Elevated Blood Lead Levels Associated with Retained Bullet Fragments — United States, 2003–2012
| Autor: | Walter A. Alarcon, Debora Weiss, Kristine M. Bisgard, Carrie Tomasallo, Jon G Meiman, Nathan Graber, Henry A. Anderson |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Health (social science) Adolescent Epidemiology Health Toxicology and Mutagenesis Poison control Lead poisoning Occupational safety and health Young Adult 03 medical and health sciences 0302 clinical medicine Health Information Management Injury prevention medicine Humans Full Report 030212 general & internal medicine Young adult Aged medicine.diagnostic_test business.industry 030208 emergency & critical care medicine General Medicine Middle Aged Foreign Bodies medicine.disease Adult Blood Lead Epidemiology and Surveillance United States Surgery Lead Poisoning Lead Toxicity Female Wounds Gunshot Blood lead level business |
| Zdroj: | MMWR. Morbidity and Mortality Weekly Report |
| ISSN: | 1545-861X 0149-2195 |
| Popis: | An estimated 115,000 firearm injuries occur annually in the United States, and approximately 70% are nonfatal (1). Retained bullet fragments (RBFs) are an infrequently reported, but important, cause of lead toxicity; symptoms are often nonspecific and can appear years after suffering a gunshot wound (2,3). Adult blood lead level (BLL) screening is most commonly indicated for monitoring of occupational lead exposure; routine testing of adults with RBFs is infrequent (3). States collaborate with CDC's National Institute for Occupational Safety and Health (NIOSH) to monitor elevated BLLs through the Adult Blood Lead Epidemiology and Surveillance (ABLES) program (4,5). To help assess the public health burden of RBFs, data for persons with BLLs ≥10 μg/dL reported to ABLES during 2003-2012 were analyzed. An RBF-associated case was defined as a BLL ≥10 μg/dL in a person with an RBF. A non-RBF-associated case was defined as a BLL ≥10 μg/dL without an RBF. During 2003-2012, a total of 145,811 persons aged ≥16 years with BLLs ≥10 μg/dL were reported to ABLES in 41 states. Among these, 457 RBF-associated cases were identified with a maximum RBF-associated BLL of 306 μg/dL. RBF-associated cases accounted for 0.3% of all BLLs ≥10 μg/dL and 4.9% of BLLs ≥80 μg/dL. Elevated BLLs associated with RBFs occurred primarily among young adult males in nonoccupational settings. Low levels of suspicion of lead toxicity from RBFs by medical providers might cause a delay in diagnosis (3). Health care providers should inquire about an RBF as the potential cause for lead toxicity in an adult with an elevated BLL whose lead exposure is undetermined. |
| Databáze: | OpenAIRE |
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