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Related Experiment Videos

Children with moderately elevated lead levels: is chelation with DMSA helpful?

M E O'Connor1, D Rich

  • 1Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.

Clinical Pediatrics
|June 23, 1999
PubMed
Summary

Environmental remediation is recommended for children with elevated blood lead levels. DMSA (2,3 dimercaptosuccinic acid) treatment did not significantly improve long-term blood lead levels in this study.

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Area of Science:

  • Pediatric Environmental Health
  • Toxicology
  • Clinical Pharmacology

Background:

  • Childhood lead exposure remains a significant public health concern.
  • Elevated blood lead levels (BPb) in children are associated with adverse neurodevelopmental outcomes.
  • Environmental remediation is a cornerstone of lead exposure management.

Purpose of the Study:

  • To evaluate the effectiveness of DMSA (2,3 dimercaptosuccinic acid) in conjunction with environmental remediation for children with BPb levels of 30-45 µg/dL.
  • To compare DMSA treatment against a placebo, both combined with environmental remediation.
  • To assess the impact of DMSA on BPb levels at 1 and 6 months post-intervention.

Main Methods:

  • A double-blind, placebo-controlled trial was conducted.

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  • 39 children aged 2-5 years with BPb levels between 30-45 µg/dL were randomized.
  • Participants received either one course of DMSA or a placebo, alongside environmental remediation.

    • Main Results:

    • Mean BPb levels at study entry were similar between groups (Placebo: 33.0 µg/dL, DMSA: 34.9 µg/dL).
    • At 1 month, mean BPb levels were lower in the DMSA group (27.4 µg/dL) compared to placebo (33.2 µg/dL), but the difference was not statistically significant (p=0.16).
    • At 6 months, mean BPb levels were 25.1 µg/dL for placebo and 28.8 µg/dL for DMSA, also not statistically significant (p=0.06).

    Conclusions:

    • DMSA treatment, when combined with environmental remediation, did not lead to statistically significant long-term reductions in blood lead levels in children within the studied BPb range.
    • Environmental evaluation and remediation are essential for all children with elevated BPb levels.
    • DMSA is not shown to be an effective adjunct therapy for improving long-term blood lead levels in this population.