A systematic review of clinical and laboratory findings of lead poisoning: lessons from case reports

Toxicol Appl Pharmacol. 2021 Oct 15:429:115681. doi: 10.1016/j.taap.2021.115681. Epub 2021 Aug 18.

Abstract

Lead is one of the most toxic heavy metals in the environment. The present review aimed to highlight hazardous pollution sources, management, and review symptoms of lead poisonings in various parts of the world. The present study summarized the information available from case reports and case series studies from 2009 to March 2020 on the lead pollution sources and clinical symptoms. All are along with detoxification methods in infants, children, and adults. Our literature compilation includes results from 126 studies on lead poisoning. We found that traditional medication, occupational exposure, and substance abuse are as common as previously reported sources of lead exposure for children and adults. Ayurvedic medications and gunshot wounds have been identified as the most common source of exposure in the United States. However, opium and occupational exposure to the batteries were primarily seen in Iran and India. Furthermore, neurological, gastrointestinal, and hematological disorders were the most frequently occurring symptoms in lead-poisoned patients. As for therapeutic strategies, our findings confirm the safety and efficacy of chelating agents, even for infants. Our results suggest that treatment with chelating agents combined with the prevention of environmental exposure may be an excellent strategy to reduce the rate of lead poisoning. Besides, more clinical studies and long-term follow-ups are necessary to address all questions about lead poisoning management.

Keywords: Lead; chelating; poisoning; pollutant sources; systematic review; toxicities.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Chelating Agents / therapeutic use
  • Child
  • Child, Preschool
  • Drug Contamination
  • Electric Power Supplies / adverse effects*
  • Evidence-Based Medicine
  • Female
  • Global Health*
  • Humans
  • India / epidemiology
  • Infant
  • Infant, Newborn
  • Iran / epidemiology
  • Lead Poisoning / diagnosis
  • Lead Poisoning / drug therapy
  • Lead Poisoning / epidemiology*
  • Male
  • Medicine, Ayurvedic / adverse effects*
  • Occupational Exposure / adverse effects
  • Opium / adverse effects*
  • Opium Dependence / diagnosis
  • Opium Dependence / epidemiology*
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • United States / epidemiology
  • Wounds, Gunshot / diagnosis
  • Wounds, Gunshot / epidemiology*

Substances

  • Chelating Agents
  • Opium