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Lead Toxicity From Imported Jewelry

We summarize here the presentation and course of lead poisoning in a 1-year-old who ingested a lead-containing metallic medallion from India. We analyzed the medallion to determine its composition, using x-ray fluorescence spectroscopy and field emission scanning electron microscopy. A simple extrac...

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Published in:Pediatrics (Evanston) 2024-10, Vol.154 (Suppl 2), p.1
Main Authors: Hauptman, Marissa, Nascarella, Marc, Silvester, Jocelyn, Kellogg, Mark, Shah, Shalini H, Acosta, Keith, Yousuf, Aroub, Woolf, Alan D
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container_issue Suppl 2
container_start_page 1
container_title Pediatrics (Evanston)
container_volume 154
creator Hauptman, Marissa
Nascarella, Marc
Silvester, Jocelyn
Kellogg, Mark
Shah, Shalini H
Acosta, Keith
Yousuf, Aroub
Woolf, Alan D
description We summarize here the presentation and course of lead poisoning in a 1-year-old who ingested a lead-containing metallic medallion from India. We analyzed the medallion to determine its composition, using x-ray fluorescence spectroscopy and field emission scanning electron microscopy. A simple extraction test was used to estimate oral bioavailability. We used the US Environmental Protection Agency Integrated Exposure Uptake Biokinetic model to compare actual versus predicted blood lead levels. X-ray fluorescence analysis revealed the composition of the medallion to be: Lead 155 000 ppm (15%), copper 530 000 ppm (53%), nickel 49 000 ppm (4.9%), arsenic 22 000 ppm (2.2%), antimony 12 000 ppm (1.2%), tin 3000 ppm (0.3%), and silver 1300 ppm (0.13%). With a fixed ingestion of 7786 µg/d (estimated by simulated gastric extraction analysis) and assuming 50% bioavailability, Integrated Exposure Uptake Biokinetic modeling predicted the geometric mean blood lead level would increase from 2.05 µg/dL to 173.9 µg/dL. This patient had potentially life-threatening lead poisoning from an ingested piece of jewelry. The medallion contained 550 times the allowable content of lead in children's metallic jewelry sold in the United States. This case highlights the ubiquitous nature of lead in our global environment and the risk of exposure to novel sources, especially for children.
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subjects Antimony
Arsenic
Bioavailability
Blood levels
Fluorescence spectroscopy
Fluoroscopy
Humans
India
Infant
Ingestion
Jewelry
Lead - blood
Lead - toxicity
Lead content
Lead poisoning
Lead Poisoning - etiology
Male
Poisoning
Scanning electron microscopy
Silver
Toxicity
title Lead Toxicity From Imported Jewelry
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