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This case study explores the causes, symptoms, and prevalence of lead poisoning in children. It also highlights the risk factors and potential interventions for this environmental health issue.
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Case study 1 Children with Lead Poisoning
Lead Poisoning A.K.A. saturnism, plumbism or painter's colic Roman’s recognized that water from terra cotta pipes was healthier than water from lead pipes
Frontal radiograph of both knees of a child with lead poisoning show dense metaphyseal (metaphysis area of bone growth) bands involving not only distal femurs and proximal tibias but proximal fibulas as well Increased lead in a kid’s knees
An oxide of lead was once added to wine to artificially sweeten it. Since lead can make crystal clearer and people like to you crystal decanters there have been cases of lead poisoning due to people leaving alcoholic beverages in crystal decanters for months.
Lead: no biological role an environmental problem of many chemicals Lead mimics other metals like Zinc. ALAD is a zinc binding protein in Heme (part of hemoglobin) Genetic mutations of ALAD leads to porphyria which was the Madness of King George III
The average person has less than 10 micrograms per deciliter, or 100 parts per billion, ppb, of lead in their blood serum. Symptoms show up when you’ve got 100ppb Higher than 200 ppb unusual Cause your not quite evil enough. Your semi-evil, your quasi-evil, your the margarine of evil, your the diet coke of evil, just one calorie, not "evil" enough 100 parts per billion
Famous cases of Lead Poisoning • Much of Rome's affluent class suffered from lead-induced gout • Ludwig Van Beethoven • Francisco Goya was considered skilled but unremarkable until he contracted lead poisoning in his late forties and painted a series of disturbing paintings called "the Caprices. • “the sleep of reason produces monsters
What is the etiology of the mental and physiological signs shown by these patients? Etiology: Source of the disease In this case lead poisoning from the abandoned building
2. What risk factors for lead poisoning can you identify in this case study? Risk factors: Conditions that increase the probability of having a disease In this case the financial situation and where the people lived were risk factors
3. Is lead a toxin? Toxin: poison produced by a living organism No lead is not a toxin
4. Do any of the people in this story exhibit idiopathic lead poisoning? Why or why not? Idiopathic: No apparent cause. No the cause for every case of lead poisoning is known
5. Would you consider lead poisoning a syndrome? Why or why not? Syndrome: Collection of signs, symptoms, degenerative processes that occur together in a disease. Yes all of the joint pain, excessive salivating, seizures, and personality changes happened at the same time. But its debatable
6. At what point in this case does histopathology become relevant? Histopathology: Microscopic study of disease. In this case its relevant when blood and urine tests are done.
7. Based on the information presented, does the lead poisoning in this community show a high morbidity? A high mortality? A high prevalence? A high incidence? Morbidity: Prevalence of disease. Yes, of course it will depend on the population Mortality: Death rate from disease: Low Prevalence: # of people with disease at a given span of time. Yes. Incidence: # of new cases over a given time period: High
Would you consider the lead poisoning in this case an epidemic? Epidemic: High incidence. Above normal expectations. Yes this is an epidemic
Signs: Objective visual indication of disease Salivation Personality change RBC Lead in urine Intelligence? Vision? Symptom: Subjective feeling only know to patient Joint pain Difficulty walking? Can a sign be faked? 9. Identify as signs or symptoms
10 The elderly woman with pica lives with her daughter’s family. Her daughter says she can’t get her mother to stop chewing the foil from the wine bottles, and the mother says she likes the metallic feel on her teeth. If you were the physician, what might you suggest to control the lead poisoning? What is pica? Eating of non-nutritive substances for extended periods Aluminum or gold foil. I'm from Holland. Isn't that vierd?
14.3 Million Sand blasted off 1970’s paint Vaccum kept lead dust from spreading OSHA has fined companies cleaning other Pittsburgh bridges millions for not talking proper precautions 2005 Fort Duquesne is unleaded
From Leadsafepittsburgh.com In Allegheny County, more than 90% of the homes were built prior to 1978 when lead paint was still used. Up to 25% of the preschool children in our region have elevated blood lead _levels.
Lead and Behavior • Prof Needleman, from Pitt suggests that increased cases of lead poisoning could cause lowered IQs and unstable personalities that will lead to increased crime in the future.
Leading cause of lead poisoning in Texas. • Don’t mess with Texas.