AMBULATORY TREATMENT OF LEAD POISONING: REPORT OF 1,155 CASES

Subjects with lead concentrations greater than 50 µg per 100 ml whole blood were referred to a municipal lead poisoning clinic for evaluation. Chelating agents were administered when two blood lead levels were more than 50 µg, or calcium disodium edetate (EDTA) provocative test yielded over 1,000 µg/l of lead in the urine in the succeeding 8 hours. Therapy was on an ambulatory basis. Patients with moderate encephalopathy were hospitalized. Intramuscular EDTA, oral penicillamine, or the two drugs in sequence were given to 582 patients in 1967 and to 573 patients in 1968. Clinical evidence of lead intoxication was present in 103 or 8.9% of the 1,155 patients. Several drug reactions to penicillamine were observed, but none to EDTA, and mortality dropped due to early detection and detoxification of subclinical cases of lead poisoning.