Chelation therapy in workers with lead exposure.
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.
Royce
S
S
Hazard Evaluation System and Information Service, California Department of Health Services, Berkeley 94704.
Rosenberg
J
J
D015913:Chelation Therapy; D004112:Dimercaprol / Q000627:therapeutic use; D004492:Edetic Acid / Q000627:therapeutic use; D006801:Humans; D007854:Lead / Q000097:blood; D007855:Lead Poisoning / Q000517:prevention & control*; D016273:Occupational Exposure; D009786:Occupational Health Services; D010396:Penicillamine / Q000627:therapeutic use
D004112:Dimercaprol; D007854:Lead; D004492:Edetic Acid; D010396:Penicillamine