Occupational lead intoxication: report of four cases.

We discuss the cases of four immigrant workers in whom lead intoxication developed via inhalation while they were cutting steel beams removed from a dismantled bridge. They all had toxic lead levels with symptoms and received chelation therapy; the therapy was followed by a decrease in blood lead levels. Rebound increases in their blood lead levels and return of the symptoms necessitated two additional chelation treatments. Prevention is certainly superior to treatment, and these cases underscore the importance of prevention of occupational lead exposure. These workers should have been provided with protective clothing to minimize the accumulation of lead on their skin and hair. This clothing should have been left at the work site to protect the members of the workers' households. They should also have been provided with respiratory protection by the strict use of respirators and by engineering controls. Physicians should be aware of the potential health problems related to lead intoxication.