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Shortened forms of provocative lead chelation
R K Sokas1, J Atleson, J P Keogh
1Department of Medicine, University of Pennsylvania, Philadelphia 19104.
Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association
|May 1, 1988
Summary
Shortened urine collections after chelation effectively measure adult lead excretion. Three-hour and six-hour post-chelation urinary lead levels correlate with 24-hour collections, proving reliable for adults.
Area of Science:
- Toxicology
- Clinical Chemistry
- Environmental Health
Background:
- Standard 24-hour urine collections for lead excretion post-chelation are cumbersome for adults.
- Previous studies focused on pediatric patients, leaving adult standardization lacking.
Purpose of the Study:
- To compare shortened urinary lead collections with standard 24-hour collections in adults.
- To determine the adequacy of 3-hour and 6-hour post-chelation urine samples for assessing lead excretion.
Main Methods:
- Thirty-five adult patients underwent provocative chelation with Calcium Disodium EDTA.
- Urine samples were collected at 3, 6, and 24 hours post-chelation for lead analysis.
- Correlation and diagnostic accuracy (sensitivity, specificity) were calculated.
Main Results:
- Both 3-hour (r=.89) and 6-hour (r=.94) urinary lead excretion correlated linearly with 24-hour excretion.
- The 6-hour collection demonstrated 82% sensitivity and 100% specificity for identifying elevated lead levels (≥600 µg).
- Mild renal insufficiency did not significantly impact the correlations.
Conclusions:
- Shortened urine collections (3- and 6-hour) are reliable indicators of lead excretion in adults.
- This method offers a more practical alternative to 24-hour collections for lead chelation monitoring.
- The findings support the use of shortened collections in clinical practice for adult lead exposure assessment.