[Blood lead levels in children from a ceramic center with respect to residence and parental occupation]. / Livelli di piombo ematico nei bambini del comprensorio ceramico in relazione alla residenza e all'occupazione dei genitori.

In a survey carried out in 1981, Pb exposure of children living in two geographical areas of the district of Scandiano and attending the first year of primary school was studied. The two areas were different concerning both traffic and the presence of ceramic tile industries, thus suggesting a different exposure of children. The survey demonstrated blood lead levels (PbB) markedly higher than 10 micrograms/100 ml, a value recently identified by the Centers for Disease Control (CDC, Atlanta, USA) as the limit beyond which children's learning capacity may be damaged. It was evident that both the occupational exposure of parents and, to a lower extent, the residence in zones with higher levels of pollution influenced PbB levels. During the last ten years significant improvements have led to the reduction of atmospheric emissions and of occupational exposure of ceramic workers. A new survey has been carried out in 1995. We examined 147 children attending the first year of primary school, and living in two zones for which a different level of Pb exposure could be assumed. In both zones, a clear reduction of PbB was observed in comparison with data obtained in 1981. Mean and standard deviation for PbB in the two groups were 4.1 +/- 1.71 and 4.5 +/- 2.04 micrograms/100 ml, with median values of 3.7 and 4.0 micrograms/100 ml, respectively. Only two cases (1.4%) exceeded the limit values proposed by CDC. Although the mean PbB were much lower than those observed in 1981, higher PbB were found in children whose parents were occupationally exposed to Pb. Maternal exposure seems to be particularly important in determining PbB in children. In comparison with data from the international literature, our results are very close to those obtained for children living in Scandinavian countries, in Germany or in France and rather different from those obtained by other authors in Italy.

Intradialytic changes of the oxyhaemoglobin dissociation curve during acetate and bicarbonate haemodialysis. Possible interactions with haemodialysis-associated hypoxaemia.

In nine chronic haemodialysis patients, treated alternately with acetate and bicarbonate, the main critical factors in oxygen supply to the tissues were evaluated: Hb values, blood gas parameters, red cell 2-3 diphosphoglycerate (2-3 DPG), phosphataemia and P50 in vivo. Predialytic P50 was higher than in normal controls. During dialysis, arterial pO2 and pCO2 significantly decreased in acetate dialysis, whereas they were stable in bicarbonate dialysis. Rising alkalinisation was accompanied, both in acetate dialysis and in bicarbonate dialysis, by reduction of P50, while 2-3 DPG did not change. The acute increase in Hb-O2 affinity adversely affected peripheral oxygen release. In acetate dialysis this mechanism might magnify the effects of dialysis-induced hypoxaemia, affecting the clinical tolerance.