Lead Paint Removal >> Lead Paint Removal Certification

Ether enzyme, ferrochelatase, is also inhibited at low blood lead levels. Inhibition of ferrochelatase leads to increase free erythrocyte protoporphyrin (FEP) in the blood which can then bind to zinc to yield zinc protoporphyrin (ZPP). At a blood lead level of 50 µg/100 g or greater, nearly 100% of the population will have an Lead Paint Removal Certification increase in FEP. 

There is also an exponential relationship between blood lead levels greater than 40 µg/100 g and the associated ZPP level, Lead Paint Removal Certification which has led to the development of the ZPP screening test for lead exposure. While the significance of these effects is subject to debate, these enzymatic disturbances may be early stages of a disease process which eventually results in the clinical symptoms of lead poisoning. 

Whether or not the effects do progress to the later stages of clinical disease, Lead Paint Removal Certification disruption of these enzymatic processes over a working lifetime is considered to be a material impairment of health. One of the eventual results of lead-induced inhibition of enzymes in the heme synthesis pathway is anemia which can be asymptomatic if mild but associated with a wide array of symptoms including dizziness, fatigue, and tachycardia when more severe. 

Studies have indicated that lead levels as low as 50 µg/100 g can be associated with a definite decreased hemoglobin, although most cases of lead-induced anemia, Lead Paint Removal Certification as well as shortened red-cell survival times, occur at lead levels exceeding 80 µg/100 g. Inhibited hemoglobin synthesis is more common in chronic cases whereas shortened erythrocyte life span is more common in acute cases. 

In lead-induced anemias, there is usually a reticulocytosis along with the presence of basophilic stippling, and ringed sideroblasts, Lead Paint Removal Certification although none of the above are pathognomonic for lead-induced anemia. 2. Neurological Effects. Inorganic lead has been found to have toxic effects on both the central and peripheral nervous systems. 

The earliest stages of lead-induced central nervous system effects are manifested by behavioral disturbances and central nervous system symptoms including irritability, restlessness, insomnia and Lead Paint Removal Certification other sleep disturbances, fatigue, vertigo, headache, poor memory, tremor, depression, and apathy. With more severe exposure, symptoms can progress to drowsiness, stupor, hallucinations, delirium, convulsions and coma. 

The most severe and acute form of lead poisoning which usually follows ingestion or inhalation of large amounts of lead is acute encephalopathy which may arise precipitously with the onset of intractable seizures, coma, cardiorespiratory arrest, and Lead Paint Removal Certification death within 48 hours. 

While there is disagreement about what exposure levels are needed to produce the earliest symptoms, Lead Paint Removal Certification most experts agree that symptoms definitely can occur at blood lead levels of 60 µg/100 g whole blood and therefore recommend a 40 µg/100 g maximum. 

The central nervous system effects frequently are not reversible following discontinued exposure or Lead Paint Removal Certification chelation therapy and when improvement does occur, it is almost always only partial. The peripheral neuropathy resulting from lead exposure characteristically involves only motor function with minimal sensory damage and has a marked predilection for the extensor muscles of the most active extremity. 

The peripheral neuropathy can occur with varying degrees of severity. The earliest and Lead Paint Removal Certification mildest form which can be detected in workers with blood lead levels as low as 50 µg/100 g is manifested by slowing of motor nerve conduction velocity often without clinical symptoms. 

With progression of the neuropathy there is development of painless extensor muscle weakness usually involving the extensor muscles of the fingers and Lead Paint Removal Certification hand in the most active upper extremity, followed in severe cases by wrist drop or, much less commonly, foot drop. 

In addition to slowing of nerve conduction, electromyographical studies in patients with blood lead levels greater than 50 µg/100 g have demonstrated a decrease in the number of acting motor unit potentials, Lead Paint Removal Certification an increase in the duration of motor unit potentials, and spontaneous pathological activity including fibrillations and fasciculations. 

Whether these effects occur at levels of 40 µg/100 g is undetermined. While the peripheral neuropathies can occasionally be reversed with therapy, Lead Paint Removal Certification again such recovery is not assured particularly in the more severe neuropathies and often improvement is only partial. The lack of reversibility is felt to be due in part to segmental demyelination. 

3. Gastrointestinal. Lead may also affect the gastrointestinal system producing abdominal colic or diffuse abdominal pain, constipation, obstipation, diarrhea, anorexia, nausea and vomiting. Lead colic rarely develops at blood lead levels below 80 µg/100 g. 4. Renal. Renal toxicity represents one of the Lead Paint Removal Certification most serious health effects of lead poisoning. 

In the early stages of disease nuclear inclusion bodies can frequently be identified in proximal renal tubular cells. Renal function remains normal and Lead Paint Removal Certification the changes in this stage are probably reversible. With more advanced disease there is progressive interstitial fibrosis and impaired renal function. Eventually extensive interstitial fibrosis ensues with sclerotic glomeruli and dilated and atrophied proximal tubules; all represent end stage kidney disease. 

Azotemia can be progressive, eventually resulting in frank uremia necessitating dialysis. There is occasionally associated hypertension and hyperuricemia with or Lead Paint Removal Certification without gout. rly kidney disease is difficult to detect. The urinalysis is normal in early lead nephropathy and the blood urea nitrogen and serum creatinine increase only when twothirds of kidney function is lost. 

Measurement of creatinine clearance can often detect earlier disease as can other methods of measurement of glomerular filtration rate. An abnormal Ca-EDTA mobilization test has been used to differentiate between lead-induced and other nephropathies, Lead Paint Removal Certification but this procedure is not widely accepted. A form of Fanconi syndrome with aminoaciduria, glycosuria, and hyperphosphaturia indicating severe injury to the proximal renal tubules is occasionally seen in children. 

5. Reproductive effects. Exposure to lead can have serious effects on reproductive function in both males and females. In male workers exposed to lead there can be a decrease in sexual drive, impotence, Lead Paint Removal Certification decreased ability to produce healthy sperm, and sterility. 

Malformed sperm (teratospermia), decreased number of sperm (hypospermia), and sperm with decreased motility (asthenospermia) can all occur. Teratospermia has been noted at mean blood lead levels of 53 µg/100 g and hypospermia and asthenospermia at 41 µg/100 g. Furthermore, Lead Paint Removal Certification there appears to be a dose–response relationship for teratospermia in lead exposed workers.

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