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Case Study Charlie is a 3-year-old at a community preschool facility. The staff reported he tends to put everything in his mouth and is frequently found eating dirt. A home visit by a school staff member to discuss the problems with his parents revealed a generally clean environment in a very old home that was being renovated. Recently Charlie has been falling well behind in academic skills compared to other children in his class; his linear growth has slowed, and he is tired and irritable. His physician noted pallor and what look like “pencil lines” on the gums adjacent to the teeth. He ordered blood tests that revealed a low hemoglobin level and an elevated lead level. Discussion Questions Based on the patient history, the signs/symptoms, and lab test results, discuss the probable environmental factors responsible for Charlie’s ingestion of lead. (See: Heavy Metals—Lead) Discuss the other toxic effects of lead poisoning that Charlie may experience if the situation is not addressed. Discuss other possible sources in children’s environments that have been identified as containing lead.

Answer 1

Lead poisoning in childhood is one of the most common toxic condition of environmental origine. The lead poisoning can be acute or chronic with characteristics of anaemia, and depression of the central nervous system that may leads to coma, convulsions and death. There is no safe level for lead in blood and very low levels of  5 micrograms per deciliter may have toxic effects in children.

1) The probable environmental factors responsible for Charlie’s ingestion of lead.

• As per the case study, It is mentioned as Charlie put everything in his mouth and is frequently found eating dirt.Contaminated soil with lead is one of the main factor responsible for lead poisoning. The ingestion of dirt by charlie make him at risk of lead poisoning.
• His home was being renovated. The mining works involving lead containing soil, lead-based paints and pigments, ceramic glazes, lead solder and lead pipes using for drinking-water systems which are the major environmental risk factors that can expose Charlie during the house renovation.

2) Discuss the other toxic effects of lead poisoning that Charlie may experience if the situation is not addressed.

• Developmental toxicity like delay in growth and development, decreased hearing, decreased hearing ability, decreased intelligent level
• Decreased calcium hemostasis
• Decreased vitamin D metabolism
• Decreased hemoglobin synthesis.
• Nephropathy
• Encephalopathy
• Death

3) Discuss other possible sources in children’s environments that have been identified as containing lead.

• Cosmetics and toys which are painted with leaded
• Lead solder in food cans and feeding bottles.
• Paint on the furniture surface
• Air pollution by incineration of lead added to petrol, gasoline, and batteries.
• Dust contain lead on the surface and floor if home near mining industries.