Document 2yjzZEG4Nx5endGR49QpyoQg

DEPARTMENT OIF HEALTH AND HUMAN SERVICES - PUBLIC HEALTH SERVICE CENTERS FOR DISEASE CONTROL, ATLANTA, GEORGIA 30333 TEH 0531820 N33770 ENV1RONM HEALTH B1BLIO 00-3832 DEPARTMENT OF HEALTH AND HUMAN SERVICES - PUBLIC HEALTH SERVICE CENTERS FOR DISEASE CONTROL, ATLANTA, GEORGIA 30333 TEH 0531821 r DUP050032318 Prepared by Centers for Disease Control Center for Environmental Health Publications Activities Editor: Anne A. Olin Atlanta, Ga. 30333 Trade names are used for identification only and do not represent an endorsement by the U.S. Department of Health and Human Services or the Public Health Service. TEH 0531822 DUP050032319 Foreword Environmental Health Abstracts and Bibliography presents a survey of recently published literature in the field. Effort is made to keep the abstracts as current as possi ble and sufficiently informative to enable the reader to decide whether the original arti cle would be of interest to him or her. The journals in which articles originally appeared should be checked for reprint addresses. The Centers for Disease Control (CDC) is unable to supply reprints ofarticles cited in this publication. In compiling these abstracts we use the National Library of Medicine's (NLM's) in teractive retrieval service, MEDLARS II. Under this system, both foreign and domes tic biomedical periodicals are searched for material dealing with or related to environ mental health. We also use the libraries of Emory University, CDC, and other federal agencies. Abbreviations of periodical titles are those used by MEDLARS and listed in NLM's List ofJournals Indexed in Index Medicus. Future issues of Environmental Health Abstracts and Bibliography mil be devoted to various environmental health topics. Individuals wanting to be placed on the mailing key to receive future issues as published should write to the Environmental Health Ser vices Division, Center for Environmental Health, Centers for Disease Control, Atlan ta, Georgia 30333. Vernon N. Houk, M.D. Director Environmental Health Services Division iii TEH 0531823 `Mfa* Vi* DUP050032320 Contents FOREWORD ............ ................................... ........................... ........... ......................... iii GENERAL......... .................. ................. ............ .................. ......... ................................ 1 SOURCES AND ETIOLOGY .................... ........................................... ...........4 DIAGNOSIS AND SCREENING .......... ................................. .................................... 8 EPIDEMIOLOGY ................ ...................... ...................... ........................................ 13 RESEARCH AND EVALUATION - 19 THERAPY 27 v TEH 0531824 DUP050032321 GENERAL Is Low-Level Lead Pollution Dangerous? D. Gloag. BR MED J 1980 Dec 13;281 (6255):1622~5. From author's conclusions: The inferences drawn from the published work about children's susceptibility to the effects of modest concentra tions of lead differ widely. One report concludes that there is probably no threshold for toxicity and that neurotoxic effects are liable to occur above a lead concentration of 5 ppm in dentine and 0.24 /xmol/1 (5 /xg/100 ml) in blood. Another report concludes that there were toxic effects above 3.9 ftmo 1/1 (80 /xg/100 ml) and that there was no con vincing evidence of effects below about 1.7 /xmol/1 (35 /*g/100 ml). Although the research findings are "somewhat contradictory," the evidence sug gests slight cognitive impairment (an average of one to five points' reduction) and, possibly, behav ioral difficulties as a result of persistently raised blood lead concentrations over 1.9 /xmol/1 (40 /xg/100 ml); with concentrations below this, there are pointers to psychological risks, but the evi dence is inconclusive. Residual Effects of Lead Poisoning on Denver Developmental Screening Test Scores S.C. Kirkconnell and L.E. Hicks. J ABNORM CHILD PSYCHOL 1980 Jun;8(2):257-67. Authors' abstract: Subtest and total scores on the Denver Developmental Screening Test Were examined for a group of 22 preschool-aged lowincome children who had been lead poisoned, then medically deleaded. Pretest scores were obtained before blood lead elevations occurred; posttest scores were obtained an average of 4.5 months after deleading. Pretest scores were comparable with those of a matched control group, but posttest scores on the Fine Motor-Adaptive subtest de clined, indicating significant residual effects of lead poisoning. Some Comments on the 1980 Report of the United Kingdom DHSS Working Party on Lead in the Environment M.J. Duggan. SCI TOTAL ENVIRON 1980 Dec;16(3):285- 91. Children and Lead: Some Remaining Doubts (Editorial) Anonymous. ARCH BIS CHILD 1980 Jul; 55(7):497-9. This editorial summarizes the conclusions of two comprehensive and authoritative reports on the effects of lead on the health and development of children. Although neither report conclusively confirmed a link between moderate body lead burdens (insufficient to cause obvious poisoning) and neuropsychological impairment, the majority of studies suggest such an adverse effect. Calculations suggest that the average city child derives 55%-95% of his blood lead from food, 0%-40% from water, and 396-10% from air. Inhaled lead thus appears relatively unimportant. Priority should be given to removing lead-based paint from old houses, reducing lead in tap water in those areas where plumbosolvent water is drawn through lead pipes, and reducing emissions of lead into the air from gasoline. . A Department of Health and Social Security (DHSS) Working Party was appointed in 1978 to review the overall effects on health of environmen tal lead from all sources, particularly its effects on children's health and development, and to assess the contribution lead in gasoline makes to the body burden. Present author criticizes the Working Party's Report, which was published in March 1980, for a lack of emphasis on the exposure of children. The author is also critical of other aspects of the Report: "The Report does not deal with lead in dust and soil in a very unified way and plays down the importance of the contribution from petrol-derived lead by its emphasis on other sources--for example, paint, emissions from lead works, and such miscellaneous sources as the leadbased cosmetics used by the Indian community." The Report concludes that lead in gasoline is not an important contributor to the lead body burden in children and that the blood-lead level of this population is not high enough to give cause for concern. Author maintains that the Working Party, in reaching its conclusions, concentrated on adult rather than child exposure, and did not con- TEH 0531825 DUP050032322 sider data (from other countries) which suggest Armenia in antiquity. The most commonly mined marked urban/suburban or urban/rural ratios for lead ore in Asia Minor in antiquity was galena, an I children's blood-lead levels. easily mined yet relatively nontoxic substance. Lead products were used in cosmetics in ancient Lead Poisoning: A Historic View E. Morris. OCCUP HEALTH (LOND) 1980 Sep; 32(9):449-59. Mesopotamia by both sexes. In view of the wide spread use of lead in trade and industry and of colored lead salts for cosmetic purposes, it is surprising that cases of overt plumbism are not fre From author's discussion: Of all the diseases known to medicine, few have been so widely stud ied and described as lead poisoning. Between the years 1500 and 1900 it reached almost epidemic proportions in many countries. The main symptom was severe, persistent abdominal pain, leading in many cases to eventual death. A milestone in the gradual awareness of the harmful effects of lead was the investigation in 1767 by Sir George Baker of an ailment known as Devonshire Colic. Baker noticed an analogy be tween lead colic and Devonshire Colic, an ailment which frequently befell people who drank cider quently mentioned in Akkadian literature, but this is not the case. Although inhabitants of Mesopota mia, Greece, and Rome were all exposed to toxic lead salts, the degree of plumbism must have varied markedly between these different societies. Mesopotamian burial practices, however, left skeletal material exposed to acid soils and subsur face water, so it is hardly surprising that the ar chaeologists concerned took neither skeletal long bones nor samples of the surrounding soil to be chemically analyzed for lead content. This situation may, however, be remedied in future archaeologi cal explorations. made in Devonshire, where it was common prac tice to line cider presses with lead. His findings were reported to the Royal College of Physicians, Psychometric Techniques in Environmental and, as a result, the practice of putting lead linings Ifeg09roll in cider presses was discontinued. J.A. Valciukas andR. Lilis. ENVIRONRES 1980 In 1839, a Frenchman, Tanquerel des Planches, Apr;21 (2):275- 97. conducted a very thorough study of lead poisoning. He showed clearly the causes and symptoms of Authors' abstract: Behavioral changes may be such ailments, and later studies added little to his the earliest and only manifestation of neurotoxici findings. The problem, however, lay not so much ty. Moreover, it is well known that extensive brain in the identification, but rather with the remedies. damage can occur with little or nondetectable clini In the latter half of the 19th century, legislative at cal neurological deficit. Psychometric techniques tempts were made to overcome the problem of now in use in toxicological and epidemiological re lead poisoning in industry. search have been proposed to assess in an objective Lead is a normal constituent of human tissue manner early manifestations of functional neu and regular absorption is a universal human experi rological changes that may be due to environmen ence. Only a small proportion of normally ingested tal neurotoxic agents. Methodological issues are lead is actually absorbed into the body. When an reviewed and the following topics are addressed: individual is exposed to more than the usual (1) the description of representative examples of quantities of lead in the normal environment, evi performance tests; (2) the validity and reliability dence can be found in the body. Because specific of psychometric techniques; (3) the analysis of in clinical signs and symptoms do not usually present dividual and composite test scores; (4) the nature themselves until the stage of poisoning is reached, of these variables; (5) the assessment of individu effective monitoring can only be done by using bio als and groups; (6) the use of multivariate statisti chemical and hematological methods to determine cal techniques; (7) the assessment of dose- changes before the onset ofsymptoms. response relationships; and (8) some methodologi cal problems in the evaluation of neurotoxic effects Absorption of Lead in Ancient Mesopotamia when confounding variables are present. Psy P.B. Adamson. MED SECOLJ 1979 Sep-Dee; chometric techniques can be easily included in the 16(3):333-7. protocol of cross-sectional health evaluation stud ies (morbidity studies); the sensitivity of psy Evidence has been presented that lead poisoning chometric techniques is partly a function of the dis did occur in ancient Greece as early as the begin criminative selection of the appropriate tests, but it ning of the fourth century B.C. Lead and silver may be enhanced through the use of adequate ores were extensively mined in Anatolia and mathematical-statistical techniques. 2 TEH 0531826 ! DUP050032323 SELECTED BIBLIOGRAPHY 'Adamson PB: Absorption of lead in ancient Mesopotamia. MED SECOLI1979 Sep-Dec;16(3):333-7. 'Anonymous: Children and lead: some remaining doubts (editorial). ARCH DIS CHILD 1980 Jul; 55(7):497-9. Anonymous: Recommended health-based limits in oc cupational exposure to heavy metals. Report of a WHO study group. WHO TECH REP SER 1980; 647:1-116. Anonymous: The environmental lead question (edito rial). MED J AUST 1980 Sep 20;2(6):296-7. 'Duggan MJ: Some comments on the 1980 Report of the United Kingdom DHSS Working Party on Lead in the Environment. SCI TOTAL ENVIRON 1980 Dec;I6(3):285-91. 'Gloag D: Is low-level lead pollution dangerous? BR MED J1980 Dec 13;281(6255):1622-5. 'Kirkconnell SC, Hicks LE: Residual effects of lead poisoning on Denver Developmental Screehing Test scores. J ABNORM CHILD PSYCHOL 1980 Jun; 8(2):257-67, 'Morris E: Lead poisoning: a historic view. OCCUP HEALTH (LOND) 1980Sep;32(9):449-59. Newman C: Nature of Samuel Pepys's "wind colic." BR MED J1980 Dec 20-27;281 (6256): 1716-7. 'Valdukas JA, Lilis R; Psychometric techniques in envi ronmental research. ENVIRON RES 1980 Apr; 21(2):275-97. 3 * V *1 'Abstracted TEH 0531827 DUP050032324