Lead toxicity and chelation therapy

Rebeca C. Gracia, Wayne R. Snodgrass

Research output: Contribution to journalArticle

95 Citations (Scopus)

Abstract

Purpose. Common sources of lead exposure, the primary clinical effects of lead toxicity, and current recommendations for managing lead toxicity, including chelation therapy, are reviewed. Summary. Common sources of lead exposure in children and adults include industrial and mining activities, paint, dust, soil, water, air, the workplace, food, trinkets, ethnic folk remedies, and cosmetics. The absorption and biological fate of lead are affected by a variety of factors, including an individual's nutritional status, health, and age. Children with a blood lead concentration of >10 μg/dL and adults with a blood lead concentration of ≥45 μg/dL should undergo further evaluation. Symptoms and time to onset of symptoms postexposure may vary, and it can be difficult to identify the early, subtle neurologic effects of lead toxicity. The classic symptoms of lead toxicity generally correlate with blood lead concentrations of 25-50 μg/dL in children and 40-60 μg/dL in adults. Management of lead toxicity requires extensive risk assessment and caregiver education. Chelation is generally not indicated for adults with blood lead concentrations of <45 μg/dL because of the potential risk of adverse drug events and concerns about remobilized lead, and chelation for children with blood lead concentrations of <45 μg/dL remains controversial. Dimercaprol, edetate calcium disodium, and succimer are the three agents primarily used for chelation. Conclusion. Lead toxicity remains a significant public health concern. Elimination of elevated blood lead levels in children can be accomplished by educating appropriate health care providers and caregivers, recognizing potential lead sources, and adopting aggressive prevention and case management measures.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalAmerican Journal of Health-System Pharmacy
Volume64
Issue number1
DOIs
StatePublished - Jan 1 2007

Fingerprint

Chelation Therapy
Caregivers
Lead
Succimer
Dimercaprol
Paint
Case Management
Traditional Medicine
Drug-Related Side Effects and Adverse Reactions
Nutritional Status
Dust
Edetic Acid
Cosmetics
Workplace
Health Personnel
Nervous System
Soil
Public Health

Keywords

  • Absorption
  • Age
  • Antidotes
  • Blood levels
  • Case management
  • Dimercaprol
  • Drugs, body distribution
  • Edetate calcium disodium
  • Heavy metal antagonists
  • Lead
  • Pediatrics
  • Poisoning
  • Succimer
  • Toxicity

ASJC Scopus subject areas

  • Pharmaceutical Science
  • Leadership and Management

Cite this

Lead toxicity and chelation therapy. / Gracia, Rebeca C.; Snodgrass, Wayne R.

In: American Journal of Health-System Pharmacy, Vol. 64, No. 1, 01.01.2007, p. 45-53.

Research output: Contribution to journalArticle

Gracia, Rebeca C. ; Snodgrass, Wayne R. / Lead toxicity and chelation therapy. In: American Journal of Health-System Pharmacy. 2007 ; Vol. 64, No. 1. pp. 45-53.
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