October 1984

Lead Poisoning in a West Bank Arab Village

Author Affiliations

From the Departments of Medicine and Pediatrics, Shaare Zedek Medical Center (Drs Hershko, Abrahamov, Moreb, Hersh, and Shiffman); the Department of Pediatrics, Bikur Holim Hospital (Dr Shahin); the Departments of Nutrition, Medical Ecology, and Environmental Health, Hebrew University (Drs Richter, Yaffe, and Konijn); the Department of Public H ealth and Institute for Standardization and Control of Pharmaceuticals, Israel Ministry of Health (Drs Weissenberg, Grauer, Avni, and Eisenberg); and the Nablus Public Health Department (Dr Shahin), Jerusalem.

Arch Intern Med. 1984;144(10):1969-1973. doi:10.1001/archinte.1984.04400010077015

• Eleven patients from the West Bank village of Es-Sawiyeh were admitted with lead poisoning to two Jerusalem hospitals between November 1982 and January 1983. They all belonged to several households of a single large family. Colicky abdominal pains were present in five patients, weakness in four, behavioral changes ranging from irritability to frank psychosis in four, and paralysis in one. Anemia of various degrees was seen in all patients. Basophilic stippling and reticulocytosis were encountered in all patients with moderate to severe anemia. Therapy with edetate disodium calcium and penicillamine resulted in clinical improvement in all patients. A preliminary survey of 270 subjects in the same village disclosed 84 subjects with abnormally elevated blood lead levels, 17 of whom had grade IV lead burden according to the Centers for Disease Control risk classification. Contamination of homemade flour by lead used for stabilizing the metal parts of stone mills was the source of poisoning. As the method of milling in many West Bank villages is similar, these findings may have important implications to the well being of a large section of the rural West Bank population.

(Arch Intern Med 1984;144:1969-1973)