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American Family Physician Jul 2019Asymptomatic lead poisoning has become more common in children. Blood lead levels of less than 5 µg per dL are associated with impairments in neurocognitive and... (Review)
Review
Asymptomatic lead poisoning has become more common in children. Blood lead levels of less than 5 µg per dL are associated with impairments in neurocognitive and behavioral development that are irreversible. Risk factors for lead poisoning include age younger than five years, low socioeconomic status, living in housing built before 1978, and use of imported food, medicines, and pottery. The U.S. Preventive Services Task Force released a recommendation in 2019 citing insufficient evidence to assess the balance of benefits and harms of universal screening for elevated blood lead levels in asymptomatic children and pregnant women. Local risk factors can be substantial, and the Centers for Disease Control and Prevention (CDC) recommends that states and cities formulate their own targeted screening guidelines. In the absence of local guidance, the CDC recommends screening all Medicaid-eligible children at 12 months and again at 24 months, or at least once between 36 and 72 months if not previously screened. The CDC also recommends universal screening in areas where more than 27% of the housing was built before 1950, or where at least 12% of children 12 to 36 months of age have blood lead levels greater than 10 µg per dL. Life-threatening lead levels are treated with chelation therapy, and lower levels should prompt case management and environmental investigations to identify and remove the source of exposure. Primary prevention strategies are essential to eliminate the harmful effects of lead on child development.
Topics: Chelation Therapy; Child; Child, Preschool; Housing; Humans; Infant; Lead Poisoning; Mass Screening; Risk Factors; Socioeconomic Factors; United States
PubMed: 31259498
DOI: No ID Found -
The Western Journal of Medicine Aug 1994Lead 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... (Review)
Review
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.
Topics: Adult; Body Burden; Child; Environmental Monitoring; Environmental Pollution; Epidemiological Monitoring; Female; Humans; Lead; Lead Poisoning; Mass Screening; Preconception Care; Research; United States
PubMed: 7941534
DOI: No ID Found -
Hong Kong Medical Journal = Xianggang... Dec 2017Childhood lead poisoning is a major public health concern in many countries. In 2015, the Hong Kong SAR Government and its citizens faced a major public health crisis... (Review)
Review
Childhood lead poisoning is a major public health concern in many countries. In 2015, the Hong Kong SAR Government and its citizens faced a major public health crisis due to the presence of lead in the drinking water of a number of public housing estates. Fortunately, no child was diagnosed with lead poisoning that required treatment with chelation. Lead is a ubiquitous, naturally occurring material that exists in air, dust, soil, and water. It is also widely present in industrial products including petrol, paints, ceramics, food cans, candies, cosmetics, traditional remedies, batteries, solder, stained glass, crystal vessels, ammunition, ceramic glazes, jewellry, and toys. It can also be found in human milk. There is no safe blood lead level and it may be impossible to completely eliminate lead from any city. Hence routine measurement of blood lead levels is not considered useful. Acute poisoning, especially with encephalopathy, deserves immediate medical treatment in hospital. Chelation therapy is recommended if blood lead level is 45 μg/dL or higher. For blood levels between 20 and 45 μg/dL, treatment is indicated if the child is symptomatic. For blood levels below 20 μg/dL in otherwise asymptomatic children, the principle of treatment is to provide long-term neurodevelopmental follow-up and counselling. In all cases, immediate removal of the source of lead exposure is vital. Even low levels of lead exposure can significantly impair learning, educational attainment, and neurodevelopment.
Topics: Child; Hong Kong; Humans; Lead Poisoning
PubMed: 29026055
DOI: 10.12809/hkmj176214 -
Dimensions of Critical Care Nursing :... 2017Lead poisoning is receiving much attention and increased awareness lately owing to the tainted water supply crisis in Flint, Michigan. This article provides an important... (Review)
Review
Lead poisoning is receiving much attention and increased awareness lately owing to the tainted water supply crisis in Flint, Michigan. This article provides an important review about lead poisoning in both children and adults, potential causes, signs and symptoms, long-term effects, prevention, and recommendations for nursing practice. This article is not an in-depth examination of the topic, but rather a quick review.
Topics: Adolescent; Adult; Child; Humans; Lead Poisoning; Nursing Diagnosis; Risk Factors
PubMed: 27902665
DOI: 10.1097/DCC.0000000000000227 -
Pediatrics in Review Oct 2000
Review
Topics: Absorption; Chelation Therapy; Child; Environmental Exposure; Female; Humans; Lead; Lead Poisoning; Male; Risk Factors
PubMed: 11010979
DOI: 10.1542/pir.21-10-327 -
Pediatrics in Review Dec 1992
Review
Topics: Chelating Agents; Child; Child, Preschool; Humans; Infant; Lead Poisoning; Mass Screening; United States
PubMed: 1293574
DOI: No ID Found -
Journal of Health Care For the Poor and... 2023In 1934, the Federal Housing Authority precluded mortgage loans to residents of neighborhoods with non-White families or where housing was deteriorated; these were... (Review)
Review
In 1934, the Federal Housing Authority precluded mortgage loans to residents of neighborhoods with non-White families or where housing was deteriorated; these were declared "hazardous" and labeled red on maps. In 1962 three redlined north Brooklyn neighborhoods had 41 children, all Black and Puerto Rican, with lead levels >60ug/dL. A review of public polices in the U.S. from 1898 to the present revealed that lead poisoning followed an income gradient with multiple disproportionate effects on non-White children in redlined neighborhoods. The poisonings diminished when federal and local regulations prevented lead exposure. While redlining had profound influences on both likelihood and severity of lead poisoning and its consequences, it was a mediator of effects. The principal causes were federal policies failing to prevent environmental contamination and local governments failing to prevent exposure.
Topics: Child; Humans; Hispanic or Latino; Housing; Lead; Lead Poisoning; Residence Characteristics; Black or African American
PubMed: 37464504
DOI: 10.1353/hpu.2023.0028 -
JAMA Mar 2023
Topics: United States; Humans; Lead Poisoning
PubMed: 36897599
DOI: 10.1001/jama.2023.1543 -
Rhode Island Medicine Jan 1995Lead 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... (Review)
Review
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)
Topics: Chelation Therapy; Child, Preschool; Guidelines as Topic; Humans; Infant; Lead; Lead Poisoning; Mass Screening; Paint; Rhode Island; United States
PubMed: 7873811
DOI: No ID Found -
Pediatric Clinics of North America Dec 2002Although the average blood lead levels of Americans have markedly declined, a significant number of children remain at risk. This article discusses the mechanisms of... (Review)
Review
Although the average blood lead levels of Americans have markedly declined, a significant number of children remain at risk. This article discusses the mechanisms of lead poisoning and the screening of children for lead poisoning, and the treatment of symptomatic and asymptomatic children.
Topics: Chelation Therapy; Child; Child, Preschool; Humans; Infant; Lead Poisoning; Mass Screening; Nutrition Surveys; Risk Factors; United States
PubMed: 12580366
DOI: 10.1016/s0031-3955(02)00097-4