1.
Increased lead levels in pregnancy among immigrant women.
Alba, A, Carleton, L, Dinkel, L, Ruppe, R
Journal of midwifery & women's health. 2012;(5):509-14
Abstract
Antepartum lead screening typically involves identification of current environmental or occupational risk and pica habits. However, for foreign-born women who have immigrated to the United States, distant exposure years prior may be a more significant factor contributing to elevated lead levels. Because lead can be stored in bone for decades and mobilized to the blood when calcium needs increase in pregnancy, women and their children can be at risk for lead-related complications like anemia, gestational hypertension, preterm labor, low birth weight, and developmental delays without any identifiable current exposure. Midwives and other women's health clinicians must carefully evaluate the history of every woman under their care, individualizing screening and treatment to identify risk and provide timely intervention.
2.
[Integrating the environmental clinic history into prenatal counseling and health care in gastroschisis: 2 case reports].
Ortega García, JA, Martín, M, Brea Lamas, A, De Paco-Matallana, C, Ruiz Jiménez, JI, Soldin, OP
Anales de pediatria (Barcelona, Spain : 2003). 2010;(3):215-9
-
-
Free full text
-
Abstract
INTRODUCTION Gastroschisis is a malformation with an unknown aetiology, likely involving genetic and environmental risk factors (RF). The aim of this paper is to develop the paediatric environmental clinical history (PECH) of two patients with gastroschisis. PATIENTS AND METHODS Review of the medical literature using Pubmed and the Developmental and Reproductive Toxicology Database. Search teratogenic substances using the Hazardous Substances Data Bank. Keywords used were: "Gastroschisis" and "Gastroschisis and Risk Factor". RESULTS Among the RFs known and present in both cases were: short cohabitation, unintended pregnancies of relatively young mothers, recent change of paternity, excessive alcohol intake, important nutritional deficiencies, and active and passive smoking. Additionally, one of the cases was exposed to cocaine, cannabis smoke and ionizing radiation from an orthopantography during pregnancy. CONCLUSIONS 1. The PECH should be obtained in all patients with gastroschisis. 2. A thorough PECH requires a proper review of the related RFs and basic training to characterise and quantify environmental exposures. 3. Following these steps, useful recommendations to improve patient care and family advice in future pregnancies are provided.
3.
Identifying and managing adverse environmental health effects: 3. Lead exposure.
Sanborn, MD, Abelsohn, A, Campbell, M, Weir, E
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne. 2002;(10):1287-92
-
-
Free full text
-
Abstract
Lead levels in North American children and adults have declined in the past 3 decades, but lead persists in the environment in lead paint, old plumbing and contaminated soil. There are also a number of occupations and hobbies that carry a high risk of lead exposure. There is no evidence for a threshold below which lead has no adverse health effects. Blood lead levels previously considered safe are now known to cause subtle, chronic health effects. The health effects of lead exposure include developmental neurotoxicity, reproductive dysfunction and toxicity to the kidneys, blood and endocrine systems. Most lead exposures are preventable, and diagnosing lead poisoning is relatively simple compared with diagnosing health effects of exposures to other environmental toxins. Accurate assessment of lead poisoning requires specific knowledge of the sources, high-risk groups and relevant laboratory tests. In this article we review the multiple, systemic toxic effects of lead and provide current information on groups at risk, prevention, diagnosis and clinical treatment. We illustrate how the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) and specific screening questions are useful tools for physicians to quickly obtain an environmental exposure history and identify patients at high risk of lead exposure. By applying effective primary prevention, case-finding and treatment interventions for lead exposure, both the individual patient and the larger community reap the benefits of better health.