HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Gracia, R. C. Articles by Snodgrass, W. R. Search for Related Content PubMed PubMed Citation Articles by Gracia, R. C. Articles by Snodgrass, W. R.

REBECA C. GRACIA, PHARM.D., DABAT, is Director, North Texas Poison Center, Dallas. WAYNE R. SNODGRASS, M.D., PH.D., is Professor, Department of Pediatrics, The University of Texas Medical Branch, Galveston, and Medical Director, Southeast Texas Poison Center, Galveston.

Address correspondence to Dr. Gracia at the North Texas Poison Center, 5201 Harry Hines Boulevard, Dallas, TX 75235 (rgracia{at}parknet.pmh.org).

Purpose. Common sources of lead exposure, the primary clinical effects of lead toxicity, and current recommendations for managing lead toxicity, including chelation therapy, are reviewed. Summary. Common sources of lead exposure in children and adults include industrial and mining activities, paint, dust, soil, water, air, the workplace, food, trinkets, ethnic folk remedies, and cosmetics. The absorption and biological fate of lead are affected by a variety of factors, including an individual’s nutritional status, health, and age. Children with a blood lead concentration of >10 µg/dL and adults with a blood lead concentration of 45 µg/dL should undergo further evaluation. Symptoms and time to onset of symptoms postexposure may vary, and it can be difficult to identify the early, subtle neurologic effects of lead toxicity. The classic symptoms of lead toxicity generally correlate with blood lead concentrations of 25–50 µg/dL in children and 40–60 µg/dL in adults. Management of lead toxicity requires extensive risk assessment and caregiver education. Chelation is generally not indicated for adults with blood lead concentrations of <45 µg/dL because of the potential risk of adverse drug events and concerns about remobilized lead, and chelation for children with blood lead concentrations of <45 µg/dL remains controversial. Dimercaprol, edetate calcium disodium, and succimer are the three agents primarily used for chelation. Conclusion. Lead toxicity remains a significant public health concern. Elimination of elevated blood lead levels in children can be accomplished by educating appropriate health care providers and caregivers, recognizing potential lead sources, and adopting aggressive prevention and case management measures. Index terms: Absorption; Age; Antidotes; Blood levels; Case management; Dimercaprol; Drugs, body distribution; Edetate calcium disodium; Heavy metal antagonists; Lead; Pediatrics; Poisoning; Succimer; Toxicity

 

This article has been cited by other articles:

				P. J. Dougherty, M. van Holsbeeck, T. G. Mayer, A. J. Garcia, and S. Najibi Lead Toxicity Associated with a Gunshot-Induced Femoral Fracture. A Case Report J. Bone Joint Surg. Am., August 1, 2009; 91(8): 2002 - 2008. [Full Text] [PDF]

				P. J. Dougherty, R. Vaidya, C. D. Silverton, C. Bartlett, and S. Najibi Joint and Long-Bone Gunshot Injuries J. Bone Joint Surg. Am., April 1, 2009; 91(4): 980 - 997. [Full Text] [PDF]

				F. Busse, L. Omidi, K. Timper, A. Leichtle, M. Windgassen, E. Kluge, and M. Stumvoll Lead Poisoning Due to Adulterated Marijuana N. Engl. J. Med., April 10, 2008; 358(15): 1641 - 1642. [Full Text] [PDF]

				M. A. Vance Hippocrates and lead poisoning Am. J. Health Syst. Pharm., August 1, 2007; 64(15): 1584 - 1584. [Full Text] [PDF]