Treatment of Lead Poisoning
Treatments for lead poisoning are based on the following blood lead levels. Social services are often required to assist in home remediation, to reduce the level of exposure to lead in the home.
- Less than 10 micrograms/dl: The child should be reassessed in one year or sooner if the child’s home situation changes, resulting in exposure to an increasing amount of lead.
- Any level above 10 micrograms/dl indicates a concern. Between 10 and 44 micrograms/dl: The family needs to be taught about lead poisoning and the child should receive follow up testing. The home environment needs to be investigated for the presence of lead, which involves an environment specialist testing samples of paint, dust, soil and water in the home. There are also home kits that can test for the presence of lead. Social service needs to provide support for the family.
- Between 45 and 69 micrograms/dl: The child must receive medical treatment within 48 hours to remove the lead from his or her body. When a child’s blood lead level is above 45 micrograms/dl, chelation therapy is necessary to remove the lead from the body. The medication given to the child binds with the lead in the blood and is then excreted in urine. The two primary drugs of choice are calcium disodium edetate (EDTA), and succimer. Social services and home investigation/lead removal are necessary, because the child cannot return to the lead-hazardous environment.
- Results of 70 micrograms/dl or more: The child must receive immediate medical treatment, usually including British antilewisite (BAL) used together with EDTA. These medications are excreted by the kidneys, so the child must be adequately hydrated during the chelation treatment. Close measurement of the child’s intake (food and fluids) and output (urine and stool) must be maintained to ensure proper kidney function.
Depending on the severity of symptoms and the blood lead levels, treatment is usually started with the child in the hospital for the first few days. If the child is responding well and there are no complications, treatment may be continued with the child closely monitored as an outpatient. The child must be discharged from the hospital to an environment that is lead-free, and a Social Services referral is often used to help mediate the home environment.
The prognosis for each child depends on the amount of lead exposure, the length of time over which the exposure has occurred and the age of the child. The more exposure the child has, the greater the risk of a poor treatment outcome, and the younger the child is, the higher the risk is of permanent damage.