Treatments can vary depending on the level of lead in the blood. Below is an outline describing elevated levels and their corresponding treatments.
Blood
Lead Level (µg/dL) |
Treatment/Management |
| <10 | Anticipatory guidance |
| 10-14 | Guidance, nutrition evaluation & lead-exposure history. Retest in 3 months. |
| 15-19 | Guidance, nutrition evaluation
& lead-exposure History. Retest in 1 to 2 months. Consider hgb/hct.
Treat persistent elevated levels of 15-19 µg/dL as recommended
for 20-44 µg/dL. |
| 20-44 | Guidance, nutrition evaluation
& lead-exposure history, psychosocial & neurodevelopment status.
Public health referral for case management & environmental investigation.
Depending on elevated level, retest in 1 week to 1 month. Order hgb/hct. |
| 45-69 | Guidance, nutrition evaluation
& lead-exposure history, psychosocial & neurodevelopment status.
Public health referral, as above. Retest elevated levels of 45-59
µg/dL in 48 hours and elevated levels of 60-69 µg/dL in
24 hours. Order hgb/hct. Consider chelation. |
| 70 & above | Medical emergency. Immediately hospitalize, retest, & chelate. Public health referral, as above. |
Chelation therapy is a treatment for severe lead poisoning that has been used for over 40 years and is approved by the U.S. Food and Drug Administration (FDA). It involves the injection of a synthetic solution, EDTA (ethylene diamine tetraacetic acid), which binds to lead and is eventually removed from the body through the kidneys. From the Greek word chele, which means ‘claw’, the term chelation refers to the manner in which the chemical grabs onto the lead.
Chelation therapy, which is performed on an outpatient basis, is administered through an IV while the patient relaxes in a chair. It is common for many patients to be depleted of essential vitamins and minerals as the body flushes out the toxic lead; consequently, it is often necessary for patients to take supplements during treatment to replenish this deficit.
Chelation therapy usually takes ten to twelve weeks and sometimes longer in more severe cases. After the first few sessions, the elevated blood level will drop significantly as the EDTA cleanses the blood and soft tissues. However, it is not uncommon for the levels to rebound as much as 70% as the lead previously stored in the bones transfers to the blood and soft tissues.
Removing the child from the source of lead exposure dramatically increases the success of chelation therapy. Environmental intervention, developmental referrals, medical treatment, and follow-up care are all essential components in a healthy treatment plan. Discussing your child’s complete care and treatment with your doctor is very important.
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