Neurophysiologic and Neurocognitive Case Profiles of Andean Patients with Chronic Environmental Lead Poisoning

被引:34
作者
Counter, S. Allen [1 ,2 ]
Buchanan, Leo H. [3 ,4 ]
Ortega, Fernando [5 ]
机构
[1] Harvard Univ, Sch Med, Biol Labs, Dept Neurol, Cambridge, MA 02138 USA
[2] Massachusetts Gen Hosp, Dept Neurophysiol, Boston, MA 02114 USA
[3] Univ Massachusetts, Sch Med, Shriver Ctr, Dept Pediat, Waltham, MA USA
[4] Harvard Univ, Hlth Serv, Dept Otolaryngol, Cambridge, MA 02138 USA
[5] Univ San Francisco Quito, Coll Hlth Sci, Integrated Community Dev Dept, Quito, Ecuador
来源
JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH-PART A-CURRENT ISSUES | 2009年 / 72卷 / 19期
关键词
AUDITORY BRAIN-STEM; BLOOD LEAD; EXPOSED CHILDREN; NEUROBEHAVIORAL DEVELOPMENT; EVOKED-POTENTIALS; CHELATION-THERAPY; BREAST-MILK; INTOXICATION; IMPAIRMENT; COMPONENTS;
D O I
10.1080/15287390903091772
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
This report presents case profiles of three siblings in a family of lead (Pb) glazing workers living in a Pb-contaminated Andean village who presented with extreme plumbism (blood Pb levels: 47 to 128 mu g/d1) from childhood to adolescence. These cases are examples of persons who have chronic Pb poisoning as a result of prolonged occupational and environmental exposure in a Pb-glazing ceramic cottage industry in the study area. Using behavioral and physiological techniques for measuring the integrity of the peripheral and central auditory systems, including otoacoustic emissions, and replicated auditory brainstem electrophysiological potentials, the authors found normal auditory neurosensory function in each patient, thus ruling out hearing impairment as a basis for adverse neurocognitive outcomes. This finding is contrary to the prevailing view regarding the detrimental effects of Pb poisoning on the cochlear and auditory brainstem of children. Performance on tests of visual spatial intelligence and auditory memory/attention was below average in these patients, which may underlie their reported learning disabilities. In two of the cases, there was an improvement in cognitive performance following a lowering of PbB levels from chelation therapy and Pb prevention education, suggesting some level of reversibility of their neurocognitive deficits. Nevertheless, these case profiles suggest that if the patients persist in Pb-glazing activities, in spite of repeated chelation therapy and family counseling, they may continue to be re-intoxicated and remain at risk for learning disabilities and other neurological impairments.
引用
收藏
页码:1150 / 1159
页数:10
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