"What do you know?"--knowledge among village doctors of lead poisoning in children in rural China

Severe Abdominal Pain as a Presentation of Lead Poisoning: A Case Presentation

Background

Lead poisoning is a rare but serious disease. The clinical manifestations of lead poisoning are various and nonspecific, such as abdominal pain, headache, dizziness, nightmare, fatigue and so on. Rapid diagnosis of lead poisoning is challenging because it does not have special symptoms and the morbidity is very low.

Case Presentation

A 31-year-old woman presented with epigastric discomfort without any obvious cause. The patient was diagnosed with lead poisoning, as the blood levels of heavy metals were detected and the lead was 463.17 µg/L, which was very high (normal value was less than 100 µg/L). The patient was treated with intravenous drip of calcium sodium edentate and got better. The patient achieved good recovery and there was no recurrence.

Conclusion

Lead poisoning is a rare disease and easy to be misdiagnosed as acute abdomen disease when present with abdominal pain. Lead poisoning should be considered when common causes of abdominal pain are excluded, especially patients with anemia and abnormal liver function. The diagnosis of lead poisoning is mainly replied on the blood or urine lead concentrations. Then we should firstly cut off the contact with lead and use metal complexing agent to facilitate lead excretion.

Comparison of knowledge of occupational hazards of lead exposure and blood lead estimation among roadside and organized panel beaters in Enugu metropolis, Nigeria

INTRODUCTION

occupational practices continuously exposes workers to hazards of lead. This study aimed to compare the knowledge of occupational hazards associated with lead exposure, and blood lead estimation among roadside and organized panel beaters in Enugu metropolis, Nigeria.

METHODS

this was a cross-sectional study. Multistage sampling method was used to select 428 panel beaters in Enugu metropolis. Samples were analyzed using Atomic Absorption Spectrometer at 283.3 wavelengths. Data were entered and analyzed using Statistical Package for Social Science 20. Comparative analysis were done using chi - square, T-test, Mann-Whitney U-test, Kruskal-Wallis test, logistic regression and level of significance was set at 5%.

RESULTS

the majority of respondents on both roadside (59.8%) and organized (73.4%) sectors had poor knowledge of hazards of lead exposure. The difference was significant using χ² (P<0.05). The median blood lead levels were 3.0µg|dl and 16.0µg|dl for roadside and organized panel beaters respectively. The difference was significant with Mann-Whitney U test (P<0.001). The prevalence of elevated blood lead at 10µg|dl were 36.9% (roadside sector) and 64.5% (organized sector). The duration of working hours (OR = 4.34, CI = 1.729 - 10.338) was found to be the predictor of elevated blood lead levels.

CONCLUSION

there were general poor knowledge of hazards of lead exposure and high prevalence of elevated lead levels which were more among organized panel beaters. Advocacy on standard organizational structures that support improved occupational health practices is needed and routine outreach by research institutions for health education and safety training.

Frequency of Depression-Related Symptoms in Caregivers of Patients with Silicosis

Background

Few studies have evaluated depression in female caregivers of patients with silicosis. Thus, the aim of this study was to estimate the prevalence of depression in such caregivers and to clarify the factors associated with symptoms of depression.

Methods

Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D).

Results

A total of 561 participants met the inclusion criteria and were enrolled in the study. The mean CES-D score was 16.68, with a standard deviation (SD) of 8.57; the sex-classified analysis indicated that the mean CES-D score of female caregivers was 17.79 (SD: 10.17), while the mean score of male caregivers was 14.98 (SD: 8.36) (p < 0.05). 68.6% caregivers who were beyond the cutoff score (16) with the following factors were more likely to report depression-related symptoms: unemployed status (OR = 1.752, 95% CI: 1.35–2.01, p=0.032) and caregiver for more than 48 months (OR = 1.26, 95% CI: 1.61–2.43, p=0.027).

Conclusions

Collectively, there is statistical difference between female caregivers of patients with silicosis and male ones. More effort is needed to meet the psychosocial needs of these caregivers.