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BioMed Research International 2018Lead poisoning is a public health problem in many areas of the world. Children are at particularly high risk for adverse effects of lead exposure; even at low...
Lead poisoning is a public health problem in many areas of the world. Children are at particularly high risk for adverse effects of lead exposure; even at low concentrations, lead can affect physical, mental, and behavioral development. Children living near lead-zinc mines are at high risk for environmental lead poisoning, especially the contaminated soil. We conducted a cross-sectional descriptive study in Ban Thi Commune, northern Vietnam. 195 children (92,9% participation) aged 3-14 years old (average: 7.69 ± 2.90) were randomly selected from a list of all children prepared by the village health collaborators. 109 (55.90%) were boys and 86 (44.10%) were girls. The research measures were the lead concentration in native soil and the children's total blood lead concentration determined by the inductively coupled plasma-mass spectrometry (ICP-MS) method. The results showed that lead content in soil was many times higher than American Environmental Protection Agency and Vietnam standards (average 2980.23 ± 6092.84 mg/kg dry weight of soil (range 80.05 - 33820.62)). Average blood lead levels for children were 15.42 ± 6.45 g/dL (95% CI: 14.50 -16.33 g/dL). The percentage of children with lead levels >10 g/dL (value considered to be lead poisoning for children according to the Ministry of Health of Vietnam) was 79.49% of the total number of children. None of the children in this study had blood lead level (BLL) that required chelation treatment according to Vietnam MOH guideline (BLL ≥45 g/dL). There is weakly evidence that lead exposure relates to the physical development of children. Children with low lead concentrations (less than 10 g/dL) had height and weight of 1.47-3.51 cm and 1.19-2.81 kg, greater than those with BLL >10 g/dL (p>0.05).
Topics: Adolescent; Chelating Agents; Child; Child, Preschool; Cross-Sectional Studies; Environmental Exposure; Environmental Pollutants; Environmental Pollution; Female; Humans; Lead; Lead Poisoning; Male; Mining; Soil; Vietnam; Zinc
PubMed: 30581854
DOI: 10.1155/2018/5156812 -
Annals of Global Health 2021A major episode of lead poisoning caused by lead-adulterated opium occurred in Iran in 2016. Patients were removed from exposure and treated with chelating agents. A...
BACKGROUND
A major episode of lead poisoning caused by lead-adulterated opium occurred in Iran in 2016. Patients were removed from exposure and treated with chelating agents. A subset of those patients was evaluated in this follow-up study to evaluate treatment efficacy in relation to patient outcome.
METHODS
Between March 2016 and December 2017, thirty-five male cases of lead poisoning due to ingestion of lead-adulterated opium were followed for two years. There are three patient groups: 1) those who abstained from opium use; 2) those who continued to use potentially contaminated opium; and 3) those who abstained from opium and were placed on maintenance therapy. Maintenance therapy included: methadone and opium tincture, offered by the Opioid Maintenance Therapy (OMT) clinics. Amongst the three patient groups Blood Lead Levels (BLL), complete blood count, and kidney and liver function tests were compared.
FINDINGS
The results of BLL, hemoglobin, hematocrit, and aspartate aminotransferase were significantly different between the admission time and follow-up. Of the three patient groups, no difference was detected in these measures.
CONCLUSIONS
Treatment of lead poisoning combined with OMT proved an effective method to prevent recurrent lead poisoning.
Topics: Adult; Follow-Up Studies; Humans; Iran; Lead; Lead Poisoning; Male; Opium
PubMed: 34567981
DOI: 10.5334/aogh.3420 -
Anales Del Sistema Sanitario de Navarra 2003Metals are amongst the oldest toxic substances known to man. In today's industrialized world the sources of exposure to metals are ubiquitous both in the field of work... (Review)
Review
Metals are amongst the oldest toxic substances known to man. In today's industrialized world the sources of exposure to metals are ubiquitous both in the field of work and from polluted water, foodstuffs and the environment. Their toxicity is characterized by the metallic element in question, but this is modified by the type of compound, whether organic or inorganic, and its characteristics of hydrosolubility and liposolubility, which determines its toxicokinetics and thus the possibilities of it reaching its targets. The biomolecules most affected by metals are the proteins with enzymatic activity, which is why their pathology is multisystemic. The principal systems affected are the gastrointestinal, central and peripheral neurological, haematic and renal. Some metallic compounds are carcinogenic. Metals's treatment is conditioned by their chemical reactivity. They can be deactivated and eliminated by the administering of chelating agents that produce complex molecules, which are non-toxic and can be excreted. The principal chelating agents are: BAL (British Anti-Lewisite or dimercaprol) DMPS (2,3-Dimercapto-1-propanesulfonic Acid) and DMSA (meso-2,3-Dimercaptosuccinic or Succimer), EDTA, Penicilamine (b,b-dimethylcysteine) and Deferoxamine. Toxicokinetic characteristics, mechanism of action, clinical picture and treatment of some of the most relevant metals and metalloids: lead, mercury and arsenic, are considered.
Topics: Acute Disease; Arsenic Poisoning; Humans; Lead Poisoning; Mercury Poisoning; Metals
PubMed: 12813482
DOI: No ID Found -
Basic & Clinical Pharmacology &... Jan 2018Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of... (Review)
Review
Adulteration of drugs with poisonous substances during production or consumption has caused numerous health problems. Among contaminants that have the potential of producing poisonous effects are the heavy metals lead, arsenic and thallium that make up an important group of toxic substances. The emergence of these new health problems related to opioid abuse has precipitated this MiniReview on the status of the most hazardous and common opioid adulterants. In fact, adulterated opium is a major public health problem and can threaten the health of users. In this study, we searched for information on opium, opiates, lead poisoning, toxicity, intoxication, Iran and heavy metals in the TUMS Digital Library, PubMed, Scopus, EMBASE and Google Scholar bibliographical databases. This MiniReview primarily included articles on lead poisoning, signs and symptoms, and management in opioid-dependent individuals. Exclusion criteria were articles dealing with animal studies, specific paediatric studies, adulterants other than heavy metals and substances other than opioids. Adulterated opium is one of the new sources of exposure to lead and has precipitated an increase in lead-poisoned cases owing to the widespread use of opium. The toxicology of lead and general guidelines on diagnosis and treatment of lead poisoning is briefly reviewed. The symptoms of lead toxicity mimic several diseases often leading to unnecessary diagnostic methods, misdiagnoses and even surgery. Finally, owing to the fact that lead toxicity shows non-specific signs and symptoms, screening for this disease, by taking blood samples and assessing blood lead levels in high-risk people, should be given an utmost priority. It is recommended that screening tests are adopted and applied for any drug-abusing patient with non-specific subacute signs and symptoms like abdominal pain, constipation and anaemia.
Topics: Antidotes; Drug Contamination; Gastric Lavage; Humans; Iran; Lead; Lead Poisoning; Mass Screening; Opioid-Related Disorders; Opium
PubMed: 28802093
DOI: 10.1111/bcpt.12855 -
International Journal of Occupational... 2018The recent Colorado Gold King Mine waste-water spill and Michigan's water supply re-routing program catastrophe, has directed renewed public attention towards resurgent... (Review)
Review
Resurgent lead poisoning and renewed public attention towards environmental social justice issues: A review of current efforts and call to revitalize primary and secondary lead poisoning prevention for pregnant women, lactating mothers, and children within the U.S.
The recent Colorado Gold King Mine waste-water spill and Michigan's water supply re-routing program catastrophe, has directed renewed public attention towards resurgent environmental lead contamination threats. Leaded environments present social justice issues for children and mothers possessing blood lead levels (BLLs) > 5 μg/dL. Childhood lead exposure remains a continual U.S. public health problem manifesting in lifelong adverse neuropsychological consequences. The 2007 Inspector General Report demonstrated low BLL screening rates across the U.S. and this study examined the regularity of children's BLL screening rates. The Centers for Disease Control and Prevention (CDC) Lead Poisoning National Surveillance 2010-2014 children's BLL screening rates, were examined to assess BLL screening regularity in states traditionally known to have regularly occurring BLL screenings: New York, New Jersey, and Pennsylvania. The results extracted from the CDC data showed that < 50% of children were BLL screened by six-years of age across the states that were sampled. The findings highlight that without a "clear map" of lead exposed areas through accurate and consistent BLL screenings, how the potential for such disparities within - and between-states within the U.S. could arise due to environmental social justice issues in relation to BLL screening barriers. Barriers preventing children's BLL screenings were considered, and public health interventions recommended to improve screening rates included: routine BLL screening for all pregnant women, lactating mothers, and children; while, removing known lead exposure sources within communities. This study calls for action during a time of renewed public attention to resurgent lead poisoning within the U.S.
Topics: Child; Environmental Exposure; Female; History, 20th Century; History, 21st Century; Humans; Lactation; Lead; Lead Poisoning; Mass Screening; Mothers; Pregnancy; Primary Prevention; Secondary Prevention; Social Justice; United States
PubMed: 30139311
DOI: 10.1080/10773525.2018.1507291 -
American Journal of Public Health Dec 1998In 1991, the Public Health Service published the Strategic Plan for the Elimination of Childhood Lead Poisoning. This document marked a fundamental shift in federal... (Review)
Review
In 1991, the Public Health Service published the Strategic Plan for the Elimination of Childhood Lead Poisoning. This document marked a fundamental shift in federal policy from finding and treating lead-poisoned children to authentic primary prevention. It spelled out a 15-year strategy to achieve this goal and provided a cost-benefit analysis showing that the monetized benefits far exceeded the costs of abatement. A strong national effort to eliminate the disease developed. Now, 7 years after publication of the plan, primary prevention of lead exposure has been abandoned. This article examines the role of some prevailing attitudes and institutions in derailing the effort. Some institutions--the lead industry, real estate interests, and insurance interests--behaved as anticipated. Others, including private pediatricians, the American Academy of Pediatrics, some federal agencies, and a public interest group ostensibly dedicated to eliminating lead poisoning, also played an unexpected part in derailing the plan.
Topics: Attitude of Health Personnel; Child; Health Knowledge, Attitudes, Practice; Health Planning; Humans; Lead Poisoning; Population Surveillance; Primary Prevention; Public Health Practice; United States; United States Public Health Service
PubMed: 9842392
DOI: 10.2105/ajph.88.12.1871 -
BMC Gastroenterology May 2020Abdominal pain may be a presenting symptom of lead poisoning and is often difficult to diagnose. This study aimed to determine the prevalence of abdominal pain in... (Observational Study)
Observational Study
BACKGROUND
Abdominal pain may be a presenting symptom of lead poisoning and is often difficult to diagnose. This study aimed to determine the prevalence of abdominal pain in patients seen in the Laghman Hakim Hospital ED and GI clinic who were lead-intoxicated, with or without opiate use disorder.
METHODS
Between July 2017 and January 2018, patients seen in the ED and GI clinic of Loghman Hakim Hospital with unexplained abdominal pain or abdominal pain resistant to treatment were enrolled. Informed consent was obtained from potential enrollees. For standardization, a pre-designed data collection tool was developed for uniform data acquisition. Opiate use was determined historically. For this study, lead poisoning was defined as a blood lead level (BLL) greater than or equal to 30 μg/dL (1.45 μmol/L) with concomitant GI symptoms.
RESULTS
Of 125 patients admitted, 28 (22.4%) had BLLs higher than 30 μg/dL. None of the patients had signs and symptoms of opioid withdrawal syndrome during evaluation. Elevated BLLs were significantly correlated with oral opium use/abuse, history of addiction for over the preceding 12 years. The daily opium use was more than 2.75 g. There was a statistical correlation between lead toxicity and abdominal pain consistency and intensity, constipation, and paresthesias. Anemia, leukocytosis, and abnormal liver enzyme tests were laboratory findings associated with lead toxicity. Four patients died, one of whom was diagnosed with lead toxicity.
CONCLUSION
Lead toxicity should be considered in the potential differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs or GI clinics if a positive history of opium abuse exists.
Topics: Abdominal Pain; Adolescent; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Female; Humans; Lead; Lead Poisoning; Male; Middle Aged; Opioid-Related Disorders; Prevalence; Prospective Studies; Young Adult
PubMed: 32375657
DOI: 10.1186/s12876-020-01284-1 -
Clinical Pediatrics Jun 2019
Review
Topics: Ambulatory Care; Autism Spectrum Disorder; Child; Combined Modality Therapy; Hospitalization; Humans; Lead Poisoning
PubMed: 30938166
DOI: 10.1177/0009922819839237 -
The Science of the Total Environment Jun 2022Poisoning caused by ingestion of spent lead (Pb) ammunition in food items is a common cause of death of raptors. However, there has been no previous attempt to assess...
Poisoning caused by ingestion of spent lead (Pb) ammunition in food items is a common cause of death of raptors. However, there has been no previous attempt to assess the impact of lead poisoning on populations of raptors throughout Europe or examine how this relates to the prevalence of hunting. We used measurements of lead concentration in the liver from over 3000 raptors of 22 species found dead or dying in the wild in 13 countries and a lead poisoning threshold of 20 ppm (dry weight) to assess the proportion of these in which lead poisoning caused or contributed to death. The prevalence of lead poisoning as a cause of death of raptors varied substantially among European countries and was positively correlated across countries with the reported number of hunters per unit area. Ten species had a non-zero proportion of individuals with concentrations exceeding the lead poisoning threshold ranging between 0.3% and 16.5%. The estimated annual conditional death rate from lead poisoning for these ten species averaged 0.44% (range 0.06-0.85%). Scavenging species feeding regularly on carcasses of game animals,tended to have a high annual probability of death from lead poisoning. So too did some predators which only sometimes scavenge, but prey on frequently hunted birds, such as gamebirds, waterfowl and pigeons, which may contain ingested or embedded lead shot. Small-bodied predators had a low annual probability of death from lead poisoning. Modelling indicated that European populations of adult raptors of the ten focal species averaged 6.0% smaller (range 0.2-14.4%) than they would be without the effects of lead poisoning. A given rate of lead poisoning mortality resulted in greater expected population reductions for species with high annual survival rate and late age at first breeding.
Topics: Animals; Birds; Europe; Humans; Lead; Lead Poisoning; Raptors
PubMed: 35305837
DOI: 10.1016/j.scitotenv.2022.154017 -
Iranian Journal of Medical Sciences Nov 2023Gastrointestinal (GI) manifestations of lead poisoning include abdominal pain, constipation, and diarrhea. Depending on the severity of a symptom, surgical consultation...
Gastrointestinal (GI) manifestations of lead poisoning include abdominal pain, constipation, and diarrhea. Depending on the severity of a symptom, surgical consultation is required. The present study aimed to make a comparison between the mean blood lead levels of patients hospitalized for lead toxicity and the various Gl symptoms. A retrospective cross-sectional study was performed in 2020 at Khorshid Hospital, the main regional referral center for poisoned patients (Isfahan, Iran). A total of 82 patients aged ≥18 years who were hospitalized for lead poisoning during 2017-2018 were included in the study. Patients' information was extracted from hospital medical records, including demographic information, clinical manifestations, blood lead levels, and treatment outcome. The mean age of the patients was 48.18±11.9 years, 91.5% were men, and 62.2% suffered from multiple GI symptoms, with abdominal pain being predominant (31.7%). Blood lead levels in patients with multiple GI symptoms were higher than those with only one symptom (P=0.01). Surgical consultation was required in 14.6% of the patients. Multiple GI symptoms were the main predictive factor for blood lead levels above 70 mg/dL (P=0.03, Odds ratio=3.06, 95% CI=1.09-8.61). Given the prevalence of abdominal pain and its association with elevated blood lead levels, differential diagnosis of abdominal pain should include lead toxicity.
Topics: Male; Humans; Adolescent; Adult; Middle Aged; Female; Lead; Retrospective Studies; Cross-Sectional Studies; Gastrointestinal Diseases; Abdominal Pain; Lead Poisoning
PubMed: 38094284
DOI: 10.30476/IJMS.2023.95824.2749