Department of Gastroenterology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Gastroenterology and Hepatology Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Subst Abuse Treat Prev Policy. 2017 Oct 5;12(1):43. doi: 10.1186/s13011-017-0127-0.
Lead (Pb) poisoning among people using opium has been an increasing problem in Iran. The present study highlights the clinical effects of lead toxicity associated with opium use in Iran, Kerman province.
Between January 2016 and June 2016, patients with signs and symptoms of Pb poisoning were questioned to assess whether they had a history of opium dependency. In total, 249 patients were enrolled onto this cross-sectional study, all were opium dependent. Para-clinical data including blood lead level (BLL), demographic information, user preferences, and symptoms were obtained.
The patients used either opium (83.9%), refined opium (6.4%) or a combination of both (9.7%) via ingestion (71.9%), smoking (8.4%) or a combination of both (19.7%). The overall median BLL was 80.0 μg/dL [IQR: 51.7-119.0]. The median BLL did not differ significantly between opium and refined opium users. Further, BLL was not significantly affected by the type of substance, route of use, duration of use, or daily quantity consumed. Common symptoms included abdominal pain (86.9%), constipation (75.8%), anorexia (71.5%) and nausea (54.7%). Linear regression analysis showed log of BLL was significantly associated with abdominal pain, myalgia and anorexia.
The study unravelled an increase in opium-related Pb poisoning in the Kerman province. Raised awareness of this emerging Pb source and investigation of its aetiology is recommended. Pb poisoning should be considered among the primary differential diagnosis of opium users with gastrointestinal symptoms.
在伊朗，使用鸦片的人群中铅（Pb）中毒已成为一个日益严重的问题。本研究重点介绍了与伊朗克尔曼省使用鸦片相关的铅毒性的临床影响。
在 2016 年 1 月至 2016 年 6 月期间，询问出现铅中毒迹象和症状的患者是否有鸦片依赖史。共有 249 名患者参与了这项横断面研究，他们均为鸦片依赖者。收集了包括血铅水平（BLL）、人口统计学信息、使用者偏好和症状等临床前数据。
患者通过摄入（71.9%）、吸烟（8.4%）或两者兼用（19.7%）的方式使用鸦片（83.9%）、精制鸦片（6.4%）或两者的混合物。总的来说，BLL 的中位数为 80.0μg/dL[IQR：51.7-119.0]。鸦片和精制鸦片使用者的 BLL 中位数无显著差异。此外，BLL 不受物质类型、使用途径、使用时间长短或每日消耗量的影响。常见症状包括腹痛（86.9%）、便秘（75.8%）、食欲不振（71.5%）和恶心（54.7%）。线性回归分析显示，BLL 的对数与腹痛、肌痛和食欲不振显著相关。
本研究揭示了克尔曼省鸦片相关铅中毒的增加。建议提高对这种新出现的铅源的认识并调查其病因。铅中毒应作为有胃肠道症状的鸦片使用者的主要鉴别诊断之一。
