1/13. Occupational and adult lead exposure in wisconsin.Lead is a versatile metal with many industrial applications. It is among the oldest recognized occupational health hazards. lead poisoning has been a reportable disease in wisconsin since 1911. Although reportable, it was not until wisconsin established an Occupational and environmental health epidemiology program in 1979 that modern reporting levels were adopted, physician and laboratory reporting promoted and publicized, and elevated blood lead report tracking initiated. With the federal funding from the National Institute of Occupational safety and Health (NIOSH), a comprehensive adult blood lead surveillance program was created in 1987. Eleven years of surveillance trend data reveal a wisconsin success story. Most wisconsin industries have made substantial strides toward reducing occupational lead exposure. The improvement is reflected in the reduced number of elevated blood lead levels in wisconsin's adult blood lead surveillance data. However, wisconsin must remain vigilant as new and re-emerging lead exposures continue to be identified through adult blood lead surveillance. wisconsin will also need to continue with its occupational lead exposure reduction efforts if it is to achieve the Federal Healthy People 2010 goals and objectives to have no adult blood lead level greater than 25 micrograms/dL.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/13. 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 = 1keywords = physician (Clic here for more details about this article) |
3/13. Lead ingestion associated with ceramic glaze--alaska, 1992.In August 1992, a physician notified the alaska Division of public health (ADPH) that three patients at a psychiatric hospital had consumed ceramic glaze during ceramic therapy (i.e., recreation therapy involving the production of ceramic ware), and two of these patients had elevated blood lead levels (BLLs). This report summarizes the ADPH's investigation of these ingestions.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/13. Severe lead poisoning in the plastics industry: a report of three cases.BACKGROUND: Lead stabilizers (e.g., lead sulfate, lead stearate) are common additives in plastics used in electrical devices. In 1997, three plastics compounders at one california company were severely lead-poisoned. methods: The poisonings were investigated by interviewing the workers, employer, and treating physician and reviewing medical records and environmental monitoring results. In addition to measuring blood lead levels (BLLs), noninvasive K X-ray fluorescence was used to measure bone lead concentration of the index case. RESULTS: Blood lead concentrations of the three workers at time of diagnosis were 159, 114, and 108 microg/dl. The worker with highest exposure presented with clinical findings of crampy abdominal pain, constipation, normocytic anemia, fatigue, and reversible azotemia. Bone lead concentration in his tibia, calcaneous, and patella were 102, 219, and 182 ppm, respectively. The poisonings resulted from uncontrolled use of powdered lead sulfate stabilizer. CONCLUSION: Clinicians should be aware of potential serious overexposure to lead in compounding of plastics.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/13. lead poisoning caused by Indian ethnic remedies in italy.BACKGROUND: Complementary or alternative medicine has become widespread in Western Countries and since the remedies are "natural" they are believed to be free of toxic effects and health risks. Ethnic remedies may contain lead, other metals and toxic substances. OBJECTIVES: To show how lead poisoning as a result of using ethnic remedies may be severe enough to cause serious damage to health, and to increase awareness among family doctors and occupational physicians of the risks associated with ethnic remedies. methods AND RESULTS: Description of ethnic remedy-related lead poisoning in 2 native Italian adults, with clinical, laboratory and toxicological data. CONCLUSIONS: When metal poisoning is diagnosed, ethnic remedies should be included among the putative sources so as to avoid erroneous attribution to workplace exposure and application of unneeded preventive measures.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/13. Plumbism or lead intoxication mimicking an abdominal tumor.The clinical presentation of lead intoxication may vary widely and in the absence of a high clinical index of suspicion, the diagnosis may be missed. The effects of lead on mitochondrial oxidative phosphorylation and its interaction with calcium-mediated processes explain the heterogenous presentation. In this case report, the diagnosis was finally made when bilateral wrist drop developed on top of abdominal cramps and anemia. Before, ascites raised the suspicion of a tumor. Therefore, each element of the triad of unexplained anemia, abdominal cramps, and bilateral wrist (or foot) drop should lead any physician to consider the diagnosis of lead intoxication. This case also illustrates the importance of a careful and meticulous social history in patient management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/13. Lead and mercury exposures: interpretation and action.Lead and mercury are naturally occurring elements in the earth's crust and are common environmental contaminants. Because people concerned about possible exposures to these elements often seek advice from their physicians, clinicians need to be aware of the signs and symptoms of lead and mercury poisoning, how to investigate a possible exposure and when intervention is necessary. We describe 3 cases of patients who presented to an occupational medicine specialist with concerns of heavy metal toxicity. We use these cases to illustrate some of the issues surrounding the investigation of possible lead and mercury exposures. We review the common sources of exposure, the signs and symptoms of lead and mercury poisoning and the appropriate use of chelation therapy. There is a need for a clear and consistent guide to help clinicians interpret laboratory investigations. We offer such a guide, with information about population norms, lead and mercury levels that suggest exposure beyond that seen in the general population and levels that warrant referral for advice about clinical management.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/13. lead poisoning in adults from renovation of an older home.Presented is the case of a group exposure to lead occurring during the removal of lead-based paint from an older home. One patient had symptoms from the time of exposure to the time of presentation, when he was acutely ill and encephalopathic. The patient was treated successfully with an initial course of British Anti-Lewisite agent and calcium disodium versenate (CaEDTA) chelation, and two subsequent chelations with CaE-DTA alone. The other two patients had elevated lead levels but were asymptomatic. They were followed closely, and their lead levels steadily declined over several months. The evaluation and treatment of lead poisoning and excessive lead levels in adults is discussed, as is the need for physicians and the lay public to become aware of the hazards of renovating older homes.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/13. Acute lead poisoning in nursing home and psychiatric patients from the ingestion of lead-based ceramic glazes.To our knowledge, acute inorganic lead poisoning from single ingestions of lead compounds has been only rarely reported. During a 14-month period, we were contacted regarding eight instances of acute ingestions of liquid lead-based ceramic glazes by mentally impaired residents of nursing homes or psychiatric facilities participating in ceramic arts programs. While some ingestions did not cause toxic effects, some patients developed acute lead poisoning characterized by abdominal pain, anemia, and basophilic stippling of red blood cells. In the blood of several patients, lead concentrations were far above normal (4 to 9.5 mumol/L). Urinary lead excretions were tremendously elevated during chelation therapy, with one patient excreting 535.9 mumol/L of lead during a 6-day period, the largest lead excretion ever reported in a patient suffering from acute lead poisoning, to our knowledge. All patients recovered following supportive care and appropriate use of chelating agents. Lead-based glazes are commonly found in nursing homes and psychiatric facilities. We suspect that acute or chronic lead poisoning from the ingestion(s) of lead-based ceramic glazes may be an unrecognized but not uncommon problem among such residents. We urge physicians to take ingestions of lead-based glazes seriously and to consider the diagnosis of lead poisoning in nursing home and psychiatric patients who have participated in ceramic crafts programs.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/13. Lead-contaminated health food. association with lead poisoning and leukemia.A doctor prescribed a dietary supplement prepared from powdered animal bone for a young woman with dysmenorrhea. Severe lead poisoning developed while she was taking the powder, which was shown to be contaminated with lead. The diagnosis eluded more than 20 physicians and was finally made by the patient herself. The Food and Drug Administration, informed of the contamination, declined to take action, stating that a food supplement is neither a food nor a drug and, besides, there are no maximal limits for heavy-metal contamination of foods and drugs.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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