Evaluation of Symptoms and Characteristic Features of Lead Poisoning and their Assistance in Clinical Decision Making

Aim of the present study is to evaluate the symptoms and characteristics features in lead based industrial workers and accessing their reliability in clinical decision making and diagnosing lead toxicity. Study involves 15 industrial workers (exposed) and 15 non-exposed individuals, matched for age, sex and nationality selected from Bangalore, India. Association of various symptoms and characteristic features in exposed and non-exposed groups were evaluated and their association with high blood lead levels was studied. Exposed individuals had significantly higher blood lead levels (114.13 ± 39.95 μg/dl) than non-exposed (5.47 ± 2.00 μg/dl). Corresponding with increase in lead levels, a decrease in hemoglobin and increase in zinc protoporphyrin levels were seen in all exposed individuals. Specific symptoms of lead poisoning such as wrist drop was seen in 33.3% and blue line on gums and basophilic stippling was seen in 26.7% of lead exposed industrial workers. Though the reported general symptoms of lead poisoning like weakness, abdominal colic, constipation, insomnia, dizziness, generalized body ache, loss of appetite, anxiety were strongly associated with high blood lead levels, similar symptoms were also seen in non-exposed individuals. Lead exposed industrial workers had higher prevalence of symptoms observed. Proper diagnosis of lead poisoning based only on symptoms may not be possible. Despite high blood lead levels, the specific symptoms of lead poisoning are not apparent, hence many cases of lead poisoning remain undiagnosed and untreated or might receive only symptomatic treatment. Estimating blood lead levels and correlating with specific symptoms may help diagnosing patients with lead poisoning and subsequent intervention.