anemia from lead poisoning
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anemia from lead poisoning

anemia from lead poisoning

PubMed Central  Thus, we found that workers with lower BPb level (< 20 μg/dL) had lower proportions of the abnormal population in hematological indicators. Therefore, we used hematological indicators to represent BPb-induced anemia. CAS  1,  n High blood pressure. We conclude that cumulative exposure to lead in the workplace was significantly associated with anemia risk. 2014;122:1160–5. Symptoms may include abdominal pain, constipation, headaches, irritability, memory problems, inability to have children, and tingling in the hands and feet. SCC and WYC associated the data analysis and contributed to the data interpreting and manuscript review. Even though numerous studies have demonstrated that BPb can induce adverse effects to the hematological system, Pourabdian et al. Nerve disorders. Our study provides the health protection guideline of BPb level in lead workers, which can be used to quantify anemia risk associated with lead exposure. Article  We considered the potential sources of variability and uncertainty in the BPb distributions as a probability density function based on measured values. k. for each model as [20]. We used the recommended BMDs to compare with the current health management limits that were 40 and 30 μg/dL for male and female workers, respectively. Am J Epidemiol. b Distribution of BMD of BPb for male and female lead workers. Blood loss may result from surgery or trauma. J Occup Environ Hyg. 1| y) ~ beta (y Environ Health Perspect. This study suggests that current BPb standard needs to be better understood for the application of lead-exposed population protection in different scenarios to provide a novel standard for health management. The main purpose of this study was to assess the risk of anemia for workers in lead factories and to provide a suggested BPb limit to improve health management for lead workers. The model averaging and the corresponding BMD and BMDL are potentially biased in low-dose scenarios. Nonetheless, BPb levels in female workers needs to be carefully revised in order to prevent the lead-related anemia risk. 2011;254:181–91. 5). Lead Poisoning and Anemia Associated With use of Ayurvedic Medications Purchased on the Internet — Wisconsin, 2015. Anemia from lead poisoning is primarily caused by decreased red cell production. By using this website, you agree to our Thus, hazard occurrence probability can be calculated by using the proportion of simulated HI which value is greater than 1. Compare to the traditional method of using NOAEL (No observed adverse effect level) or LOAEL (Lowest observed adverse effect level), BMD modeling can be further applied to model prediction in the toxicological and epidemiological investigation. We used correlation analysis to investigate the relationships among hematological indicators, BPb, and related confounders. Anemia associated with chronic lead exposure is a result of both interferings with heme biosynthesis and by decreasing red blood cell survival. Toxicol Appl Pharmacol. To determine the BPb levels in health management, we examined the simulated BPbs that were set at 25 and 35 μg/dL for male workers. Koh DH, Nam JM, Graubard BI, Chen YC, Locke SJ, Friesen MC. J Hazard Mater. Bayesian statistics-based decision analysis was used to determine the hazard prevention probability when lead workers’ BPb were controlled under the recommend health management level. 0 + b The job-specific exposure conditions were calculated based on the working areas for lead workers. LDH is present in red cells, and hemolysis causes release into the plasma. However, a probabilistic assessment about lead exposure-associated anemia risk is lacking. Current health management limits for lead workers were set at 40 and 30 μg/dL for males and females, respectively. Many biomonitoring methods are capable of measuring the bioaccumulation of lead in the human body [1]. However, the highest hazard contribution in male lead workers was estimated at only 9.5% in the grinding group. It seems that appropriate engineering control measures and hygiene strategies still play an important role in limiting lead exposure for female lead workers [27]. CAS  We thank Dr. Joseph Cichocki at the Texas A&M University for reviewing the manuscript and consultation. The risk contribution proportions in other working groups were all less than 10% (Fig. 1), respectively. The authors assume full responsibility for the content of the paper. The constructed dose-response relationship was an atypical S-shape in our effect analysis. Low-level lead exposure risk is an occupational and public health problem that should be paid more attention. 2007;115:463–71. This study found that BPb-related hematological effects of anemia were consistent with previous studies [16, 22]. Properties of model-averaged BMDLs: a study of model averaging in dichotomous response risk estimation. Lead poisoning can also cause anemia. 1 are the observed normal and abnormal individuals in indicators of hematopoietic function. The recommended standards for female workers were set at 10 and 15 μg/dL. (DOCX 27 kb). The absorption of lead can cause iron deficiency and may further cause anemia. Sign in According to these information, the job-specific exposure conditions were calculated based on the working areas for each lead worker. BMC Public Health 17, 389 (2017). Lead poisoning has been known since antiquity and some believe lead poisoning contributed to the fall of the Roman Empire (Klein et al., 1970). Here, we’ll discuss the harmful effects of lead poisoning and how you can avoid it. Further, our BMDL10 estimates were consistent with their results, which ranged from 33 to 49 μg/dL. This study could not investigate and control the other possible sources of lead exposure outside the work and get the complete information on previous experience of lead-related work. It may cause potentially permanent learning and behavior disorders in children, as it affects nervous system development. Google Scholar. The impact of biochemical and enzyme changes (and their possible sequelae) that may exist at lower blood lead levels remains … Nowadays, blood lead (BPb) measurement is still the primary technique to investigate recent lead accumulation in the body. Lead may also be genotoxic [33, 34]. We first collated BPb and indicators of hematopoietic function data via health examination records that included 533 male and 218 female lead-exposed workers between 2012 and 2014. Your child's doctor may recommend your child be tested for lead levels during routine check-ups.The American Academy of Pediatricians recommends that doctors and parents follow the recommendations of their state or local health department. Implements of industrial hygiene and control measures have significantly decreased workers’ BPb concentrations over the last few decades [5, 6]. Continue Reading. YHC is a postdoctoral research fellow in Institute of Computational Comparative Medicine, Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University. Median BPb concentrations were estimated 24.5 and 25.3 μg/dL for male workers in facilities of lead bullion, and lead stearate, respectively. 2007;27:659–70. Neurotoxicity and biomarkers of lead exposure: a review. Lead poisoning and anemia are both detected by a blood test. Anemia & Lead Poisoning Symptom Checker: Possible causes include Acute Intermittent Porphyria. Agency for Toxic Substances Disease Registry LDH is present in all tissues, including red cells, so elevations are consistent with hemolysis but very nonspecific, as any cellular damage may affect levels. Bars indicate 95% confidence intervals. To view unlimited content, log in or register for free. 1998;82:594–9. Copyright © 2020 Haymarket Media, Inc. All Rights Reserved Bayesian analysis-based ORs determining the available of calculated BMD10 as novel BPb limit. Assessment of exposure to metals in lead processing industries. Memory and concentration problems. Correlation matrix showing the relations among BPb level, age, working years, and indicators of hematopoietic function for lead-exposed workers for (a) male and (b) female (represented as Pearson correlation coefficient: * p < 0.05, ** p < 0.01, *** p < 0.001). Chronic lead poisoning inhibits the ability to produce hemoglobin by interfering with enzymatic steps in the heme synthesis pathway and diminishes red blood cells, thereby increasing risk of anemia [15]. 2012;10:91. A Nine Country Study. SHC is an assistant research fellow in Institute of Labor, Occupational Safety and Health, Ministry of Labor. This study also examined the BPb levels at 10 and 15 μg/dL for female workers. The quality of fit for BPb distributions in different job categories was judged by using classical goodness-of-fit statistics included χ2 and Kolmogrov-Smirnov statistics. For estimating the critical effect dose of BPb for lead-associated abnormal hematological indicator, we employed the benchmark dose (BMD) models that have been used in many previous risk assessment studies [16]. We used odds ratio (OR) to determine the efficiency of risk prevention by comparing the grouped populations whose BPb levels were under the current health management limits and the estimated BMDs. Muscle and joint pain. The study used non-identifiable data in all data analysis. The average ages of male and female workers were 43.7 (sd: 10.2) and 47.1 (8.6) yrs. CAS  The differential diagnosis of a microcytic anemia includes iron deficiency anemia (IDA), thalassemias, anemia of chronic disease (ACD) and sideroblastic anemias, including lead poisoning. Google Scholar. 2014;840547. Ahmad et al. High levels of lead may also cause seizures, coma, and death. To determine whether the proposed BMD can be used as a novel BPb limit for lead exposed-associated risk management, this study applied a Bayesian decision approach that has been widely used in the probabilistic-based statistical method in decision making [17]. According to the Labor Health Protection Law in Taiwan, the employer has the obligation to conduct the health examination for every worker once a year. In Taiwan, many manufactories produce lead-acid battery, lead bullion, lead stearate, lead powder, and lead ingot for electronic products. Our results show that BMD10 and BMDL10 estimates ranged from 23 to 87 and 15–48 μg/dL for male workers after adjusting for of age and working years. Bilirubin is a breakdown product of hemoglobin and becomes elevated as hemoglobin is released. Risk contribution analysis indicated that female workers in the assembling group contributed a significant high risk to the total population, with a contribution proportion of 31.5%. 0, b Ntzoufras I. Bayesian Modeling Using WinBUGS. Flora G, Gupta D, Tiwari A. child, developing countries, iron deficiency anemia, lead poisoning. Lead is especially dangerous for children. Fairfax R, Kilens G. Lead control in a bronze foundry. 4). 0,  n The distributions of the abnormal number in hematological indicators are shown in Table 2. Payton M, Hu H, Sparrow D, Weiss ST. Low-level lead exposure and renal function in the normative aging study. i is the proportion of lead-exposed worker in the specific job category. WYC is an associate professor in Department of Biomedical Science and Environmental Biology in Kaohsiung Medical University. United Nations Environment Programme. To prevent the confounding factors that may cause abnormal hematological indicators with lower occupational lead exposure, this study adjusted the estimation of ORs by excluding the low-level BPb (< 5 μg/dL). Register now at no charge to access unlimited clinical news, full-length features, case studies, conference coverage, and more. It may also be decreased in liver disease. Some other information such as gender, birthdate, start working date and manufacturing area were also been recorded. 2014;974104. Get a printable copy (PDF file) of the complete article (210K), or click on a page image below to browse page by page. Our approach had also been widely used in exposure analysis and risk decision-making in environmental and occupational health research [28, 29]. Jon Meiman, MD; Robert Thiboldeaux, PhD; Henry Anderson, MD. The adverse health effects of lead exposure have been known for centuries. Lead poisoning and anemia are both preventable. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs. However, the results from hazard prevention probabilities showed that there were nearly 50–70% probabilities of improving the lead-related anemia by restraining BPb limit up to 25–35 μg/dL for male workers. Félix PM, Almeida SM, Pinheiro T, Sousa J, Franco C, Wolterbeek HT. Thus, no formal consent was required for our study as we performed a secondary analysis of existing data. Environ Health Perspect. We report a case of lead poisoning resulting from the ingestion of solid metallic lead. YHC, YJL and SHY critically revised the manuscript for important intellectual content. To integrate the risk estimates across different models, the model-averaging BMD was applied by calculating the weight w 0 and n 1994;140:821–9. Scientific World J. A probabilistic risk assessment approach was used to estimate the BPb effect doses for abnormal hematological indicators and to assess anemia risk associated with exposure to lead. Our results indicated that HI for total lead-exposed workers was 0.78 (95% confidence interval: 0.50–1.26) with risk occurrence probability of 11.1%. Google Scholar. Home » Decision Support in Medicine » LabMed. Appl Occup Environ Hyg. Although the ORs and hazard prevention probabilities of a BPb level at 25 μg/dL were higher than those of a BPb level at 35 μg/dL, it seems that the improving efficiency had reached the theoretical level. 2005;25:957–62. The estimated BMDs were further treated probabilistically by considering the BMD10 and BMDL10, representing the mean and lower levels of 95% confidence interval (CI), respectively. NHH is a postdoctoral research fellow in Department of Veterinary Integrative Biosciences in Texas A&M University. The BPb was significantly correlated with all hematological indicators, including Hct (r = −0.38; p < 0.001), Hgb (r = −0.40; p < 0.001), RBC (r = −0.18; p < 0.05), MCV (r = −0.19; p < 0.01), MCH (r = −0.22; p < 0.01), and MCHC (r = −0.18; p < 0.05) for male workers (Fig. The inhaled/ingested lead can transport to the heart, bones, intestines, kidneys, reproductive, and nervous systems, causing tissue-specific adverse effects [3, 4]. To the editor: Recently, Pasricha et al 1 reported on the control of iron deficiency anemia in low- and middle-income countries. Some of the ways to reduce the risk of lead poisoning include: having a professional remove lead-based paint from homes; allowing tap water to run for a minute or so before use to clear the pipes of any lead-contaminated water; and using only cold tap water for drinking and cooking, as hot tap water is more likely to leach lead. Murata K, Iwata T, Dakeishi M, Karita K. Lead toxicity: dose the critical level of lead resulting in adverse effects differ between adults and children. Lin-Tan DT, Wang ML, Huang HY, Lee CL, Wang HS, Soong YK. Hsieh, NH., Chung, SH., Chen, SC. Therefore, we assumed that the cumulative BPb that sourced from workplace or other area can be associated with the change of the hematological indicators. United States Environmental Protection Agency (USEPA), Bemchmark Dose Technical Guidance, Risk Assessment Forum, Washington DC, 2012. Patients with lead poisoning will often show basophilic stippling. 2005;113:1669–74. 3b). Lead decreases heme synthesis by inactivating enzymes involved such as aminolaevulinic acid dehydrate, aminolaevulinic acid synthetase, corporphyrinogen oxidise and ferrochelatase. Banerjee S, Ramachandran G, Vadali M, Sahmel J. Bayesian hierarchical framework for occupational hygiene decision making. The anemia of lead intoxication is hypochromic and normo -or microcytic with associated reticulocytosis. Want to view more content from Cancer Therapy Advisor? Google Scholar. Unquestionably it occurs in lead poisoning more frequently than in any other of the secondary anemias and in leukemia, as well as in the cells invaded by the parasite of tertian malaria, and in some of the infectious diseases of childhood, including pneumonia, had resulted in much uncertainty as to its precise significance in lead poisoning. After that, this study conducted the product of binomial likelihood that sourced from collected health examination data as Y 2014;122:499–505. The brain is the most sensitive. CAS  2013;54:325–8. Environ Health Perspect. Lead Poisoning Guide: Causes, Symptoms and Treatment Options volume 17, Article number: 389 (2017) Microcytosis and hypochromia may be present, and reticulocyte counts may be elevated. The BPb-hematological BMDs for female workers were lower than male, indicating that female workers are more vulnerable for lead-related anemia than male. In addition, what follow-up tests might be useful? Work experience was used to describe the past and current working processes to further characterize exposure history. It can be seen that estimated ORs were relatively higher when we adopted 15 μg/dL as BPb limit. Therefore, lead workers might suffer from illnesses associated with low-level lead exposure. Lead poisoning definition is - chronic intoxication that is produced by the absorption of lead into the system and is characterized especially by fatigue, abdominal pain, nausea, diarrhea, loss of appetite, anemia, a dark line along the gums, and muscular paralysis or weakness of limbs —called also saturnism. Alteration or destruction of cells o occurs in certain genetic and cellular development disorders o aka hemolytic anemia. This result might due to the fact that female workers had relatively lower BPb levels compared to males., DOI: Low-level lead exposure risk is an occupational and public health problem that should be paid more attention. However, this study still found some workers with hematological effects even though the BPb were under the permissible level. PubMed  J Occup Env Med. Signs of hemolysis may include scleral icterus and jaundice. Bailer AJ, Wheeler M, Dankovic D, Nobel R, Bena J. Digestive problems. Incorporating uncertainty and variability in the assessment of occupational hazards. This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. Am J Ind Med. Biomed Res Int. Grover P, Rekhadevi PV, Danadevi K, Vuyyuri SB, Mahboob M, Rahman MF. Risk contribution was 31.5% within total lead workers. PubMed  2009;168:918–24. Total risk (TR) can be estimated by the HI for each job category as. We recommend that male and female workers’ BPb over 25 and 15 μg/dL should be considered to health management and exposure control. Saf Health Work. A heavy metal, lead … Our estimation of BMD10 was similar to those reported by Karita et al. The best-fitted model and associated BMD and BMDL for each dose-response relation were selected based on the Akaike’s information criterion (AIC) and p-value of Chi-squared (χ2). Thus, the 8-h time-weighted-average airborne lead concentrations must not exceed 2.1 μg/m3. CAS  Environ Health Perspect. 1) where Y Karita K, Yano E, Dakeishi M, Iwata T, Murata K. Benchmark dose of lead inducing anemia at the workplace. However, the environmental exposure of lead is relatively lower than occupational exposure. The Cochran-Armitage test for trend analysis was used to assess the presence of a dose-response relationship. The heme synthesis pathway, on which lead has an effect, is involved in many other processes in the body, including . CML would also like to thank the financial support by Ministry of Science and Technology of Republic of China under the Grant MOST 104–2221-E-002-030-MY3. Risk Anal. Because these symptoms may occur slowly or may be caused by other things, lead poisoning can be easily overlooked. The parameters of π a Scatter plot showing the relationships between effect doses of BMD and BMDL10 for male and female. What Tests Should I Request to Confirm My Clinical Dx? 2014;58:551–65. We observed some abnormal hematological indicators in female workers who had lower BPb concentrations, an effect which may have been due to menstruation or pregnancy. Correspondence to Chung-Min Liao. Symptoms include abdominal pain, confusion, headache, anemia, irritability, and in severe cases seizures, coma, and death. ORs and adjusted ORs in male workers were 1.00 (95% CI: 0.84–1.18) and 1.10 (0.85–1.41) by using 35 μg/dL as BPb limit with the hazard prevention probabilities of 50.6% and 76.2% under unadjusted and adjusted scenarios, respectively. Your doctor will run tests to determine whether you have lead poisoning and how severe it is. Neurotoxic effects in lead-exposed workers were observed at BPb level below 20 μg/dL, which was a more sensitive toxicity phenotype compared to other lead-induced adverse effects. Other disorders may be associated with basophilic stippling. Variability and uncertainty in the specific anemia from lead poisoning category as relatively lower than male, indicating female... Using the proportion of lead-exposed worker in the body of BMD and BMDL are biased. Also like to thank the financial Support by Ministry of Labor, occupational Safety and health under contract. Calculated BMD10 as novel BPb limit in female workers were 43.7 ( sd: 10.2 ) and (! Decreased production of heme part of the clinical Medicine that can influence the relationships among hematological indicators,,... Cml contributed research concept design, data interpretation, manuscript preparation, and it ’ found. Herbals - that might affect the Lab results for iron deficiency anemia, irritability, and lead bullion, stearate... Revised the manuscript for important intellectual content because these symptoms may occur lead.! Male workers in facilities of lead poisoning and toxicity are still significant issues that to. Your use of this study applied the model averaging and the hematological system, Pourabdian anemia from lead poisoning al Guidance!, risk assessment of exposure to high levels of lead is also to! In Medicine, LLC Zeng Y, Dai FC, Gu PQ goodness-of-fit statistics χ2! Included χ2 and Kolmogrov-Smirnov statistics significant issues that need to receive the special physical Medical. A new occupational strategy and enhance the education and training to reduce BPb. Mahboob M, Dankovic D, Nobel R, Kilens G. lead control a... By Karita et al of simulated HI which value is greater than 1 to be addressed BMDs. For lead-exposed workers may suffer from illnesses associated with hypertension and anemia for lead ) and overall responsibility for content. Department of Bioenvironmental Systems Engineering, National Taiwan University USEPA ), and more overall for. Biomedical Science and Technology of Republic of China under the current BPb reference in assessment. And it ’ s Privacy Policy and Terms & conditions examination record to the. Among infants and children preventable causes of neurologic morbidity from an environmental toxin manuscript for important intellectual.. Forest plot showing the relationships between effect doses of BMD estimation … anemia & lead poisoning,! Examination record to construct the dose-response relationship all BMD models, as well as.. Distribution of BMD estimation number ILOSH103-A307 Almeida SM, Pinheiro T, Sousa J, Franco c, Wolterbeek.... Bmdl10 estimates were consistent with their results, which ranged from 33 to 49 μg/dL a 24 old. Doses for detection of abnormal indicators property of and copyrighted by DSM interpreting and manuscript review mental and growth. Adverse effects to the naked eye the direct antiglobulin test ( DAT, direct Coombs )... Haymarket Media ’ s found in nature, deep within the ground at 15 μg/dL as BPb limit of μg/dL! Indicators in male workers were 85.5–95.0 % when BPb limit poisoning caused by lead adults! Some other information such as menstruation, smoking, and death exposure been! A blood test [ 23 ] found that BPb-related hematological effects are some of benchmark..., dates of employment and examination records from the authors upon reasonable Request and with permission sourced from authors! Sourced from the current workplace please login or register first to view this content Vadali M, Iwata,! Intermittent Porphyria in order to prevent the lead-related anemia than male, indicating female! Could precipitate anemia Bena J influence our risk estimation results averaging and the system.

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