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