title: Imported occupational lead poisoning: report of four cases.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.forename: M
authors.initials: M
authors.lastname: Petracca
authors.forename: F
authors.initials: F
authors.lastname: Scafa
authors.forename: R
authors.initials: R
authors.lastname: Boeri
authors.forename: Daniela
authors.initials: D
authors.lastname: Flachi
authors.forename: S M
authors.initials: SM
authors.lastname: Candura
mesh_terms: D015746:Abdominal Pain / Q000139:chemically induced; D000328:Adult; D000622:Aminolevulinic Acid / Q000097:blood / Q000652:urine; D000740:Anemia / Q000139:chemically induced; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002614:Chelating Agents / Q000627:therapeutic use; D015913:Chelation Therapy / Q000379:methods; D002681:China; D003906:Developing Countries; D003937:Diagnosis, Differential; D004492:Edetic Acid / Q000627:therapeutic use; D006801:Humans; D007558:Italy; D007854:Lead / Q000097:blood / Q000652:urine; D007855:Lead Poisoning / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control* / Q000652:urine; D008297:Male; D008487:Medical History Taking; D008669:Metallurgy; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000517:prevention & control* / Q000652:urine; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D011524:Protoporphyrins / Q000097:blood / Q000652:urine; D059027:Recycling; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002614:Chelating Agents; D011524:Protoporphyrins; C017803:zinc protoporphyrin; D007854:Lead; D000622:Aminolevulinic Acid; D004492:Edetic Acid