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2. Comunicación institucional

3.8 Programación general

3.8.2 Determinación de actividades

&out, 1n v.h1ch unuc builds up Thu cond1uon IS kno,vn os Slllummc gout

LJJI C�RDIOVASCUI..AR S\S1 £.\I

E,iih:ncc iuggc:sls lead c-.posurc m GSIOCllllCI v.�lh h,ijh blood pn::si.urc anJ other relnl�

co,orw)' h.!.111 dlM:llSC heart r111c \MW)Llll), and dcub from sirol.c rcople who hn,c bcai C'f'Osoi 10 luW')Cf conc:cnu1111ons or leud ffla), 01 :i h1(!1lo' nu. ror CArd1x aulonomic

d)'lfuncuon on da)ll "hm a,onc anJ line parudes Ill! hi£hff tl'•t. .-, al, 200R)

LJ.9 Rf.PRODUCTIVE S\'�7·t;.l\1 UNIVERSITY

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2.3.9 REPRODUCTIVE S\'Sl'EM

�.id arrects both the mnlc nnd femolc reproductive systems. In men. \vhen blood lead le\'cls exceed 40µg/dl spenn count is reduced ond chnngc:; occur in volume of sperm. their motility, and their morphology {Oront 2009). A prcgnnnt woman's elevotcd blood lead le\'el con lc:id to miscorriogc, prcmoturity, low birth weight, and problems ,v1th development during childhood (Cleveland er al., 2008). A fctus may be poisoned in uccro if lead from the mother's bones is

sub�qucntly mobili,.cd by the ch11ngC!'i in mctnbolism due: to pregnancy, 1ncrclbed colcium intnkc in prcgnoncy may help mitigacc chis phrnomenon.

2.3.10 NERVOUS SYl>,EM

Lcod affects the peripheral nervous sy)ICm (cspcciolly motor nerves) Md the: c:c:ntrul nervous system (Dan er al, 2004). Lend ci1u!>C� chc: n.xons or nerve cells 10 degc:ncmtc 1111d lose their myelin coats. The bnun Is lhe orgnn mo\l �nshi\lc co lead c;,.�un:: (Cecil et al., 2008). Lcod poisoning lnh:rfi:re\ ,.,i1J1 the normal development of child's bruin nnd nervous system:

tJ1crcforc children o.rc: Ill grcnccr ri�k oflCU>d nc:uroto'(jcity thnn odult� .ire (Snndffl et al_ 2009).

Lead exposure in youns children hos been linked to l=ing disabilities 11nd children ,vith

blood lead conccntf'DliOfl_, ivcoter IJ1.1n I 011g/c.ll an: In dnngcr or c.lcvclopmc:ntol diS11hilitics.

Increased blood lead level In children hn.s been corrclJltcd wilh dc:c:� in intclli i; cncc, non ,crb:11 rc:a\Onina. ,hnn-term ,ncmory, 1111cn1lon, n::ic.ling 1111d arithmetic ability. fine motor ,1,.;11,. emotional rcgulo1ion, 1111d soc:bl cns;agcmcnc. The clTc:ct of lc111l on chlldrcn•, cognitive

abililie 141.c place 11 \cl) lo" levels (Clc,cl111d ,., o/ 2008, Bellinger, 2008) Tiicn: i\

1pp:1rcn1ly no lu"cr thn:-.hold 10 1hc c.l01oC-rcs110nsc n:louonmip (unlike ochcr h eavy meuils e.g.

mercury), Reduced 11c:idcmle performance In childn:n bas abo bc:cn lln!.c:d V•ilh lc::id c,poiurc.

even al blood lead lc:\ch lo"-.:r lhon 51111/c.lL. llcl\l!ccn lhc hlMc.l lcnd lc,·cl, of sand lSii&fc.11�

an IQ tlc:w'e:uc or 2-t poinl.J for cac.h 1111/dl, lncrca..c 1n n:poncd in chilJn:n (llrunll•n ,., ,,1,

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I hgh blood lead levels 1n oduJts are also ossoc13led \\1lh deceases 1n cogruti\e perrormance and \\1th psycluntnc symptoms such as depression and an\Jety. lncre.ises in blood leoo Je,els

rrom nbout 50 to obout lOOµlifdL m oduJlS hll\-e been roWld to be msoaated ,,,th persistent.

and possibly permnnen1, 1mp111rmcru of ccntml nenous S)Stem funcuon (Grant 2009) Countries \\llh the highest llir lead lc\'clS h3\c also been round to luive the highest

murder rates, nf\er odJusung ror confounding f11ctors (Needleman. 200-I)

A t,.1a) 2000 study by economic consultant Riel. Nevin, theon/CS that le:id c.,posur..: 1!'.plruns 65% to 90% of the ,nrinuon in violent crime nue:s on tho: US A 2007 p11pcr b) the same outJ1or

chums 10 show n strong B.SSOCUUJon bCf\\een pr&-Sehool blood le:xl ond subsequent cnmc role trends o,cr so,eral decades ocross rune countncs (NC\1n. 2007)

2.4 lNV£STICA"flONS lN LEAD POISONING

The preferred 5'J)CClmcn for OS$CS.11ng lead IO'.'CIOI) as ,vbolc blood Olood lead le,cl 1s tJic best ond most scnsi11,c b1onw\.cr for idenUf)ing lead pollu11on. humnn e,,;posure and its od\C:rsc clfeclS 110,,c,cr, single Pb-8 m=ruremcnlS do not reflect the bod� bun!Cfl of lc:w (ATSDR..

2005)

f'I' B Ounng collccuon of samples for lead csum:11.100, use or lead-fn:c S) nn1,_'CS nnd tubes nre cncournclOII in c.onJuncuon \\llh 1111 ,m-1..uc ,c,11pune1ure technique l..oborntof\ on.nlrsis

�ould commcna: prompUy as Pb 1111.Jorb on lhc \\lilt, of thi.ss/ lubes ,,11h hmc \Vhcn Jctcmun1ng the blood IC3&1 lc\l:ls 1n hwmns (DLL} \\hole blood 15 UMd lllC values arc c:atC81)rvcd m bclo"

\Vbol-, blood lnid Ind.,

• < 111111','dl. nonml

• '>11111£/dl. fTlll) caJIW ,mpurrd CX>EJ1U1,0 J�,\"lopmoll ,n ch1ldu:11

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• >-15µg/dL GI (g;ls1roin1.esun3l) symptoms in adults and children

• >70µg/dL - high nsl. of acute CNS symptoms

• >IOOµg/dL may be hfe �1en1ng.

(Health Protection Agency. 2011 Morcus. 2010 nnd Khan etol 2011)

II hns been considered for mnny yenrs lh111 le\cls of IOµg/dL rune the potcnlJal 10 nffect phys1cnl ond nlCfltal development 1n cluldren. Studies suggest th:JJ IC\cls e\ en lo\\er lhnn this cnnbounsafe

roe (full blood count), bnsopluhc sllpphng of Cl)'\hrOC)'tcs mn) be seen ond fc.uurcs of o m1crocy11c hypochrom,c onacm1c such o.s o lo\\ r.1cv (l\llean cell \Olun,e) ltlll} be present S1dcroblas1S m:iy be seen.

Rcnill function tests 10 detect rcno.t eomphco11ons and unc 11e 1 il lc�cts to llctccl gout mn) nlso be od\isoblc .

Nen e conduction ICSlS should be c:onsidcmt tf ncurop:uhy 1s suspcc;lcd Psychomctnc tc:sllng should be considered ,r chn1c:all)' 1nd. 1c.ucd

Rod10-11n:ig,ng (Kh:in et al, 2011)

Plnin ..,_.my may slio\\ lm!IS\cr1C I.IJlCS on tubula.r bones Tiieso lll'C octuoll) arc.u of nm:s1od bone sro"lh ond 111.1)' petMst o long lime ancr �po:rurc ends They arc not )CCl1 1n c.111> phll:\e of l:'poiurc

• Pl0tn a.bdomu\lJ X-111)'1 nu} sho,\ rwl1o-opnque Oc,c;L:s 1n c::isc, of suspected IC!ld forai:11 bod) rni;CJ\Jon (cg pico 1n duWrm)

• X-na) nuOf� \\orls b) dctccllng sf)CClric em1u1olt'i from 11�1,cs l\hl!l"I bomblltdtd "'lh X-rll), II is o '°"''"e method of dct«1mn lo\\ lcn:els ol lcad tn lhe

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• CT or MRI scan or the br.un 1113y be coninbutory in p:Ulents with symptoms suggcst1,·c

or encephaloplllh)