Draft available for public comment on the ATSDR website (1):
“The measurement of lead excreted in urine following an injection (intravenous or intramuscular) of the chelating agent, Calcium disodium EDTA (EDTA provocation) has been used to detect elevated body burden of lead in adults (2,3,4,5) and children (6,7), and is considered to be a reliable measure of the potentially toxic fraction of the lead body burden (8).”
The excretion of lead provoked by chelating agents, such as Ca-Na2-EDTA, is thought to reflect the biologically active portion of the body burden. It is probably a more sensitive index of over exposure and excess absorption than the Pb-B level since, clearly elevated values have been reported in cases of only marginally elevated Pb-B levels.
(2) Biagini G et al. Renal morphological and functional modification in
chronic lead poisoning. In: Brown SS, ed. Clinical chemistry and chemical toxicology of metals.
Elsevier/North-Holland Biomedical Press, (1977);123-126
(3) Lilis R et al. Nephropathy in chronic lead poisoning. Br J Ind Med (1968);25:196-202
(4) Wedeen RP et al. Occupational lead nephropathy. Am J Med (1975):59:630-641
(5) Wedeen RP. Removing lead from bone: Clinical implications of bone lead stores.
Neurotoxicol ( 1992):13:843-852.
(6) Chisolm J et al. Interrelationships among blood lead concentration,
quantitative daily ALA-U and urinary lead output following calcium EDTA. In:Nordberg GF, ed. Proceedings of third meeting of the subcommittee on the toxicology of metals under the Permanent Commission and International Association on Occupational Health, November 1974, Tokyo, Japan.Amsterdam, Netherlands: Elsevier Publishing Co., (1976)416-433.
(7) Markowitz M et al. Zinc (Zn) and copper (Cu) metabolism in CaNa2 EDTA-treated children with plumbism. Pediatr Res (1981)15:635
(8) WHO. Environmental transport, distribution and transformation. Geneva, Switzerland: WorldHealth Organization, (1995)60-65
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