Lead Therapy Won't Help Most Kids.Drugs exist that will bind to lead and remove the toxic heavy metal from a person's blood. This therapy, called chelation Chelation
The process by which a molecule encircles and binds to a metal and removes it from tissue.
Mentioned in: Heavy Metal Poisoning
chelation , has saved the lives of people suffering from acute poisoning. However, a major study now finds that for children who have had moderate exposure to lead, chelation fails to prevent brain impairments.
Behavioral problems, difficulty with reasoning, and a permanently diminished IQ are hallmarks of excessive lead. Federal guidelines define as excessive any childhood exposures that result in lead concentrations of at least 10 micrograms per deciliter deciliter /dec·i·li·ter/ (dL) (des´i-le?ter) one tenth (10minus;1) of a liter; 100 milliliters.
100 cubic centimeters (cc).
Mentioned in: Hypercholesterolemia ([micro]g/dl) of blood.
Nearly 1 million U.S. children under 6 years of age show such concentrations in their blood, mostly from exposure to lead-based paint. However, even youngsters whose lead concentrations peaked at well below 10 [micro]g/dl may suffer notable IQ drops, recent studies have shown (SN: 5/5/01, p. 277).
In hopes of preventing toddlers from developing the permanent brain changes that underlie cognitive impairments, researchers launched a multicenter study of 1- to 3-year-olds. The 780 participants lived in deteriorating inner-city housing and initially had 20 to 44 [micro]g/dl lead in their blood. Although excessive, these concentrations are not life threatening.
Half the children received succimer, a lead-binding drug, three times a day. Each course of treatment lasted 26 days--and, depending on lead concentrations in blood afterward, was repeated up to two times. The remaining children received drugfree capsules that resembled succimer. Before and at several intervals after treatment, scientists administered developmental, behavioral, and IQ tests to the children.
Youngsters receiving the drug performed no better on those tests than kids receiving the sham capsules did. Moreover, treated children exhibited slightly more behavioral problems than did kids in the placebo group, and they grew a bit less in height. The findings appear in the May 10 NEW ENGLAND JOURNAL OF MEDICINE The New England Journal of Medicine (New Engl J Med or NEJM) is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It is one of the most popular and widely-read peer-reviewed general medical journals in the world. .
While the aggressive drug therapy effectively removed lead from blood, the researchers found that the children's bones, which store lead, compensated by releasing more of the metal. Long-term, the drug therapy lowered circulating lead concentrations only by about 4.5 [micro]g/dl.
Still, "that's about as good as you can get with chelation [in kids]," observes study leader Walter J. Rogan of the National Institute of Environmental Health Sciences The National Institute of Environmental Health Sciences (NIEHS) is one of 27 Institutes and Centers of the National Institutes of Health (NIH),which is a component of the Department of Health and Human Services (DHHS). The Director of the NIEHS is Dr. David A. Schwartz. in Research Triangle Park Research Triangle Park, research, business, medical, and educational complex situated in central North Carolina. It has an area of 6,900 acres (2,795 hectares) and is 8 × 2 mi (13 × 3 km) in size. Named for the triangle formed by Duke Univ. , N.C.
Though some heavily exposed adults have received chelation for years, he says, lengthy treatments are impractical for children. The drug is expensive and "nasty"--with a sulfurous sul·fur·ous
1. Of, relating to, derived from, or containing sulfur, especially with valence 4.
2. Characteristic of or emanating from burning sulfur. stink--he notes. Moreover, mixing the contents of the capsules into food and getting this combo into toddlers three times a day proved "tedious, taking a big chunk out of families' lives," Rogan adds.
John F. Rosen, who heads the lead program at Children's Hospital A children's hospital is a hospital which offers its services exclusively to children. The number of children's hospitals proliferated in the 20th century, as pediatric medical and surgical specialties separated from internal medicine and adult surgical specialties. at Montefiore in New York City New York City: see New York, city.
New York City
City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. , has observed 19,000 kids. His findings suggest that once blood lead reaches 20 [micro]g/dl, "children are irrevocably brain damaged," he says. "What's critically important about the Rogan paper is that there are now data to confirm this--and they're unequivocal."
It appears "no longer tenable ten·a·ble
1. Capable of being maintained in argument; rationally defensible: a tenable theory.
2. to focus our primary lead-screening efforts on children," says Bruce P. Lanphear of Children's Hospital Medical Center in Cincinnati. By the time lead poisoning lead poisoning or plumbism (plŭm`bĭz'əm), intoxication of the system by organic compounds containing lead. shows up in blood tests, it's usually too late to reverse it, he explains.
Public policy, Lanphear argues, "has been to use children as biological indicators of substandard housing." He and Rosen would prefer that buildings be routinely screened--and lead problems fixed--before children move in.
For federally assisted housing, the U.S. Department of Housing and Urban Development is taking steps in that direction. Last September, HUD Hud (hd), a pre-Qur'anic prophet of Islam. Hud unsuccessfully exhorted his South Arabian people, the Ad, to worship the One God. enacted a rule that renovations to such structures must "control" the release of dust from lead-based paint. Afterward, tests must confirm that any lead dust released has been removed.