Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- FHx of lead poisoning or parental work with lead
- cognitive impairment (children)
- behavioural changes (children)
- headaches (children)
- clumsiness and agitation (children)
- loss of appetite (children)
- constipation (children)
- somnolence (children)
- altered mental state
- cerebellar signs
- seizures
- coma
Other diagnostic factors
- colicky abdominal pain (adults)
- hypertension (adults)
Risk factors
- age 9 to 36 months
- housing with lead hazards
- occupational lead exposure
- lead-contaminated water supplies
- low socioeconomic status
- hobbies working with lead
- pica
- use of folk medications
- fetal exposure
- mineral-deficient and high-fat diets
- hand-to-mouth activity with toys and other objects
- working in bullet firing ranges
Diagnostic investigations
Investigations to consider
- 24-hour urine lead with chelation
- abdominal radiographs
- nerve conduction studies
Treatment algorithm
Contributors
Authors
Professor Emeritus of Pediatrics
Medical University of South Carolina
Charleston
SC
Disclosures
JRR declares that he has no competing interests.
Peer reviewers
NSF International Chair
Department of Environmental Health Sciences
Professor of Environmental Health Sciences, Epidemiology and Internal Medicine
University of Michigan Schools of Public Health and Medicine
Ann Arbor
MI
Disclosures
HH is an author of a reference cited in this monograph. HH has received research funding greater than 6 figures USD.
Chief
Occupational & Environmental Medicine
Cambridge Health Alliance
Associate Professor of Medicine
Harvard Medical School
Associate Professor of Environmental Health Sciences
Harvard School of Public Health
Boston
MA
Disclosures
None disclosed.
Dean
School of Medicine
Campbelltown Campus
University of Western Sydney
Australia
Disclosures
AJ declares that she has no competing interests.
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