Document O38Kw5RMNEZeRMXkVjeMv9jQj

A* Occurrence X Lead Trades (1) Mining, smelting, refining : . (2) Handling and melting metallic lead. Lead burning, soldering, making type (Lead oxide dusts) (3) Dust and finely divided particles White lead - manufacture - paint mixing Red lead - manufacture - storage batteries Painting - spray painting ' Paint finishing - rubbing, sanding etc. Enameling ' Pottery and glazing Insecticide manufacture and handling * Rubber manufacture XX* General Population (1) Water supply - lead pipes - hard water rich in C02 (2) Other beverages - beer, home brew, whiskey . ($) Contaminated foods Important - - - (ij.) Children - pica H 00087# j ' v V'-:' $ Recognition I. Occurrence of significant exposure. (1) History (a) Necessity for detailed and accurate description of exposure. (b) Personal Investigation frequently required. (c) History of pica in children (2) Analytical evidences of exposure. (a) Significance of lead in faeces (b) Significance of lead in urine (c) Significance of lead in tissues Post mortem diagnosis (d) Significance of lead in environment Lead in air Lead in materials handled Lead on painted objects Lead in water (3) Other evidences of exposure (absorption) (a) X-ray evidence in children. (b) Lead line on gums (c) Changes in blood II. Presence of characteristic Signs and Symptoms (1) Circulatory disturbances Pallor Alternating vascular tone with generally low blood pressure and fleeting vascular crises Anemia Haemorrhages - as retinal (2.) Digestive disturbance Loss of appetite Loss of weight Diarrhea (onset) Constipation Colic (3) Nervous and neuromuscular disturbances Neuritis . Muscle weakness and atrophy Paralysis fleeting or permanent Musculo-spiral palsy Sensory abnormalities - often atrophy/ arthra l-J Central Tremor and increased myotactic irritability Headache Insomnia Encephalopathy - especially common in children Somnolence Mania He 0008708