THE USE OF CHELATING-AGENTS IN OCCUPATIONAL LEAD-POISONING

Chelating agents have long been used in the pharmacological treatment of lead poisoning, whose management is still a problem, particularly i n developing countries. This article reviews the pharmacological prope rties of dimercaprole, penicillamine, CaNa2EDTA and dimercaprosuccinic acid, examines their indications, contraindications and side effects and discusses the possible use of each drug in occupational Pb poisoni ng. Proposals are also presented for the treatment and follow-up of su bjects with signs and symptoms of poisoning and of subjects with low-m oderate Pb absorption. CaNa2EDTA seems to be the most reliable and saf er chelating agent nowadays available and with a wider spectrum of act ion. DMSA seems to be promising in the treatment of occupational Pb po isoning. Even though there is no doubt that chelation therapy has sign ificantly contributed to reduce mortality and morbidity from occupatio nal Pb poisoning, the efficacy of this treatment in subjects with subt le neurological or renal damage has not yet been studied properly.