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Lead toxicity

Последний просмотренный: 20 Aug 2025
Last updated: 09 Jun 2023

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
Полная информация

Другие диагностические факторы

  • colicky abdominal pain (adults)
  • hypertension (adults)
Полная информация

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
Полная информация

Диагностические исследования

Исследования, которые показаны в первую очередь

  • whole-blood lead level
  • complete blood count
  • serum ferritin
Полная информация

Tests to avoid

  • post-chelator challenge urinary metal testing
  • hair or nail testing
  • heavy metal screening test
Полная информация

Исследования, проведение которых нужно рассмотреть

  • 24-hour urine lead with chelation
  • abdominal radiographs
  • nerve conduction studies
Полная информация

Алгоритм лечения

Острый

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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

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