Bone lead content assessed by L-line x-ray fluorescence in lead-exposed and non-lead-exposed suburban populations in the United States.

Rosen, John F.; Crocetti, Annemarie F.; Balbi, Kenneth; Balbi, Julie; Bailey, Cheryl; Clemente, Isabella; Redkey, Nancy; Grainger, Sarah

doi:10.1073/pnas.90.7.2789

Cited by 29 publications

(21 citation statements)

References 31 publications

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“…Assessment of BPbs remains the gold standard for evaluating children; however, it does not necessarily predict tissue Pb. 55 It remains possible that treatment did have an effect on the Pb content in the soft tissues, and that remains to be studied in animal models. We did collect data on a measure of Pb's biochemical effect, the EP level.…”

Section: Discussionmentioning

confidence: 99%

A Randomized Trial of Calcium Supplementation for Childhood Lead Poisoning

2004

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ABSTRACT. Objective. Lead (Pb) poisoning remains a common disease among children despite successful public health efforts that have reduced its prevalence. Treatment options for children with blood Pb levels (BPbs) <45 g/dL are limited because chelation therapy is generally not indicated. Calcium (Ca) and Pb interactions are well documented. Competition for binding to Ca-binding proteins may underlie a mechanism for Pb absorption. The purpose of this study was to determine the role, if any, of supplemental Ca at reducing BPbs in moderately poisoned children.Methods. Children aged 1 to 6 years with BPbs 10 to 45 g/dL were enrolled in a double-blinded, placebocontrolled trial of the effects of Ca supplementation on BPbs. Children received either a Ca-containing liquid or an indistinguishable placebo. Dosage was adjusted biweekly on the basis of responses to a dietary Ca intake questionnaire to reach 1800 mg in the Ca-supplemented group. Samples for BPbs and measures to assess safety were collected before and after 3 months of supplementation and after an additional 3 months of follow-up. Bivariate and multiple regression analyses were performed.Results. A total of 67 of 88 enrolled children with a mean age of 3.6 years completed 3 months of supplementation. There were no statistically significant differences between groups on hematologic and biochemical measures, including serum and urinary Ca, at any time points. The average compliance rate was estimated to be 80% for each group during the 3-month supplementation period.Conclusions. At enrollment, the average daily Ca intake in this group of inner-city children was greater than the recommended daily intake for age. Although BPbs declined during a 3-month period in both groups, Ca supplementation aimed at providing 1800 mg of Ca/day had no effect on the change in BPbs. Ca supplementation should not be routinely prescribed for mild to moderately Pb-poisoned children who are dietarily Ca sufficient. Pediatrics 2004;113:e34 -e39. URL: http://www. pediatrics.org/cgi/content/full/113/1/e34; lead, lead poisoning, calcium, calcium supplementation.ABBREVIATIONS. Pb, lead; BPb, blood lead level; CDC, Centers for Disease Control and Prevention; EP, erythrocyte protoporphyrin; AAS, atomic absorption spectrometry; SD, standard deviation; sCa, serum calcium; uCa, urinary calcium; uCr, urinary creatinine. C hildhood lead (Pb) poisoning is prevalent worldwide. In the United States alone, an estimated 0.5 million preschool-aged children have elevated blood Pb levels (BPbs; Ն10 g/dL). 1 The poisoning of this large number of children is, in large part, the consequence of the widespread presence of leaded paint in US residential housing. The National Academy of Sciences estimates that there are 3 million tons of leaded paint in housing built primarily before 1960. 2 Outside the US, the continued use of leaded gasoline is associated with elevated BPbs in urban populations. 3 A study completed recently in India found that average BPbs in 5 major cities were comparable to that in the U...

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Section: Discussionmentioning

confidence: 99%

A Randomized Trial of Calcium Supplementation for Childhood Lead Poisoning

2004

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“…Chelation efficiency, defined in the model as the fraction of the total outflow of Pb from plasma that is assigned to the urinary bladder contents, was empirically set to 0.85 to provide the best fit to the PbB measurements during the chelation period. Table 4 (21)(22)(23)(24).…”

Section: Simulated Chelation Therapymentioning

confidence: 99%