1/31. lead poisoning. A comprehensive review and report of a case.Lead, a ubiquitous heavy metal which has realized increased use, can cause poisoning by environmental contamination in either its organic or its inorganic form. lead poisoning can be either acute or chronic, with the latter being the more common. The clinical signs and symptoms of lead poisoning are nonspecific, resulting in a difficult diagnostic problem, especially when it is not industrially related. On occasions, the dentist or oral surgeon may be the first to see an afflicted patient because of oral manifestations.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/31. Fatal pediatric lead poisoning--New Hamphshire, 2000.Fatal pediatric lead poisoning is rare in the united states because of multiple public health measures that have reduced blood lead levels (BLLs) in the population. However, the risk for elevated BLLs among children remains high in some neighborhoods and populations, including children living in older housing with deteriorated leaded paint. This report describes the investigation of the first reported death of a child from lead poisoning since 1990 (1). The investigation implicated leaded paint and dust in a home environment as the most likely source of the poisoning. lead poisoning can be prevented by correcting lead hazards, especially in older housing, and by screening children at risk according to established guidelines (2).- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/31. Neuro-ototoxicity in andean adults with chronic lead and noise exposure.Brainstem auditory evoked responses and audiological thresholds were used as biomarkers for neuro-ototoxicity in adults with chronic lead (Pb) intoxication from long-term Pb exposure in ceramic-glazing work. Venous blood samples collected from 30 adults (15 men and 15 women) indicated a mean blood Pb level of 45.1 micrograms/dL (SD, 19.5; range, 11.2 to 80.0 micrograms/dL) and in excess of the world health organization health-based biological limits (men, 46.2 micrograms/dL; SD, 19.6; range, 18.3 to 80.0 micrograms/dL; women, 44.0 micrograms/dL; SD, 20.1; range, 11.2 to 74.2 micrograms/dL). Mean auditory thresholds at frequencies susceptible to ototoxicity (2.0, 3.0, 4.0, 6.0, and 8.0 kHz) revealed sensory-neural hearing loss in men, which may be attributable to occupational noise exposure in combination with Pb intoxication. Bilateral brainstem auditory evoked response tests on participants with elevated blood Pb levels (mean, 47.0 micrograms/dL) showed delayed wave latencies consistent with sensory-neural hearing impairment. The results suggest that environmental noise exposure must be considered an important factor in determining sensory-neural hearing status in occupationally Pb-exposed adults.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/31. Identifying and managing adverse environmental health effects: 3. Lead exposure.Lead levels in North American children and adults have declined in the past 3 decades, but lead persists in the environment in lead paint, old plumbing and contaminated soil. There are also a number of occupations and hobbies that carry a high risk of lead exposure. There is no evidence for a threshold below which lead has no adverse health effects. blood lead levels previously considered safe are now known to cause subtle, chronic health effects. The health effects of lead exposure include developmental neurotoxicity, reproductive dysfunction and toxicity to the kidneys, blood and endocrine systems. Most lead exposures are preventable, and diagnosing lead poisoning is relatively simple compared with diagnosing health effects of exposures to other environmental toxins. Accurate assessment of lead poisoning requires specific knowledge of the sources, high-risk groups and relevant laboratory tests. In this article we review the multiple, systemic toxic effects of lead and provide current information on groups at risk, prevention, diagnosis and clinical treatment. We illustrate how the CH2OPD2 mnemonic (Community, Home, hobbies, Occupation, Personal habits, diet and Drugs) and specific screening questions are useful tools for physicians to quickly obtain an environmental exposure history and identify patients at high risk of lead exposure. By applying effective primary prevention, case-finding and treatment interventions for lead exposure, both the individual patient and the larger community reap the benefits of better health.- - - - - - - - - - ranking = 7keywords = environment (Clic here for more details about this article) |
5/31. Lead-related gout. A case report.gout secondary to lead-induced nephropathy is a long-term complication of occupational lead exposure. We report a case of this now-rare condition. The patient was a 63-year-old man who had been a miner from 1950 to 1970. Thirty years after cessation of his exposure to lead, he experienced onset of inflammatory symmetric polyarthritis with joint deformities. hyperuricemia, moderately severe renal failure, and tubular acidosis were found, indicating gouty polyarthritis. blood lead levels were high, establishing that the cause was lead poisoning. EDTA chelation therapy was effective. lead poisoning is frequently under-recognized because the clinical manifestations are often minimal and the diagnosis difficult to establish. We suggest that lead bound to bone may result in continued exposure to lead after cessation of industrial or environmental exposure. chelating agents are valuable for the diagnosis and can ensure a full recovery.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/31. Childhood lead poisoning from paint chips: a continuing problem.Although lead poisoning (plumbism) has been recognized for centuries, lead exposures still occur frequently today because of its varied uses and persistence in the environment. Despite the awareness of the adverse effects of lead on adults, childhood plumbism was first reported only about a century ago. Young children are one of the most vulnerable groups to the adverse effects of lead because of their rapidly developing central nervous systems. Federal regulations in the 1970s have been successfully implemented to decrease the amount of environmental lead by decreasing the content of lead in gasoline and indoor paint. However, almost 30 years after these laws were passed, inner-city housing with leaded paint still exists. We describe three children living in new york city who developed plumbism from the ingestion of leaded paint chips.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
7/31. Chronic lead poisoning in an adult battery worker.BACKGROUND: lead poisoning is a common environmental health hazard in developing countries. Incidences of lead poisoning are seen in all age groups, especially in adults working in lead-based industries, where many still remain unaware of the adverse effects of exposure to unusually high levels of lead. methods: We report the case of an adult battery worker, who initially received symptomatic treatment because of clinical misdiagnosis. Later, he was treated with appropriate chelators, which helped to decrease blood lead levels drastically. However, being unable to change his occupation, he continues to be exposed to potentially lethal doses of lead. CONCLUSIONS: A key role for health agencies, besides providing opportunities for diagnosis and therapy, should be to increase public awareness about this widespread environmental hazard through education, documentation and communication.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
8/31. Gunshot-induced plumbism in an adult male.Our objective is to present a case of symptomatic lead toxicity (plumbism) with abdominal colic and hemolytic anemia following a gunshot wound. It is a retrospective case report and the setting is in a teaching hospital in south central los angeles. The case report is that of a patient who presented with abdominal pain, generalized weakness, and hypertension following multiple gunshot wounds, 15 years previously. Other causes of abdominal pain and weakness--such as diabetes mellitus, alcohol abuse, pancreatitis, and substance abuse--were ruled out. Interventions included treatment with the newer oral chelating agent, succimer (2, 3-dimercaptosuccinic acid), and subsequent surgery. The main outcome was the initial reduction in blood lead levels with improvement of symptoms. Because of a recurrent rise in the blood lead levels, the patient was again treated with succimer and underwent surgery to remove two bullet fragments from the face. We conclude that lead toxicity should be ruled out in patients presenting with abdominal cramps and a history of a gunshot wound. Prompt therapy--including environmental intervention and chelation therapy--is mandatory, and surgical intervention may be necessary.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/31. lead poisoning from a toy necklace.A 4-year-old, previously healthy boy experienced intermittent abdominal pain for several weeks. He was diagnosed with probable gastroenteritis, but his symptoms worsened. Laboratory tests revealed normocytic anemia, and an abdominal radiograph showed a metallic foreign body in the stomach, without evidence of obstruction. endoscopy resulted in the retrieval of a quarter and a medallion pendant from the stomach. A venous blood lead level measurement was extremely elevated, at 123 microg/dL (level of concern: > or =10 microg/dL). The medallion was tested by the state environmental quality laboratory and was found to contain 38.8% lead (388,000 mg/kg), 3.6% antimony, and 0.5% tin. Similar medallions purchased from toy vending machines were analyzed and were found to contain similarly high levels of lead. State health officials notified the US consumer product safety Commission, which resulted in a national voluntary recall of >1.4 million metal toy necklaces.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/31. lead poisoning in a child after a gunshot injury.lead poisoning is a common disease that, if not detected, can lead to developmental delay and other serious sequelae. We report the case of a child with retained intracranial lead pellets from a gunshot injury, in whom elevated blood lead levels were detected approximately 1 year after the injury. No environmental source of lead was found, and a twin sister living in the same dwelling had considerably lower lead levels. The patient's lead levels diminished after each of four courses of chelation, but rebounded each time to potentially toxic levels after termination of therapy. physicians should be particularly alert in screening for elevated lead levels in children with retained bullet fragments. In patients in whom removal of the bullet fragments is impractical, the potential risks of long-term chelation therapy must be weighed against the risks of lead toxicity.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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