-
WMJ : Official Publication of the State... Apr 2019In 2016, 4,353 Wisconsin children under 6 years of age were identified with elevated blood lead levels (≥ 5 μg/dL). There is no safe level of lead in the human body;...
INTRODUCTION
In 2016, 4,353 Wisconsin children under 6 years of age were identified with elevated blood lead levels (≥ 5 μg/dL). There is no safe level of lead in the human body; extensive research shows that children with blood lead levels < 5 μg/dL may still be at risk for adverse health effects including developmental delays.
DISCUSSION
Physicians should follow current guidelines and consider factors such as the child's age, socioeconomic status, and housing situation when determining need for testing. In addition to Wisconsin's screening recommendations, federal requirements exist for testing Medicaidenrolled children. Under state statute, all blood lead test results and specified demographic information must be reported to the Wisconsin Childhood Lead Poisoning Prevention Program. To eliminate elevated blood lead levels, primary prevention is key. Physicians play an important role by educating parents, prospective parents, and caregivers about lead poisoning risks and prevention measures. Physicians are also vital in secondary prevention-mitigating the adverse effects in children already exposed to lead. Secondary prevention requires first identifying children with elevated blood lead levels through appropriate testing. Use of the Wisconsin Blood Lead Registry can alert providers about children with elevated blood lead levels and reduce duplicate testing. Recent surveillance data show current screening is inadequate; in 2015, only 32% of Medicaid-enrolled children received appropriate testing. Physicians should provide clinical management for children with elevated blood levels and their families.
CONCLUSIONS
Physicians are a vital partner in preventing, identifying, and mitigating the effects of elevated blood lead levels for Wisconsin's children.
Topics: Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Lead Poisoning; Male; Mass Screening; Primary Prevention; Wisconsin
PubMed: 31083828
DOI: No ID Found -
Environmental Health Perspectives Aug 2023Childhood lead poisoning remains an important public health issue in the United States, as well as elsewhere in the world. Although primary prevention is a major goal...
BACKGROUND
Childhood lead poisoning remains an important public health issue in the United States, as well as elsewhere in the world. Although primary prevention is a major goal and it is critically important to keep children from getting poisoned, it is also important to explore ways to reduce the neurotoxic effects of lead in those children already poisoned. Whether lead-induced neurotoxicity and its related adverse outcomes are viewed as "permanent" or "persistent" may influence the way in which potential remediation efforts are considered for improving outcomes from childhood lead poisoning.
OBJECTIVES
The objective of this commentary was to discuss the ideas of permanence and persistence in relation to the direct neurotoxic effects of lead on the brain and the resulting adverse outcomes from these effects. Recent new insights regarding potential mitigation of lead-induced neurotoxic effects on brain and behavior are considered along with clinical information on neurorehabilitation to suggest potential strategies for improving cognitive/behavioral outcomes in lead-poisoned children.
DISCUSSION
The distinction between permanent and persistent in regard to lead-induced neurotoxicity and its resulting outcomes may have broad implications for public health policies in response to the problem of childhood lead exposure. The term permanent implies that the damage is irreversible with little chance of improvement. However, there is evidence that at least some of the adverse cognitive/behavioral outcomes from lead exposure are persistent rather than permanent and potentially amenable, under the appropriate circumstances, to some level of mitigation. This author recommends that clinical, interventional research efforts be devoted to exploring optimal neurorehabilitative and enrichment conditions to stimulate plasticity and enhance functioning to determine the extent to which promising results from preclinical studies of lead-induced brain damage and the mitigation of these effects can be successfully translated to humans. https://doi.org/10.1289/EHP12371.
Topics: Child; Humans; Lead; Brain; Lead Poisoning; Neurotoxicity Syndromes; Public Health
PubMed: 37639477
DOI: 10.1289/EHP12371 -
The Milbank Quarterly Mar 2023Policy Points Child lead poisoning is associated with socioeconomic inequity and perpetuates health inequality. Methods for testing and detection of child lead poisoning...
Policy Points Child lead poisoning is associated with socioeconomic inequity and perpetuates health inequality. Methods for testing and detection of child lead poisoning are ill suited to the current demographics and characteristics of the problem. A three-pronged revision of current testing approaches is suggested. Employing the suggested revisions can immediately increase our national capacity for equitable, inclusive testing and detection. ABSTRACT: Child lead poisoning, the longest-standing child public health epidemic in US history, is associated with socioeconomic inequity and perpetuates health inequality. Removing lead from children's environments ("primary prevention") is and must remain the definitive solution for ending child lead poisoning. Until that goal can be realized, protecting children's health necessarily depends on the adequacy of our methods for testing and detection. Current methods for testing and detection, however, are no longer suited to the demographics and magnitude of the problem. We discuss the potential deployment and feasibility of a three-pronged revision of current practices including: 1) acceptance of capillary samples for final determination of lead poisoning, with electronic documentation of "clean" collection methods submitted by workers who complete simple Centers for Disease Control and Prevention-endorsed online training and certification for capillary sample collection; 2) new guidance specifying the analysis of capillary samples by inductively coupled plasma mass spectrometry or graphite furnace atomic absorption spectrometry with documented limit of detection ≤0.2 μg/dL; and 3) adaptive "census tract-specific" universal testing and monitoring guidance for children from birth to 10 years of age. These testing modifications can bring child blood lead level (BLL) testing into homes and communities, immediately increasing our national capacity for inclusive and equitable detection and monitoring of dangerous lower-range BLLs in US children.
Topics: United States; Humans; Child; Lead; Health Status Disparities; Lead Poisoning; Child Health; Centers for Disease Control and Prevention, U.S.; Environmental Exposure
PubMed: 36717973
DOI: 10.1111/1468-0009.12596 -
Environmental Health Perspectives Oct 2013
Topics: Child; Child, Preschool; China; Environmental Pollution; Humans; Industrial Waste; Infant; Infant, Newborn; Lead Poisoning
PubMed: 24218672
DOI: 10.1289/ehp.1307558 -
International Journal of Environmental... Sep 2018Drawing from ethnographic research on lead poisoning in Uruguay and secondary literature from lead poisoning cases around the world, the commentary argues that public...
Drawing from ethnographic research on lead poisoning in Uruguay and secondary literature from lead poisoning cases around the world, the commentary argues that public health policy guided by pragmatism presents multiple dangers to effective health intervention.
Topics: Humans; Lead; Lead Poisoning; Public Policy; Uruguay
PubMed: 30217042
DOI: 10.3390/ijerph15091997 -
The Pan African Medical Journal 2022Lead is a toxic substance in our environment that affects adults and children of all socioeconomic backgrounds, lead poisoning is one of the most common exposures that...
Lead is a toxic substance in our environment that affects adults and children of all socioeconomic backgrounds, lead poisoning is one of the most common exposures that can cause inter alia significant neurological and functional damage in humans. Children are particularly vulnerable because of the effects of the toxicity on their developing nervous systems with potentially irreversible consequences. We report a case of severe lead poisoning encephalo-neuropathy in a 3-year-old girl, admitted for progressive paraplegia, swallowing disorders, and aphasia. A multitude of investigations undertaken could not explain her atypic symptoms, so anamnesis was redone in the sense of a toxic origin, we found a notion of pica, and a traditional herbalist father, so probably consumption of medications based on traditional medicine products. A venous blood lead level (BLL) was extremely elevated at 176.4 μg/l. The child was treated with an oral chelator succimer (SUCCICAPTAL). During the two following months in the intensive care unit, the child showed progressive respiratory distress and worsening signs of the nervous system. Despite treatment and the use of lead chelators, the patient died due to septic shock. Lead is highly toxic even at very low exposure levels, at high levels of exposure, it can damage the reproductive organs, immune system, liver and kidneys. in children, it can affect neurocognitive and behavioral development that could be irreversible. Peripheral and central nervous system damage should be considered as a possible manifestation of lead poisoning.
Topics: Humans; Child; Female; Child, Preschool; Lead; Lead Poisoning; Brain; Peripheral Nervous System Diseases; Family; Succimer
PubMed: 36405662
DOI: 10.11604/pamj.2022.42.276.33007 -
Environmental Health Perspectives Nov 1990Exposure to excessive amounts of inorganic lead during the toddler years may produce lasting adverse effects upon brain function. Maximal ingestion of lead occurs at an... (Review)
Review
Exposure to excessive amounts of inorganic lead during the toddler years may produce lasting adverse effects upon brain function. Maximal ingestion of lead occurs at an age when major changes are occurring in the density of brain synaptic connections. The developmental reorganization of synapses is, in part, mediated by protein kinases, and these enzymes are particularly sensitive to stimulation by lead. By inappropriately activating specific protein kinases, lead poisoning may disrupt the development of neural networks without producing overt pathological alterations. The blood-brain barrier is another potential vulnerable site for the neurotoxic action of lead. Protein kinases appear to regulate the development of brain capillaries and the expression of the blood-brain barrier properties. Stimulation of protein kinase by lead may disrupt barrier development and alter the precise regulation of the neuronal environment that is required for normal brain function. Together, these findings suggest that the sensitivity of protein kinases to lead may in part underlie the brain dysfunction observed in children poisoned by this toxicant.
Topics: Blood-Brain Barrier; Brain; Child, Preschool; Humans; Infant; Lead Poisoning; Protein Kinases; Synapses
PubMed: 2088761
DOI: 10.1289/ehp.908991 -
Acta Medica Iranica 2015Lead poisoning is a historic universal disease. Acute or chronic lead exposure may cause reversible or even permanent damages in human beings. Environmental lead... (Review)
Review
Lead poisoning is a historic universal disease. Acute or chronic lead exposure may cause reversible or even permanent damages in human beings. Environmental lead exposure is a global health concern in children. Occupational lead poisoning is still a health issue, particularly in developing countries. During the last decades, new methods and medications have been advocated for the prevention and treatment of lead poisoning. This review deals mainly with recent developments in the management of lead poisoning. Sources of lead exposure are introduced, and methods for the primary prevention of lead poisoning are discussed. Details for the screening of adults and children are also explained to serve as a practical guideline for the secondary prevention. Standard chelation therapy in different groups and up-to-date less toxic new medications for the treatment of lead poisoning are finally discussed. Our published clinical research on the therapeutic effects of garlic tablets in mild to moderate occupational lead poisoning will also be discussed.
Topics: Adult; Child; Environmental Exposure; Humans; Lead Poisoning
PubMed: 26069169
DOI: No ID Found -
British Medical Journal Sep 1972
Topics: Diagnostic Errors; Humans; Lead; Lead Poisoning; Scotland
PubMed: 5069647
DOI: 10.1136/bmj.3.5826.586-c -
American Family Physician Feb 1998The continued occurrence of occupational lead overexposure and lead poisoning in the United States remains a serious problem despite awareness of its adverse health... (Review)
Review
The continued occurrence of occupational lead overexposure and lead poisoning in the United States remains a serious problem despite awareness of its adverse health effects. Lead exposure is arguably the oldest known occupational health hazard. It is a particularly insidious hazard with the potential for causing irreversible health effects, including hypotension, central nervous system problems, anemia and diminished hearing acuity before it is clinically recognized. Scientific evidence of subclinical lead toxicity continues to accumulate, making further reduction in workplace exposure, regular screening, and earlier diagnosis and treatment of critical importance in the prevention of this occupational hazard. For the most part, the diagnosis of lead poisoning in the adult worker is based on the integration of data obtained from the history, a physical examination, laboratory tests and tests of specific organ function. A blood level of 40 micrograms per dL (1.95 mumol per L) or greater requires medical intervention; a level of 60 micrograms per dL (2.90 mumol per L) or three consecutive measurements averaging 50 micrograms per dL (2.40 mumol per L) or higher indicate the necessity for employee removal. The decision to initiate chelation therapy is not based on specific blood levels but depends on the severity of clinical symptoms.
Topics: Adult; Chelating Agents; Humans; Lead Poisoning; Middle Aged; Occupational Diseases; Patient Education as Topic; Teaching Materials; United States
PubMed: 9490995
DOI: No ID Found