Children can be severely affected by lead poisoning. Early screening with monitoring of children at high risk should be done to allow therapy and to prevent long term sequelae.
|
Blood Lead Level in µg/dL |
Associated Toxicity |
|
9 |
decreased IQ, decreased hearing, decreased growth |
|
12 |
developmental toxicity |
|
16 |
increased erythrocyte protoporphyrin |
|
20 |
decreased nerve conduction velocity |
|
30 |
decreased vitamin D metabolism |
|
40 |
decreased hemoglobin synthesis |
|
55 |
colic |
|
65 |
decreased longevity |
|
70 |
frank anemia |
|
80 |
encephalopathy, nephropathy |
|
130 |
death |
(Figure 28-5, page 990, Moyer 1999)
Comments:
• Blood specimens should be collected in lead-free tubes with lithium heparin or EDTA as the anticoagulant. An elevated blood level should be confirmed due to possibility of false positive levels from improper specimen collection.
• Children with elevated lead levels should also have their iron status determined.
|
Blood Lead Concentration in µg/dL |
CDC Class |
Comment |
|
<= 9 |
I |
• not considered to be lead poisoned |
|
10 - 14 |
IIA |
• implement communitywide lead poisoning prevention activities. • rescreen child more frequently |
|
15 - 19 |
IIB |
• start nutritional and educational interventions • more frequent screening. • If the blood level persists in this range, environmental investigation and intervention should be done. |
|
20 - 44 |
III |
• perform environmental evaluation and remediation • medical evaluation with frequent screening • child may need pharmacologic treatment for lead poisoning. |
|
45 - 69 |
IV |
• medical intervention including chelation therapy should be started • perform environmental interventions |
|
>= 70 |
V |
• a medical emergency • Medical and environmental management must begin immediately. |
Specialty: Toxicology, Emergency Medicine, Critical Care, Pedatrics
