Med Lav. 2013 Nov-Dec;104(6):428-33.
In most industrialized countries, occupational lead poisoning has become increasingly rare, however this metal remains a serious health hazard in the rest of the world.
We observedfour male patients (aged 35 / 54 years) who had suffered recurrent abdominal pain due to recent lead exposure (for 7 to 13 months) in two Chinese battery recycling plants. On their return to Italy, three of them presented normocytic, normochromic anaemia. The diagnosis was confirmed by high lead levels in the blood and urine, decreased erythrocyte delta-aminolevulinic acid dehydratase (ALA-D), raised erythrocyte zinc protoporphyrin (ZP), and elevated urinary excretion of b-aminolevulinic acid (ALA-U) and porphyrins. Chelation with EDTA resulted in increased urinary lead excretion, improvement of the clinical picture, decreased ZP, and progressive normalization of the other lead biomarkers (Pb-B, ALA-D, ALA-U, urinary porphyrins).
Temporary work in developing countries may result in imported lead poisoning. Differential diagnosis of this unusual condition requires careful medical history collection and specific toxicological analysis. Preventive measures for workers going abroad are needed.
在大多数工业化国家，职业性铅中毒已变得越来越罕见，但在世界其他地区，这种金属仍然是一个严重的健康危害。
我们观察了 4 名男性患者（年龄 35/54 岁），他们在两家中国电池回收厂因近期铅暴露（7-13 个月）而反复出现腹痛。回到意大利后，其中 3 人出现正细胞正色素性贫血。通过血液和尿液中铅水平升高、红细胞 δ-氨基酮戊酸脱水酶（ALA-D）降低、红细胞锌原卟啉（ZP）升高以及尿中β-氨基酮戊酸（ALA-U）和卟啉排泄增加，确诊为铅中毒。用 EDTA 螯合治疗导致尿铅排泄增加、临床症状改善、ZP 降低以及其他铅生物标志物（Pb-B、ALA-D、ALA-U、尿卟啉）逐渐正常化。
在发展中国家的临时工作可能导致输入性铅中毒。这种不常见情况的鉴别诊断需要仔细收集病史和进行特定的毒理学分析。需要为出国工作的工人采取预防措施。
