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editorial
. 2012 Aug 28;20(1):8. doi: 10.1186/2008-2231-20-8

Chronic lead poisoning in Iran; a silent disease

Omid Mehrpour 1,2, Parissa Karrari 1,2, Mohammad Abdollahi 3,✉
PMCID: PMC3555738  PMID: 23351197

Lead poisoning is one of the oldest, permanent hazards in the world and Iran is not excluded and has the same risk of lead toxicity. Humans have known about the potential hazards of lead poisoning for centuries. Lead is widespread in natural substances, and almost all people are in touch with this insidiously toxic heavy metal in different ways either in workplace or at homes. The level of exposure is higher in most of countries because of extensive use of lead containing materials in normal life and the environment. Published data from Iran show that people in some jobs such as mine workers [1], employees of paint factories [2], workers of copying centers [3], bus drivers [4], and tile making factories [5] are in higher risk of lead toxicity.

The problem would be worse if we consider that even foods have high concentration of lead, for examples vegetables [6], powdered milk [7], bread [8], machine-made lemon juice [9] and tomato paste [10], peanut [11], raw milk [12] and black tea [13,14] as well as many fishes from Caspian sea, Persian gulf, and farmed fishes may have higher levels of lead [15-17]. Studies from Iran have confirmed that source of drinking water such as water wells, cistern in rural area and ground waters of some area contain lead because of many of industrial waste materials leak into underground water resources [18-20]. Besides we should be afraid of leakage of trace metal from corrosion of municipal drinking water distribution in the cities.

Make up products are another source of lead. Traditional eye make ups such as powder of Surma and powders of Kohl, which are used in Iran and other Middle East countries, contain lead and due to the long time contact with skin and eye mucosa they can cause symptoms of lead toxicity in blood and eye [21]. Although in some countries, addition of compounds containing lead and other toxic metals to toys are prohibited but results of some surveys in Iran showed that plastic toys and other PVC products manufactured for children in some area are contaminated with lead [22]. Another concern of lead exposure and lead toxicity is due to addition of lead to opium which may be a concern of opium addicted people [23,24].

Lead sources even available in medical products and drugs, for example some oral herbal drops which is available in markets and Amalgam of tooth restoration are other materials around us that make us in great danger of lead toxicity [25,26].

In another study, it was reported that 40% of randomly selected children had high level of lead in their blood which clearly show importance of screening test for lead poisoning in the population [27].

In general, data from Iran clearly show that everyone is in great danger of exposure and lead toxicity. Because of lead poisoning is a silent disease, screening of this disease have a high priority and with consideration of, we suggest screening test for everyone with nonspecific signs and symptoms, especially in subacute and chronic form like abdominal pain, constipation, irritability and anemia or even asymptomatic patients [28].

Several metal chelators have been used to manage lead toxicity in the case of accidental lead poisoning, but none of them are useful or even cost-benefit [29] in reducing lead burden in chronic lead exposure, so we suggest undertaking further precautions and designing programs in this regard. Of course in serious cases that higher blood lead levels are confirmed, use of effective oral antidote dimercaptosuccinic acid (Succimer) is recommended.

Various countries have started programs and policies to prevent and treat morbidities associated with this toxic heavy metal so in this editorial we want to make attention of readers about dangers of lead poisoning in Iran and to request immediate policies for prevention of serious health problem. Our final message is that screening for blood lead level should be performed for all people who seems are in exposure and risk. This needs portable rapid samplers and lead analyzers in easier samples like saliva [30][,31].

Authors’ contribution

OM and PK did bibliography and drafted the article. MA gave the idea and completed/edited/revised the article. All authors read and approved the final manuscript.

Authors’ information

Mohammad Abdollahi is an Adviser to the World Health Organization (WHO) for providing WHO guidelines on the prevention and management of lead poisoning. He is doing his best to integrate identification of lead toxicity in human and its hazards to the environment.

Contributor Information

Omid Mehrpour, Email: omid.mehrpour@yahoo.com.au.

Parissa Karrari, Email: parissa_karrari@yahoo.com.

Mohammad Abdollahi, Email: Mohammad@tums.ac.ir.

References

  1. Malekirad AA, Oryan S, Fani A, Babapor V, Hashemi M, Baeeri M, Bayrami Z, Abdollahi M. Study on clinical and biochemical toxicity biomarkers in a zinc-lead mine workers. Toxicol Ind Health. 2010;26(6):331–337. doi: 10.1177/0748233710365697. [DOI] [PubMed] [Google Scholar]
  2. Abdollahi M, Sadeghi Mojarad A, Jalali N. Lead toxicity in employees of a paint factory. M J I R I. 1996;10:203–206. [Google Scholar]
  3. Abdollahi M, Ebrahimi-Mehr M, Nikfar S, Jalali N. Monitoring of lead poisoning in simple workers of a copying center by flame atomic absorption spectroscopy. M J I R I. 1996;10:69–72. [Google Scholar]
  4. Abdollahi M, Shohrati M, Nikfar S, Jalali N. Monitoring of lead poisoning in bus drivers of Tehran. Irn J Med Sci. 1995;20:29–33. [Google Scholar]
  5. Balali-Mood M, Shademanfar S, Rastegar Moghadam J, Afshari R, Namaei Ghassemi M, Allah Nemati H, Keramati MR, Neghabian J, Balali-Mood B, Zare G. Occupational lead poisoning in workers of traditional tile factories in Mashhad, Northeast of Iran. Int J Occup Environ Med. 2010;1:1. [PubMed] [Google Scholar]
  6. Nazemi S, Asgari AR, Raei M. Survey the amount of heavy metals in cultural vegetables in suburbs of Shahroud. Iran J Health Environ. 2010;3:196–201. [Google Scholar]
  7. Hosseini A, Ghazi-Khansari M, Cheraghali AM. Pb and Cd in children food and powdered milk: Report from Iranian Food and Drug Association. J Res Med Sci. 2002;7:7–10. [Google Scholar]
  8. Khabnadideh S, Mokhtarifard A, Namavar-Jahromi B, Malekpour MB. Lead detection in bread ingredients of fifth district of Shiraz city in 2000. Hakim Res J. 2004;7:17–21. [Google Scholar]
  9. Poormoghaddas H, Javadi I, Eslamieh R. Cadmium, chromium, mercury and lead concentration in lemon joices. J Res Med Sci. 1998;3:114–118. [Google Scholar]
  10. Poormoghaddas H, Javadi I, Eslamieh R. Study of the toxic trace elements cadmium, lead, and mercury in tomato paste in Isfahan city. Sci J Hamedan Univ Med Sci Health Serv. 2002;9:40–46. [Google Scholar]
  11. Rahbar N, Nazari Z. Level of lead and cadmium in peanut. K A U M S J (FEYZ) 2004;7:71–77. [Google Scholar]
  12. Yasaei-Mehrgrdy GHR, Ezzatpanah H, Yasini-Ardakani SA, Dadfarnia SH. Assessment of lead and cadmium levels in raw milk from various regions of Yazd province. Food Tech Nutr. 2010;7:35–42. [Google Scholar]
  13. Ebadi AG, Zare S, Mahdavi M, Babaee M. Study and measurement of Pb, Cd, Cr and Zn in green leaf of tea cultivated in Gillan province of Iran. Pak J Nutr. 2005;4:270–272. [Google Scholar]
  14. Chen Y, Xu J, Yu M, Chen X, Shi J. Lead contamination in different varieties of tea plant (Camellia sinensis L.) and factors affecting lead bioavailability. J. 2010;90:1501–1507. doi: 10.1002/jsfa.3974. [DOI] [PubMed] [Google Scholar]
  15. Ebrahimpour M, Pourkhabbaz A, Baramaki R, Babaei H, Rezaei M. Bioaccumulation of heavy metals in freshwater fish species, Anzali, Iran. Bull Environ Contam Toxicol. 2011;87:386–392. doi: 10.1007/s00128-011-0376-y. [DOI] [PubMed] [Google Scholar]
  16. Ebrahimi M, Taherianfard M. Concentration of four heavy metals (cadmium, lead, mercury, and arsenic) in organs of two cyprinid fish (Cyprinus carpio and Capoeta sp.) from the Kor River (Iran) Environ Monit Assess. 2010;168:575–585. doi: 10.1007/s10661-009-1135-y. [DOI] [PubMed] [Google Scholar]
  17. Shokrzadeh M, Ebadi AG, Heidari R, Zare S. Measurement of lead, cadmium and chromium in five species of mostconsumed fish in Caspian sea. Int J Biol Biotech. 2004;1:673–675. [Google Scholar]
  18. Zafarzadeh A. The determination of water chemical quality of cisterns in rural areas of Golestan province. J Gorgan Univ Med Sci. 2006;8:51–54. [Google Scholar]
  19. Ebrahimi A, Ehrampoush MH, Ghaneian MT, Davoudi M, Hashemi H, Behzadi S. The survey chemical quality of ground water in the vicinity of sanitary landfill of Yazd in 2008. Health Sys Res. 2010;6:1048–1056. [Google Scholar]
  20. Mohammadian M, Nouri J, Afshari N, Nassiri J, Nourani M. Investigation of heavy metal concentrations in the water wells close to Zanjan zinc and lead smelting plant. Iran J Health Environ. 2008;1:51–56. [Google Scholar]
  21. Malakootian M. Pourshaaban Mazandarany M, Hossaini H. Lead levels in powders of surma (Kohl) used in Kerman. J Kerman Univ. Med Sci. 2010;17:167–174. [Google Scholar]
  22. Pourmoghaddas H, Pishkar AR, Kavehzade FM. Perecentage of toxic trace elements; Pb, Cr, and Cd in certain plastic toys, Isfahan city. J Shahid Sadoughi Univ Med Sci Health Serv. 2006;14:59–64. [Google Scholar]
  23. Salehi H, Sayadi AR, Tashakori M, Yazdandoost R, Soltanpoor N, Sadeghi H, Aghaee-Afshar M. Comparison of serum lead level in oral opium addicts with healthy control group. Arch Iran Med. 2009;12:555–558. [PubMed] [Google Scholar]
  24. Soltaninejad K, Flückiger A, Shadnia S. Opium addiction and lead poisoning. J Subst Use. 2011;16(3):208–212. doi: 10.3109/14659891.2010.545860. [DOI] [Google Scholar]
  25. Asghari G, Palizban AA, Tolue-Ghamar Z, Adeli F. Contamination of cadmium, lead and mercury on Iranian herbal medicines. Tabriz J Pharm Sci. 2008;1:1–8. [Google Scholar]
  26. Mortazavi VS, Fathi MH. Tooth restoration with Amalgam; treatment or tragedy. J Dent School. 2000;18:32–40. [Google Scholar]
  27. Zaman T, Hosseinzadeh H. Lead poisoning in an highly polluted district of Tehran in high school children. Iran J Pediatr. 1999;4:207–212. [Google Scholar]
  28. Soltaninejad K, Kebriaeezadeh A, Minaiee B, Ostad SN, Hosseini R, Azizi E, Abdollahi M. Biochemical and ultrastructural evidences for toxicity of lead through free radicals in rat brain. Hum Exp Toxicol. 2003;22:417–423. doi: 10.1191/0960327103ht385oa. [DOI] [PubMed] [Google Scholar]
  29. Nikfar S, Khatibi M, Abdollahiasl A, Abdollahi M. Cost and utilization study of antidotes: an Iranian experience. Int J Pharmacol. 2011;7:46–49. [Google Scholar]
  30. Ghazi M, Dehpour AR, Abdollahi M, Mortazaiee F. Lead intoxication in rats and its concentrations in blood and saliva. Toxic Subs Mech. 1997;16:327–385. doi: 10.1080/107691897229513. [DOI] [Google Scholar]
  31. Karrari P, Mehrpour O, Abdollahi M. A systematic review on status of lead pollution and toxicity in Iran; Guidance for preventive measures. DARU. 2012;20:2. doi: 10.1186/1560-8115-20-2. [DOI] [PMC free article] [PubMed] [Google Scholar]

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