PB POISONING--EFFECTS OF CALCIUM SUPPLEMENTATION

Project: Research project

Project Details

Description

DESCRIPTION: Of an estimated 1.5 million American children with Pb
poisoning, more than 90% will have mild to moderately elevated blood Pb
levels between 10 and 44 mcg/dl. Pb in this range can cause biochemical and
neurodevelopmental toxicity in young children; cognitive deficits can
persist for many years after the acute period of Pb ingestion. On the other
hand, an active intervention to lower blood Pb levels over a 6-month period
has been shown to be associated with improved cognitive scores in preschool
children.

Currently, treatment modalities for children with mild-moderate Pb poisoning
are limited. Although environmental efforts to reduce Pb exposure are an
effective means for reducing further Pb ingestion, they are often difficult
to initiate and complete successfully, especially for children living in
urban, poor neighborhoods. The ability of chelating agents to permanently
reverse biochemical and cognitive toxicity for mild to moderately
Pb-poisoned children has not been demonstrated.

Ca is known to interact with Pb at multiple biological levels: Pb
interferes with intracellular Ca-mediated processes; Ca and Pb compete for
binding to what are normally Ca-binding proteins. Nutritionally, diets
deficient in Ca enhance the absorption of Pb; blood Pb levels in children
are inversely related with Ca intake. This information serves as a basis to
begin an investigation of the effect of Ca supplementation as a treatment
component for childhood Pb poisoning. In a pilot study, moderately
Pb-poisoned children, supplemented with Ca to reach a daily intake of 1800
mg, had a fall in their blood Pb levels over 3 months that was more than
twice that of unsupplemented controls.

This study is proposed to define the role of Ca supplementation as a
treatment for children with mild to moderate Pb poisoning. It will use a
prospective, randomized, placebo-controlled study design. Supplementation
will be aimed to achieve a daily intake of 1800 mg of Ca (diet plus
supplement) in the experimental group. Treatment will continue for 3
months, to be followed by an additional 3 month observation period. Change
in blood Pb will be the main outcome measure. Ca treatment is posited to
decrease Pb absorption, thereby contributing to a fall in blood Pb levels.
Thus, Ca supplementation might provide a cost-effective and
readily-available treatment that will be of benefit to the millions of
children worldwide who continue to be exposed to excessive amounts of Pb and
who remain at risk for its toxic effects.
StatusFinished
Effective start/end date1/1/9712/31/97

Funding

  • National Institute of Environmental Health Sciences

ASJC

  • Pediatrics
  • Developmental and Educational Psychology
  • Nutrition and Dietetics
  • Pediatrics, Perinatology, and Child Health
  • Toxicology

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