Lead poisoning

Clinic of lead poisoning. Acute poisoning is very rare, manifested by salivation, nausea, vomiting, cramping pains in the abdomen. There is a high mortality rate.
In production conditions are observed mainly chronic intoxication.
To "the cardinal symptoms of lead poisoning are: 1) "lead color" - a kind of pale-greenish color of the skin; 2) lead the border purples gray band along the edge of the gums and teeth (sulphur deposition of lead); 3) changes in the blood appear already in the beginning of poisoning: an increase in the number of reticulocytes (2-4%0 and above) and the emergence of a significant number bazafile-grained erythrocytes (1 10-5 field of view and above); with the progression of this process is observed anemia oligofrenia type; 4) increase content coproporphyrin in the urine; 5) presence of lead in the urine. The specificity of these symptoms conditional, as each of them may also occur in other diseases.
Gastro-intestinal tract observed hypersecretion with a significant increase in the content of hydrochloric acid and pepsin, which seems to be due to a toxic effect of lead on neurosecretory mechanisms.
Quite frequent toxic liver damage. For more severe syndromes, sometimes developing on the background of chronic lead poisoning refers lead colic: 1) sharp cramping abdominal pain, especially in the area of the navel; 2) constipation, is the equal of any impact, and 3) increase in blood pressure. As a rule, it does have the most marked characteristic of saturnism hematologic changes and corresponding changes in the nervous system.
To the earliest and most frequent changes of nervous system is asthenovegetative syndrome with a number of functional easily reversible changes in the Central nervous system, proceeding by the mechanism of asthenic States on the background of changes of the vegetative departments.
With the further development of the process or when exposed to higher concentrations of lead may develop persistent changes of the Central nervous system - encephalopathy with asymmetry of innervation of the cranial nerves, speech disorder, unequal pupils, hyperkinesia, loss of coordination of movements.
Lead polyneuritis are characterized by a gradually developing mainly symmetric defeat motor fibers. In the early stages are observed weakness extensor brush, violation irritability of nerves and muscles of upper extremities. As the development process can be observed paresis, and paralysis extensor fingers and hand (hanging brush).
These changes, as lead encephalopathy, at the present time there are only rarely. More likely to develop sensitive form polinevrita, which is characterized by pain in the extremities, hypesthesia, soreness in the course of nerve trunks, cyanosis and reduced skin temperature in the hands and feet.
Lead has an adverse effect on the function of procreation, causing irregular periods (dysmenorrhoea), premature birth, intrauterine death of the fetus.
According to the classification approved by Ministry of health of the USSR, allocate 4 groups of lead poisoning. Carrier - lead border and the presence of lead in the urine in the absence of subjective and objective violations. Light poisoning - reticulocytosis (20-30), asthenovegetative phenomenon. Moderate - reticulocytosis (above 40), hepatitis, asthenic syndrome. Heavy - significant anemia, colic, and paralysis, encephalopathy, leading to irreversible changes in the nervous system.
The diagnosis of lead intoxication is put on set of symptoms - the content of Pb in blood above 0.03 mg% and urine above 0.05 mg/L.
Treatment. First aid at acute poisoning - see Poisoning (table).
Treatment of chronic poisoning. The most effective therapeutic tool are kompleksoobrazovateli, forming a solid low-toxic complexes with lead easily receding through the kidneys: 10% solution tetatsin-calcium (15-20 ml dissolved in 200 ml of 5% glucose and slowly injected). Daily dose of 2 g of the drug daily for three days followed by a break in 4-5 days. The course of treatment is 2-3 cycle. Kompleksoobrazovateli quickly cropped attack of heavy lead colic.
To restorative therapy is a glucose with ascorbic acid. When polyneuritis shown introduction of vitamin B1 50 mg daily, as well as massage and warm baths, Spa treatment (Pyatigorsk, Matsesta, Sernovodsk).
Prevention: mechanization of production processes, elimination of manual operations, the maximum sealing equipment. Possible replacement of Pb less toxic compounds. Hydration of dusty materials. The device household premises changing and shower facilities. Working clothes made of dense crisp, lint-free tissue. Special handling of clothing. Handwashing 1% solution of acetic acid. The use of respirators. The sanitation of the oral cavity. Special meals. Preliminary and periodic medical examinations. The maximum allowable concentration of lead in air of a working zone - 0.01 mg/m3.