pica and Lead-Poisoning

Pica is a common condition in childhood that is commonly missed.. To familiarize physicians with the clinical evaluation and management of children with pica.. A PubMed search was completed in Clinical Queries using the key term "pica" OR "dirteating". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Only papers published in English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article.. Pica refers to the persistent, compulsive craving for and the ingestion of substances usually considered inedible and the behavior is discordant with cultural practices and continues beyond the normal developmental phase of occasional indiscriminate and experimental mouthing and swallowing over a period of at least one month. The condition is more common among children in lower socioeconomic classes and those who are mentally handicapped or emotionally deprived. Pica is a significant cause of anemia and lead poisoning. Pica generally resolves in children of normal intelligence after they have been trained to discriminate between edible and inedible items and proper supervision is provided. While relief of family economic and housing difficulties is an adjunct, attention to the individual's emotional needs and stresses is of paramount importance. Children with iron deficiency anemia should be treated with iron replacement therapy. Complications such as gastrointestinal obstruction and lead poisoning should be promptly recognized and treated.. Pica is often an overlooked phenomenon and its association with iron deficiency and lead poisoning has been known for centuries. The underlying cause and complications should be treated if possible. Primary care physicians should be aware of pica and proactively seek information about pica in patients that belong to the high-risk groups.

Topics: Anemia, Iron-Deficiency; Animals; Child; Disease Management; Global Health; Humans; Intellectual Disability; Lead Poisoning; Malnutrition; Morbidity; Pica; Risk Assessment; Risk Factors

We sought to describe the impact of pica, the craving for and intentional ingestion of substances not defined as food, as a risk factor for lead poisoning in New York City (NYC) pregnant women. In order to describe pregnant women with elevated blood lead levels (BLLs) who report pica, NYC health department data from 491 cases of lead-poisoned pregnant women from January 2001 to June 2009 were reviewed. Descriptive frequencies were obtained for women reporting pica. Data were compared between women reporting and not reporting pica. In NYC, of the 43 (9%) lead-poisoned pregnant women reporting pica, 42 (97.7%) were immigrants and 28 (64.6%) had consumed soil. Compared to lead-poisoned pregnant women not reporting pica, women reporting pica had higher peak BLLs (29.5 vs. 23.8 μg/dL, P = 0.0001), were more likely to have had a BLL ≥ 45 μg/dL (OR = 3.3, 95% CI, 1.25, 8.68) and receive chelation (OR = 10.88, 95% CI, 1.49, 79.25), more likely to have emigrated from Mexico (OR = 3.05, 95% CI, 1.38–6.72), and less likely to have completed high school (OR = indeterminate; 0 vs. 34%; P = 0.003). Among NYC lead-poisoned pregnant women, pica was associated with higher peak BLLs. Providers in NYC, and possibly other urban settings, should be vigilant and question pregnant women, especially immigrants, about pica and strongly consider testing this at-risk population for lead poisoning.

Topics: Adult; Confidence Intervals; Emigrants and Immigrants; Environmental Pollutants; Feeding Behavior; Female; Humans; Lead; Lead Poisoning; Maternal Exposure; New York City; Odds Ratio; Pica; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnant Women; Risk Factors; Young Adult

Topics: Child, Preschool; Female; Humans; Lead Poisoning; Pica; Rickets; Vitamin D

Topics: Aggression; Behavior Therapy; Black or African American; Child; Culture; Female; Humans; Intestinal Diseases; Lead Poisoning; Nutrition Disorders; Parent-Child Relations; Parents; Pica; Pregnancy; United States

Topics: Brain; Child, Preschool; Environmental Exposure; Humans; Infant; Lead Poisoning; Pica

Topics: Adult; Body Burden; Central Nervous System; Child; Demyelinating Diseases; Humans; Intellectual Disability; Lead; Lead Poisoning; Pica

Topics: Adult; Age Factors; Anemia, Hypochromic; Animals; Calcium, Dietary; Child; Child Behavior; Child, Preschool; Deficiency Diseases; Fingersucking; Gastric Mucosa; Humans; Infant; Intestinal Absorption; Iron; Lead; Lead Poisoning; Nail Biting; Pica; Protein Deficiency; Rats

Topics: Adult; Air Pollution; Animals; Anura; Calcium; Central Nervous System Diseases; Chelating Agents; Child, Preschool; Cyprinidae; Edetic Acid; Environmental Pollution; Female; Food Contamination; Gastrointestinal Diseases; Hair; Hematologic Diseases; Humans; Industrial Waste; Infant; Lead; Lead Poisoning; Male; Mass Screening; Mice; Pica; Porphyrins; Rats; Saliva; United States; Vehicle Emissions; Water Pollution, Chemical; Water Supply

Topics: Adult; Anemia; Blood Chemical Analysis; Brain Diseases; Child, Preschool; Edetic Acid; Environmental Exposure; Gout; Humans; Infant; Lead; Lead Poisoning; Nephritis; Neuromuscular Diseases; Pica; Skin Absorption

Topics: Air Pollution; Bone and Bones; Child, Preschool; Chronic Disease; Dexamethasone; Dimercaprol; Edetic Acid; Globins; Humans; Hydro-Lyases; Infant; Infant, Newborn; Lead; Lead Poisoning; Mannitol; Nephritis; Paint; Penicillamine; Pica; Porphyrins; Spectrum Analysis; Time Factors; United Kingdom; Water Pollution

Topics: Adult; Central Nervous System Diseases; Chicago; Child; Child, Preschool; Edetic Acid; Environmental Exposure; Female; Fetal Diseases; Gastrointestinal Diseases; Gingival Diseases; Hematologic Diseases; Humans; Lead; Lead Poisoning; Male; Neuromuscular Diseases; New York City; Ohio; Penicillamine; Pentetic Acid; Pica; Porphyrins; Pregnancy; Pregnancy Complications

Topics: Age Factors; Black or African American; Brain Chemistry; Child; Child Behavior Disorders; Child, Preschool; Humans; Infant; Intellectual Disability; Intelligence Tests; Lead; Lead Poisoning; Mental Disorders; Mother-Child Relations; Pica; Population; Research; Socioeconomic Factors

Blood lead levels were measured by atomic absorption spectrometry in 82 children suffering from various neurological disorders (cerebral palsy 42, seizure disorders 35, acute encephalopathy of unknown origin 5) and in 28 healthy children, aged 1 to 12 years. Mean blood lead levels were 11.96 +/- 10.97 micrograms/dl in control children and 19.30 +/- 17.65 micrograms/dl in children with neurological disorders. A significant number of control children as well as those who had neurological disorders were found to have blood lead concentrations of > or = 10 micrograms/dl and > or = 20 micrograms/dl, the cut-off limits for lead poisoning and medical evaluation, respectively. Blood lead levels were, statistically, elevated in children with cerebral palsy compared to controls. Children with pica behaviour exhibited higher blood lead concentrations.

Topics: Central Nervous System Diseases; Cerebral Palsy; Child; Child, Preschool; Encephalomyelitis; Female; Humans; India; Lead; Lead Poisoning; Male; Pica; Reference Values; Risk Assessment; Seizures

Forty-six children, aged 24 to 47 months (25 controls and 21 subjects) chosen according to low and high blood lead levels respectively, were studied to ascertain the presence or absence of a relationship between dietary intake and the occurrence of plumbism (in children of low-income families). Through single-blind interviews by a nutritionist, dietary intakes were gathered, and the average daily intake of calories, protein, and iron was calculated. Hemoglobins, hematocrits, heights, weights, blood lead levels, and social demographic data had been gathered during the routine check for lead poisoning and at registration at the clinic. The mean caloric and protein intake as percent of recommended dietary allowances were equal and adequate for both controls and subjects. There was no statistically significant difference between the controls and subjects with respect to iron intake which was low in both groups. Mean hemoglobin and hematocrit levels were in the anemic range for both groups. The subjects were shorter and weighed less than the control group. Pica was more prevalent among children with plumbism. The findings of this study suggest that some factors other than dietary intake must account for the occurrence of lead poisoning in the subjects and that Blacks have a higher prevalence of plumbism in our area.

Topics: Body Height; Body Weight; Child Nutritional Physiological Phenomena; Child, Preschool; Clinical Trials as Topic; Connecticut; Demography; Diet; Dietary Proteins; Hematocrit; Hemoglobins; Humans; Iron; Lead; Lead Poisoning; Nutritional Requirements; Pica; Socioeconomic Factors

Topics: Child, Preschool; Housing; Humans; Iron Deficiencies; Lead Poisoning; Male; Paint; Pica; Risk Factors

Even at low levels in blood, lead has been associated with reduced IQ scores, behavioural problems, learning impediments, aggression and violent behaviour. Since the 1980s, the South African Medical Research Council (SAMRC) has been investigating the sources of exposure to lead in South Africa (SA), the groups at highest risk of lead poisoning and a selection of the myriad associated health and social consequences. SAMRC research evidence contributed to the phasng out of leaded petrol, restrictions on lead in paint and other interventions. Subsequently, childhood blood lead levels in SA declined significantly. More recent studies have revealed elevated risks of lead exposure in subsistence fishing and mining communities, users of arms and ammunition, those ingesting certain traditional medicines, and users of certain ceramicware and artisanal cooking pots. Lead-related cognitive damage costs the SA economy ~USD17.7 (ZAR261.3) billion annually, justifying further SAMRC investment in lead exposure research in the country.

Topics: Academies and Institutes; Aggression; Biomedical Research; Ceramics; Cooking and Eating Utensils; Environmental Exposure; Firearms; Gasoline; Humans; Intellectual Disability; Lead; Lead Poisoning; Medicine, Ayurvedic; Mining; Paint; Pica; Puberty, Delayed; South Africa; Violence

Topics: Abdominal Pain; Adult; Anemia, Iron-Deficiency; Depressive Disorder; Diagnosis, Differential; Female; Hemoglobins; Humans; Lead; Lead Poisoning; Menorrhagia; Pica; Vomiting

Lead colic is a rare cause of abdominal pain. The diagnosis of lead poisoning is most often mentioned in at risk populations (children, psychotic). We report the case of a 2 year old child that was presented for acute abdomen. Abdominal plain radiograph showed multiple intra-colonic metallic particles and suggested lead poisoning diagnosis. Anamnesis found a notion of pica and consumption of peeling paint. Elevated blood lead levels (BLL) confirmed the diagnosis. The lead poisoning is a public health problem especially in children, but its manifestation by a lead colic is rare and could simulate an acute abdomen table.

Topics: Abdomen, Acute; Abdominal Pain; Child, Preschool; Colic; Humans; Lead; Lead Poisoning; Male; Paint; Pica; Radiography, Abdominal

Topics: Humans; India; Infant; Lead Poisoning; Male; Pica

The objectives of this study were to ascertain the prevalence and potential sources of lead exposure among pregnant women residing in a socially-disadvantaged immigrant community in Albuquerque, New Mexico. Pregnant women (n = 140) receiving prenatal care through a community clinic participated in a structured interview and screening to measure their blood lead levels (BLLs). Potential sources of lead exposure were ascertained by the CDC and New Mexico Department of Health questionnaires. Self-reported risk factors were examined as predictors of BLLs using multiple linear regression and partial least squares discriminant analysis. Most patients were Spanish-speaking (88.6%), Latina (95%), foreign-born (87.1%), lacked health insurance (86.4%), and had a high school education or lower (84.3%). While risk factors were prevalent in this population, only three women (2.1%) had BLLs ≥3 μg/dL. Results of multivariate analyses demonstrated that pica symptoms in pregnancy, history of elevated BLLs before pregnancy, use of non-commercial pottery, and living in older houses were important predictors of elevated BLLs. Although the prevalence of other risk factors relevant to immigrant communities (i.e., use of traditional/folk remedies and cosmetics, seasonings and food products from Mexico) was high, they were not predictive of elevated BLLs. Clinics providing prenatal care to immigrant Hispanic communities should carefully assess patients' pica symptoms, use of non-commercial pottery, and a history of elevated BLLs. Moreover, additional efforts need to focus on the development of screening questionnaires which better reflect exposures of concern in this population.

Topics: Adolescent; Adult; Cross-Sectional Studies; Emigrants and Immigrants; Female; Hispanic or Latino; Humans; Interviews as Topic; Lead Poisoning; Mass Screening; Maternal Behavior; Maternal Exposure; Multivariate Analysis; New Mexico; Pica; Pregnancy; Pregnant Women; Prevalence; Regression Analysis; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; Young Adult

Topics: Adult; Developmental Disabilities; Female; Humans; Lead; Lead Poisoning; Maternal Exposure; Pica; Pregnancy; Pregnancy Complications

A 37-year-old man was admitted to hospital after complaining of abdominal pain for the past two weeks. On admission the abdominal radiograph showed multiple radio-opaque flecks dispersed throughout the gastrointestinal tract. Blood testing showed hemoglobin level 8.7 g/dL and a blood lead level of 112.4 microg/dL. The family interview revealed that the patient had pica-like behavior since childhood. He was a site foreman and had been ingesting pieces of roofing plates for a few weeks. The patient was treated with laxatives and CaNa(2)EDTA therapy was initiated. The blood lead level then dropped to 69.9 microg/dL. The patient received two subsequent courses of oral succimer and the blood lead level decreased to 59 microg/dL 21 days after the first course. The follow-up abdominal X-ray 20 days after the first examination was normal. Four months later, an outpatient follow-up visit showed a blood lead level within normal limits (14.5 microg/dL) and a psychiatric follow-up was initiated. Lead poisoning following the ingestion of lead-containing foreign bodies is particularly rare in adults, while it is sometimes observed in children. Pica behavior is a well-identified risk factor of lead intoxication in children but is quite exceptional in adults, where it is usually considered to be a psychiatric condition. Other unusual sources of lead poisoning include the ingestion of lead bullets, ceramic lead glaze or glazed earthenware, lead-contaminated candies, ethnic or herbal remedies.

Topics: Abdominal Pain; Adult; Bone Diseases; Chelating Agents; Edetic Acid; Electromyography; Humans; Laxatives; Lead; Lead Poisoning; Leukemia; Male; Neuropsychological Tests; Pica; Radiography

Topics: Anemia, Iron-Deficiency; Breast Feeding; Dietary Supplements; Humans; Infant; Infant, Newborn; Iron; Lead Poisoning; Pica; Vitamin D

Long-term backyard smelting of lead in a district known as Mona Commons, Kingston, Jamaica, has produced lead burdens as high as 30 000 mg/kg in soils near to the smelter, and indoor dust loadings of 373 microg/f2 in the residents' home. The blood lead levels (BPb) of 107 children from the district were in the range 2.2-202 microg/dL. Fifty-nine per cent of these had BPb levels above 10 microg/dL and the population mean was an unacceptably high 25.1 microg/dL. The highest levels were observed for five siblings, two of whom presented with lead encephalopathy. This severe chronic exposure to lead was exacerbated by a significant history of pica, and chronic nutritional anaemia. Chelation therapy significantly reduced the BPb levels but due to lead storage in other organs, the values after several months were still higher than desirable. This study emphasizes the importance of reducing the exposure of children to lead.

Topics: Acute Disease; Brain Diseases; Chelation Therapy; Child; Child, Preschool; Female; Health Surveys; Humans; Jamaica; Lead; Lead Poisoning; Male; Pica; Residence Characteristics; Risk Assessment

Up to 70% of young Nigerian children have been reported to have blood lead concentrations > or =10 microg/dl.. To better elucidate risk factors for lead toxicity among Nigerian families with children at risk for lead toxicity.. Two geographic wards in Jos, Nigeria were selected for study, one previously reported to have a high mean blood lead level (37 (SD 13) microg/dl) and one with a lower mean blood lead level (17 (SD 10) microg/dl) in young children. Data pertaining to potential risk factors for lead exposure were collected from children and adults in 34 households.. The mean (SD) blood lead concentration of 275 subjects, aged 3 weeks to 90 years, was 8.7 (5.7) microg/dl (range 1-34 microg/dl); 92 (34%) had concentrations > or =10 microg/dl. In multivariate analysis, an age of 5 years and under, flaking house paint, residence near a gasoline seller, male gender, increasing maternal and paternal education, and use of a lead ore eye cosmetic were independently associated with greater blood lead concentration. Vehicle ownership was associated with reduced lead concentration. Compared with the low-lead ward, residence in the high-lead ward remained significantly associated with greater lead values, indicating that additional factors likely contribute to lead exposure.. Although the cause of increased lead levels in Jos appears to be multi-factorial, several remediable sources contribute to lead exposure in Nigeria.

Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Child; Female; Housing; Humans; Infant, Newborn; Lead Poisoning; Male; Middle Aged; Nigeria; Paint; Pica; Regression Analysis; Risk Factors; Urban Health; Water Supply

Topics: Cheek; Chelation Therapy; Child, Preschool; Dimercaprol; Drug Therapy, Combination; Edema; Edetic Acid; Environmental Exposure; Foreign Bodies; Humans; Lead; Lead Poisoning; Male; Pica; Play and Playthings; Protoporphyrins; Seizures; Self-Injurious Behavior; Succimer; Wounds, Gunshot

A 6-month-old child presented to a local pediatrician with an elevated blood lead level (BLL) of 41 microg/dL. The child was treated as an outpatient for chelation therapy by a toxicologist. Subsequent BLLs obtained at 8 and 13 months of age were 40 microg/dL and 42 microg/dL, respectively. Siblings and family members had BLLs < 5 microg/dL except for the mother, who had a BLL of 14 microg/dL when the child was 6 months of age. Home inspections and phone calls to the family revealed no sources of lead from paint, dust, toys, mini-blinds, keys, food, water, or any take-home exposure. The family denied use of folk remedies such as Greta and Azarcon. The child was breast-fed, but the mother's BLL was not sufficiently high to explain the elevated BLL in the child. Housekeeping was excellent. The mother did admit to cooking beans in Mexican pottery (pieces found outside were positive for lead), but she discontinued use after the initial lead check at 6 months. The bean pot was not a likely source, as none of the family had elevated BLLs including a 5-year-old sister. Follow-up testing of blood lead when the child was 15 months of age revealed values of 28 microg/dL for the child and 9 microg/dL for the mother. Subsequent testing of the child shows a slow decline. The slow release of lead suggests depletion of bone stores acquired during pregnancy, possibly due to pica behavior of the mother during pregnancy.

Topics: Adult; Chelating Agents; Environmental Exposure; Female; Humans; Infant; Lead Poisoning; Maternal-Fetal Exchange; Pica; Pregnancy

Topics: Child, Preschool; Humans; Lead; Lead Poisoning; Male; Paint; Pica

Topics: Aluminum Silicates; Chelation Therapy; Child; Clay; Humans; Lead Poisoning; Male; Pica

To describe the results of combined exchange transfusion and chelation therapy in a neonate with an elevated blood lead level (BLL).. A 34-year-old Latina woman with a long history of pica (eating glazed pottery) gave birth to a healthy-appearing girl at 40 weeks of gestation. The mother's preconception BLL was 117 microg/dL and remained elevated throughout pregnancy. At parturition, the mother's BLL was 87 microg/dL and the infant's cord BLL was 100 microg/dL. The infant underwent single-volume exchange transfusion within 12 hours of birth. BLL was 28 microg/dL following the exchange, and a 5-day course of chelation with dimercaprol and CaNa2 ethylenediamine tetraacetic acid was initiated at 36 hours of life. The infant's BLL was 37 microg/dL at the end of inpatient chelation.. Long-term neurologic disability from in utero lead exposure is well described, but the optimal treatment of elevated neonatal BLLs in healthy-appearing infants at the time of birth is not established. This strategy of combined chelation and exchange transfusion therapy was well tolerated and resulted in decreased lead levels, but the long-term neurologic efficacy of our combination strategy remains to be seen.. Combined exchange transfusion and chelation therapy resulted in rapidly decreased lead levels in a neonate with chronic in utero lead exposure.

Topics: Adult; Ceramics; Chelating Agents; Chelation Therapy; Combined Modality Therapy; Dimercaprol; Edetic Acid; Exchange Transfusion, Whole Blood; Female; Humans; Infant, Newborn; Lead Poisoning; Pica; Pregnancy; Pregnancy Complications

Topics: Adult; Anemia, Sideroblastic; Blood Transfusion; Chelating Agents; Dimercaprol; Edetic Acid; Female; Foreign Bodies; Humans; Lead Poisoning; Pica; Schizophrenia; Sinus Thrombosis, Intracranial; Stomach

Topics: Canada; Child, Preschool; Humans; Lead; Lead Poisoning; Paint; Pica; Soil

Topics: Canada; Child; Child, Preschool; Dust; Humans; Lead; Lead Poisoning; Paint; Pica

Acute cerebral edema due to lead intoxication is an unusual presentation in an adult. Here we describe an adult with pica presenting with severe encephalopathy due to extremely high lead levels (>200 microg/dl) with marked cerebral edema and mild hyperammonemia. Rapid initiation of chelation therapy led to a reduction in serum lead and ammonia levels and a resolution of the cerebral edema and encephalopathy, suggesting a close relationship between lead toxicity and hepatic dysfunction.

Topics: Brain Edema; Chelation Therapy; Female; Humans; Lead Poisoning; Liver; Magnetic Resonance Imaging; Middle Aged; Pica; Time Factors

Topics: Child; Female; Housing; Humans; Lead Poisoning; Paint; Pica; South Africa

This study was carried out as part of a larger interagency investigation in response to concerns about human health following the death of three cattle from lead poisoning in an old lead mining area in Silvermines, Tipperary. Its aim was to screen for lead toxicity in the local child population. Screening consisted of measurement of blood lead concentrations and the completion of questionnaires regarding exposure to lead and general health. Pre-school and primary school children resident in four surrounding district electoral divisions (DEDs) were specifically targeted. One out of 334 (0.3%) children screened had an elevated blood lead concentration. The geometric mean lead concentration was 2.6 microg/dl which is below the intervention lead concentration of 10 microg/dl recommended by the CDC. The mean lead concentration in those aged under three years was statistically significantly higher than in those aged three years and over (3.4 microg/dl vs 2.5 microg/dl; p=0.000581). No specific health problems were identified by the questionnaires. This study concluded that the elevated environmental lead levels which were demonstrated by other agencies involved in this investigation are not currently being transferred to children. It recommends further blood screening of children in the area and ongoing education to minimise the risk of lead toxicity in the area in the future.

Topics: Adolescent; Age Distribution; Animals; Cattle; Cattle Diseases; Child; Child Welfare; Child, Preschool; Fingersucking; Humans; Ireland; Lead Poisoning; Pica; Population Surveillance; Risk Assessment; Risk Factors

A 3 year, 9 month old child with pica presented with a blood lead concentration of 1.74 micromol/l (360 microg/l). The source of poisoning was snooker chalk (lead content 7200 microg/g). She was treated with intravenous calcium disodium edetate chelation. Thirty months later her blood lead was 0.39 micromol/l (80 microg/l). This case illustrates the need to be vigilant for more unusual causes of lead poisoning in the home.

Topics: Calcium Carbonate; Chelating Agents; Child, Preschool; Edetic Acid; Female; Humans; Lead Poisoning; Pica; Recreation

Topics: Child, Preschool; Housing; Humans; Lead Poisoning; Male; Pica; Risk Factors; Wisconsin

Topics: Anemia, Hypochromic; Humans; Lead Poisoning; Male; Middle Aged; Pica; Schizophrenia

It has come to be generally accepted that low levels of lead exposure may result in mental deficit. This causal inference is based on claimed time precedence of the lead exposure and on biological plausibility. The objective of this study is to argue that mental deficit causes pica which causes lead exposure (i.e. to support the theory of reverse causation).. The literature since the 1930s has been interpreted in the light of our own long experience in the investigation of lead exposure in children and adults to support the arguments in favour of reverse causation.. The arguments for reverse causation are based on: (i) analogy with mental retardation which causes increased lead exposure; (ii) the results of published prospective studies that show a special relationship between blood lead levels at 24 months and intelligence tested later, exactly what would be predicted by the reverse causation theory; and (iii) on an alternative explanation for mental retardation following lead encephalopathy (i.e. that mental retardation following encephalopathy is due to anoxia and not due to a direct destructive effect on the brain neurones). The arguments, which have been proposed for the conventional view, are rejected for the following reasons: (i) none of the prospective studies have found a relationship between cord blood lead levels and intelligence tested later, undermining the argument based on time precedence of lead exposure; and (ii) there is no convincing evidence that lead poisoning, short of encephalopathy, causes mental retardation.. We believe that the reverse causation hypothesis is a more plausible explanation of the facts.

Topics: Causality; Child; Environmental Exposure; Humans; Intellectual Disability; Intelligence; Lead; Lead Poisoning; Pica

To investigate the observation that children with pervasive developmental disorders have later and more prolonged lead exposure and are more likely to be reexposed when compared to lead-poisoned children without pervasive developmental disorders.. Retrospective chart review.. A large, urban lead treatment program.. Over a six year period 17 children with pervasive developmental disorders (including autism) were treated. Compared to a randomly selected group of 30 children without pervasive developmental disorders who were treated for plumbism over the sam interval, those with pervasive developmental delay were significantly older at diagnosis (46.5 vs 30.3 months, p = .03) and had a longer period of elevated blood lead levels (39.1 vs 14.1 months, p = .013) during management. Despite close monitoring, state-mandated environmental inspection and prompt lead hazard reduction or alternative housing, 75% of children with pervasive developmental disorders were reexposed to lead during medical management compared with 23% of children without pervasive developmental disorders (p = .001).. 1) lead intoxication among children with pervasive developmental disorders may appear de novo beyond the third year of life and is associated with a high rate of reexposure; 2) the provision of deleaded housing (by current techniques) may not be sufficient to protect these children from repeated lead exposure; 3) these data support recommendations by the Centers for Disease Control that children with developmental delays be closely monitored for the appearance of lead intoxication. This monitoring should continue beyond the third year of life.

Topics: Chelating Agents; Child Development Disorders, Pervasive; Child, Preschool; Environmental Exposure; Humans; Lead Poisoning; Penicillamine; Pica; Recurrence; Retrospective Studies; Succimer

A case of severe lead poisoning following ingestion of an imported clothing accessory is reported. The child presented with abdominal pain, vomiting, and anemia but did not develop encephalopathy.. Prompt removal of the object in conjunction with whole bowel irrigation and chelation therapy led to a favorable outcome.

Topics: Child, Preschool; Clothing; Female; Foreign Bodies; Humans; Lead Poisoning; Pica; Radiography; Stomach

The limited literature on hypersomnolence suggests that it is a poorly defined symptom associated with a spectrum of disorders from monosymptomatic hypersomnolence to the Kleine-Levin syndrome. These disorders often herald an organic central nervous system syndrome. Recent evidence suggests a frequent association between these disorders and hypothalamic dysfunction, which itself may be caused by a variety of factors. This case study of a patient with persistent hypersomnolence, hypothalamic dysfunction (in the form of precocious puberty), pica, and chronic lead intoxication strengthens the association between hypersomnolence and hypothalamic dysfunction and suggests a heretofore unreported cause of hypothalamic dysfunction in humans.

Topics: Age of Onset; Child; Humans; Lead Poisoning; Male; Narcolepsy; Pica; Puberty, Precocious

Topics: Ascariasis; Child, Preschool; Diagnosis, Differential; Hemoglobin SC Disease; Humans; Lead Poisoning; Male; Pica; Toxocariasis

Pica and scavenging are serious, sometimes life-threatening behavior problems among a significant percentage of individuals with mental retardation. This study describes procedures developed to reduce life-threatening pica and food scavenging in two adolescents with severe to profound mental retardation. Treatment was designed to teach the subjects to discriminate safe from unsafe items by training them to ingest only those items put on a specified placemat and to communicate with simple signs or gestures to obtain more food to be put on the mat. Discrimination was achieved by praising subjects when they selected and ingested items from their placemats and delivering a mild punisher when attempts to ingest nonplacemat items were made. A multiple baseline design across settings was used to evaluate the effects of the treatment package in three inpatient settings. All environments were "baited" with both edible and inedible items. Our treatment procedures appeared to be effective in reducing pica in each of the settings. Generalization of treatment effects to natural environments for one of the two subjects was documented.

Topics: Adolescent; Behavior Therapy; Discrimination Learning; Follow-Up Studies; Generalization, Response; Humans; Infant; Intellectual Disability; Lead Poisoning; Male; Pica; Punishment

To determine the risk of increased blood lead levels in children with aural, nasal, or gastrointestinal foreign bodies, the authors prospectively obtained venous blood lead and erythrocyte protoporphyrin levels from 40 study patients and two control groups without foreign bodies (65 patients presenting to a medical clinic and 40 patients presenting to an emergency department). A questionnaire was used to assess environmental and behavioral risk factors for lead poisoning in the three groups. Mean blood lead level was higher in children with foreign bodies (P less than .001), and they were more likely to have a venous blood lead value of more than 1.2 mumol/L (25 micrograms/dL, P less than .01) than patients in either control group. Seventy-eight percent of study patients had no prior lead screening by parent's report vs 64% of emergency department control subjects and 55% of medical clinic control subjects. Control patients in the emergency department had the same incidence of elevated blood lead values as patients enrolled from the medical clinic (6%). No differences in environmental risk factors were found among the three groups. Study patients more often had a history of pica or ingestion of a poison than control patients from the medical clinic. Inner-city children with foreign bodies have increased lead exposure and may have an increased risk for lead poisoning. In areas of high prevalence of lead poisoning, children with foreign bodies should be screened for lead poisoning in the emergency department. General lead screening in the emergency department may be justified for high-risk, inner-city populations.

Topics: Child, Preschool; Digestive System; Ear; Erythrocytes; Female; Foreign Bodies; Housing; Humans; Lead; Lead Poisoning; Male; Nose; Pica; Prevalence; Prospective Studies; Protoporphyrins; Risk Factors

Topics: Child; Developmental Disabilities; Humans; Lead Poisoning; Male; Pica

Blood lead levels of children admitted to Sion Hospital, Bombay (India), from the adjoining Dharavi slum areas have been determined by proton-induced X-ray emission (PIXE). Blood samples were collected from 36 children with suspected lead poisoning and from 20 control children. The analysis showed that the lead concentration of the patients varied from 0.1 to 6.0 micrograms ml-1. In addition to lead, K, Ca, Fe, Cu, Zn, Se, Br and Rb were also detected simultaneously, of which the concentrations of Fe, Cu, Zn, Se, Rb and Pb were determined. The high blood lead levels of the children from this area may be ascribed to environmental pollution due to heavy vehicular traffic and industrial sources.

Topics: Anemia, Hypochromic; Child; Humans; India; Intellectual Disability; Lead; Lead Poisoning; Pica; Reference Values; Spectrometry, X-Ray Emission; Trace Elements; Urban Population

Topics: Administration, Oral; Anemia, Hypochromic; Brain Diseases; Canada; Child, Preschool; Developmental Disabilities; Female; Humans; Iron Chelating Agents; Lead; Lead Poisoning; Male; Paint; Pica

Topics: Adult; Brain Diseases; Celiac Disease; Female; Humans; Lead Poisoning; Menopause; Pica; Time Factors

Dentine lead levels were obtained for a sample of 996 children who were participants in a longitudinal study of child development. Mean dentine lead levels were just over 6 micrograms g-1 and had a log normal distribution. The relationship between dentine lead values and a number of variables (social background, residence in old weatherboard housing, residence on busy roads, pica) describing exposure to sources of lead was analysed. This showed that all factors made small but statistically significant contributions to variations in dentine lead values and that collectively these factors explained 10% of the variance in lead values. The implications of these results are discussed.

Topics: Achievement; Child; Child Behavior; Cohort Studies; Dentin; Female; Humans; Intelligence; Lead; Lead Poisoning; Longitudinal Studies; Male; New Zealand; Pica; Risk Factors; Social Environment

The relationship between dentine lead levels and maternal/teacher ratings of inattentive/restless behaviour in children was examined for a birth cohort of New Zealand children. There were small but relatively consistent and stable correlations between dentine lead values and behaviour ratings. After correction for errors of measurement in dentine lead values and behaviour ratings it was estimated that the correlation between lead levels and inattentive/restless behaviour was in the region of +0.18. However, after control for various sources of confounding there was only a small, but statistically significant, correlation of +0.08 between lead levels and inattention/restless in children. It is concluded that the weight of the evidence favours the view that there is a very weak causal association between lead levels and attention and activity levels in children.

Topics: Achievement; Attention; Child; Child Behavior; Cohort Studies; Dentin; Female; Humans; Intelligence; Lead; Lead Poisoning; Longitudinal Studies; Male; Motor Activity; New Zealand; Pica; Psychological Tests; Risk Factors; Social Environment

The relationship between dentine lead levels and measures of cognitive ability was examined for a birth cohort of New Zealand children studied until the age of 9. There were small, consistent and stable correlations between dentine lead measures and all measures of cognitive ability including intelligence, word recognition and teacher ratings of school performance. After adjustment for the effects of confounding covariates, sample selection factors and possible reverse causal effects, the correlations between intelligence and dentine lead levels became non-significant. However, small but statistically significant correlations persisted between dentine lead values and all measures of school performance after adjustment for sources of confounding. It is concluded that the weight of the evidence from this analysis favours the hypothesis that low level lead exposure may have deleterious effects on levels of achievement in children.

Topics: Achievement; Child; Child Behavior; Cognition; Cohort Studies; Dentin; Female; Humans; Intelligence; Lead; Lead Poisoning; Longitudinal Studies; Male; New Zealand; Pica; Risk Factors; Social Adjustment; Social Environment

Acute lead encephalopathy has become a rare syndrome in the United States. Early recognition of the disease, with institution of specific chelation therapy, is critical in order to minimize mortality and morbidity. Lead intoxication, however, may mimic other more common diseases. We report an 8-year-old child with known sickle cell anemia who presented initially with findings suggestive of vaso-occlusive crisis but who deteriorated rapidly and was found to have severe lead poisoning. We present her hospital course and review the management of lead encephalopathy in detail.

Topics: Anemia, Sickle Cell; Brain Diseases; Chelating Agents; Child; Diagnosis, Differential; Emergencies; Erythrocytes; Exchange Transfusion, Whole Blood; Female; Follow-Up Studies; Humans; Lead; Lead Poisoning; Pica; Protoporphyrins; Seizures; Socioeconomic Factors

Children with accidental ingestions exhibit excessive hand-to-mouth behavior. In a lead-burdened environment, hand-to-mouth behavior contributes to increased lead absorption. To test the hypothesis that accidental-ingestion patients experience greater lead absorption than other urban children, 95 children under 6 years of age with recent ingestions of nonlead-containing materials and a matched control group were compared. Ingestors had higher mean blood lead levels than controls (25.0 micrograms/dl versus 22.2 micrograms/dl, P = 0.036) and higher mean erythrocyte protoporphyrin levels (40.6 micrograms/dl versus 28.6 micrograms/dl, P = 0.006). Ingestion victims were more than three times as likely as controls to be classified as having increased lead absorption. Thumb-sucking was twice as common among ingestors as controls (37% versus 19%). These findings indicate that children with accidental ingestions are at greater risk of increased lead absorption than other urban children.

Topics: Child, Preschool; Demography; Erythrocytes; Female; Humans; Infant; Intestinal Absorption; Lead; Lead Poisoning; Male; Pica; Prospective Studies; Protoporphyrins; Urban Population

Topics: Air Pollutants; Brain Diseases; Child; Child, Preschool; Chronic Disease; Diagnosis, Differential; Environmental Pollutants; Food Contamination; Humans; Infant; Lead; Lead Poisoning; Pica

Blood lead screening of 8062 state hospital residents in California revealed 143 residents with excessive lead levels (greater than or equal to 30 micrograms/dL). This screening was part of the Childhood Lead Project and was performed in 1978. The purpose of this study was to identify "critical" lead sources in California State Hospitals. Accurate identification is crucial if subsequent abatement programs are to be effective. The strategy involved the following sequence of steps: 1) Selection of cases based on blood lead and erythrocyte protoporphyrin screening. 2) Determination of pica habits and environmental exposures through interviews with ward's staff and/or parents. 3) Measurement of lead levels in environmental samples reflecting exposures. 4) Interpreting these data in order to identify critical lead sources. 5) Reducing exposure to critical lead sources. 6) Following up of cases and controls to validate the effects of this strategy. A group of 36 lead-burdened cases with pica (30-60 micrograms Pb/dL blood) and 36 matched controls (PbB less than 20 micrograms/dL) were selected from among the developmentally disabled residents of two California State Hospitals. These subjects were studied in order to identify the lead sources to which they were exposed and to abate the major ones. Three major lead sources were found in the state hospitals: wall and furniture paints (100-45,400 micrograms Pb/g paint); surface soil (33-570 micrograms Pb/g soil); educational format was presented to all involved staff. The results have indicated a trend towards lower lead intake by the lead-burdened cases. In one of the two hospitals a "lead-free unit" had been established. All the lead-burdened cases were transferred to this unit in August 1981. A few months later the blood lead levels of all the cases dropped below 30 micrograms/dL. Initial epidemiological monitoring indicated where there were preventable hazards, which abatement efforts succeeded in reducing. Further monitoring of such problems is indicated in this and other developmentally-disabled populations.

Topics: Adolescent; Adult; California; Child; Environmental Exposure; Epidemiologic Methods; Female; Hospitals, Public; Hospitals, State; Humans; Lead; Lead Poisoning; Male; Middle Aged; Pica; Protoporphyrins

Topics: Humans; Intelligence; Lead Poisoning; Pica

Topics: Behavior Therapy; Child, Preschool; Discrimination, Psychological; Exploratory Behavior; Female; Humans; Lead Poisoning; Male; Pica; Reinforcement, Psychology

A diagnosis of chronic lead poisoning in a mentally retarded adult with pica was initially proposed because of the presence of a "lead line" on the patient's gingiva. The patient had no other signs or symptoms suggestive of her toxic state. Lead poisoning is reviewed from the standpoint of epidemiology, pathophysiology, clinical and oral manifestations, and diagnostic procedures. Dentists working with children or mentally retarded patients should be aware of the increased incidence of lead poisoning in these patient populations and the importance of oral findings and lead-screening techniques in the detection of lead poisoning.

Topics: Chronic Disease; Female; Gingival Diseases; Humans; Intellectual Disability; Lead Poisoning; Middle Aged; Pica; Pigmentation Disorders

Topics: Age Factors; Air Pollutants; Australia; Child; Child, Preschool; Female; Humans; Lead; Lead Poisoning; Male; Pica

Subacute lead encephalopathy due a chronic poisoning was present in a 6 year-old child. Neurologic features (coma, seizures, CSF abnormalities) began after 2 weeks of vomiting, abdominal pain and constipation. Diagnosis was confirmed by studies of porphyrin metabolism. Lead poisoning following pica in childhood has rarely been reported in France. Its pathogenesis, main features, diagnosis and treatment are reviewed.

Topics: Central Nervous System Diseases; Child; Humans; Lead Poisoning; Male; Pica; Porphyrins

Topics: Child; Child, Preschool; Eosinophilia; Female; Humans; Infant; Larva Migrans; Lead Poisoning; Male; Parasitic Diseases; Pica

Topics: Australia; Child; Child, Preschool; Environmental Exposure; Humans; Lead; Lead Poisoning; Paint; Pica; Rural Health; Socioeconomic Factors; Urban Health; Vehicle Emissions

An infant exposed to high levels of lead in utero was found to have increased numbers of cells with chromosome breaks in blood samples obtained at 6 weeks and 3 months of life. Later samples did not show significant abnormality. Physical and neurological examinations of the patient up to 18 months of age gave results within normal limits.

Topics: Adolescent; Chromosome Aberrations; Edetic Acid; Female; Fetus; Follow-Up Studies; Humans; Infant, Newborn; Lead; Lead Poisoning; Maternal-Fetal Exchange; Pica; Pregnancy

Because lead crosses the placenta throughout pregnancy, the fetus is at risk for lead poisoning. A full term, asymptomatic child was born with congenital lead poisoning secondary to maternal pica. Radiographic findings of a dense cranial vault, lead lines, and delayed skeletal and deciduous dental development were noted at birth. After chelation therapy, when the patient was seven months old, radiographs revealed normal skeletal maturation. Tooth eruption did not occur until 15 months of age. Newborn infants with these radiographic findings should be screened for subclinical, congenital lead poisoning.

Topics: Adolescent; Bone and Bones; Calcium; Edetic Acid; Female; Humans; Infant, Newborn; Lead Poisoning; Maternal-Fetal Exchange; Pica; Pregnancy; Pregnancy Complications; Radiography

Topics: Calcium; Child, Preschool; Dimercaprol; Edetic Acid; Female; Follow-Up Studies; Humans; Lead; Lead Poisoning; Pica

Research findings on the effects of raised lead levels on children's cognitive and behavioural functioning are reviewed. The results are considered separately with respect to clinic-type studies of children with high lead levels, studies of mentally retarded or behaviourally deviant children, chelation studies, smelter studies, and general population studies of dental lead. It is concluded that, although the findings are somewhat contradictory, the evidence suggests that persistently raised blood levels in the range above 40 microgram/100 ml may cause slight cognitive impairment (a reduction of one to five points on average) and less certainly may increase the risk of behavioural difficulties. There are pointers that there may also be psychological risks with lead levels below 40 microgram/100 ml, but the evidence on this point is inconclusive so far. Parallels are drawn with studies of other brain traumata and some suggestions are made with respect to both practical implications and the needs for further research.

Topics: Adolescent; Child; Child Behavior Disorders; Child Development; Child, Preschool; Cognition Disorders; Humans; Intellectual Disability; Lead; Lead Poisoning; Motor Skills; Pica

Topics: Child; Child Behavior Disorders; Dentin; Dose-Response Relationship, Drug; Environmental Exposure; Environmental Pollution; Female; Humans; Infant; Intellectual Disability; Intelligence; Lead; Lead Poisoning; Maternal-Fetal Exchange; Pica; Pregnancy

Topics: Child, Preschool; Female; Humans; Infant; Interpersonal Relations; Lead Poisoning; Male; Pica; Play and Playthings; Social Environment

Topics: Child; Child Behavior Disorders; Humans; Lead Poisoning; Pica

Visceral larva migrans, Entamoeba coli, evidence of latent toxoplasmosis and a history of plumbism were found in an emotionally disturbed, retarded child. Patients with pica should be screened for parasitism and other diseases transmitted orally.

Topics: Child; Diagnosis, Differential; Drug Hypersensitivity; Entamoebiasis; Eosinophilia; Humans; Intellectual Disability; Larva Migrans, Visceral; Lead Poisoning; Male; Pica; Psychotic Disorders

Topics: Child; Child Behavior Disorders; Humans; Intelligence Tests; Lead; Lead Poisoning; Learning Disabilities; Pica

Topics: Child; Child Behavior Disorders; Dentin; Humans; Lead; Lead Poisoning; Learning Disabilities; Pica

Topics: Child; Child Behavior Disorders; Dentin; Humans; Intelligence Tests; Lead; Lead Poisoning; Learning Disabilities; Pica

Topics: Animals; Child; Child Behavior Disorders; Humans; Lead; Lead Poisoning; Learning Disabilities; Pica

Topics: Child, Preschool; Humans; Infant; Lead Poisoning; Pica; Time Factors; Weaning

Topics: Animals; Avoidance Learning; Body Weight; Calcium; Calcium, Dietary; Deficiency Diseases; Drinking Behavior; Female; Humans; Iron Deficiencies; Lead Poisoning; Magnesium Deficiency; Male; Pica; Quinine; Rats; Taste; Zinc

Cognitive evaluation of children with elevated blood lead levels was compared with that of a control group similar in age, sex, race, neonatal condition, socioeconomic status, and presence of pica. No significant differences in cognitive functioning were found between the study and control groups. Implications of the present data and their relationship to those of previous investigations are discussed.

Topics: Child; Child, Preschool; Cognition; Female; Humans; Infant; Lead; Lead Poisoning; Male; Pica; Space Perception

Levels of lead ingestion and inhalation producing increased body burden of lead and clinical toxicity in adults and children are compared with usual levels of exposure. The magnitude of lead exposure from air, water, and food is estimated. Sources of high level exposure to lead are described; urban street dirt, house dust, and paint are particularly common sources of high concentrations of lead. The bioavailability of different lead compounds is reviewed as well as factors affecting susceptibility to lead.

Topics: Adult; Air Pollution; Animals; Biological Availability; Child, Preschool; Diet; Dust; Environmental Exposure; Feces; Female; Food Contamination; Humans; Infant; Infant, Newborn; Intestinal Absorption; Lead; Lead Poisoning; Male; Maximum Allowable Concentration; Organometallic Compounds; Paint; Pica; Tissue Distribution; Water Pollution

Children with severely atypical development often display pica, habitual mouthing, and odd food preferences as symptoms from the first year of life. Such children can ingest dangerous amounts of lead even in environments that are usually considered safe. Mean blood lead concentration was notably higher in 18 autistic children than in 16 nonautistic psychotic children or in ten normal siblings. Fifteen (44%) of the psychotic children (autistic and nonautistic) had blood lead levels greater than two standard deviations above the mean for normal controls. Behavioral and neurological sequelae of elevated blood lead level may be obscured in severely disorganized children. Screening for blood lead should be part of the medical care of these vulnerable children with pica.

Topics: Adolescent; Autistic Disorder; Cerebrospinal Fluid Proteins; Child; Child, Preschool; Dimercaprol; Edetic Acid; Female; Haloperidol; Hemoglobins; Humans; Lead; Lead Poisoning; Male; Pica; Psychotic Disorders

Blood samples from people exposed to inorganic lead were examined by fluorescence microscopy for excess erythrocyte porphyrin. With continued lead absorption, fluorescent erythrocytes appeared in the circulation of workers handling this metal or its compounds, and they progressively increased in number and brilliance. These changes ensued if the blood lead concentration was maintained above 2-42 mumol/l (50 mug/100 ml), and preceded any material fall in the haemoglobin value. At one factory, 62-5% of 81 symptomless workers showed erythrocyte fluorescence attributable to the toxic effects of lead. Excess fluorocytes were found in blood samples from a child with pica and three of her eight siblings. These four were subsequently shown to have slightly increased blood lead concentrations (2-03 to 2-32 mumol/l). Fluorescence microscopy for excess erythrocyte porphyrin is a sensitive method for the detection of chronic lead intoxication. A relatively slight increase in the blood lead is associated with demonstrabel changes in erythrocyte porphyrin content. The procedure requires little blood, and may be performed upon stored samples collected for lead estimation. The results are not readily influenced by contamination, and provide good confirmatory evidence for the absorption of biochemically active lead.

Topics: Adult; Child; Erythrocytes; Female; Humans; Lead; Lead Poisoning; Male; Microscopy, Fluorescence; Pica; Porphyrins

Topics: Adult; Age Factors; Animals; Child; Child, Preschool; Dose-Response Relationship, Drug; Forecasting; Humans; Infant; Infant, Newborn; Lead; Lead Poisoning; Nutrition Disorders; Paint; Pica; United States; United States Food and Drug Administration

To investigate the relation between low-level absorption and neuropsychological function, blind evaluations were under-taken in forty-six symptom-free children aged 3-15 years with blood-lead concentrations of 40-68 mug. per 100 ml. (mean 48 mug. per 100 ml.) and in seventy-eight ethnically and socioeconomically similar controls with levels greater than mug. per 100 ml. (mean 27 mug. per (100 ml). All children lived within 6-6 km. of a large, lead-emitting smelter, and in many cases residence there had been lifelong. Mean age in the lead group was 8-3 years and in the controls 9-3. Testing with Wechsler intelligence scales for schoolchildren and preschool children (W.I.S.C. and W.P.P.S.I.) showed age-adjusted performance I.Q. to be significantly decreased in the group with higher lead levels (mean scores, W.I.S.C. plus W.P.P.S.I., 95 v. 103). Children in all ages in the lead group also had significant slowing in a finger-wrist tapping test. Full-scale I.Q., verbal I.Q., BEHAVIOUR, AND HYPERACTIVITY RATINGS DID NOT DIFFER.

Topics: Absorption; Adolescent; Affective Symptoms; Age Factors; Child; Child, Preschool; Cognition Disorders; Colic; Environmental Exposure; Humans; Hyperkinesis; Lead; Lead Poisoning; Motor Skills; Nervous System Diseases; Neurologic Examination; Neurologic Manifestations; Perceptual Disorders; Pica; Seizures; Socioeconomic Factors; Texas; Wechsler Scales

A study of childhood blood lead levels and of soil lead levels has been carried out in Christchurch. The results indicate a potent hazard especially to the child with unusual appetite for soil. Screening and preventative programmes are briefly discussed.

Topics: Child, Preschool; Environmental Exposure; Humans; Infant; Lead; Lead Poisoning; New Zealand; Pica; Soil; Spectrophotometry, Atomic

It has been known for many years that the eating of leaded paint is the prime cause of lead poisoning and elevated blood leads of children living in deteriorated housing. Recently, there has been speculation that children may eat dirt and dust contaminated with lead exhausted from cars and that this amount of ingested lead is sufficient to contribute significantly to the childhood lead problem. This study used a naturally occurring radioactive tracer (lead-210) to determine the relative amounts of dust and other lead-containing materials (e.g., paint) eaten by young children. This tracer is present in very low concentrations in paint and in significantly higher concentrations in fallout dust. Stable lead and lead-210 were analyzed in fecal material from 8 children suspected of having elevated body burdens of lead and 10 children living in good housing where lead poisoning is not a problem. The normal children averaged 4 micrograms lead per gram dry feces, with a range of 2 to 7. Of the eight children suspected of having elevated lead body burdens, two had fecal lead values within the normal range. However, the remaining six were 4 to 400 times higher. Despite these differences in fecal lead between the two groups, the groups were essentially identical in the lead-210 content of their feces. The "elevated" children averaged 0.040 picocurie lead-210 per gram dry feces, while the normal group averaged 0.044. The results provide sound evidence that these children suspected of elevated lead body burden were not ingesting dust or air-suspended particulate.

Topics: Air; Chelating Agents; Child, Preschool; Diet; Dust; Feces; Humans; Infant; Lead; Lead Poisoning; Pica; Radioisotopes; Urban Population

Topics: Child, Preschool; Environment; Humans; Infant; Lead Poisoning; Mother-Child Relations; Pica

Twenty-seven asymptomatic children with confirmed chronic increased lead absorption were compared with 27 matched control children for evidence of neuropsychological impairment. Evaluation of each child included a complete history, physical examination, quantitative neurological tests, and comprehensive psychological tests. There was significantly increased incidence of hyperactive behavior in the subjects with increased lead levels, but there was no significant difference in any of the quantitative test results. Uncontrolled variables, especially lead absorption in infancy and adverse environmental pressures other than lead, still leave questions about the relationship between chronic lead exposure and behavior of intelligence.

Topics: Chelating Agents; Child; Child, Preschool; Chronic Disease; Coproporphyrins; Feeding Behavior; Female; Humans; Hyperkinesis; Intellectual Disability; Lead; Lead Poisoning; Male; Medical History Taking; Neurologic Examination; Perceptual Disorders; Pica; Psychological Tests; Socioeconomic Factors; Urban Population; Wechsler Scales

Sixty-seven 7-year-old children, who had asymptomatic lead exposure between 1 and 3 years of age, were compared in their performance on a series of psychologic tests to 70 children of the same age and socioeconomic background who presumably did not have significant exposure to lead. Exposed children had deficits in global IQ and associative abilities, in visual and fine motor coordination, and in behavior. School failure due to learning and behavior problems was more frequent in the lead exposed than in the control group.

Topics: Achievement; Child; Child Behavior; Child Development; Child, Preschool; Environmental Exposure; Female; Follow-Up Studies; Humans; Infant; Intelligence; Lead Poisoning; Male; Motor Skills; Pica; Vision, Ocular

Topics: Acceleration; Accidents; Accidents, Traffic; Asphyxia; Child; Child, Preschool; Deficiency Diseases; Drowning; England; Environmental Health; Female; Fires; Humans; Infant; Infant, Newborn; Lead Poisoning; Male; Mortality; Pediatrics; Pica; Poisoning; Radiation Effects; Wales

Topics: Child; Humans; Infant; Lead Poisoning; Pica

While leadpoisoning has been with mankind since the dawn of civilization, only in recent years this disease was recognized as a serious public health problem. It has been estimated that more than half a million children are suffering from lead intoxication in the U.S.A. In most instances this disease is caused by eating lead containing peeling paint or plaster crumbs which are abundantly found in run-down neighborhoods of the slums. Children, often unsupervised, develop a craving for these toxic substances and their parents are usually unaware of the inherent dangers of such activities. Education of parents, early recognition and appropriate treatment of affected children and -- most important -- eradication of slum living supported by legislative action and governmental financial aid comprise the ingrediences to a rational approach to overcome the presenting dilemma in childhood lead poisoning.

Topics: Child; Child, Preschool; Female; Humans; Infant; Lead; Lead Poisoning; Male; Pica; Social Class; Socioeconomic Factors; United States

The ingestion of airborne lead fallout is the mechanism responsible for increased lead body burdens found in 10 urban Connecticut children. The mean indoor lead levels found in housedust was 11,000 mug/g; highest concentrations occurred on windowsills and in floor dust. The mean lead content of Hartford street dirt was 1,200 mug/g; levels were highest near the street and next to the buildings. The mean lead concentration of hand samples taken from the subject children was 2,400 mug/g; the mean weight of hand samples was 11 mg. The concentration of lead in dirt and househould dust was high enough to theoretically result in excessive lead accumulation in young children who are putting their dusty, dirty hands in their mouths during play. While we believe that lead emitted from automobiles contributes significantly to air, dirt and dust lead levels the environmental impact of reducing or eliminating lead from gasoline is not yet completely understood.

Topics: Air Pollution; Body Burden; Child, Preschool; Connecticut; Dust; Hand; Housing; Humans; Lead; Lead Poisoning; Pica; Soil; Urban Population; Vehicle Emissions

Topics: Anemia, Sickle Cell; Child; Child, Preschool; Female; Hemoglobin, Sickle; Humans; Lead; Lead Poisoning; Male; Peripheral Nerves; Peripheral Nervous System Diseases; Pica; Reflex

Topics: Air; Air Pollution; Black or African American; Child; Dentin; Dust; Environmental Exposure; Housing; Humans; Industry; Lead; Lead Poisoning; Methods; Pennsylvania; Pica; Potentiometry; School Health Services; Soil; Surveys and Questionnaires; Tooth, Deciduous

Topics: Blood Cell Count; Chelating Agents; Child, Preschool; Community Health Services; Erythrocytes; Fluorometry; Hemoglobins; Housing; Humans; Indicators and Reagents; Infant; Lead; Lead Poisoning; Levulinic Acids; Mass Screening; Methods; Paint; Photomicrography; Pica; Porphyrins; Radiography; Socioeconomic Factors; Spectrophotometry, Atomic

Topics: Air Pollution; Child; Child, Preschool; Dust; Environmental Exposure; Hand; Housing; Humans; Infant; Lead; Lead Poisoning; Maximum Allowable Concentration; New York; Paint; Pica; United States; Urban Population

Topics: Air Pollution; Books; Child; Color; Environmental Exposure; Environmental Pollution; Fires; Humans; Lead; Lead Poisoning; Mastication; Maximum Allowable Concentration; New York City; Newspapers as Topic; Periodicals as Topic; Pica; Printing; Refuse Disposal

A biphase program of screening and treating high-risk children for lead poisoning resulted in a 30% fall in mean lead values in the target areas over a 5-year period. The mean and median for subjects under 6 years was 4-10 mug/100 ml higher than for those over 6. Median for a high incidence area was 42 mug/100 ml in 1967 and 30.0 in 1971; for a low incidence area, 33 and 20 mug/100 ml in the equivalent years. Ingestion of lead paint was observed or demonstrated by x-ray in 90% of 2200 patients treated in the Lead Clinic. Gross neurologic sequelae were limited to two cases of mild, persistent ataxia. Impaired intellectual performance was observed subsequently in several asymptomatic patients with initial blood lead levels (PbB) >/= 100 mug/100 ml.

Topics: Chicago; Child; Child, Preschool; Housing; Humans; Lead; Lead Poisoning; Mass Screening; Paint; Pica; Psychological Tests; Radiography; Time Factors

The lead exposure of children and their mothers has been studied in two towns with mean soil lead contents of 900 and 400 ppm. No significant difference in blood or fecal lead contents was demonstrated between the two populations, but a small difference in hair lead content was shown. The blood lead content of children was greater than that of their mothers and was higher in the summer than in the spring samples. Children with pica for soil in the control area had increased lead content of blood and hair. Preliminary data for children and mothers from villages with mean soil lead contents of 500 ppm and 10,000 ppm are reported which show significant differences in blood and hair lead content within the normal range. The data suggest that soil lead content of 10,000 ppm may result in increased absorption of lead in children, but to a degree which is unlikely to be of biological significance.

Topics: Adult; Child, Preschool; England; Feces; Female; Hair; Humans; Lead; Lead Poisoning; Pica; Sampling Studies; Seasons; Soil

It has been known for many years that the eating of leaded paint is the prime cause of lead poisoning and elevated blood leads of children living in deteriorated housing. Recently, there has been speculation that children may eat dirt and dust contaminated with lead exhausted from cars and that this amount of ingested lead is sufficient to contribute significantly to the childhood lead problem. This paper reports on a twopart study conducted to evaluate the validity of the dirt-and-dust hypotheses. The first part of the study was made to determine the source of lead in dirt to which children are normally exposed. Dirt samples were taken in old urban areas around 18 painted frame houses and 18 houses of brick construction. Samples also were taken around seven old frame farmhouses remote from traffic. Based on the fact that lead concentrations in the dirt were similar in city and rural yards at corresponding distances from the houses, it is clear that nearly all of the lead in dirt around these houses is due to paint from the houses. Lead antiknock additives are therefore not a significant contributor to the lead content of dirt around houses where children usually play. The second part of the study used a naturally occurring radioactive tracer (210)Pb to determine the relative amounts of dust and other lead-containing materials (e.g., paint) eaten by young children. This tracer is present in very low concentrations in paint and in significantly higher concentrations in fallout dust. Stable lead and (210)Pb were analyzed in fecal material from eight children suspected of having elevated body burdens of lead and ten children living in good housing where lead poisoning is not a problem. The normal children averaged 4 mug Pb/g dry feces, with a range of 2 to 7. Of the eight children suspected of having elevated lead body burdens, two had fecal lead values within the normal range. However, the remaining six were 4 to 400 times as high. Despite these differences in fecal lead between the two groups, the groups were essentially identified in the (210)Pb content of their feces. The "elevated" children averaged 0.040 pCi of (210)Pb dry feces, while the normal group averaged 0.044 pCi/g. The results provide sound evidence that these children suspected of elevated lead body burden were not ingesting dust or air-suspended particulate.

Topics: Air Pollution; Child, Preschool; Dust; Feces; Housing; Humans; Infant; Lead; Lead Poisoning; Paint; Pica; Radioisotopes; Soil

Topics: Animals; Dog Diseases; Dogs; Humans; Ink; Lead Poisoning; Newspapers as Topic; Paper; Periodicals as Topic; Pica

Topics: Adult; Child; Child, Preschool; Dimercaprol; Dust; Edetic Acid; Environmental Exposure; Female; Humans; Infant; Lead; Lead Poisoning; New Zealand; Pica; Soil

Topics: Child, Preschool; Female; Humans; Infant; Lead; Lead Poisoning; Male; Mass Screening; New York; Pica

Topics: Child; Child, Preschool; Humans; Infant; Lead Poisoning; Pica; Porphyrins; Virginia

Topics: Age Factors; Attitude to Health; Child Care; Child, Preschool; Ethnicity; Family Characteristics; Female; Health Education; Housing; Humans; Infant; Lead Poisoning; Male; Parent-Child Relations; Pica; Porphyrins; Poverty; Public Housing; Sampling Studies; Socioeconomic Factors; Virginia

Topics: Brain Diseases; Child; Child, Preschool; Female; Humans; India; Infant; Lead; Lead Poisoning; Male; Pica

Topics: Chelating Agents; Child, Preschool; Environmental Exposure; Female; Housing; Humans; Lead; Lead Poisoning; Paint; Pica

Topics: Child; Color; Humans; Ink; Lead; Lead Poisoning; Male; Newspapers as Topic; Periodicals as Topic; Pica; Poaceae; Printing; Soil; Spectrophotometry, Atomic

Topics: Adult; Air; Air Pollution; Child; Child, Preschool; Dust; Environmental Exposure; Humans; Infant; Lead; Lead Poisoning; Mass Screening; Paint; Pica; Rural Population; Soil; United States; Urban Population

Topics: Abnormalities, Drug-Induced; Age Factors; Air Pollutants; Air Pollution; Brain Diseases; Child; Child, Preschool; Electroencephalography; Female; Humans; Intellectual Disability; Lead; Lead Poisoning; Maternal-Fetal Exchange; Motor Skills; Paint; Pica; Pregnancy; Seizures

Topics: Central Nervous System; Chelating Agents; Child, Preschool; Female; Humans; Hyperkinesis; Infant; Lead; Lead Poisoning; Male; Motor Activity; Penicillamine; Pica; Sex Factors; Syndrome

Topics: Child, Preschool; Edetic Acid; Female; Humans; Lead; Lead Poisoning; Male; Microchemistry; Pica; Spectrophotometry, Atomic; Time Factors

Topics: Black or African American; Child; Child, Preschool; Environmental Exposure; Ethnicity; Humans; Infant; Infant, Newborn; Lead; Lead Poisoning; Mass Screening; New York City; Paint; Pica; Puerto Rico; Seasons

Topics: Black or African American; Child, Preschool; Humans; Infant; Lead Poisoning; New York; Paint; Pica; Puerto Rico; Transients and Migrants

Topics: Apgar Score; Birth Weight; Child; Child Development; Child, Preschool; Environment; Female; Gestational Age; Humans; Infant; Language Development; Lead; Lead Poisoning; Male; Motor Skills; Pica; Psychological Tests; Socioeconomic Factors

Topics: Child; Child, Preschool; Environmental Exposure; Humans; Indicators and Reagents; Infant; Lead; Lead Poisoning; Learning Disabilities; Maximum Allowable Concentration; Occupational Diseases; Occupational Medicine; Paint; Pica; Spectrophotometry; Spectrophotometry, Atomic; United States

Topics: Adolescent; Adult; Aged; Birth Order; Black or African American; Child; Child, Preschool; Construction Materials; Culture; Ethnicity; Female; Housing; Humans; Infant; Lead Poisoning; Male; Middle Aged; Ohio; Paint; Parity; Pica; Poverty; Socialization; United States

Topics: Age Factors; Child; Humans; Lead; Lead Poisoning; Legislation, Medical; Paint; Pica; United States

Topics: Age Factors; Anemia; Child, Preschool; Cobalt Isotopes; Female; Fluorescence; Housing; Humans; Infant; Lead; Lead Poisoning; Male; Methods; Ohio; Paint; Pica; Radiography; Socioeconomic Factors; Spectrometry, Fluorescence; Spectrum Analysis

Topics: Child; Child Health Services; Child, Preschool; District of Columbia; Housing; Humans; Infant; Lead; Lead Poisoning; Mass Screening; Paint; Pica; Socioeconomic Factors

Topics: Adult; Air Pollution; Child; Child, Preschool; Environmental Exposure; Humans; Lead; Lead Poisoning; Levulinic Acids; Paint; Pica; Porphyrins

Topics: Child, Preschool; Environmental Exposure; Environmental Health; Humans; Lead Poisoning; Mother-Child Relations; Paint; Pica; United States

Topics: Connecticut; Ethnicity; Humans; Lead; Lead Poisoning; Levulinic Acids; Mass Screening; Pica; Poverty; Sex Ratio

Topics: Adult; Air; Anemia; Brain; Child; Child, Preschool; Environmental Health; Feces; Female; Food Analysis; Humans; Infant; Lead; Lead Poisoning; Male; Maximum Allowable Concentration; Pica; Time Factors; Water

Topics: Child; Child, Preschool; Housing; Humans; Infant; Lead; Lead Poisoning; Mass Screening; New York City; Paint; Pica; Poverty; Urban Population

Topics: Behavior Therapy; Child; Child, Preschool; Housing; Humans; Lead Poisoning; Pica; Psychological Theory

Topics: Feeding and Eating Disorders; Feeding Behavior; Humans; Lead Poisoning; Pica

Topics: Feeding and Eating Disorders; Humans; Lead Poisoning; Maternal Deprivation; Pica

Topics: Black or African American; Child; Female; Humans; Lead Poisoning; Male; Pica; Prejudice; Psychiatry; Puerto Rico; Race Relations; Research; Social Conditions; United States

Topics: Child; Housing; Humans; Lead; Lead Poisoning; Paint; Pediatrics; Pica

Topics: Ambulatory Care; Angioedema; Blood Chemical Analysis; Child; Child, Preschool; Diarrhea; Dimercaprol; Edetic Acid; Female; Hematocrit; Humans; Infant; Lead Poisoning; Male; Outpatient Clinics, Hospital; Paint; Penicillamine; Pica; Radiography; Urticaria; Vomiting

Topics: Arsenic Poisoning; Cadmium Poisoning; Chelating Agents; Child; Child, Preschool; Copper; Deferoxamine; Dimercaprol; Edetic Acid; Gold; Humans; Infant; Iron; Lead Poisoning; Mercury Poisoning; Metals; Paint; Penicillamine; Pica; Poisoning; Thallium

Topics: Child; Child Health Services; Humans; Lead Poisoning; New York City; Pica

Topics: Ceramics; Chelating Agents; Child; Child, Preschool; Cooking and Eating Utensils; Housing; Humans; Infant; Lead Poisoning; Pica; United States

Topics: Brain Damage, Chronic; Chelating Agents; Child, Preschool; Chronic Disease; Environmental Exposure; Female; Humans; Infant; Lead; Lead Poisoning; Male; Pica

Topics: Adrenal Cortex Hormones; Child; Child, Preschool; Dimercaprol; Edetic Acid; Environment; Humans; Lead; Lead Poisoning; Penicillamine; Pica

Topics: Child, Preschool; Comprehensive Health Care; Humans; Infant; Lead Poisoning; Male; Pica

Topics: Brain Diseases; Child, Preschool; Humans; Infant; Lead; Lead Poisoning; Levulinic Acids; Mass Screening; Pica

Topics: Child; Counseling; Environmental Exposure; Humans; Lead; Lead Poisoning; Legislation, Medical; Long-Term Care; Mass Screening; Parent-Child Relations; Pica; Psychological Tests; Social Work; Social Work, Psychiatric

Topics: Adolescent; Child; Child, Preschool; Edetic Acid; Feeding and Eating Disorders; Feeding Behavior; Humans; Intellectual Disability; Lead; Lead Poisoning; Pica

Topics: Child; Feeding and Eating Disorders; Humans; Intellectual Disability; Lead Poisoning; Pica; Toxicology

Topics: Feeding and Eating Disorders; Humans; Laboratories; Lead; Lead Poisoning; Pica

Topics: Child; Climate; Humans; Lead Poisoning; Pica

Topics: Child; Feeding and Eating Disorders; Humans; Infant; Lead Poisoning; Pica

Topics: Child; Humans; Infant; Lead Poisoning; Pica; Poverty

Topics: Child; Feeding and Eating Disorders; Humans; Infant; Lead Poisoning; Pica

Topics: Child; Emotions; Feeding and Eating Disorders; Humans; Infant; Lead Poisoning; Pica; Psychotherapy

Topics: Achlorhydria; Anemia; Anemia, Hypochromic; Child; Humans; Infant; Lead Poisoning; Male; Pica; Urine

Topics: Child; Feeding and Eating Disorders; Humans; Lead; Lead Poisoning; Pica