Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- family history of lead poisoning or parental work with lead
- cognitive impairment (children)
- behavioral changes (children)
- headaches (children)
- clumsiness and agitation (children)
- loss of appetite (children)
- constipation (children)
- somnolence (children)
- altered mental state
- cerebellar signs
- seizures
- coma
Другие диагностические факторы
- colicky abdominal pain (adults)
- hypertension (adults)
Факторы риска
- 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
- bullet firing ranges
Диагностические исследования
Исследования, которые показаны в первую очередь
- whole-blood lead level
- complete blood count
- serum ferritin
Tests to avoid
- post-chelator challenge urinary metal testing
- hair or nail testing
- heavy metal screening test
Исследования, проведение которых нужно рассмотреть
- 24-hour urine lead with chelation
- abdominal radiographs
- nerve conduction studies
Алгоритм лечения
all patients
Составители
Авторы
J. Routt Reigart, MD
Professor Emeritus of Pediatrics
Medical University of South Carolina
Charleston
SC
Раскрытие информации
JRR declares that he has no competing interests.
Рецензенты
Howard Hu, MD, MPH, ScD
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
Раскрытие информации
HH is an author of a reference cited in this topic. HH has received research funding greater than 6 figures USD.
Rose H. Goldman, MD, MPH
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
Раскрытие информации
None disclosed.
Alison Jones, MD, FRCPE, FiBIOL, FRCP, FRACP
Dean
School of Medicine
Campbelltown Campus
University of Western Sydney
Australia
Раскрытие информации
AJ declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Centers for Disease Control and Prevention (CDC). Understanding blood lead levels. Adult Blood Lead Epidemiology and Surveillance (ABLES). National Institute for Occupational Safety and Health (NIOSH) workplace safety & health topics. Apr 2023 [internet publication].Полный текст
Centers for Disease Control and Prevention (CDC). Blood lead levels: United States, 1988-1991. MMWR Morb Mortal Wkly Rep. 1994;43:545-548.Полный текст Аннотация
Harvey B, ed. Managing elevated blood lead levels among young children: recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention. Atlanta, GA: CDC; 2002.Полный текст
Centers for Disease Control and Prevention (CDC). Adult blood lead epidemiology and surveillance - United States, 2008-2009. MMWR Morb Mortal Wkly Rep. 2011 Jul 1;60(25):841-5.Полный текст Аннотация
Mahaffey KR. Nutrition and lead: strategies for public health. Environ Health Perspect. 1995;103(suppl 6):191S-196S.Полный текст Аннотация
Nussbaumer-Streit B, Mayr V, Dobrescu AI, et al. Household interventions for secondary prevention of domestic lead exposure in children. Cochrane Database Syst Rev. 2020 Oct 6;10:CD006047.Полный текст Аннотация
Yeoh B, Woolfenden S, Lanphear B, et al. Household interventions for preventing domestic lead exposure in children. Cochrane Database Syst Rev. 2014;(12):CD006047.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Iron deficiency anemia
- Non-lead peripheral neuropathy
- Arsenic poisoning
Больше ОтличияРекомендации
- Childhood lead poisoning prevention
- WHO guideline for clinical management of exposure to lead
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