6.

Williams JD, Leigh DA. (Edgware General Hospital) Lead poisoning. Letters to the editor. British Med J. 1964; 1:1511 (June 6). (2841) [This letter was prompted by the leading article in the May 9 issue of the Journal. The authors had carried out a series of tests on men working with Pb in the Hemel Hempstead area. The test included stipple-cell and reticulocyte counts, and determination of urinary coproporphyrin and of Pb in blood and urine. Often a discrepancy was found between the results of the tests in the same individual, some indicating excessive absorption and some giving results in the normal range. In order to assess the amount of absorbed Pb, a test dose of 1 g CaNa2EDTA was administered orally and urinary Pb was determined before and 8 hr after the dose. In normal persons, unexposed to Pb, very little change occurred before (30-40 mg Pb/l) and after the dose (45-80 mg/l). In cases of mild and moderate Pb absorption and in Pb poisoning, urinary Pb excretion before and after EDTA was in mg/l, respectively: 70-140 and 160-700; 180-240 and 600-1000; 200+ and 900-2700. The authors point out that the CaNA2 salt of EDTA and not the acid is used. In their experience, a 7-day course of oral EDTA resulted in as good a Pb excretion as a 5-day course of iv administration, was considerably more convenient to use in industry, and should be even more so for children. It appears to them that the amount of Pb removed by EDTA salts is greater than that following treatment with penicillamine, and that their toxicity is probably low, according to experience reported by others.]

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