Acute lead poisoning associated with backyard lead smelting in Jamaica / Envenenamiento agudo con plomo asociado con la fundición casera de plomo en Jamaica

Long-term backyard smelting of lead in a district known as Mona Commons, Kingston, Jamaica, has produced lead burdens as high as 30 000 mg/kg in soils near to the smelter, and indoor dust loadings of 373 microg/f2 in the residents' home. The blood lead levels (BPb) of 107 children from the district were in the range 2.2-202 microg/dL. Fifty-nine per cent of these had BPb levels above 10 microg/dL and the population mean was an unacceptably high 25.1 microg/dL. The highest levels were observed for five siblings, two of whom presented with lead encephalopathy. This severe chronic exposure to lead was exacerbated by a significant history of pica, and chronic nutritional anaemia. Chelation therapy significantly reduced the BPb levels but due to lead storage in other organs, the values after several months were still higher than desirable. This study emphasizes the importance of reducing the exposure of children to lead.

Childhood pica; some aspects of the clinical profile in Manchester, Jamaica

The clinical profile of 108 children aged 1 1/2 years to 10 years who practised pica was compared to that of 50 non-pica patients aged 2 years to 10 years. Of the patients with pica, 85% were less than 5 years of age and 29% were aged 1 1/2 years to 2 years. The male to female ratio was 1:1.4. Ninety-two patients ingested dirt, 35 marl, 33 stone, 17 coal and 10 ashes. Twenty-two patients ingested multiple substances. Family history for pica was positive in 44 patients. Forty-six per cent of pica patients and 12% control patients had poor nutritional status (p < 0.05). Ten per cent of pica patients were constipated while 26% had persistent diarrhoea. Intestinal parasites were identified in 70.3% of cases and were distributed as follows: Trichuris species 66%, Ascaris lumbricoides 26.6%, Giardia lamblia 17%, and mixed infestations 28.8%. Initial haemoglobin values were less than 8 gm/dl in 34.8% and 11 gm/dl or greater in 20.9% of pica patients compared with 12% and 56%, respectively, in control patients (p < 0.05) It is concluded that, in our country, the children who practise pica are prone to malnutrition, anaemia, diarrhoeal/constipation and worm infestation. Geophagia is most frequently involved and there is often a family history of pica