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Hello123 · February 20, 2008, 09:45 PM

Lead poisoning is probably the most important chronic environmental illness affecting modern children. Perhaps the organ of most concern is the developing brain. Effects on the brain appear to continue into the teenaged years and beyond.

Recent literature suggests that significant insult to the brain occurs at very low levels and that medical intervention with chelation fails to reverse such effects.

The effects of lead poisoning on the brain are manifold and include delayed or reversed development, permanent learning disabilities, seizures, coma, and even death.

Lead is excreted through the urine.

Generally, adults develop lead poisoning as the result of an occupational exposure or from exposure through a hobby.

Mortality is rare today. However, death during the 1960s from lead encephalopathy was not rare in urban centers.

* Morbidity is common. Because lead is an enzymatic poison, it perturbs multiple essential bodily functions, producing a wide array of symptoms and signs.

* Adults with lead poisoning have increased incidences of depression, aggressive behavior, and antisocial behavior. Men with lead poisoning tend to have lower sperm counts; women have an increase in miscarriages and smaller babies.

* Children younger than 3 years are at the greatest risk for lead poisoning. This is because these children are most likely to put things containing lead into their mouths and because their brains are rapidly developing and are most vulnerable to any disorganizing influence.

* Adults present with minor nonspecific findings.
*
o Adults with lead poisoning frequently have sleep disorders. They may be hypersomnolent or have difficulty falling asleep at the appropriate time.
o In adults, obtaining a careful occupational and hobby history is important. The history of ingestion of illicit liquor may be an important clue to the etiology of lead poisoning. According to a study performed in a large urban ED, of the patients reporting ingestion of "moonshine" sometime during the previous 5 years, 51% had elevated blood lead levels and 31% had levels in the very elevated range of 50 mcg/dL or higher.

o Additionally, numerous reports document lead poisoning resulting from retained bullet or shrapnel fragments; thus, history of military or other trauma may be important.

Causes

* The department of labor lists more than 900 occupations that are associated with lead use. These occupations include lead workers, welders, glassmakers, and scrap metal workers. Parents employed in any of these occupations may bring lead dust on their persons or clothing into the home.
* Some hobbies are associated with exposures to lead. These hobbies may include making bullets, making fishing-weights, soldering, indoor firearm shooting, and remodeling older homes.
* Some cosmetics and folk remedies contain lead pigments or salts.

* Several reports exist of lead poisoning that develops as the result of absorption of lead from retained bullet or shrapnel fragments. Incidental finding of such fragments on an x-ray should prompt consideration of possible elevated lead levels, though most of these cases occur only with intraarticular fragments.
* Several reports have documented cases of childhood lead poisoning resulting from the ingestion of lead-based foreign bodies. Lead dissolves reasonably quickly in acid solutions such as in the stomach; thus, significant amounts of lead may be absorbed. The full extent of the problem is unclear, however, exercise caution when treating a child who has ingested an object that contains a significant concentration of lead.
* The history of illicit liquor ingestion may be an important clue to the etiology of lead poisoning. According to a study performed in a large urban ED, of the patients reporting ingestion of "moonshine" sometime during the previous 5 years, 51% had elevated blood lead levels and 31% had levels in the very elevated range of 50 mcg/dL or higher.

The treatment of lead poisoning is separating the child from the source of lead exposure. Chelation is used only when separation fails to drop the lead fast enough or far enough or when the lead level is in the potentially encephalopathogenic level (>60 mcg/dL).

The most important treatment of lead poisoning is the separation from the source of lead.
The word chelator is derived from the Greek term for claw; chelators form a chemical claw around the heavy metal and allow them to be excreted. Two parenteral and 2 oral drugs may be used.

February 20, 2008, 09:45 PM	#75
Hello123 Senior Member Join Date: February 21, 2005 Posts: 571	Taken from emedicine Lead poisoning is probably the most important chronic environmental illness affecting modern children. Perhaps the organ of most concern is the developing brain. Effects on the brain appear to continue into the teenaged years and beyond. Recent literature suggests that significant insult to the brain occurs at very low levels and that medical intervention with chelation fails to reverse such effects. The effects of lead poisoning on the brain are manifold and include delayed or reversed development, permanent learning disabilities, seizures, coma, and even death. Lead is excreted through the urine. Generally, adults develop lead poisoning as the result of an occupational exposure or from exposure through a hobby. Mortality is rare today. However, death during the 1960s from lead encephalopathy was not rare in urban centers. * Morbidity is common. Because lead is an enzymatic poison, it perturbs multiple essential bodily functions, producing a wide array of symptoms and signs. * Adults with lead poisoning have increased incidences of depression, aggressive behavior, and antisocial behavior. Men with lead poisoning tend to have lower sperm counts; women have an increase in miscarriages and smaller babies. * Children younger than 3 years are at the greatest risk for lead poisoning. This is because these children are most likely to put things containing lead into their mouths and because their brains are rapidly developing and are most vulnerable to any disorganizing influence. * Adults present with minor nonspecific findings. * o Adults with lead poisoning frequently have sleep disorders. They may be hypersomnolent or have difficulty falling asleep at the appropriate time. o In adults, obtaining a careful occupational and hobby history is important. The history of ingestion of illicit liquor may be an important clue to the etiology of lead poisoning. According to a study performed in a large urban ED, of the patients reporting ingestion of "moonshine" sometime during the previous 5 years, 51% had elevated blood lead levels and 31% had levels in the very elevated range of 50 mcg/dL or higher. o Additionally, numerous reports document lead poisoning resulting from retained bullet or shrapnel fragments; thus, history of military or other trauma may be important. Causes * The department of labor lists more than 900 occupations that are associated with lead use. These occupations include lead workers, welders, glassmakers, and scrap metal workers. Parents employed in any of these occupations may bring lead dust on their persons or clothing into the home. * Some hobbies are associated with exposures to lead. These hobbies may include making bullets, making fishing-weights, soldering, indoor firearm shooting, and remodeling older homes. * Some cosmetics and folk remedies contain lead pigments or salts. * Several reports exist of lead poisoning that develops as the result of absorption of lead from retained bullet or shrapnel fragments. Incidental finding of such fragments on an x-ray should prompt consideration of possible elevated lead levels, though most of these cases occur only with intraarticular fragments. * Several reports have documented cases of childhood lead poisoning resulting from the ingestion of lead-based foreign bodies. Lead dissolves reasonably quickly in acid solutions such as in the stomach; thus, significant amounts of lead may be absorbed. The full extent of the problem is unclear, however, exercise caution when treating a child who has ingested an object that contains a significant concentration of lead. * The history of illicit liquor ingestion may be an important clue to the etiology of lead poisoning. According to a study performed in a large urban ED, of the patients reporting ingestion of "moonshine" sometime during the previous 5 years, 51% had elevated blood lead levels and 31% had levels in the very elevated range of 50 mcg/dL or higher. The treatment of lead poisoning is separating the child from the source of lead exposure. Chelation is used only when separation fails to drop the lead fast enough or far enough or when the lead level is in the potentially encephalopathogenic level (>60 mcg/dL). The most important treatment of lead poisoning is the separation from the source of lead. The word chelator is derived from the Greek term for claw; chelators form a chemical claw around the heavy metal and allow them to be excreted. Two parenteral and 2 oral drugs may be used.