Blood lead levels in pregnant women referring to midwifery clinic in a referral center in Tehran

Hassanian‐Moghaddam, Hossein; Zamani, Nasim; Hamidi, Fatemeh; Farnaghi, Fariba; Gachkar, Latif

doi:10.4103/jrms.jrms_72_18

Cited by 5 publications

(8 citation statements)

References 8 publications

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“…Simultaneous presence of lead poisoning and anemia has also been mentioned in the previous studies. Lead interferes with the production of heme [18][19][20][21]. In fact, during the heme production, two pivotal enzymes (5-aminolevulinic acid dehydratase and ferrochelatase) are inhibited [22,23].…”

Section: Discussionmentioning

confidence: 99%

“…Capillary blood lead levels were checked by Lead Care II device using voltametry method. This device determines the BLLs between 3.2 to 65 μg/dL [18]. The levels below and above these limits are determined as "low" and "high" levels.…”

Section: Methodsmentioning

confidence: 99%

“…Considering the previously performed pilot study on 93 patients which showed an average frequency of BLLs higher than 10 μg/dL to be about 47.3% [18], the desired 95% level of confidence, and the desired ±1.8 μg/dL accepted margin of error, a sample size of 142 was determined. Sixty-seven patients were expected to have BLLs higher than 10 μg/dL.…”

Section: Sample Sizementioning

confidence: 99%

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Lead poisoning; a neglected potential diagnosis in abdominal pain

Shabani¹,

Hadeiy

Parhizgar

et al. 2020

BMC Gastroenterol

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Background: Abdominal pain may be a presenting symptom of lead poisoning and is often difficult to diagnose. This study aimed to determine the prevalence of abdominal pain in patients seen in the Laghman Hakim Hospital ED and GI clinic who were lead-intoxicated, with or without opiate use disorder. Methods: Between July 2017 and January 2018, patients seen in the ED and GI clinic of Loghman Hakim Hospital with unexplained abdominal pain or abdominal pain resistant to treatment were enrolled. Informed consent was obtained from potential enrollees. For standardization, a pre-designed data collection tool was developed for uniform data acquisition. Opiate use was determined historically. For this study, lead poisoning was defined as a blood lead level (BLL) greater than or equal to 30 μg/dL (1.45 μmol/L) with concomitant GI symptoms. Results: Of 125 patients admitted, 28 (22.4%) had BLLs higher than 30 μg/dL. None of the patients had signs and symptoms of opioid withdrawal syndrome during evaluation. Elevated BLLs were significantly correlated with oral opium use/abuse, history of addiction for over the preceding 12 years. The daily opium use was more than 2.75 g. There was a statistical correlation between lead toxicity and abdominal pain consistency and intensity, constipation, and paresthesias. Anemia, leukocytosis, and abnormal liver enzyme tests were laboratory findings associated with lead toxicity. Four patients died, one of whom was diagnosed with lead toxicity. Conclusion: Lead toxicity should be considered in the potential differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs or GI clinics if a positive history of opium abuse exists.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Sample Sizementioning

confidence: 99%

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Lead poisoning; a neglected potential diagnosis in abdominal pain

Shabani¹,

Hadeiy

Parhizgar

et al. 2020

BMC Gastroenterol

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“…Capillary blood lead levels were checked by Lead Care II device using voltametry method. This device determines the BLLs between 3.2 to 65 µg/dL [18]. The levels below and above these limits are determined as "low" and "high" levels.…”

Section: Methodsmentioning

confidence: 99%

“…Considering the previously performed pilot study on 93 patients which showed an average frequency of BLLs higher than 10 µg/dL to be about 47.3% [18], the desired 95% level of confidence, and the desired ± 1.8 µg/dL accepted margin of error, a sample size of 142 was determined. Sixty-seven patients were expected to have BLLs higher than 10 µg/dL.…”

Section: Sample Sizementioning

confidence: 99%

Lead Poisoning; a Neglected Potential Diagnosis in Abdominal Pain

Shabani

Hadeiy

Parhizgar

et al. 2019

Preprint

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Background Abdominal pain may be a presenting symptom of lead poisoning, and is often difficult to diagnose. We aimed to determine the prevalence of abdominal pain in patients seen in the Laghman Hakim Hospital ED and GI clinic who were lead-intoxicated, with or without opiate use disorder.Methods Between July 2017 and January 2018, patients seen in the ED and GI clinic of Loghman Hakim Hospital with unexplained abdominal pain or abdominal pain resistant to treatment were enrolled. Informed consent was obtained from potential enrollees. For standardization, a pre-designed data collection tool was developed for uniform data acquisition. Opiate use was determined historically. For this study, lead poisoning was defined as a blood lead level (BLL) greater than or equal to 30 μg/dL (1.45 micromoles/L) with concomitant GI symptoms.Results Of 125 patients admitted, 28 (22.4%) had BLLs higher than 30 μg/dL. None of the patients had signs and symptoms of opioid withdrawal syndrome during evaluation. Elevated BLLs were significantly correlated with oral opium use/abuse, history of addiction for over the preceding 12 years. The daily opium use was more than 2.75 grams. There was a statistical correlation between lead toxicity and abdominal pain consistency and intensity, constipation, and paresthesias. Anemia, leukocytosis, and abnormal liver enzyme tests were laboratory findings associated with lead toxicity. Four patients died, one of whom was diagnosed with lead toxicity.Conclusion Lead toxicity should be considered in the potential differential diagnosis of severe and resistant abdominal pain in patients referring to general EDs or GI clinics if a positive history of opium abuse exists.

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A Preliminary Report on the Largest Ongoing Outbreak of Lead Toxicity in Iran

Zamani

Mehrpour

Hassanian‐Moghaddam

et al. 2020

Sci Rep

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no countrywide data exists on the patients' characteristics of lead exposure in iran. We aimed to evaluate the demographic characteristics and blood lead level (BLL) of these patients in the country scale during five consecutive years, including the epidemic outbreak year (2016). Between 2014 and 2018, records of all patients who had referred to two reference laboratories in Tehran, Iran, to check BLL were evaluated. Of 58,642 patients, 48,589 were male. Mean age was 44.9 ± 20.7 years. Males had higher BLLs and were significantly older. Median BLL was 16 µg/dL (0.3 to 263 µg/dL). Median BLL was significantly higher in 45-to 60-year-old patients. The highest median BLL was reported in May 2016 confirming our records about the peak of the epidemic. Although the frequency of high BLL declined after 2016, it never returned to the measures before that. Considering the ongoing high prevalence of increased BLLs after 2016 and similar environmental and occupational exposures as before, lead-contaminated opium still seems to persist in the Iranian opium black market. Substitution of this lead-contaminated opium by opioid Maintenance therapy (oMt)-prescribed opium tincture is recommended.

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Blood lead levels in pregnant women referring to midwifery clinic in a referral center in Tehran

Cited by 5 publications

References 8 publications

Lead poisoning; a neglected potential diagnosis in abdominal pain

Lead poisoning; a neglected potential diagnosis in abdominal pain

Lead Poisoning; a Neglected Potential Diagnosis in Abdominal Pain

A Preliminary Report on the Largest Ongoing Outbreak of Lead Toxicity in Iran

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