Health
Lead poisoning has been a public health issue for centuries.
During the Roman Empire, it was caused by lead in aqueducts, water pipes and drinking vessels. In fact, the word plumber comes from “plumbum,” the Latin word for lead. The medical term for lead poisoning is plumbism.
During the Middle Ages, lead was used in alchemy. During the Renaissance, lead was used to make weapons of war, printing presses, and other items.
By the 1900s the U.S. was the largest producer of lead in the world. It was used commonly in water pipes, paint and as a gasoline additive.
In 1904, however, it was recognized as dangerous to children. The first reports came from Dr. Gibson in Australia who linked lead paint to lead poisoning cases. In 1914 the first case of childhood lead poisoning was published in the United States.
Through the 1920s and 1930s, more cases surfaced and the evidence mounted. But many physicians did not recognize the symptoms of lead poisoning. Not until after 1940 was a blood test developed to measure blood lead levels (BLL).
More and more physicians recognized the toxic nature of lead ingestion on children. Many other countries in the 1920s and 1930s passed legislation restricting or banning the use of lead paint indoors or in items such as cribs.
However lead paint continued to be used in households in the U.S. until it was first banned in 1970. In 1978 the maximum allowable lead limit was lowered to 0.06 percent. (The previous industry standard was 1 percent even though many paints had levels up to 10 percent!)
Why is lead poisoning such an issue for children? Because of their growing and developing brains along with a tendency for kids to place everything in their mouths.
No minimum safe lead level (other than zero) has ever been discovered. For decades the Centers for Disease Control used a BLL of 10 µg/dl as a “level of concern.” They recently reduced this to 5 µg/dl.
Studies have shown brain damage (like loss of IQ points) even at levels less than 10. At higher levels, people can have abdominal pain. If exposure continues, seizures, coma, and even death can result.
At low blood levels, children may have no symptoms. Their exposure can only be found by routine BLL screening. Current recommendations are to screen all children at 1 and 2 years of age.
Any BLL > 5 should be investigated for a source in the home. This may be done by the local public health departments. Many older homes may still have lead paint. If paint is peeling or remodeling taking place, lead paint dust can be in the environment.
Lead has also been found occasionally in toys, imported candy, and sometimes folk remedies from other countries (Greta or Azarcon in Latino cultures, Ghasard from India, or Ba-baw-san from China)
The take home message? Be sure to have your children’s blood level checked at ages 1 and 2.
Dr. Jeff Ribordy is a regional medical director of Partnership HealthPlan of California (PHC).
- Details
- Written by: Jeff Ribordy, MD
Secondhand smoking is linked with pregnancy loss, including miscarriage, stillbirth and tubal ectopic pregnancy, according to new research from scientists at Roswell Park Cancer Institute (RPCI) and the University at Buffalo (UB).
The study findings, published online by the journal Tobacco Control, mark a significant step toward clarifying the risks of secondhand smoke exposure.
“This study demonstrated that pregnancy outcomes can be correlated with secondhand smoking. Significantly, women who have never smoked but were exposed to secondhand smoke were at greater risk for fetal loss,” said the study's lead investigator, Andrew Hyland, PhD, Chair of RPCI's Department of Health Behavior.
While there was previously some evidence that smoking during pregnancy was associated with the three outcomes of fetal loss studied here – spontaneous abortion or miscarriage (loss of a fetus before 20 weeks of gestation), stillbirth (loss of a fetus after 20 or more weeks of gestation) and tubal ectopic pregnancy – such evidence for secondhand smoke (SHS) exposure had been limited.
This study is significant in two ways: One, it considered lifetime SHS exposure rather than only during pregnancy or reproductive years, taking into consideration smoke exposure in participants' childhood and adult years. Two, the comparison group of never-smokers was limited to women without any SHS exposure, producing a truer control group compared to previous studies.
The large sample size and comprehensive assessment of SHS exposure added strength to the findings. Historical reproductive data, current and former smoking status, and details about SHS exposure over lifetime were collected from the Women's Health Initiative Observational Study. This allowed for a study group of 80,762 women.
“The statistical power gained from the large cohort of women that was available is noteworthy,” added co-author Jean Wactawski-Wende, PhD, Professor in the Departments of Social and Preventive Medicine and Obstetrics and Gynecology, and Vice Provost for Research Advancement and Strategic Initiatives at UB. “As a result of the Women's Health Initiative Observational Study, participants came from a broad range of geographic areas and had multiple ethnic, educational and socio-economic backgrounds. This allowed for a comprehensive assessment of detailed information on exposures, outcomes and potential confounders.”
Women with the highest levels of SHS exposure – despite never having smoked themselves – had significantly greater estimates of risk for all three adverse pregnancy outcomes, and these risks approached the risk seen among women who smoke (those who smoked more than 100 cigarettes in their lifetime).
The highest levels of lifetime SHS exposure were defined by childhood exposure for longer than 10 years, adult home exposure for more than 20 years and adult work exposure for more than 10 years.
“This study offers new information for women regarding the lifetime impact secondhand smoke can have on reproductive outcomes and their ability to successfully bring a pregnancy to full term,” says Dr. Hyland. “The strength of the study also provides public-health professionals and others with information upon which to base health guidelines about the significant consequences of secondhand smoke.”
- Details
- Written by: Editor
How to resolve AdBlock issue?