ABSTRACT
Blood lead levels of 253 Delhi children were estimated by dithizone method. In 82 (controls) children with no symptoms mean blood lead level was 9.6 micrograms/dl (+/- SD 6.8: median 10 micrograms); only 6 had high levels between 30-33 micrograms/dl. In 88 children with pica, the mean blood lead level was 23.0 micrograms/dl (+/- SD 13.82; median 17 micrograms) which was significantly higher than the control; 26 had high levels between 30-92 micrograms/dl. Sixteen children with pica and surma-use and 46 children suspected of lead poisoning showed lead level patterns like the pica group. However, 21 surma-using children without pica resembled the control group. Children with pica were significantly more anemic than the controls and showed higher prevalence of abdominal-neurological symptoms. Because, in India, blood lead cannot be estimated in most of the hospitals, it is suggested that children with severe pica, anemia, abdominal-neurological symptoms and exposure to surma or lead, be suspected of lead poisoning, kept in lead-free environment with corrected nutrition, and be given a short cautious therapeutic trial with oral penicillamine.