We encountered two children with lead poisoning who were administered herb medicinal pills recommended by their clergyman. These patients presented anemia and severe coliky abdominal pain, but no neurologic symptoms. For this reason, they were initially misdiagnosed with gastrointestinal hemorrhagic disease. However, we got a clue that they took herb medicinal pills. Finally, based on the assay of blood lead level, we made a correct diagnosis of lead poisoning in these patients. These patients underwent chelating therapy. Subsequently, the concentration of blood lead was decreased. Finally, we drew a conclusion that the possibility of lead poisoning must be considered in children who complained of colicky abdominal pain accompanying anemia. Here, we report two pediatric cases of lead poisoning with a review of literature.
Journal of agricultural medicine and community health
/
v.26
no.1
/
pp.57-64
/
2001
A 23-year-old female has visited university hospital for abdominal colic and constipation. She took home-made herb pills for 15 days as a traditional remedy for skin eczema. On clinical examinations, conjunctiva was pale, sclera was icteric and lead line was visible on gingiva. Laboratory examinations are as follows; hemoglobin was 8.6g/$d{\ell}$, reticulocyte was 4.2% and there was basophilic stippling of erythrocytes in peripheral blood smear. Blood level of lead was elevated as $69{\mu}g/d{\ell}$. The herb pills contained 3.32% lead, with cumulative dose of lead over 3.2g. The herb pills were manufactured by a 70-year-old man who was not aware of the health hazard of lead. We suppose that he made herb pills with the imported raw materials from China that contained a high percentage of lead.
Linda Ratna Wati;Djanggan Sargowo;Tatit Nurseta;Lilik Zuhriyah;Bambang Rahardjo
Journal of Preventive Medicine and Public Health
/
v.56
no.5
/
pp.422-430
/
2023
Objectives: Prolactin is vital for breastfeeding and milk production, and its secretion is influenced by factors related to the mother, infant, and environment. To date, no study has concurrently investigated the correlation of these factors with serum prolactin levels during lactation. Therefore, the objective of this study was to investigate the correlations among maternal and infant factors, lead exposure, and serum prolactin levels during lactation. Methods: A cross-sectional approach was employed in Surabaya, Indonesia, among 110 exclusively lactating mothers. The mothers' daily diets were determined using multiple 24-hour recalls, while blood lead levels were measured with inductively coupled plasma mass spectrometry. Serum prolactin levels were assessed using the electrochemiluminescence immunoassay. For bivariate analysis, we employed the Spearman correlation, Mann-Whitney, and Kruskal-Wallis tests, while for multivariate analysis, we utilized multiple linear regression. Results: The average serum prolactin level of the lactating mothers was 129.19±88.96 ng/mL. Positive correlations were found between serum prolactin levels and breastfeeding frequency (p<0.001), protein intake (p<0.001), and calcium intake (p=0.011) but had negative correlation with blood lead levels (p<0.001) and vitamin B6 intake (p=0.003). Additionally, prolactin levels were not significantly associated with maternal age; parity; intake of calories, vitamin D, vitamin E, zinc, folic acid, magnesium, or iron; infant age; or infant sex. Conclusions: Breastfeeding frequency had a stronger positive relationship with serum prolactin levels than protein and calcium intake. However, lead exposure was associated with reduced serum prolactin levels during lactation. Consequently, specific interventions from policymakers are necessary to manage breastfeeding in mothers exposed to lead.
The purpose of this paper is to evaluate 1) blood lead levels of workers at auto repair shops as Biological Exposure Indices (BEI) of toxic substances such as lead and toluene that are produced during automotive painting process, 2) the differences depending on personal characteristics of workers who have been exposed to toluene by using urine hippuric acid concentration as a marker and 3) the correlation between the concentration of hazardous chemicals in each workplace and the BEL. All subjects were male with a mean age of 36.2 years. In terms of age, most were in the 30 to 40 age group (13 persons, 48.1%). In relation to the length of work experience, the highest proportion had experience of 10 years of less (18 persons, 66.7%). Twenty three workers were cigarette smokers (85.2%) while 4 (14.8%) were non-smokers. In addition, more than 80% of the workers drank alcohol. Dust concentration and toluene exposure during automotive painting showed no significant difference with age, length of work experience, smoking and drinking while a significant difference (p<0.05) has been detected between lead concentration and smoking. The geometric mean of dust concentration, lead concentration and toluene concentration were $0.38mg/m^3,\;0.0021mg/m^3$ and 1.08ppm respectively. In addition, the geometric mean of blood lead levels and urine hippuric acid concentration were $1.70{\mu}g/dl$ and 0.25g/g respectively, which were lower than the standard levels suggested by the Ministry of Labor. To determine the influential factors on blood lead and urine hippuric acid concentrations, a correlation analysis has been conducted with variables of air, lead and toluene concentrations, age, length of work experience and amount of cigarette smoking. According to the analysis, a relatively high correlation (p<0.01) has been observed between air lead concentration and biological sample concentration.
Kim, Hwa-Sung;Lee, Gap-Soo;Lee, Sung-Soo;Ahn, Kyu-Dong;Lee, Byung-Kook
Journal of Preventive Medicine and Public Health
/
v.27
no.3
s.47
/
pp.547-556
/
1994
In order to identify the necessary information of biochemical Indices for renal effect of lead for the early detection in medical surveillance of lead worker, the reference values of urinary N-acetyl-$\beta$-D-glucosaminidase (NAG) activities were studied with 205 office workers in one industrial complex area who were not exposed to lead occupationally. While study variables selected for lead exposure were blood lead (PbB), blood zinc protoporphyrin(ZPP) and $\delta$-aminolevulinic acid (DALA) in urine, those for renal effect were urinary N-acetyl-$\beta$-D-glucosaminidase (NAG), blood urea nitrogen (BUN), serum creatinine(Cr), serum uric acid (Ua), and urinary total protein(U-TP). The results obtained were as follows: 1. The mean values of blood lead, ZPP and DALA in all subjects were $14.39{\pm}4.02{\mu}g/dl,\;21.61{\pm}8.00{\mu}g/dl,\;and\;2.73{\pm}0.90mg/l$ respectively. 2. The mean value of urinary NAG activities in all subjects was $3.51{\pm}2.01U/l$. The mean value of urinary NAG activities, which calculated from NAG activities divided by urinary creatinine concentration (CNAG), was $5.42{\pm}5.53U/g$ creatinine and log-arithmic normal distributed. 3. The reference value of urinary NAG activity was 12.06 U/g creatinine(95% CU=10.57-14.76 U/g creatinine). 4. Logarithmic CNAG(r=0.781 p<0.0l), U-TP(r=0.670 p<0.01) and ZPP(r=0.172 p<0.05) showed statistically significant correlation with CNAG.
This study was performed to investigate the effects of lead poisoning and different levels of dietary lipid on lead and lipid metabolism in the rats. Forty eight male weanling rats of Sprague-Dawley strain weighing 73.1$\pm$11.1g were blocked into 6 groups according to body weight. Dietary lipid were given at the lev딘 of 5, 20 and 40% of total caloric intake and lead were either administered or not. The results obtained are summerized as follows ; 1) Food intake, weight gain, F.E.R. liver and epididymal. fat pad weights, weight and length of bone, hematocrit and hemoglobin content in Pb-adminstered groups were lower than these in Pb-free groups. 2) Plasma lipid and cholesterol levels were tended to be higher in Pb-administered groups than in Pb-free groups, while liver lipid and cholesterol levels were tended to be lower in Pb-adminstered groups. 3) Fecal dry matter excretion was tended to be higher in Pb-adminstered groups than in Pb-free groups, and were increased with increasing dietary lipid level. Daily fecal excretions of lipid and cholesterol were higher in high lipid groups than in low lipid groups and these levels were even higher in the animals exposed to Pb than in Pb-free groups. 4) Pb contents in blood, liver, kidney and bone were significantly higher in Pb administered groups than in Pb-free groups. Pb levels of blood, liver and bone did not show any significant difference among groups with different levels of dietary lipid, but Pb concentration in kidney of Pb-adminstered groups increased with increasing dietary lipid level.
The objective of this study was to investigate the nutritional and health status of women industrial workers by working fields. One hundred forty eight (105 lead and 43 office) workers were recruited from March 2005 to October 2005. Information on age, education, smoking and drinking status were collected using questionnaire and nutrient intake and diet quality of workers were assessed by average of two-day 24 hr recall method. Biochemical indexes including blood lead level (PbB), indexes for iron status, serum calcium (Ca) and serum lipid profiles were analyzed from fasting venous blood or serum. Results showed that education level of lead workers was lower than that of office workers (p<0.05), but nutrient intake levels were not significantly different by working fields. Overall nutritional status of the subject were good except for calcium, vitamin $B_2$, C and folic acid intakes. PbB of lead workers were significantly higher than that of office workers while mean corpuscular hemoglobin concentration (MCHC) and serum Ca levels were significantly lower in lead workers. MCHC was positively correlated with zinc intake (r=0.166) and serum Ca was positively correlated with vitamin C intake (r=0.179). This study confirms that lead workers need extra care to keep their health and nutritional management especially for the nutrients known to interact with lead. Tailored nutrition education for workers at specific working fields needs to be more focused for the improvement of health status of industrial workers.
This study was performed to investigate the effect of lactose in 4 different concentrations against the protective effect of calcium on the acute lead poisoning in rats after 4 weeks treatment. In this animal experiment, 70 albino male weanling rats (50-70g of body weight) of Sprague-Dawley strain were used. Lead was dissolved in the distilled water and intubated at the dose of 400mg lead (as acetate)/ kg of body weight/day. Calcium and lactose were administered in drinking water ad libiturn dissolved with the solution of 0.7% calcium gluconate mixed with 40, 80, 160 and 320mM lacotse respectively. The results obtained were summarized as follows: 1. The rate of body weight gain in all treated groups turned out to be lower than that in the control group during 4 weeks treatment. The slow-down of body weight gain was the most significantly observed in the group treated with lead only ( p < 0.05). 2. The relative spleen weight in lead only treated group was significantly lower than that of lead + calcium, lead + calcium + 80mM lactose treated group ( p < 0.05). 3. The value of RBC, WBC, Hb and Hct showed a decreasing tendency in the group treated with lead only ( p < 0.05), however, a significant decrease was not observed in the group treated with lead + calcium. On the other hand, the protective effect of calcium was deteriorated in the group treated with lead + calcium + lactose. 4. The activity of $\delta$-aminolevulinic acid dehydratase ($\delta$-ALAD activity) showed the same tendency as No. 2. 5. The lead concentration in the blood (PbB) showed an increasing tendency and the interrelation among the different groups was also identical with No. 2. 6. With a statistical approach, it was found out that the activity of $\delta$-ALAD and the lead concentration in the blood show a relation of inverse proportion(r=-0.7301). The diagram was interpreted with the logarithmic equation InY = 5.5357-0.0251X (X:PbB, Y:$\delta$-ALAD activity). 7. In the histopathological findings of the kidney, the protective effect of calcium was observed. However, the protective effect of calcium was restricted in the group treated with lead + calcium + lactose. As a conclusion, the intensity of the acute ingested lead poisoning was obviously reduced by calcium, however, the protective effect of calcium was deteriorated in proportion with the concentration of the lactose to be administered. On the other hand, it was also noted that the deterioration was lightly restrained in the group treated with the physiological concentration of 80mM lactose than the results shown in the groups treated with lactose of other concentrations.
This study was carried out to evaluate the relationship between the biological lead exposure indices and air lead concentrations measured by personal air samplers. The 72 occupationally lead exposed workers were observed and the bioiogical lead Exposure indices chosen for this study were blood lead(PbB), urine lead(PbU), zinc protoporphyrin in whole blood(ZPP), $\delta$-aminolevulinic acid in urine(ALAU), $\delta$-aminolevulinic acid dehydratase activity (ALAD), coproporphyrin in urine(CPU) and hemoglobin(Hb). The workers were divided into four groups by air lead concentrations: Group I; under $0.05mg/m^3$, Group II; $0.05-0.10mg/m^3$, Group III; $0.10-0.15mg/m^3$ and Group IV; and over $0.15mg/m^3$. For evaluation the relationship between the biological lead exposure indices and air lead concentrations was used as correlation coefficients. The results obtained were as follows: 1. In Group I, II, III and IV, the mean value of PbB were $25.45{\pm}1.84{\mu}g/dl,\;27.87{\pm}3.53{\mu}g/dl,\;31.21{\pm}1.76{\mu}g/dl\;and\;47.02{\pm}13.96{\mu}g/dl$. Between Group IV and other groups showed statistically significant difference(p<0.05). 2. There was an increasing tendency of PbB, PbU, ALAU and ZPP according to the increase the mean air lead concentration, while ALAD has decreasing tendency. CPU and Hb did not show any constant tendency. 3. Correlation coefficients between PbB, PbU, ZPP, ALAU, ALAD, CPU, Hb and air lead concentration were 0.95, 0.83, 0.89, 0.72, -0.83, 0.51 and -0.45 respectively, and regression coefficient between PbB(Y) and PbA(X) was Y=126.8746X+16.9996(p<0.01).
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