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Neurotoxicology
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Sean D. McCann, Trevonne M. Thompson
Diagnosis and monitoring of lead poisoning rely on venous blood lead level measurements. Unlike screening for other metal toxicities, these levels are typically more readily available, reliable, and should be drawn on any patient with suspected exposure including any children with notable hand-to-mouth behavior. Pediatricians regularly perform lead screening by capillary blood lead level measurements, which, if elevated, are then confirmed by venous blood sample. The primary treatment of lead poisoning is identification and removal of the source of the exposure from the patient. Involvement of local public health department is a critical component of this evaluation, and reporting of elevated venous lead levels to health departments is required by law in nearly every US state. Chelation therapy can be performed for lead poisoning using oral succimer, or in severe cases (defined by the presence of encephalopathy or lead concentration > 70 µg/dL) intramuscular British anti-Lewisite (BAL) or intravenous calcium disodium edetate (CaNa2EDTA). Chelation therapy will gradually reduce lead levels but has not been shown to change neurocognitive outcomes in lead poisoned patients. Chelators are nonspecific and can also chelate essential trace metals from the body, in addition to having a variety of potential adverse effects. Therefore, chelation therapy should be guided by a health care provider familiar with these effects such as a medical toxicologist, local poison center, or pediatrician with experience in managing lead poisoning.
Inhalational Durg Abuse
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Jacob Loke, Richard Rowley, Herbert D. Kleber, Peter Jatlow
Chelation therapy has been used for the treatment of the tetraethyl lead toxicity and may decrease the blood lead level and improve some of the neurologic symptoms. Dimercaprol, calcium disodium edetate, and penicillamine are some of the chelating agents used (Fortenberry, 1985).
The Chemical Environment
Published in Vilma R. Hunt, Kathleen Lucas-Wallace, Jeanne M. Manson, Work and the Health of Women, 2020
Vilma R. Hunt, Kathleen Lucas-Wallace, Jeanne M. Manson
We have no adequate quantitative information on human exposures to develop a dose-response relationship for these conditions during pregnancy, so that choice of a “safe” maternal blood lead level is very subjective. A maternal blood lead level above 30 μg/100 mℓ is cause for concern.
Estimation and selection in linear mixed models with missing data under compound symmetric structure
Published in Journal of Applied Statistics, 2022
In this section, we apply the proposed approach to incomplete blood lead concentrations data. The data recorded the results from the treatment of lead-exposed children, a placebo-controlled and randomized study on Succimer, a treatment that enhances urinary excretion of lead, in children with blood levels of 20–44 μ g/ dl. The utilized data were from TLC Research Group [14], and the collection of the data was also described in it. As mentioned in TLC Research Group [14], the data were collected following the rules of the Centers for Disease Control and Prevention (CDC) as described in CDC [1]. We analyze the blood lead levels from 100 children who were randomly assigned to either the lead Chelation treatment with Succimer or to the placebo group. Every participant was observed four times; each at baseline (17.
Lead poisoning due to incense burning: an outbreak in a family
Published in Clinical Toxicology, 2021
Dong-Zong Hung, Kai-Wei Yang, Chin-Ching Wu, Yu-Han Hung
Childhood lead poisoning is completely preventable, but no safe BLL threshold for the pediatric population has been identified [12]. A birth cohort study demonstrated that household incense burning was associated with delays in the gross motor neurodevelopmental milestones [15]. Another study identified incense burning at homes as a significant causative factor for increased BLL between 1.70 ± 1.51 and 1.92 ± 1.57 µg/dL (p < 0.0003). The study demonstrated a dose-dependent relationship between the BLL (up to 1.94 µg/dL) in preschool children and incense use frequency [9]. In our patients, we were able to confirm that frequent incense burning at homes could seriously impact the health of children. For a healthy living, we strongly recommend that incense smoke, which is a primary source of lead poisoning in several regions of the world, be avoided by children.
Monitoring of blood lead level in young children using new mode of liquid phase microextraction and graphite furnace atomic absorption spectrometry
Published in Toxin Reviews, 2020
Reza Akramipour, Mohammad Reza Golpayegani, Negar Noori, Nazir Fattahi
Human exposure to toxic metals is usually estimated by monitoring the metals in biological samples such as blood, serum, and urine. Lead is toxic to humans and shows only deleterious effects on human health (Jones et al. 2017). The harmful effects on the human health, caused by the lead contamination are reduction of the enzymatic activity, kidneys function, and neuromuscular difficulties (Soares and Nascentes 2013). It is well-known that exposure to lead can adversely affect the nervous system and children are particularly susceptible to lead poisoning (Ebrahimzadeh and Behbahani 2017). Children with blood lead levels (BLLs) >10 μg dL−1 are at an increased risk for learning and behavioral problems (Cizdziel 2007). Nevertheless, BLLs above the current acceptable threshold of 10 μg dL−1 remain prevalent in one particular subset of the population: low-income, urban children living in older housing (Pirkle et al. 1994). Until 2012, children were identified as having a blood lead “level of concern” if the test result is 10 μg dL−1 or higher of lead in blood. The Centers for Disease Control and Prevention's (CDC) is no longer using the term “level of concern” and is instead using a reference value, currently 5 μg dL−1, to identify children who have been exposed to lead and who require case management (CDC 2012). Therefore, it is necessary to determine the lead ions to estimate its toxic effects and health risks (Kazi et al. 2013, Shah et al. 2013, Shah et al. 2016).