Exposición ambiental a plomo y biomarcadores de estrés oxidativo en niños sanos de La Plata, Argentina / Environmental exposure to lead and oxidative stress biomarkers among healthy children in La Plata, Argentina

Introducción. La exposición ambiental a plomo (Pb) aún constituye un problema de salud pública, particularmente para los niños. El estrés oxidativo podría representar un mecanismo primario asociado a su toxicidad. El objetivo del presente estudio fue determinar los niveles de Pb en sangre (Pb-S) en niños de 1 a 6 años de La Plata y alrededores con exposición ambiental, y su relación con biomarcadores de estrés oxidativo. Población y métodos. Estudio analítico de corte transversal. Se evaluaron niños clínicamente sanos de 1 a 6 años. Se determinaron los niveles de Pb-S, las actividades de enzimas antioxidantes y el grado de peroxidación lipídica. Se utilizó el paquete estadístico R versión 3.5.1. Resultados. Participaron 131 niños, mediana de edad 2,33 años. La media geométrica de los niveles de Pb-S fue 1,90 µg/dL; el 32 % presentó plombemias cuantificables y el 3 %, niveles ≥5 µg/dL (referencia internacional). Al comparar los biomarcadores de estrés oxidativo según los niveles de Pb-S, solo se observó diferencia significativa entre las medianas de las sustancias reactivas al ácido tiobarbitúrico (TBARS): 12,0 versus 10,0 nmol MDA/mL plasma; p = 0,02. Asimismo, la correlación entre las plombemias y las TBARS fue positiva (r = 0,24; p = 0,012). Conclusiones. La mayoría de los niños mostraron niveles de Pb-S menores a los límites recomendados por agencias internacionales, que si bien, no producen alteraciones en la actividad de enzimas antioxidantes, sí inducen peroxidación lipídica. Estos resultados reflejan la utilidad de este biomarcador como una herramienta diagnóstica temprana para evaluar los efectos subtóxicos del Pb.

Introduction. Environmental exposure to lead is still a major public health problem, especially in children. Oxidative stress may be a primary mechanism associated with toxicity. Theobjective of this study was to measure blood lead levels (BLLs) in children aged 1 to 6 years expos to lead in La Plata and suburban areas and their relation to oxidative stress biomarkers. Population and methods. Cross-sectional,analytical study. Clinically healthy children aged1 to 6 years were analyzed. BLLs, antioxidant enzyme activity, and extent of lipid peroxidation were measured. The statistical softwarepackage R, version 3.5.1, was used. Results. A total of 131 children participated; their median age was 2.33 years. The geometric mean of BLLs was 1.90 µg/dL; 32% showed a measurable BLL and 3%, BLLs ≥ 5 µg/dL (international reference). The comparison ofoxidative stress biomarkers based on BLshowed a significant difference in median thiobarbituric acid reactive substances (TBARS):12.0 versus 10.0 nmol MDA/mL of plasma;p = 0.02. In addition, the correlation between BLLs and TBARS was positive (r = 0.24; p = 0.012 Conclusions. Most children had a BLL below the limit recommended by international agencies; although such BLLs do not affantioxidant enzyme activity, they can induce lipid peroxidation. These results demonstrate theusefulness of this biomarker as an early diagnosistool to assess subtoxic lead effects.

Analysis on incidence of occupational diseases in Guangzhou from 2010 to 2020 / 中华劳动卫生职业病杂志

Objective: To analyze the incidence characteristics of occupational diseases in Guangzhou from 2010 to 2020, provide scientific basis for formulating occupational disease prevention and control policies. Methods: In January 2021, based on the data of occupational diseases in Guangzhou reported in the Information Monitoring System of Occupational Diseases and Occupational Health, descriptive epidemiological method was used to analyze the types and characteristics of occupational diseases in Guangzhou from 2010 to 2020. Results: A total of 1341 cases of 38 kinds of occupational diseases in 9 categories were reported in the past 11 years. The incidence of occupational pneumoconiosis, occupational otolaryngology and oral diseases and occupational chemical poisoning ranked the top three, accounting for 38.1% (511/1341) , 30.5% (409/1341) and 16.2% (217/1341) of the total cases respectively. The cases of pneumoconiosis in welders and silicosis accounted for 47.7% (244/511) and 34.4% (176/511) of the cases of occupational pneumoconiosis respectively. The cases of noise deafness accounted for 99.8% (408/409) of occupational otorhinolaryngology oral diseases. Acute occupational chemical poisoning cases accounted for 26.7% (58/217) of the occupational chemical poisoning cases, in which dichloroethane poisoning cases ranked the first, accounting for 79.3% (46/58) . Chronic occupational chemical poisoning cases accounted for 73.3% (159/217) of the occupational poisoning cases, in which benzene and lead poisoning cases ranked the top two, accounting for 79.2% (126/159) and 17.6% (28/159) respectively. Conclusion: Pneumoconiosis, silicosis, noise deafness, benzene poisoning, lead poisoning, dichloroethane poisoning should be supervised and managed as key occupational diseases in Guangzhou.

Analysis of suspected occupational chronic lead poisoning reported online and subsequent diagnosis in Jiangsu Province from 2014 to 2018 / 中华劳动卫生职业病杂志

Objective: To understand the distribution and characteristics of suspected occupational chronic lead poisoning reported online by Jiangsu Province, and to track the final diagnosis of suspected cases. Methods: The suspected occupational chronic lead poisoning cases in Jiangsu Province reported online from 2014 to 2018 were collected as the survey objects. Based on the reporting of the Occupational Disease Report Card from January 1, 2014 to November 5, 2019, the distribution characteristics and reporting institutions of suspected cases and final confirmed cases were analyzed. Results: From 2014 to 2018, 312 cases of suspected occupational chronic lead poisoning were reported online in Jiangsu Province. There were significant differences in the number of online reported cases of occupational chronic lead poisoning, online reported cases of suspected occupational chronic lead poisoning and confirmed cases of suspected occupational chronic lead poisoning in different years (P<0.05) , especially in 2015. Among the suspected occupational lead poisoning cases reported online, 236 cases (75.6%) were male, mainly distributed in the manufacturing industry, and 246 cases (79.1%) were operators. All the suspected occupational chronic lead poisoning cases reported online were concentrated in private enterprises, 229 cases (73.4%) in small and medium-sized enterprises. The top three cities were Suqian with 111 cases (35.6%) , Yangzhou with 79 cases (25.3%) and Huai'an with 50 cases (16.0%) . From 2014 to 2018, 19 suspected cases of occupational chronic lead poisoning were finally confirmed in Jiangsu Province, with a diagnosis rate of 6.1%. Conclusion: The majority of suspected occupational chronic lead poisoning cases reported online in Jiangsu Province are men, manufacturing and small and medium-sized enterprises, and the final diagnosis rate of suspected occupational chronic lead poisoning cases reported online is low.

Los acúfenos de Miguel Ángel y su relación con la toxicología / Miguel Ángel's tinnitus and its relation to toxicology

Resumen El Plomo ha tenido una estrecha relación con el mundo artístico pictórico a través de los pigmentos utilizados por los artistas durante milenios. El íntimo contacto con sustancias químicas potencialmente peligrosas para la salud, casi siempre sin medidas de higiene y seguridad laboral, ha desarrollado en muchos casos, enfermedades laborales en estos artistas, a veces sospechadas y en otros casos, más que confirmadas. En el presente trabajo se analiza la historia de vida laboral de Miguel Angel Buonarroti, de quien se tiene registro suficiente como para establecer un nexo causal con exposición laboral al Plomo.

Abstract Lead has shown a close relationship with the fine arts'world through the pigments used by artists for thousand of years. Close contact with potentially dangerous chemical substances for health, almost always without occupational hygiene and safety measures, has produced, in many cases, occupational illnesses in these artists, sometimes suspected and in other cases, more than confirmed. In the present work, the history of Miguel Angel Buonarroti's working life is analyzed, since there is sufficient record to establish a causal link with occupational exposure to Lead.

Evaluación biológica de la exposición laboral al plomo / Biological assessment of the work-related exposure to lead

Introducción: El plomo, por su amplio uso causa una gran contaminación ambiental y problemas de salud en muchas partes del mundo. La Organización Mundial de la Salud incluyó el plomo dentro de una lista de diez productos químicos causantes de graves efectos sobre la salud. Objetivo: Evaluar los niveles de plomo en sangre y de protoporfirina libre eritrocitaria en un grupo de trabajadores expuestos a plomo inorgánico. Métodos: Estudio descriptivo de corte transversal donde se evaluaron 776 casos que acudieron a los laboratorios del Instituto Nacional de Salud de los Trabajadores en el año 2018, provenientes de diferentes sectores industriales. Se les realizó la determinación de plomo en sangre a 288 y la de protoporfirina a 488, según métodos establecidos en el laboratorio. Los datos obtenidos fueron procesados utilizando Microsoft Excel® y el paquete estadístico Statgraphics Centurion XVI.II. Resultados: El 92 por ciento de los pacientes fue del sexo masculino. La concentración de plomo en sangre osciló entre 5 µg/dL y 89 µg/dL para un promedio en hombres de 24 µg/dL ± 21 µg/dL y en las mujeres de 11 µg/dL ± 9 µg/dL. Para la protoporfirina, esta fluctuó entre 21 µg/dL y 274 µg/dL, con un promedio de 47 µg/dL ± 22 µg/dL en hombres y 66 µg/dL ± 32 µg/dL en las mujeres. El 8 por ciento de los casos evaluados tuvo valores de plomo en sangre mayores de 60 µg/dL y para la protoporfirina el 5 por ciento de los casos presentaron valores por encima de 85 μg/dL. Conclusiones: Algunos casos evaluados presentaron niveles elevados de plomo que superan los límites permitidos, lo que pone en evidencia la necesidad de reforzar las medidas de protección aplicadas a los trabajadores y la importancia de detectar precozmente el problema en el ámbito laboral, antes de que aparezcan repercusiones derivadas de una intoxicación por plomo(AU)

Introduction: Lead, due to its large use, causes a major environmental pollution and health problems in many places around the world. The World Health Organization included lead in a list of ten chemical products causing severe effects in health. Objective: To assess lead levels in blood and free-erythtocyte protoporphyrin (FEP) levels in groups of workers exposed to inorganic lead. Methods: Descriptive. cross-sectional study where 776 cases coming from different industrial sectors were assessed in the laboratories of the National Institute of Workers Health in the year 2018. It was conducted to 288 of the cases a test to determine if there was lead in blood and a test for FEP to 488 cases, according to the methods established in the laboratory. The data collected were processed using Microsoft Excel® and the statistical program called Statgraphics Centurion XVI.II. Results: 92 percent of the patients were males. Lead concentration in blood ranged from 5 µg/dL and 89 µg/dL, for an average in men of 24 µg/dL ± 21 µg/dL, and in women of 11 µg/dL ± µg/dL. FEP concentration swung from 21 µg/dL to 274 µg/dL, with an average of 47 µg/dL ± 22 µg/dL in men, and 66 µg/dL ± 32 µg/dL in women. 8 percent of the assessed cases presented values of lead in blood higher than 60 µg/dL and for FEP, 5 percent of the cases presented values higher than 85 µg/dL. Conclusions: Some of the assessed cases presented high levels of lead which exceed the permitted levels; so, this demonstrates the need of reinforzing the protection measures applied to the workers and the importance of early detecting this problem in work-related environments prior to the onset of repercutions derived from lead poisoning(AU)

Investigación de la intoxicación secundaria por plomo de un proyectil por arma de fuego retenido en el cuerpo: reporte de caso / Investigation of secondary lead poisoning of a projectile by firearm retained in the body: case report

Resumen El plomo es un metal que encontramos depositado en el ambiente a causa de la contaminación o la explotación mineral. Debido a que este componente ha tenido una gran diversidad de usos en su historia, los medios y formas de intoxicación ha generado un cambio en la perspectiva de los componentes que pueden generar una intoxicación por plomo. Durante la investigación de la intoxicación por plomo mediante proyectiles de arma de fuego se analizó la posibilidad de que se produzca intoxicación por plomo en un caso de una femenina con retención del proyectil por arma de fuego en hueso occipital con más de 50 años, abordando desde una revisión bibliográfica, la historia de formas o productos en que este metal producía intoxicación, los mecanismos de absorción, distribución y metabolismo en el cuerpo, el mecanismo de acción, el daño a los órganos, los hallazgos clínicos, la composición de la bala y su relación médico legal para confirmar la presencia de un proyectil por arma de fuego retenido en el cuerpo con la finalidad de descartar si es posible una intoxicación por plomo por un proyectil de arma de fuego retenido en hueso occipital.

Abstract Lead is a metal that we find deposited in the environment because of pollution or mineral exploration. In reason that this component had a great diversity of uses in its history, the means and forms of intoxication have generated a change in the perspective of which components could generate a lead poisoning. During the investigation of lead poisoning through firearm projectile it was analyzed the possibility that a lead poison gets produced in a feminine that holds a firearm projectile for more than 50 years in the occipital bone, addressing from a bibliographic review, the history of forms or products in which this metal produced intoxication, the mechanisms of absorption, distribution and metabolism in the body, the mechanism of action, damage to the organs, the clinical findings, the composition of the bullet and its legal medical relationship to confirm the presence of a projectile by firearm retained in the body in order to rule out if lead poisoning is possible by a firearm projectile retained in occipital bone.

Biosorption potential of lead tolerant fungi isolated from refuse dumpsite soil in Nigeria

Metals are non-biodegradable and recurrent in the environs. Heavy metals tolerant fungiwere isolated from refuse dumpsite soil using pour plate method. These fungiwere identified as Aspergillus niger, Penicillium chrysogenumandRhizomucor sp. The fungal isolates were screened for cadmium (Cd), lead (Pb) and zinc (Zn) with concentration of 200ppm, 400ppm and 600ppm. Aspergillus nigerand Penicillium chrysogenumshowed high tolerance for the metals in contrast to the control. The fungiwith high tolerance were used for biosorption study. However, Penicillium chrysogenumshowed higher lead removal or biosorption potential of 1.07ppm, 3.35ppm and 4.19ppm as compared with Aspergillus nigerwith lead removal of 0.67ppm, 3.11ppm and 3.79ppm at 5th, 10thand 15thday respectively. One-way Analysis of Variance was used to interpret the data generated from the biosorption study which revealed that there was no significant different (p>0.05)between the lead removal of Aspergillus nigerandPenicillium chrysogenumon the 5thday but there was significant difference (p<0.05)in the lead removal of Aspergillus nigerand Penicillium chrysogenumon the 10thand 15thday. This study suggests the use of these fungal isolates for removal and biotreatment of heavy metal contaminated and polluted environment.

Análisis de la distribución nacional de intoxicación por plomo en niños de 1 a 4 años. Implicaciones para la política pública en México / Analysis of the national distribution of lead poisoning in 1-4 year-old children. Implications for Mexican public policy

Resumen: Objetivo: Estimar la magnitud de intoxicación por plomo (Pb) (≥5μg/dL en sangre) en niños de 1 a 4 años e identificar la contribución del uso de loza de barro vidriado con Pb (LBVPb) como fuente de exposición en los 32 estados de México. Material y métodos: Muestra de Pb en sangre (PbS) capilar de niños participantes en la Encuesta Nacional de Salud y Nutrición 2018-2019. Se estimó la prevalencia de intoxicación, su asociación con LBVPb y distribución nacional. Resultados: La prevalencia nacional de intoxicación fue 17.4%, lo cual representa 1.4 millones de niños. Esta prevalencia fue 30.7% entre usuarios de LBVPb y 11.8% entre no usuarios. En 17 estados la prevalencia de intoxicación es ≥10%; en 11 es ≥5-10% y en 4 es <5%. Conclusiones: Existe una distribución diferencial geográfica del problema; se confirma la asociación con LBVPb y se estima la contribución de otras fuentes de exposición. Esta información ofrece una guía para implementar acciones de prevención y control en México.

Abstract: Objective: To estimate de magnitude of Pb poisoning (≥5μg/dL blood) in 1-4 year old children and to identify the contribution of lead-glazed ceramics use (LGC) as a source of exposure in the 32 Mexican states. Materials and methods: Using the results from a sample of capillary blood lead (BPb) we estimated the prevalence of Pb poisoning, it's association with LGC and national distribution. Results: The national prevalence of Pb poisoning was 17.4% representing 1.4 million children. The prevalence was 30.7% among LGC users and 11.8% in non-users. In 17 states the prevalence of Pb poisoning was ≥10%, in 11 states between 5-10%, and in 4 states <5%. Conclusions: There is a geographic differential distribution of the problem; confirming the association with LGC and estimating the contribution of other Pb exposure sources. This information offers a guide to implement prevention and control actions in Mexico.

Outbreak investigation of lead neurotoxicity in children from artificial jewelry cottage industry

BACKGROUND@#Although lead neurotoxicity is a known phenomenon, it can often be missed at a primary or secondary care level especially if detailed environmental exposure history is missed.@*METHODS@#This is an outbreak investigation where we observed 15 pediatric cases with neurologic signs and symptoms clustered in a slum area known for an unorganized artificial jewelry industry. Their clinical, biochemical, and epidemiological features were compared with 14 other children from the same region reporting with non-neurological symptoms who were considered as unmatched controls.@*RESULTS@#Cases with neurological manifestations had a higher in-house lead smelting activity [OR 7.2 (95% CI 1.4-38.3)] as compared to controls. Toddlers below 3 years of age were more vulnerable to the effects of lead.@*CONCLUSION@#This study emphasizes that many focal sources of lead poisoning still remain especially in the unorganized sector. In cases presenting with unexplained neurotoxicity, specific occupational and environmental inquiry for chemical poisoning, with special consideration for lead, should be actively pursued.

Collective exposure to lead from an approved natural product-derived drug in Korea

BACKGROUND: In Asian countries, including Korea, lead poisoning caused by traditional herbal medicines is often observed in the clinic. However, there have been no reports thus far of lead poisoning caused by drugs that were approved by the Korea Food and Drug Administration (KFDA). Here, we describe seven patients who ingested a problematic natural product-derived drug (NPD). CASE PRESENTATION: In July 2018, seven patients visited a university hospital after ingesting an NPD, S. capsules. These patients complained of various symptoms, and their blood lead levels (BLLs) were elevated relative to those of the general population (arithmetic mean: 19.5 ± 11.6 µg/dL, range: 6.28–35.25 µg/dL). The total doses and BLLs were directly proportional to each other among the patients (r = 0.943, p = 0.001). After the patients discontinued drug intake, their BLLs decreased gradually. The capsule was confirmed to contain lead above the standard value (arithmetic mean: 2,547 ± 1,821.9 ppm). CONCLUSION: This incident highlights the need to strengthen standards for the management of NPD ingredients in Korea. NPDs are more likely to be contaminated than other drugs. Thorough management by the KFDA is essential to prevent a recurrence. Moreover, systematic health care is needed for many patients who have taken problematic NPDs.

Influence of clozapine on neurodevelopmental protein expression and behavioral patterns in animal model of psychiatric disorder induced by low-level of lead

Exposure to lead during pregnancy is a risk factor for the development of psychiatric disorders in the offspring. In this study, we investigated whether exposure to low levels of lead acetate (0.2%) in drinking water during pregnancy and lactation causes behavioral impairment and affects the expression of proteins associated with neurodevelopment. Lead exposure altered several parameters in rat offspring compared with those unexposed in open-field, social interaction, and pre-pulse inhibition tests. These parameters were restored to normal levels after clozapine treatment. Western blot and immunohistochemical analyses of the hippocampus revealed that several neurodevelopmental proteins were downregulated in lead-exposed rats. The expression was normalized after clozapine treatment (5 mg/kg/day, postnatal day 35–56). These findings demonstrate that downregulation of several proteins in lead-exposed rats affected subsequent behavioral changes. Our results suggest that lead exposure in early life may induce psychiatric disorders and treatment with antipsychotics such as clozapine may reduce their incidence.

A Case of Severe Lead Poisoning with Basophilic Stippling Teardrop Cell

No abstract available.

Association between the HOTAIR Polymorphism and Susceptibility to Lead Poisoning in a Chinese Population / 生物医学与环境科学（英文）

This study explored the association between the lncRNA HOTAIR polymorphism and susceptibility to lead poisoning in a Chinese population. We speculated that lead poisoning caused elevated levels of oxidative stress, which, in turn, activate the HOTAIR gene to cause apoptosis. Three lncRNA HOTAIR tagSNPs (rs7958904, rs4759314, and rs874945) were genotyped by TaqMan genotyping technology in 113 lead-sensitive and 113 lead-resistant Chinese workers exposed to lead. Rs7958904 was significantly associated with susceptibility to lead poisoning (P = 0.047). The rs7958904 G allele had a protective effect compared with the C allele and reduced the risk of lead poisoning (P = 0.016). Rs7958904 may act as a potential biomarker for predicting the risk of lead poisoning and distinguishing lead-sensitive individuals from lead-resistant individuals.

Intoxicación por plomo y nivel de marginación en recién nacidos de Morelos, México / Lead poisoning and marginalization in newborns of Morelos, Mexico

Resumen: Objetivo: Determinar la prevalencia de intoxicación por plomo (IPb) al nacimiento en Morelos, analizar su distribución por nivel de marginación y estimar la asociación con el uso de barro vidriado (BV). Material y métodos: Se midió plomo en sangre (PbS) en cordón umbilical de una muestra representativa de 300 nacimientos seleccionados aleatoriamente de aquéllos atendidos por los Servicios de Salud de Morelos e IMSS estatal. Resultados: La prevalencia de IPb al nacimiento (PbS>5µg/dL) fue 14.7% (IC95%: 11.1, 19.3), y 22.2% (IC95%: 14.4, 32.5) en los municipios más marginados. 57.1% (IC95%: 51.3, 62.7) de las madres usaron BV durante el embarazo y la frecuencia de uso se asoció significativamente con PbS. Conclusión: Este es el primer estudio que documenta la proporción de recién nacidos con IPb que están en riesgo de sufrir los consecuentes efectos adversos. Se recomienda monitorear PbS al nacimiento y emprender acciones para reducir esta exposición, especialmente en poblaciones marginadas.

Abstract: Objective: To determine the prevalence of lead (Pb) poisoning at birth in Morelos, analyze its distribution by social marginalization level, and estimate the association with the use of lead glazed ceramics (LGC). Materials and methods: Blood lead level (BLL) in umbilical cord was measured in a representative sample of 300 randomly selected births at the Morelos Health Services and state IMSS. Results: The prevalence of Pb poisoning at birth (BLL> 5μg/dL) was 14.7% (95%CI: 11.1, 19.3) and 22.2% (95%CI: 14.4, 32.5) in the most socially marginalized municipalities. 57.1% (95%CI: 51.3, 62.7) of the mothers used LGC during pregnancy, and the frequency of use was significantly associated with BLL. Conclusion: This is the first study to document the proportion of newborns with Pb poisoning who are at risk of experiencing the related adverse effects. It is recommended to monitor BLL at birth and take action to reduce this exposure, especially in socially marginalized populations.

Guía de práctica clínica para el manejo de pacientes con intoxicación por plomo / Clinical practice guide for the management of patients with lead poisoning

El manual contiene: la finalidad, objetivo, ámbito de aplicación, aspectos conceptuales y responsabilidades para la atención de personas expuestas a plomo.

Dolor abdominal como presentación por intoxicación por plomo: Caso clínico / Abdominal pain as a presentation by lead poisoning: Case report

La intoxicación aguda por plomo no es una patología que con frecuencia vemos en el consultorio de pediatría. Los síntomas por intoxicación por plomo pueden ser digestivos o neurológicos, y, muchas veces, se puede confundir con otras patologías. De ahí, la importancia de tener presente y pensar en esta patología y, ante la alta sospecha, pedir estudios complementarios que confirmen la intoxicación por plomo. Este es el caso de un niño de 9 años, que consulta por dolor abdominal agudo acompañado de vómitos. Luego de realizar un minucioso examen físico y una detallada anamnesis, se tiene una alta sospecha diagnóstica de intoxicación "aguda" por plomo, motivo por el cual se interna. Después de tomar una muestra venosa para confirmar el nivel de plomo, se realiza un tratamiento con quelante, bajo la supervisión de un especialista en toxicología.

Acute lead poisoning is not a common pathology seen in the pediatrician's office. Lead poisoning symptoms can be digestive or neurological, and they can be confused with other pathologies. That is the reason why it should be considered and, in case of doubt, complementary studies to confirm lead poisoning should be requested. This is the case of a nine-year-old child that comes to the office with a strong abdominal pain and vomiting, and after a close physical examination and a detailed anamnesis, a suspicious diagnosis of "acute" lead poisoning is obtained. Therefore, the infant is hospitalized, and after taking a venous sampling to confirm the lead level, a chelation therapy is performed under the toxicology expert's supervision.

Role of ALAD and VDR genotypes on the association of low blood lead level with serum uric acid and blood pressure in automobile paint workers of Karachi, Pakistan

Lead is an environmental pollutant having nephrotoxic effects even at low level. Its continuous exposure is associated with increased serum uric acid level that resulting in renal insufficiency. This research was conducted to see the effects of delta-aminolevulinic acid dehydratase [ALAD] and vitamin D receptor [VDR] genotypes on biochemical parameters and blood pressure [BP] of automobile workers having low blood lead level [BLL] with continuous lead exposure. Automobile paints workers with ALAD 1-2 genotype showed the positive association of BLL with diastolic BP [p<0.05] whereas, a genotypic combination ofALAD -2IVDR BB showed the negative association of serum uric acid with BLL [p<0.05]. Similarly negative effects of VDR BB genotype [p<0.01] and ALAD 1-2 genotype [p<0.05] were observed in the association of serum uric acid with BLL at the mean age >30 years. This suggests that automobile paint workers having ALAD 1-2 genotypes are at the risk of increased diastolic BP. The research also foretells that combination of ALAD -2IVDR BB may play a significant role against lead induced nephrotoxicity at low BLL with continuous lead exposure

Lead Poisoning at an Indoor Firing Range

In March 2014, a 39-year-old Korean male presented with a 6-month history of various nonspecific symptoms including dizziness, fatigue, asthenia, irritability, elevated blood pressure, palpitation, eyestrain, and tinnitus. His occupational history revealed that he had been working as an indoor firing range manager for 13 months; therefore, he was subjected to a blood lead level (BLL) test. The test results showed a BLL of 64 µg/dL; hence, he was diagnosed with lead poisoning and immediately withdrawn from work. As evident from the workplace environmental monitoring, the level of lead exposure in the air exceeded its limit (0.015–0.387 mg/m³). He received chelation treatment with calcium-disodium ethylenediaminetetraacetic acid (1 g/day) for 5 days without any adverse effects. In the follow-up results after 2 months, the BLL had decreased to 9.7 µg/dL and the symptoms resolved. This report represents the first occupational case of lead poisoning in firing ranges in Korea, and this necessitates institutional management to prevent the recurrence of poisoning through this route. Workplace environmental monitoring should be implemented for indoor firing ranges, and the workers should undergo regularly scheduled special health examinations. In clinical practice, it is essential to question the patient about his occupational history.

Coexistencia de neuropatía periférica secundaria a intoxicación crónica por plomo y polimiositis: reporte de caso / Co-existence of peripheral neuropathy secondary to lead poisoning and chronic polymyositis: Case report

Se reporta el caso de un hombre de 47 arios con intoxicación crónica por plomo, secundaria a exposición laboral de 5 años, con sintomatología típica de saturnismo. Consultó por debilidad muscular generalizada, disfagia y parestesias en extremidades. Se documentaron altos niveles de plomo en sangre, asociados a neuropatía periférica, confirmada por electromiografía, y disminución de la fuerza muscular en cintura escapular y pélvica (deltoides y vasto medial), así como atrofia de músculos del cuello (flexores y extensores) manifestada como cefaloparesia. Adicional al cuadro de saturnismo se diagnosticó miopatía inflamatoria con base en la elevación de enzimas musculares, miositis por resonancia magnética nuclear y biopsia muscular compatible, siendo, hasta donde se sabe, el primer reporte conocido de la coexistencia de estas 2 enfermedades

A case is presented on a 47-year-old man with chronic lead poisoning with typical symptoms after 5 years of occupational exposure. He consulted for generalised muscle weakness, early dysphagia, cephaloparesia, and paresthesias in upper and lower limbs. He also had atrophy and decreased proximal muscle strength (deltoid and medial vast) and in both flexor and extensor muscles of the neck. He had a history of high blood lead levels and peripheral neuropathy documented by electromyography. In addition to the diagnosis of lead poisoning, inflammatory myopathy was confirmed based on muscle enzyme elevation, muscular inflammation in magnetic resonance imaging, and typical findings in a muscle biopsy. To our knowledge, this is the first report where both conditions are documented in one patient