The Effect of Chelation on Bone Pb Stores in Pb Poisoned Children

Details

• Personal Author:
  Dickerson AS ; Hu H ; Lin Y ; Nie LH ; Specht AJ ; Weisskopf MG ; Xu J ; Yan C
• Description:
  Background: Lead exposure remains a key problem for children during development. One treatment for lead poisoning is chelation - a topic that remains controversial with varied results. Bone lead serves as a marker of total body burden of lead and encompasses between 60-90% of lead storage in children. Objective: In this study, we aimed to identify the change in bone lead as a result of chelation therapy in a group of lead poisoned children (blood lead >25 µg/dL). Methods: Upon diagnosis with lead poisoning at Xinhua Hospital in Shanghai, China, children were recruited to our study, had their bone lead levels measured, and underwent one-week of intravenous, in-patient ethylenediaminetetraacetic acid chelation treatment. Up to three clinical visits with the same treatment protocol and bone lead measurements were completed over the two-year study. We measured biomarkers of lead exposure for children exposed via various potential sources, including home contaminants, local industrial emissions, traditional medicines, or lead cookware. Results: We observed significant differences with bone lead after chelation therapy (p < 0.0001), even after calculating a conservative model for theoretical decay from known bone turnover (p = 0.01). The difference identified between our observed change in bone lead and literature established bone lead change significantly increased with more chelation treatments. A significant reduction in bone lead was observed following chelation treatment of children with lead poisoning - a difference that increased more with more chelation. Significance: Study results indicate that chelation treatment is effective in reducing bone lead stores in children with initial blood lead levels greater than 25 µg/dL. Impact Statement: Lead exposure in children is a consistent problem - drastically impacting health across the life span. After exposure, lead stores in the bone of children serving as a potential endogenous source of exposure for years to decades. Our study demonstrated that chelation therapy, while reducing blood lead levels, additionally reduced bone lead levels. A reduction in bone lead would effectively reduce the potential for endogenous release of lead and restrict the damage done by lead exposure. [Description provided by NIOSH]
• Subjects:
  Biomarkers Environmental Exposure Lead Lead Poisoning Metals Occupational Health Poisoning Safety
• Keywords:
  Author Keywords: Metals Blood Lead Levels Child Exposure/Health Children Early Life Exposure Environmental Exposure Lead Poisoning
• ISSN:
  1559-0631
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Boston Region [OSHA] ; California ; Chicago Region [OSHA] ; Indiana ; Maryland ; Massachusetts ; Philadelphia Region [OSHA] ; San Francisco Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• NIOSHTIC Number:
  nn:20070541
• Citation:
  J Expo Sci Environ Epidemiol 2024 Dec; :[Epub ahead of print]
• Contact Point Address:
  Aaron J. Specht, School of Health Sciences, Purdue University, West Lafayette, IN, USA
• Email:
  aspecht@purdue.edu
• CAS Registry Number:
  Lead (CAS RN 7439-92-1)
• Federal Fiscal Year:
  2025
• Performing Organization:
  Purdue University
• Peer Reviewed:
  True
• Start Date:
  20210901
• Source Full Name:
  Journal of Exposure Science and Environmental Epidemiology
• End Date:
  20220731
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:88e06119df82eb701d47979405c8a16726182dc754a6a85703c8f3d8c3eec834f352e70dce7ebf25a75b6f7e323793cae8b3259496a7c07a2ce30bf6d99b585e
• Download URL:
  https://stacks.cdc.gov/view/cdc/208726/cdc_208726_DS1.pdf
• File Type:
  [PDF - 1000.22 KB ]