Chelation therapy in workers with lead exposure. 1993

S Royce, and J Rosenberg
Hazard Evaluation System and Information Service, California Department of Health Services, Berkeley 94704.

Occupational lead overexposure remains a major problem. To evaluate the settings in which physicians appropriately prescribe chelation therapy for lead exposure, 7 cases were identified from physician phone calls and mandatory laboratory reporting of elevated blood lead levels to the California Department of Health Services. In the 2 workers with the highest blood lead levels (both of whom had severe symptoms), treatment was indicated. Physicians inappropriately prescribed chelating agents to workers with ongoing lead exposure as prophylaxis against rising blood lead levels and to treat atherosclerotic heart disease. Workers' personal physicians identified lead overexposure in 5 of the 7 cases. Workplace lead medical surveillance programs mandated by the federal Occupational Safety and Health Administration were inadequate in all 5 of the workplaces where information was available.

UI MeSH Term Description Entries
D007854 Lead A soft, grayish metal with poisonous salts; atomic number 82, atomic weight 207.2, symbol Pb.
D007855 Lead Poisoning Poisoning that results from chronic or acute ingestion, injection, inhalation, or skin absorption of LEAD or lead compounds. Poisoning, Lead,Lead Poisonings,Poisonings, Lead
D009786 Occupational Health Services Health services for employees, usually provided by the employer at the place of work. Employee Assistance Programs (Health Care),Employee Health Services,Employment-Based Services,Health Services, Employee,Health Services, Occupational,Services, Employee Health,Services, Employment-Based,Services, Occupational Health,Assistance Program, Employee (Health Care),Assistance Programs, Employee (Health Care),Employee Assistance Program (Health Care),Employee Health Service,Employment Based Services,Employment-Based Service,Health Service, Employee,Health Service, Occupational,Occupational Health Service,Program, Employee Assistance (Health Care),Programs, Employee Assistance (Health Care),Service, Employee Health,Service, Employment-Based,Service, Occupational Health,Services, Employment Based
D010396 Penicillamine 3-Mercapto-D-valine. The most characteristic degradation product of the penicillin antibiotics. It is used as an antirheumatic and as a chelating agent in Wilson's disease. Dimethylcysteine,Mercaptovaline,beta,beta-Dimethylcysteine,Copper Penicillaminate,Cuprenil,Cuprimine,D-3-Mercaptovaline,D-Penicillamine,Metalcaptase,D 3 Mercaptovaline,D Penicillamine,Penicillaminate, Copper,beta,beta Dimethylcysteine
D004112 Dimercaprol An anti-gas warfare agent that is effective against Lewisite (dichloro(2-chlorovinyl)arsine) and formerly known as British Anti-Lewisite or BAL. It acts as a chelating agent and is used in the treatment of arsenic, gold, and other heavy metal poisoning. 2,3-Dimercaptopropanol,2,3-Dithiopropan-1-o1,B.A.L.,BAL in Oil,British Anti-Lewisite,British Anti-Lewisite Agent,Cadmium 2,3-Dimercaptopropanol,Dicaptol,2,3 Dimercaptopropanol,2,3 Dithiopropan 1 o1,2,3-Dimercaptopropanol, Cadmium,Anti-Lewisite Agent, British,Anti-Lewisite, British,British Anti Lewisite,British Anti Lewisite Agent,Cadmium 2,3 Dimercaptopropanol,Oil, BAL in,in Oil, BAL
D004492 Edetic Acid A chelating agent that sequesters a variety of polyvalent cations such as CALCIUM. It is used in pharmaceutical manufacturing and as a food additive. EDTA,Edathamil,Edetates,Ethylenediaminetetraacetic Acid,Tetracemate,Calcium Disodium Edetate,Calcium Disodium Versenate,Calcium Tetacine,Chelaton 3,Chromium EDTA,Copper EDTA,Coprin,Dicobalt EDTA,Disodium Calcitetracemate,Disodium EDTA,Disodium Ethylene Dinitrilotetraacetate,Distannous EDTA,Edetate Disodium Calcium,Edetic Acid, Calcium Salt,Edetic Acid, Calcium, Sodium Salt,Edetic Acid, Chromium Salt,Edetic Acid, Dipotassium Salt,Edetic Acid, Disodium Salt,Edetic Acid, Disodium Salt, Dihydrate,Edetic Acid, Disodium, Magnesium Salt,Edetic Acid, Disodium, Monopotassium Salt,Edetic Acid, Magnesium Salt,Edetic Acid, Monopotassium Salt,Edetic Acid, Monosodium Salt,Edetic Acid, Potassium Salt,Edetic Acid, Sodium Salt,Ethylene Dinitrilotetraacetate,Ethylenedinitrilotetraacetic Acid,Gallium EDTA,Magnesium Disodium EDTA,N,N'-1,2-Ethanediylbis(N-(carboxymethyl)glycine),Potassium EDTA,Stannous EDTA,Versenate,Versene,Acid, Edetic,Acid, Ethylenediaminetetraacetic,Acid, Ethylenedinitrilotetraacetic,Calcitetracemate, Disodium,Dinitrilotetraacetate, Disodium Ethylene,Dinitrilotetraacetate, Ethylene,Disodium Versenate, Calcium,EDTA, Chromium,EDTA, Copper,EDTA, Dicobalt,EDTA, Disodium,EDTA, Distannous,EDTA, Gallium,EDTA, Magnesium Disodium,EDTA, Potassium,EDTA, Stannous,Edetate, Calcium Disodium,Ethylene Dinitrilotetraacetate, Disodium,Tetacine, Calcium,Versenate, Calcium Disodium
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015913 Chelation Therapy Therapy of heavy metal poisoning using agents which sequester the metal from organs or tissues and bind it firmly within the ring structure of a new compound which can be eliminated from the body. Therapy, Chelation,Chelation Therapies,Therapies, Chelation
D016273 Occupational Exposure The exposure to potentially harmful chemical, physical, or biological agents that occurs as a result of one's occupation. Exposure, Occupational,Exposures, Occupational,Occupational Exposures

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