Lead poisoning classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aksiniya K. Stevasarova

Overview

  • Lead poisoning or Lead intoxication is defined as exposure to high levels of lead associated with clinical symptoms.[1].
  • Poisoning is defined as symptoms that occur with toxic effects from high levels of exposure;
  • Toxicity is a wider spectrum of effects, including the subclinical ones-that do not cause symptoms.[2]
  • However, we often use "lead poisoning" and "lead toxicity" interchangeably, and official sources do not always restrict the use of "lead poisoning" to refer only to symptomatic effects of lead.[2]

Classification

  • There is no established system for the classification of lead poisoning.
  • Based on the amount of lead in the blood and tissues, as well as the time of exposure, lead poisoning may be classified as either acute (from intense exposure of short duration) or chronic (from repeat low-level exposure over a prolonged period), but the latter is much more common.[3]


Diagnosis and treatment of lead exposure are based on blood lead level (the amount of lead in the blood), measured in micrograms of lead per deciliter of blood (μg/dL). Urine lead levels may be used as well, though less commonly. In cases of chronic exposure lead often sequesters in the highest concentrations first in the bones, then in the kidneys. If a provider is performing a provocative excretion test, or "chelation challenge", a measurement obtained from urine rather than blood is likely to provide a more accurate representation of total lead burden to a skilled interpreter.[4]

Lead forms a variety of compounds and exists in the environment in various forms.[5] Features of poisoning differ depending on whether the agent is an organic compound (one that contains carbon), or an inorganic one.[6] Organic lead poisoning is now very rare, because countries across the world have phased out the use of organic lead compounds as gasoline additives, but such compounds are still used in industrial settings.[6] Organic lead compounds, which cross the skin and respiratory tract easily, affect the central nervous system predominantly.[6]


The US Centers for Disease Control and Prevention and the World Health Organization state that a blood lead level of 10 μg/dL or above is a cause for concern; however, lead may impair development and have harmful health effects even at lower levels, and there is no known safe exposure level.[7][8] Authorities such as the American Academy of Pediatrics define lead poisoning as blood lead levels higher than 10 μg/dL.[9]

OR

  • The staging of [malignancy name] is based on the [staging system].

OR

  • There is no established system for the staging of [malignancy name].

References

  1. Grant (2009) p. 785
  2. 2.0 2.1 Guidotti, TL; Ragain, L (2007). "Protecting children from toxic exposure: three strategies". Pediatric clinics of North America. 54 (2): 227–35, vii. doi:10.1016/j.pcl.2007.02.002. PMID 17448358.
  3. Trevor, Katzung, Masters (2007) p. 479
  4. Lowry, Jennifer A. (2010) ORAL CHELATION THERAPY FOR PATIENTS WITH LEAD POISONING Archived 2016-01-26 at the Wayback Machine.. WHO
  5. Grant (2009) p. 761
  6. 6.0 6.1 6.2
  7. Barbosa Jr, F; Tanus-Santos, JE; Gerlach, RF; Parsons, PJ (2005). "A Critical Review of Biomarkers Used for Monitoring Human Exposure to Lead: Advantages, Limitations, and Future Needs". Environmental Health Perspectives. 113 (12): 1669–74. doi:10.1289/ehp.7917. PMC 1314903. PMID 16330345.

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