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PROFESSOR RONALD E. LANE. C.B.E. Correspondence to
3 Da y l e s f o r d Ro a d , Ch e a d l e , Ch e s h ir e .
GATl e y 573S-
Consu/tfng Rooms 1 1 ST. Jo h n St r e e t .
Ma n c h e s t e r . 3. BLAc k f r ia r s S362
Professor K.A. Kehoe, Kettering Laboratory? University of Cincinatti, Ohio, U.S.A.
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During the last few months I have been discussing with some of my friends and former colleagues the broad question of the diagnosis of lead poisoning. Since there has been so much ambiguity, even in the most recent medical literature, we have decided to try and establish an acceptable and uniform basis for diagnosis and have prepared a statement which expresses our opinions as clearly and concisely as possible.
I am attaching a copy of this statement which is self-explanatory and would greatly appreciate it if you would let me have your views. If you feel that you are able to support the statement in its present form or perhaps after slight amendment I should be most grateful if you would allow me to add your name to the list of signatories. It is our intention to publish an agreed statement, probably in the British Medical Journal,
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Because of varying opinions on the diagnosis o:
poisoning which appear in one international liter;
signatories hope that the following statement may ^ ^ ^ . VO The statement is intended to provide guidance for
moaical s
x,
ustraax meuacax oscacers ana otnor
tmct- i onor s ,
the examination of cases of susoec
poisoning in a cruxes
nagnosas oi a o a a personam.-
;e oas ^ w
.
landings and oupportea oy caccuomieai ovadenco c:
_eaa aoscrotaon.
_.ioro are varyang uogroes oa uosorptaon ana a ta
nacn are aescraocu d o _o v .'. Tno laoxo as
oxperacnce and ptbj.as.uc. rata; at lasts
os t amat ar.g absorotaon ana tne values
concurrently v.ratn exposure -'-5 ana also y.-.u
. D)
;ne onset ca c
Absorption found in the no max POPulati> been no occupational or abnomal srusuce, \! .increased uosorptaon rosuxtang xrom occupatacn;:__ exposure which is considered to bo safe, and which present occupationally acceptable. At these- loveabsorption the mild symptoms listed below', which to a number of minor complaints, are not attribut lead. Where symptoms arc- reported in assoc
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* The biochemical tost levels : weeks after the cassation of exposure
Ke 0012178
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reliable blood load levels below SO micrcfrans per 100 al,
it is probable Ghat other causes of z.
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been excluded.
Increased, absorption fro::: moderately excessive cccupa: or other exposure which may be associated wish mild sy or signs (see below) or rarely wish sovc.a ^ynpa^....- -,-r
These levels of absorption even an k.e
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~noruxnu; aitored sleep; irritability; anaemia; pallor;
o_uo dine; metallic taste, and less frequently diarrhoea cr
nausea. Many of-these are symptoms of other', sometimes trivia
complaints and it is therefore essential for a correct diagnos
of lead poisoning that the symptoms and signs be associated v.l
laboratory evidence of excessive absorption and that ether cau
bo excluded.
severe symptoms and signs include severe intermittent abdominal
pain; reduction of muscle power; muscle tenderness; paraesthosiae,
and other symptoms or signs of neurepntny, or encephalopathy.
In a lead worker these are strong evidence of poisoning but,
apain, require supporting laboratory evidence of high. l^ad
absorption.
KB 0012179
Comert s Tlie incidence ox' soeuelae increases not only v/it in absorption, vhen the latter is excessive, but ler. jen o* tine tnur xlxs a'osorptaon as aliov.red t Where che results o- biochemical tests, with or clinical evidence, reveal moderately excessive o the lead exposure should be reduced. At highly excessive levels ex' absorption (Cate^c should be removed iur.ediately from exposure.
KE 0012130
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