney damage. Urinary cadmium and arsenic levels were compared between participants with non-occupational exposure from Viviez and Montbazens, a nearby town not exposed to these two pollutants, in order to identify environmental factors contributing to impregnation. No case of lead poisoning was detected in Viviez, but 23 % of adults had urinary cadmium over 1 μg/g creatinine, 14 % of whom having markers of kidney damage. Viviez adults had higher levels of urinary cadmium, and to a lesser extent, higher levels of urinary arsenic than those from Montbazens. Consumption of local produce (vegetables and animals) and length of residence in Viviez were associated with higher urinary cadmium levels, independently of known confounding factors, suggesting persisting environmental exposure to contaminated soil. To conclude, health risks related to cadmium exposure were identified in the Viviez population living on contaminated soils. Lead and arsenic exposure did not pose health concerns. Interventions were proposed to reduce exposure and limit health consequences.

The frequency distribution of lead concentration in feathers, blood, bone, kidney and liver of golden eagles Aquila chrysaetos: insights into the modes of uptake

Several cases of acute lead poisoning of golden eagles Aquila chrysaetos have been documented in the Alps. The question, however, remains how often golden eagles take up lead (once, chronically or episodically) and whether this uptake is in fatal or sublethal amounts. We approached this question by examining the level and frequency distribution of lead concentration in different tissues and in three segments of flight feathers in 41 golden eagles found dead, injured or moribund in the Swiss Alps. The frequency distribution of lead concentration in the blood, liver, kidney, wing coverts and shaft of flight feathers were all right-skewed. The highest values in blood, kidney and liver reached levels typical for acute fatal poisoning. In contrast, the frequency distribution of lead in bones was more symmetrical, but 71 % had bone lead concentrations >10 µg/g, which are considered elevated, and 29 % >20 µg/g, values often observed in cases of lethal poisoning. In 22 % of individuals, only one segment of a flight feather had a high lead concentration, while the other two segments had a low concentration. These findings indicate an episodic intake of lead of various amounts that may be immediately fatal (generating high blood levels) or sublethal. The patterns of lead in flight feathers and in bone suggest a repeated sublethal lead intake by the same individual. Such an episodic lead uptake seems only possible through ingestion of lead particles from carcasses or offal left behind by hunters. This also constitutes a risk to other scavengers, notably to the bearded vulture Gypaetus barbatus for which several high bone lead values have been found.

Implications of the new Centers for Disease Control and Prevention blood lead reference value.

The Centers for Disease Control and Prevention recently established a new reference value (≥ 5 μg/dL) as the standard for identifying children with elevated blood lead levels (EBLs). At present, 535,000 US children aged 1 to 5 years (2.6%) are estimated to have EBLs according to the new standard, versus 0.8% according to the previous standard (≥ 10 μg/dL). Because EBLs signify the threshold for public health intervention, this new definition increases demands on lead poisoning prevention efforts. Primary prevention has been proven to reduce lead poisoning cases and is also cost effective; however, federal budget cuts threaten the existence of such programs. Protection for the highest-risk children necessitates a reinstatement of federal funding to previous levels.

Systemic plumbism following remote ballistic injury

We report an unusual case of systemic lead poisoning, i.e., plumbism, following a remote gunshot injury to the right femur. Plumbism is a rare side-effect of penetrating projectiles and has been shown to be directly related to the degree of ballistic fragmentation, as well as to the impact location, with intra-synovial, intra-osseous, head, spine and maxillofacial injuries having the highest correlation. Our patient, a 44-year-old male, presented to the ER with a 3-week history of mid epigastric cramping abdominal pain and intermittent vomiting as well as mild mental status changes. Abdominal radiographs and ultrasound were noncontributory. Laboratory findings were notable for underlying microcytic anemia with basophilic stippling observed on peripheral blood smear. Serum iron studies were normal. Lead levels were found to be elevated at 306 μg/dl. Prior EGD had demonstrated mild erosive gastritis with subsequent multiple negative gastric lavages. The patient's past medical history was notable for a previous gunshot injury to the right femur with open fracture 2 years previously. Radiographs of the proximal right lower extremity, subsequent ultrasound and CT demonstrated an uncomplicated healed fracture of the mid right femoral diaphysis with an adjacent partially cystic lesion, an approximately 7-cm collection in the medial soft tissues containing internal ballistic fragments. Mottled surrounding capsular density was observed with mural calcific and micrometallic fragments. Systemic plumbism was suspected in relation to the remote ballistic injury and chelation therapy was initiated. Following surgical removal of the encapsulated fluid collection, systemic lead levels were observed to decline precipitously. The abdominal and CNS symptoms resolved in due course and the patient was discharged on oral chelation therapy.

16 Epidemiological investigation of a collective contamination by lead during a renovation of old buildings, Centre region, France, 2010

Following several cases of lead poisoning among building workers in the Centre region (France), the regional office of French Institute for Public Health conducted a retrospective cohort study between May...

Investigation et gestion d’un foyer de saturnisme infantile dans un quartier de la commune du Port, Île de la Réunion

BackgroundA national survey conducted in 2008–2009 by the French Institute for Public Health Surveillance for detection of lead impact in childhood identified a high blood lead level in a young boy living in the town of “Le Port”, Reunion Island. Previously, cases of lead-poisoning on the island had been exceptional; only a dozen cases were reported in the 1980s in adults, related to the use of lead-containing instruments for food preparations. MethodsThe family of the index case was invited to participate in screening tests and an environmental investigation was conducted using a standardized questionnaire. Screening was then broadened to the neighborhood of the index case and samples of soil outside the home and in the immediate vicinity were taken. The environmental survey was then extended with soil samples taken from the entire geographical area. Information was then provided to local inhabitants (87 families and 287 people) in order to encourage lead blood testing for all children under six years and all pregnant women living in the area. ResultsThe index case lived in the neighborhood of “The Oasis”, a shantytown of Le Port. The results of soil analysis revealed heterogeneous pollution of superficial soils by lead throughout the area of the shantytown, the highest level recorded (5200mg/kg) reached more than 300 times the background level of the natural soils of the island. The screening identified 76 cases of childhood lead-poisoning (blood lead level greater or equal to 100μg/L) among 148 samples (51%). All cases of blood poisoning involved children under the age of 15 years. The median age of children with a positive test was 5.6 years; the median blood lead level was 196μg/L [102–392μg/L]. ConclusionThe main hypothesis to explain the contamination of the soil in the area of the shantytown is the presence of waste deposits (car batteries) and diffuse activities of metal recovery. The authorities managed to remove all the families from the environmental exposure to lead by rapidly ensuring rehousing outside the contaminated area.

Secondary lead poisoning due to bullets lodged in the human body

With the increase of violence and use of firearms in Colombia, we may see more cases of lead poisoning in our environment, and must be prepared to diagnose and treat them. Subtle signs and symptoms as unexplained anemia, gastro-intestinal discomfort and abdominal cramps, and severe as changes in behavior and neurological status, nephropathy, and unexplained death, may be associated with a history of gunshot wounds and projectiles in the human body, and must offer the patient knowledge and management strategies of pathology.

Environmental Inequality: Childhood Lead Poisoning as an Inadvertent Consequence of the Refugee Resettlement Process

Communities are important health determinants for resettled refugees. The risk for lead poisoning among African refugee children who resettle in the United States remains elevated, despite the gradual decrease in childhood lead poisoning in this country. We argue that the refugee resettlement process is a restricted system with a limited infrastructure that inadvertently contributes to the disproportionate burden of lead poisoning cases experienced by resettled African refugee children. We present childhood lead poisoning in a resettled African refugee population as a case study of environmental inequality. We propose recommendations for practitioners to reduce and ultimately eliminate this unintended environmental inequality.

Guillain-Barré-Like Syndrome in a Child with Lead Poisoning

Lead poisoning is a medical condition caused by increased levels of the heavy metal lead in the body, generally resulting from environmental exposure. Lead poisoning can cause a variety of symptoms which vary depending on the individual and the duration of lead exposure; lead poisoning is more noxious to children than adults, because it can damage the brain and nerve development of children.We report a case of lead poisoning in a 5-year-old girl caused by accidental ingestion of a metal ring. Simultaneously, the child showed anemia, encephalopathy, and peripheral neuropathy with albuminocytological dissociation mimicking Guillain-Barré syndrome.This case suggests that anemia with signs of peripheral and central nervous system damage could be considered as a possible manifestation of lead poisoning in children.

Toxicity of lead: a review with recent updates

Lead poisoning has been recognized as a major public health risk, particularly in developing countries. Though various occupational and public health measures have been undertaken in order to control lead exposure, cases of lead poisoning are still reported. Exposure to lead produces various deleterious effects on the hematopoietic, renal, reproductive and central nervous system, mainly through increased oxidative stress. These alterations play a prominent role in disease manifestations. Modulation of cellular thiols for protection against reactive oxygen species (ROS) has been used as a therapeutic strategy against lead poisoning. N-acetylcysteine, α-lipoic acid, vitamin E, quercetin and a few herbal extracts show prophylaxis against the majority of lead mediated injury in both in vitro and in vivo studies. This review provides a comprehensive account of recent updates describing health effects of lead exposure, relevant biomarkers and mechanisms involved in lead toxicity. It also updates the readers about recent advances in chelation therapy and newer therapeutic strategies, like nanoencapsulation, to treat lead induced toxic manifestations.

HEALTH IMPACT ASSESSMENT OF A CADMIUM, ARSENIC AND LEAD SOIL POLLUTION, CASSIOPÉE STUDY, AVEYRON, FRANCE

Background and Aims Important pollution was observed in Viviez (south-west of France) due to 150 years of smelting activity. Median concentration in surface soil of private gardens was respectively 20, 3 and 5 times higher than the reference value for cadmium, arsenic, and lead. Maximum cadmium concentrations in locally-homegrown vegetables reached 11 times the European regulation value. Thus, a global public health assessment was carried out in order to estimate the health impact of this pollution and to formulate recommendations. Methods Data from a regional register of renal insufficiencies and national data on causes of deaths were analysed to describe geographical variations in incidence or mortality. A screening for lead poisoning was proposed to children and pregnant women of Viviez. A measurement of urinary cadmium was proposed to all inhabitants in order to estimate the proportion exceeding a medical threshold. Finally, an exposure study to cadmium and arsenic was carried out in order to better understand residents’ exposure. Results As compared with other parts of the district, no excess incidence of renal insufficiencies was observed in Viviez, but excess of mortality due to renal diseases particularly in the oldest periods. No case of lead poisoning was identified among 14 participants. Among 596 adult residents, 5% exceeded 2μg of cadmium/g.creatinine and 23% 1μg/g.creatinine: they were recommended to consult their doctor. These proportions were higher than those observed in an unexposed population (4% and 0%). Results of the exposure study suggested the influence of environmental factors such as ingestion of local food and inhalation or ingestion of polluted dust and soils. Conclusions Results of this assessment establish the health impact of the soil pollution among the residents of Viviez. This warrants to propose medical follow-up for the exposed population, and to limit further exposure by implementing soil treatment of private gardens, stopping the consumption of locally-homegrown products and adopting hygiene precautions.

Long-term lead elimination from plasma and whole blood after poisoning

ObjectiveBlood lead (B–Pb), one of the most used toxicological biomarker all kind, has serious limitations. Thus, the objective is to evaluate whether plasma lead (P–Pb) is more adequate.MethodsA long-term follow-up study of five cases of lead poisoning. P–Pb was analysed by inductively coupled plasma mass spectrometry. Kinetics after end of exposure was modelled.ResultsP–Pb at severe poisoning was about 20 μg/L; haematological effects at about 5 μg/L. Biological half-time of P–Pb was about 1 month; B–Pb decay was much slower.ConclusionP–Pb is a valuable biomarker of exposure to and risk, particularly at high exposure.

A Comparison of Blood Lead Levels between Migrant and Native Lead Workers Before and After Implementation of a New Employment Permit System for Migrant Workers

We compared the blood lead and other lead biomarkers between migrant and native workers with a focus on the impact of the legal employment permit system that was effective from 2003, which required employers to provide mandatory annual health examinations for migrant workers on lead biomarkers in 1997 and 2005. The mean blood lead level of migrant workers was 59.5 ± 19.4 μg/dl, yielding 47% of lead poisoning cases, which was significantly higher than that of native workers (36.8 ± 14.5 μg/dl; 11% of lead poisoning cases) in 1997 before enactment of the act. The overall mean blood ZPP levels and ALAU of migrant workers were significantly higher than those of native workers. In 2005, after new migrant worker regulations were instituted, the mean value of above lead biomarkers workers was still significantly higher than that of native workers, but the magnitude of the differences was smaller compared with the difference in 1997. We confirmed that the 2003 regulations played an important role in improving the health of migrant workers in the lead industry in terms of their blood lead levels and other lead biomarkers.

Lead poisoning associated with Ayurvedic drug presenting as intestinal obstruction: A case report

Introduction Lead poisoning is most commonly caused by occupational exposure. It presents with a myriad of signs and symptoms ranging from mild anemia to frank encephalopathy, depending on the blood lead levels as well as the duration of exposure. Intake of herbal/Ayurvedic medicine may also lead to plumbism as heavy metals are often incorporated in such medications with the belief that such metals have medicinal properties. Methods We report a case of lead poisoning caused by Ayurvedic medication. The patient presented with symptoms of intestinal obstruction to the surgical casualty. Results The patient presented with symptoms that mimicked intestinal obstruction. No specific etiology could be determined. Serum lead levels were determined and diagnosis of lead poisoning ascertained. The lead content of the medicine was analyzed and it contained 30% w/w lead. Conclusions The diagnosis of heavy metal poisoning consequent to intake of alternative medicine must be kept in mind when a patient presents with vague complaints.