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Pica, Lead Poisoning and Public Health
  1. Kirsty McManus1,
  2. Hazel Henderson2
  1. 1 General Paediatrics, University Hospital Crosshouse, Kilmarnock, UK
  2. 2 Public Health, NHS Ayrshire and Arran, Ayr, UK
  1. Correspondence to Dr Kirsty McManus, C/o Hazel Henderson, Public Health, NHS Ayrshire and Arran, Ayr, UK; kirstymcmanus{at}nhs.net

Abstract

A boy aged 2 years and 10 months was referred to the paediatric clinic by his general practitioner with pallor and pica. He predominantly consumed cow’s milk. Non-food items eaten included paint, plaster and wood. He lived with his parents and sibling in a 1970s housing association house.

Haemoglobin 80 g/L (100–140 g/L)

Mean corpuscular volume 49 fL (73–86 fL)

Ferritin 2.1 µg/L (12–300 µg/L)

Lead level 1.67 μmol/L (threshold 0.24 μmol/L for <5 years old)

The regional haematology team did not recommend chelation as the child was asymptomatic. Ferrous fumarate was commenced. The public health team was contacted; they have a role in identifying and addressing the source of lead exposure.

Question 1 What is the most likely source of lead exposure?

  1. Paint

  2. Plaster

  3. Soil

  4. Wood

  5. Water

Question 2 What is a safe paint lead level (total lead weight content % by weight)?

  1. ≤0.25%

  2. ≤0.15%

  3. ≤0.05%

Question 3 Which commonly contributes to iron deficiency in UK toddlers?

  1. Coeliac disease

  2. Drinking tea

  3. High cow’s milk consumption

  4. Hookworm

  5. Lead toxicity

Answers can be found on page 2.

  • pica
  • public health
  • lead poisoning
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Footnotes

  • Contributors KM and HH were involved in the management of this patient. The manuscript was written by KM and edited by HH. Photographs taken by HH.

  • Competing interests None declared.

  • Patient consent Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Not applicable.

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